Promoting positive mental health in a first psychotic episode
Stigma and self-stigma remain challenges in the daily lives of people with psychotic disorders. In particular, self-stigma can profoundly affect quality of life and recovery, especially for those experiencing their first psychotic episode (FPE) (Link & Phelan, 2006; Brohan et al., 2011). Promoting positive mental health offers a promising approach to addressing these challenges and improving the overall well-being of these individuals (Sambasivam et al., 2016).
Self-stigma is an internal process in which people with mental disorders internalize negative attitudes and stereotypes from society. This can foster low self-esteem, demoralization, and a reduced willingness to seek treatment or social support, associated with poorer clinical and functional recovery, which can exacerbate the symptoms of psychotic disorders (Ocisková et al., 2014; Perlick et al., 2001).
The first psychotic episode, a critical phase
The first psychotic episodes represent an initial and highly stigmatized phase of psychotic disorders (Link & Phelan, 2006). During this stage, self-stigma can form and become entrenched, negatively impacting self-perception and willingness to seek help (Gerlinger et al., 2013). Addressing self-stigma from the outset is crucial for improving recovery and quality of life.
It has been observed that individuals experiencing a first psychotic episode tend to use less effective coping strategies, which is associated with worse outcomes and greater self-stigma. Assessing and improving these strategies can be crucial for reducing self-stigma (Riera-López de Aguileta et al., 2020; Holubova et al., 2016).
People experiencing a first psychotic episode tend to use less effective coping strategies and have higher levels of self-stigma. Reducing self-stigma can help improve difficult-to-treat negative and cognitive symptoms.
Furthermore, these individuals have a higher risk of suicide compared to the general population (Holubova et al., 2016). Self-stigma in this group is linked to suicide through factors such as self-esteem, hopelessness, quality of life, social support, and self-efficacy (Zaheer et al., 2020). Reducing self-stigma could improve difficult-to-treat negative and cognitive symptoms ; therefore, it is a key factor to consider when assessing suicide risk in individuals experiencing a first psychotic episode (Vrbova et al., 2018; Lopez, 2022).
The social approach in adolescents with a first psychotic episode
What is positive mental health?
Positive mental health refers to a state of well-being in which a person can realize their abilities, manage the normal stresses of life, work productively, and contribute to their community (Liu et al., 2022). Dr. María Teresa Lluch Canut , Professor of Psychosocial Nursing and Mental Health at the University of Barcelona, developed a model of positive mental health that includes six main factors:
- Personal satisfaction: a feeling of well-being and satisfaction with oneself and with life in general.
- Prosocial attitude: ability to relate positively to others and show empathy and support.
- Self-control: the ability to manage one's own emotions and behaviors.
- Autonomy: the ability to make independent decisions and manage one's own life.
- Problem solving: the ability to effectively deal with and resolve difficult situations.
- Interpersonal skills: ability to establish and maintain healthy and meaningful relationships.
Impact of positive mental health on self-stigma
Promoting the components of positive mental health can be crucial in reducing self-stigma in people experiencing a first psychotic episode. It can help to:
- Improved self-esteem and self-control. Fostering personal satisfaction and self-control helps develop a more positive self-image, challenging negative beliefs about oneself.
- Strengthening interpersonal relationship skills. Positive relationships provide emotional support, reducing isolation and helping people feel more accepted and valued.
- Promoting autonomy and problem-solving skills. Autonomy and problem-solving abilities allow people to take an active role in their recovery, increasing their sense of control and empowerment.
Strategies to promote positive mental health and reduce self-stigma
- Psychoeducational interventions. Educating people about their disorders and the importance of positive mental health can empower them to challenge self-stigma and actively participate in their recovery.
- Cognitive-behavioral therapies. These therapies can help improve self-control, problem-solving, and interpersonal skills, thereby reducing self-stigma.
- Social support programs. Encouraging the creation of support networks and participation in community activities can improve prosocial attitudes and personal satisfaction, helping to combat self-stigma.
- Promoting autonomy. Offering opportunities for people to make decisions about their treatment and daily life can increase their autonomy and empowerment, counteracting self-stigma.
Tips for taking better care of our positive mental health
The importance of positive mental health in people with a first psychotic episode
Promoting positive mental health during the first psychotic episodes is essential to prevent the development of negative beliefs and attitudes about oneself . Through interventions that foster positive mental health, individuals can be helped to develop internal and external resources that improve their ability to manage stress and the demands of daily life (Liu et al., 2022).
In short, self-stigma is a significant obstacle to recovery for individuals experiencing a first psychotic episode. However, promoting positive mental health offers an effective approach to reducing self-stigma and improving quality of life. By fostering personal satisfaction, self-control, autonomy, problem-solving, and interpersonal skills, we can help people build a positive self-image and better manage their mental health from the early stages of their disorder.
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