Psych Vivas · Professional — stigma, recovery and rights-based care
Stigma, recovery and rights-based care — structured clinical viva
Fellowship viva covering stigma taxonomy, CHIME, SDM, rights/CRPD debate landscape, and implementation pitfalls.
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Target exams
Interpretation
Reveal interpretation
This viva tests whether the candidate can speak multi-level social psychiatry: stigma mechanisms, recovery constructs, partnership processes, and human-rights language without legal fabrication or under-treatment ideology.[1][3][7]
Stigma. Define public vs self vs structural vs courtesy stigma; stereotype–prejudice–discrimination pathway; stigma as a fundamental cause of health inequality (resource restriction across jobs, housing, care quality). Note biogenetic messaging can increase social distance.[1][2]
Recovery. Distinguish clinical, functional, and personal recovery. CHIME: Connectedness, Hope, Identity, Meaning, Empowerment. Recovery is non-linear. Recovery-oriented practice: hope, partnership, strengths, community inclusion, peer involvement. Name abuses: KPI-driven premature discharge, denial of evidence-based care as "empowerment", token peer roles.[3][4]
Anti-stigma evidence. Protest, education, contact — contact-based approaches have strongest synthesis evidence among common strategies; education alone weaker; avoid fear-based campaigns.[5]
SDM and rights. SDM is three-talk partnership, not a form. Rights-based care: dignity, least restrictive means, non-discrimination, support for legal capacity/decision support. CRPD Article 12 debates: will-and-preferences vs capacity/best-interests frameworks; Freeman critique of absolute readings of General Comment; Szmukler on MH law/CRPD interface. Local statutes remain jurisdiction-specific — principles only, no invented sections. Rights-based care does not cancel risk assessment for imminent harm.[6][7]
Key points
[3] [5] [6] [7]References
- [1]Corrigan PW, Watson AC Understanding the impact of stigma on people with mental illness World Psychiatry, 2002.PMID 16946807
- [2]Hatzenbuehler ML, Phelan JC, Link BG Stigma as a fundamental cause of population health inequalities Am J Public Health, 2013.PMID 23488505
- [3]Leamy M, Bird V, Le Boutillier C, et al. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis Br J Psychiatry, 2011.PMID 22130746
- [4]Slade M, Amering M, Farkas M, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems World Psychiatry, 2014.PMID 24497237
- [5]Thornicroft G, Mehta N, Clement S, et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination Lancet, 2016.PMID 26410341
- [6]Freeman MC, Kolappa K, de Almeida JM, et al. Reversing hard won victories in the name of human rights: a critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities Lancet Psychiatry, 2015.PMID 26236004
- [7]Szmukler G, Daw R, Callard F Mental health law and the UN Convention on the rights of Persons with Disabilities Int J Law Psychiatry, 2014.PMID 24280316