Article

Stigma and mental illness: A review and critique

Authors:
To read the full-text of this research, you can request a copy directly from the author.

Abstract

Research on the extent and nature of psychiatric stigma is reviewed, with a goal of offering insights useful to the practising clinician. Many findings support the view that a label of psychiatric illness is stigmatising, but the effects of this stigma in practice seem to be complex. A number of factors, including age, sex and experience of psychiatric patients seem to affect levels of stigma, and selfstigmatisation also seems to be variable in its effects. Possible causes of stigma and approaches to combatting it are also discussed.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the author.

... L'un des modèles du contenu du stéréotype de la maladie mentale qui fait le plus référence dans la littérature contemporaine en psychiatrie est issu d'une synthèse de la littérature psychiatrique sur la thématique. Cette revue proposée par Hayward & Bright (1997) présente une synthèse des résultats d'une littérature psychiatrique particulièrement marquée par les théories des étiquettes de « maladie mentale » (Link et al., 1987;Link et al., 1989), les premiers travaux sur la perception de responsabilité des maladies (Weiner et al., 1988), et les enquêtes d'opinion et d'attitudes de la société (Brokington, Hall, Levings, & Murphy, 1993;Corrigan, Edwards, Green, Diwan, & Penn, 2001;Holmes, Corrigan, Williams, Canar, & Kubiak, 1999;Link et al., 1999;Taylor & Dear, 1981), ou encore des professionnels (Struening & Cohen, 1963). Dans cette revue à destination des professionnels (i.e. ...
... Dans cette revue à destination des professionnels (i.e. diffusion des connaissances aux cliniciens et proposition de stratégies de lutte contre la stigmatisation), Hayward & Bright (1997) ont organisé les principaux résultats de la littérature psychiatrique selon quatre principales causes de la stigmatisation de la maladie mentale: la dangerosité associée à la maladie mentale, l'attribution de responsabilité dans l'apparition de la (Crisp, Gelder, Goddard, & Meltzer, 2005;Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000). Deux études menées sur le contenu du stéréotype de la schizophrénie Thonon & Larøi, 2016) tendent à confirmer la structure Factorielles proposée par Hayward & Bright (1997). ...
... diffusion des connaissances aux cliniciens et proposition de stratégies de lutte contre la stigmatisation), Hayward & Bright (1997) ont organisé les principaux résultats de la littérature psychiatrique selon quatre principales causes de la stigmatisation de la maladie mentale: la dangerosité associée à la maladie mentale, l'attribution de responsabilité dans l'apparition de la (Crisp, Gelder, Goddard, & Meltzer, 2005;Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000). Deux études menées sur le contenu du stéréotype de la schizophrénie Thonon & Larøi, 2016) tendent à confirmer la structure Factorielles proposée par Hayward & Bright (1997). En effet, les 4 dimensions proposées ont été globalement validées par ces études. ...
Thesis
Ce projet doctoral s’inscrit dans le contexte de la réhabilitation psychosociale promouvant la lutte contre la stigmatisation des maladies psychiatriques sévères. Il vise à une meilleure compréhension de la stigmatisation de la schizophrénie au travers de l’étude des composantes du stéréotype et de ses effets sur les performances neuropsychologiques. La revue de la littérature sur la thématique nous amène au constat d’une grande hétérogénéité dans les méthodes d’exploration du stéréotype de la schizophrénie, en partie expliquée par un cloisonnement des recherches entre la Psychiatrie et la Psychologie sociale.Les deux études réalisées visaient à : i) explorer le contenu du stéréotype de la schizophrénie chez les familles et dans la population générale en France ; ii) étudier expérimentalement l’impact de la menace du stéréotype sur les performances cognitives des personnes souffrant de schizophrénie.La première étude montre que le stéréotype de la schizophrénie est plus massivement rejeté par les familles, et notamment dans sa dimension « Dangerosité ». Les résultats suggèrent en outre que la dimension « Incompétence » du stéréotype de la schizophrénie occupe une place centrale, autant chez les familles que dans la population générale. L’intégration de nos résultats dans les modèles développés par la Psychologie sociale nous amène à proposer un modèle du contenu du stéréotype de la schizophrénie, dans lequel les dimensions de dangerosité et d’incompétence du stéréotype prédiraient des patterns spécifiques d’émotions et de comportements discriminatoires.La seconde étude, expérimentale, ne permet pas de mettre en évidence un effet négatif de la menace du stéréotype de la schizophrénie sur les performances exécutives. Cette absence de résultat significatif nous amène à discuter des enjeux méthodologiques dans les designs expérimentaux, en particulier quant à leur application dans la schizophrénie. Ainsi, certains facteurs comme le domaine d’identification, le choix des mesures cognitives et la prise en compte des différentes menaces potentielles apparaissent primordiaux pour les recherches futures.
... 1 This occurs not only because these patients are often seen as potentially violent and dangerous, 4,5 but also because of beliefs that these diseases have a chronic course, 9 with a poor prognosis and ineffective treatments. 7,[12][13][14] The latest studies show that stigma towards psychiatric patients is observed not only in the general population but also among healthcare professionals [5][6][7]9,10,15,16 ; with some studies reporting that physicians have the highest level of stigmatising attitudes compared with other healthcare professionals, 15 with negative impact on patient care. ...
... An additional goal was to understand if attitudes towards mentally ill people were associated with sociodemographic and personal characteristics, such as sex, personality and level of empathy, and if they were influenced by the type of class attended, by previous familiarity with mental illness or even by the preference for a future area of specialisation. These factors were assessed because they seem to affect the level of stigma, 4,7,13 with studies showing more negative attitudes among males, 17 younger people, 19 students that prefer surgical specialties 17 and people with no previous contact with patients with mental illness. 4,17,20 Given that the influence of such variables is not consensual, 7,16 these aspects were questioned so that they could be investigated in our environment. ...
... The baseline and subsequent scores presented different values, with the second time point of the survey distribution having a lower score, demonstrating a statistically significant improvement in medical students' attitudes and, thus, less stigma. These results were consistent with other studies, 1 with some authors suggesting that education and contact with people with a mental condition shaped positive changes in terms of students' discrimination attitudes 1,5,13,18,20 -'contact theory'. ...
Article
Full-text available
Introduction: Stigma towards mental illness is considered a key obstacle to the provision of medical care to psychiatric patients. This is not only present in the general population but also among healthcare professionals. Therefore, medical students could be a target population for stigma prevention measures. The aim of this study is to assess the evolution of the attitudes of medical students from the Faculty of Medicine of the University of Coimbra towards psychiatric patients, before and after attending Psychology and Psychiatric courses. Material and Methods: Students from the third and fourth years of the integrated Master’s degree in Medicine in the Faculty of Medicine of the University of Coimbra were asked to complete four questionnaires. The surveys were distributed before and after the attendance of the courses. Results: There was a statistically significant decrease of the stigma scores (p = 0.025) between the two measurements (38.16 initially, 36.72 on the second moment). The baseline level of stigma was found to be negatively associated with empathy (rP = -0.477) and with the type of personality, with higher levels of openness to new experiences being associated with lower levels of initial stigma (rP = -0.357). Discussion: Overall, the students’ attitudes towards patients with mental illness were positive, with a decrease of the stigma value from the first to the second semester. This corroborates the hypothesis that education and contact with people with a mental condition could shape positive changes in attitudes and discrimination against those patients. Conclusion: Our results emphasise the importance of implementing programs inside medical schools in order to reduce stigma among future doctors.
... When the stigmatizing attitude of the society is accepted and internalized as it is by the stigmatized individual, the problems in the individual's life are increasing exponentially [2]. Among these problems, individuals with mental impairment are exposed to unfair behavior in the criminal justice system [3], restrictions on social facilities [4][5][6][7], and most importantly, avoidance of treatment seeking behaviors and reduced quality of life [8][9][10]. In addition, it is suggested that the stigmatization not only affects the lives of the members of the family and their immediate surroundings but also the quality of life [11,12]. ...
... This causes them not to start treatment or to leave it at the start of treatment. Failure to provide regular treatment affects the individual with mental disease recovery process badly [8]. Stigma affects many areas in the daily life of individuals. ...
... The negative effect of stigmatization on patience and perseverance prevents the steady maintenance of treatment. These affect the prognosis of the disease negatively [3,8]. ...
... 2 Both the general public and the mentally ill have been found to have stigmatising attitudes towards psychiatric illnesses. 3 Hayward and Bright have defined stigma associated with mental disorders as 'the negative effects of a label placed on any group, such as a racial or religious minority, or, in this case, those who have been diagnosed as mentally ill'. 3 Popular misconceptions about mentally ill people include being dangerous, weak and socially incompetent. ...
... 3 Hayward and Bright have defined stigma associated with mental disorders as 'the negative effects of a label placed on any group, such as a racial or religious minority, or, in this case, those who have been diagnosed as mentally ill'. 3 Popular misconceptions about mentally ill people include being dangerous, weak and socially incompetent. 3 The increasing burden of mental disorders has been accompanied by worldwide efforts to enlighten the public on mental health. ...
... 3 Popular misconceptions about mentally ill people include being dangerous, weak and socially incompetent. 3 The increasing burden of mental disorders has been accompanied by worldwide efforts to enlighten the public on mental health. These efforts are valuable in reducing stigmatisation and improving negative attitudes towards mentally ill people, which have both been linked to poor mental health literacy. ...
Article
Full-text available
Objective This study sought to assess knowledge of schizophrenia and help-seeking behaviour among undergraduate students of a Nigerian university. Sociodemographic predictors of correct recognition were also explored. Design The study was a cross-sectional descriptive survey. Setting The study was carried out at the University of Nigeria, a pioneer university located in Southeastern Nigeria. Participants Undergraduate students of the University of Nigeria. Methods All consenting male and female students of three purposively selected faculties were recruited for the study. Self-administered vignette-based questionnaires were distributed to students of the selected faculties between September and November 2018. Data were analysed using the IBM Statistical Product and Services Solution for Windows V.21.0. Results Out of the 400 questionnaires that were distributed, 389 were completed and returned (97.3% response rate). Respondents were mainly female (64.9%, n=252) and were between the ages of 18 and 24 years (75.8%, n=294). One in eight respondents (12.1%, n=47) correctly identified and labelled the schizophrenia vignette. Hallucination was the most identified symptom of distress for schizophrenia (47.9%, n=186). The most common alternative label for schizophrenia was ‘mental illness’ (24.7%, n=96). Schizophrenia was also mislabelled as depression (11.6%, n=45). More than a 10th of the respondents used stigmatising labels such as ‘crazy’ and ‘mad’ (11.1%, n=43). Psychiatrists were the most recommended source of help for the vignette character (36.3%, n=141). There was a strong association between the faculty of study and the ability to correctly identify and label the schizophrenia vignette (χ ² =44.557, p<0.001). Conclusion Mental health literacy among students of the University of Nigeria was poor. Research on culturally sensitive interventions to improve mental health literacy should be embarked on.
... Evaluating attitude towards mental illness through the knowledge of the causes of mental illness was critical and important for future service organization. Such findings have linked causal attribution and stigmatising attitude to mental illness [8, 21,22]. Results from the scoping review showed a poor knowledge and widespread belief that mental illnesses were caused by supernatural forces including sorcery, witchcraft and punishment from God for sins. ...
... Although studies have claimed that there is less stigmatizing attitude towards mental illness in Nigeria [23], this scoping study showed otherwise. Several studies have shown that stigmatizing attitude to mental illness is significantly associated with stereotypes and discrimination [1,21]. It was concerning the report that the Nigerians seem to despise people with mental disorders more than their illnesses (D,F,G,H,I). ...
... People with mental health problems often suffer from the consequences of intergroup bias. They are stigmatized, sometimes despite recovery from their problems (18,(22)(23)(24). Common underlying cognitions are beliefs of potential danger, incompetence, "being less useful to society, " and being responsible for their problems (22,(24)(25)(26). ...
... They are stigmatized, sometimes despite recovery from their problems (18,(22)(23)(24). Common underlying cognitions are beliefs of potential danger, incompetence, "being less useful to society, " and being responsible for their problems (22,(24)(25)(26). The effects of stigmatization can be harmful for stigmatized individuals, as these effects can increase self-stigmatization and mental health problems, and decrease self-esteem, feelings of hope, quality of life, and willingness to seek help (27,28). ...
Article
Full-text available
Objective: Stigmatization has negative consequences for people with mental health disorder diagnosis. Studies indicate that professionals have stigmatizing attitudes and behavior towards clients. Continuum beliefs are associated with less stigmatizing attitudes. The effect of a workshop to diminish stigmatizing attitudes and to enhance continuum beliefs is examined.Method: A total of 202 mental health professionals from (Functional) Assertive Community Treatment [(F)ACT] teams were randomly assigned to a workshop or a waiting list control group. Stigmatizing attitudes and continuum beliefs were assessed in both conditions at baseline and follow-up.Results: Compared to baseline, the workshop group showed an increase on continuum beliefs. However, there was no effect of the intervention on stigmatizing attitudes. Contrary to the expectations, stigmatizing attitudes increased in the waiting list condition.Conclusion: Communicating the continuity aspect can be valuable in decreasing the “us and them” discrepancy between professionals and people with mental health disorders. Further research on continuum beliefs is needed.
... Além dessa associação, o estigma social da doença mental pode também ser observado em outras equívocas convicções, como: os indivíduos com doença mental serem os responsáveis pelo acometimento da própria doença, de serem preguiçosos ou incapazes de cuidar si mesmo, de serem inaptos para o trabalho, de sofrerem de uma doença sem tratamento, e até mesmo de que a única solução para seu problema seja a internação (com o sentido de asilamento) em hospital psiquiátrico. Essas questões são veiculadas de forma pouco crítica pelos meios de comunicação, o que certamente assegura a manutenção desse estigma (Guarniero;Bellinghini;Gattaz, 2012;Hayward;Bright, 1997;Spadini;Souza, 2006). ...
... Além dessa associação, o estigma social da doença mental pode também ser observado em outras equívocas convicções, como: os indivíduos com doença mental serem os responsáveis pelo acometimento da própria doença, de serem preguiçosos ou incapazes de cuidar si mesmo, de serem inaptos para o trabalho, de sofrerem de uma doença sem tratamento, e até mesmo de que a única solução para seu problema seja a internação (com o sentido de asilamento) em hospital psiquiátrico. Essas questões são veiculadas de forma pouco crítica pelos meios de comunicação, o que certamente assegura a manutenção desse estigma (Guarniero;Bellinghini;Gattaz, 2012;Hayward;Bright, 1997;Spadini;Souza, 2006). ...
Article
Full-text available
Resumo Em 2014, na Baixada Santista, ocorreu o linchamento de uma jovem de 33 anos, episódio deflagrado por meio do compartilhamento em redes sociais do boato da existência no bairro de Morrinhos, em Guarujá (SP), de uma suposta bruxa sequestradora de crianças que realizava “rituais de magia negra”. Esse episódio ganhou importante atenção da imprensa nacional, sendo destacado - em parte relevante das reportagens - que a jovem espancada e morta era bastante conhecida na comunidade e fazia tratamento para uma doença psiquiátrica que desencadeava crises nas quais ela “perdia a noção de realidade”. Este artigo tem como objetivo apresentar uma análise do contexto sociocultural relacionado a esse acontecimento: o linchamento de uma mulher com transtorno mental. Foram utilizados os métodos e as técnicas de pesquisa tradicionais da antropologia; entre eles, observação etnográfica densa e entrevistas em profundidade com moradores de Morrinhos. A análise do material permitiu apontar que a violência é vivamente presente no local e está diretamente relacionada aos conflitos cotidianos e às disputas sociais existentes no bairro, destacando-se a violência contra o doente mental. A propagação de boatos é frequente nesse local e possui importante papel em manter certo equilíbrio nas relações sociais. Nesse contexto, pode-se considerar que a ocorrência do linchamento se configurou como um fato que, em grande medida, foi capaz de representar uma condensação desses elementos - os boatos, a estigmatização e a violência - e, assim, os expôs despidos em sua forma mais bruta.
... One potential reason is that there is a common perception in the general population that individuals with symptoms of psychosis may behave violently [9]. Less explicit fears are also known; individuals suffering from psychotic illness can struggle to fit into normal patterns of social interaction, and this can feel uncomfortable and awkward for those around them resulting in reduced social contacts and peer relationships breaking down [10]. However, research has tended to be carried out in relation to hypothetical situations [11]: it is not clear whether established peer friendships break down as a result of stigmatising attitudes of the other. ...
... Research suggests that the 'other' can feel apprehensive about interacting with individuals following an episode of psychosis [10], but the rate of actual rejections reported by participants is lower than expected from the stigma literature (for example, 9 out of 10 participants receiving secondary mental health care reported experiencing stigma, [32]). There are several possible explanations for this. ...
Article
Background: First episode psychosis and reduced social networks have been found to go hand in hand, but specific mechanisms are unclear. The manifestation of symptoms and the effect of stigma are two possibilities discussed in the literature but the experiences and views of young people with psychosis have been neglected. Aims: To explore experiences of friendships of young people with first-episode psychosis, focusing especially on any perceived changes in their friendships or approach to peer relationships as a result of the illness. Methods: Fourteen participants were interviewed using a semi-structured interview guide, which explored participants' views and experiences of their friendships during the acute phase of illness and in the path to recovery, the impact of friendships on illness experience and of illness on patterns of social contact, and the potential role of services in supporting people with their friendships. Interviews were transcribed verbatim and analysed thematically. Results: Identified themes included the loss of social contacts because both young people developing psychosis withdrew and because friends withdrew as illness developed. Regarding recovery, a unique role was identified for friends and participants were often making conscious efforts to rebuild social networks. Mental health services were viewed as having a limited direct role in this. Conclusions: Supporting the development of opportunities and skills needed for social relationships following an episode of psychosis may be a useful focus.
... [18][19][20][21] For example, the view that substance abuse causes mental health problems, which is only true for a minority of cases, is significantly related to negative mental health attitude. 19,22,23 It is reasonable to propose that, conversely, having more accurate knowledge about mental health, ie, better mental health literacy, would foster more positive mental health attitudes. However, the link between mental health literacy and mental health attitude has just been theorized and still lacks empirical evidence. ...
Article
Full-text available
Objectives: In the current study, we aimed to compare the levels of and factors associated with mental health attitude between males and females. Of particular interest was ascertaining the degree to which mental health literacy was related to mental health attitude and whether this relationship would vary by gender. Methods: A total of 732 participants aged 18 years or more were recruited from attendees at the 2016 Minnesota State Fair. We used the Mental Health Literacy Scale (MHLS) to measure attitude toward and literacy of mental health. Results: Our multivariate analysis reported that males' mental health attitude was significantly lower than females. Some factors associated with mental health attitude differed by gender as well. Among men, receiving more social support, experiencing higher levels of depression, and being married predicted greater mental health attitude. Among women, older age was associated with lower mental health attitude levels. However, mental health literacy was the strongest factor regardless of gender. Men and women with greater mental health literacy had a more positive mental health attitude. Conclusions: Provision of tailored mental health literacy education both for males and females could potentially improve the public's mental health attitude toward mental illness.
... Therefore, how the news audience view people with mental health issues likely influences how they perceive the media bias in mass shooting coverage. Previous research has suggested that the general public in the United States has widely endorsed stigmatizing attitudes about mental health problems (e.g., Angermeyer & Matschinger, 2003;Corrigan, 2000;Hayward & Bright, 1997;Hoffner et al., 2017). People tend to view mental health issues as sharing a series of negative stereotypes, such as dangerous, homicidal, need to be feared, etc. (Corrigan, 2000), so labeling mental issues as an illness has a significant negative impact on the public's attitudes toward people with mental health problems. ...
Article
Full-text available
The current study tested the “corrective action hypothesis” by analyzing intentions to engage in discursive activities for mental health in response to news coverage of mass shootings. Hypotheses were proposed regarding how involvements with the news influence on people with mental health issues moderate preexisting attitude toward people with mental health issues in predicting perceived media bias, and how perceived media bias predicts intention to engage in discursive activities for mental health. Two hundred nighty eight respondents were surveyed through Qualtrics national research panels. The results suggested participants would not be motivated by their prior attitude toward mental health to take part in discursive activities unless they are highly involved with the news issue and in the meantime perceived mass shooting coverage is biased against people with mental health. The results extended the discussion of corrective action hypothesis to the context of media coverage of mass shooting – a significant issue nowadays that intertwines with public health concerns. The results also provide a basis for the discussion of the potential benefits of employing perceived media bias in educating the public by appealing to individuals’ outcome concerns and value systems.
... There are several generic causes of mental illness stigma in our study which are similar to those reported in studies conducted in other countries. For instance, the relationship between fear and social distance towards PMI has been documented by many studies [44]. Link et al.'s study conducted in Ohio found social distance to be correlated with participant's perceived dangerousness of the mentally ill patient [45], and a review of stigma towards mental illness in Asia revealed similar findings to Link et al.'s study [46]. ...
Article
Full-text available
Background Mental illnesses pose a significant burden worldwide. Furthermore, the treatment gap for mental disorders is large. A contributor to this treatment gap is the perceived stigma towards mental illness. Besides impeding one’s help-seeking intentions, stigma also impairs persons with mental illness (PMI) in other aspects of their life. Studies have found that stigma may manifest differentially under different cultural contexts. Thus, this study seeks to elucidate the determinants of stigma towards PMI among lay public in Singapore using a qualitative approach. Methods A total of 9 focus group discussions (FGD) were conducted with 63 participants consisting of lay public Singaporeans who were neither students or professionals in the mental health field, nor had they ever been diagnosed with a mental illness. Topics discussed during the FGD were related to the stigma of mental illness. Data collected were analyzed with inductive thematic analysis method. A codebook was derived through an iterative process, and data was coded by 4 different coders. Both coding and inter-rater analysis were performed with NVivo V.11. Results In total, 11 themes for the determinants of stigma were identified and conceptualized into a socioecological model. The socioecological model comprised 4 levels of themes: 1) Individual level beliefs (fear towards PMI, perceiving PMI to be burdensome, dismissing mental illness as not a real condition), 2) Interpersonal influences (upbringing that instills stigma, intergroup bias, perceived inability to handle interactions with PMI), 3) Local cultural values (elitist mindset among Singaporeans, Chinese culture of “face”, Islamic beliefs about spiritual possession and reaction towards PMI), and 4) Shared societal culture (negative portrayal by media, Asian values). Conclusions The findings of this study improved our understanding of the various reasons why stigma exists in Singapore. The themes identified in this study concur with that of studies conducted overseas, as some determinants of stigma such as fear towards PMI are quite ubiquitous. Specifically, the themes elitist mindset among Singaporeans and perceived inability to handle interactions with PMI were unique to this study. It is highly recommended that future anti-stigma campaigns in Singapore should incorporate the findings of this study to ensure cultural misgivings and beliefs are addressed adequately.
... In this perspective, the basis of the representations of the "insane", the "mentally ill" and the "depressive" is not different from other countries in the world explored by the MHPG survey. Indeed, in most studies on social representations in the world, subjects with mental disorders are described as "dangerous, unpredictable, and poorly responsive to treatment" [16], or are carriers of "notions of danger and threat that are said to be responsible for the genesis of feelings of fear, mistrust and antipathy, and which thus form the basis of attitudes of exclusion and rejection" [17]. Depression, on the other hand, is better accepted and integrated. ...
Preprint
Full-text available
Purpose: Better know social representations and socio-cultural aspects of mental illness (FP) is critical to reduce stigma and improve care and prevention of psychiatric illness. Methods: The Mental Health in General Population Survey (MHGP) was carried out in French Polynesia (FP) in 2015 and 2017, with questionnaires on social representations of the "insane", the "mentally ill", the "depressive" and the various types of help and care. The representative sample of 968 people was built using the quota method. The data were collected in public spaces, anonymously. Results: The origin of mental health problems is considered mainly as physical, organic or hereditary. Addictive behaviours are the cause of mental illness for 1/4 of respondents. According to the Polynesian population, the “insane” or the “mentally ill” are perceived as excluded, irresponsible, unaware of their conditions and difficult to cure. Depressed people are seen as responsible for their actions, aware of their conditions and who can be treated. Conclusion: The results of this survey show stigmatizing representations of the “insane” and the mentally ill” and significant use of traditional care. They have been incorporated into the mental health plan for FP to improve the care and promotion of mental health.
... Because the Eurobarometer contains only four items referring to stigma, our analyses and results are limited to stereotypes, which are regarded as a first, but crucial, step in the stigma process ). The items refer to the four main components of the stereotype of mental illness: dangerousness, attribution of responsibility, poor prognosis, and disruption of social interaction (Hayward and Bright, 1997;Griffiths et al., 2006). For the exact wording of the items, we refer to Mojtabai (2010). ...
Article
Full-text available
Purpose: The detrimental impact of stigma on the utilization of mental health services is a well-established finding. Nevertheless, most studies consider only the personal or interactional dimensions of stigma. This contribution makes a distinction between the dominant beliefs about stigma within a culture and the personal beliefs of individuals with regard to stigma. We hypothesize that both have an impact on professional-care seeking within the field of mental health. Methods: A multi-level research design is used to estimate the effects of both types of stigma beliefs on the likelihood of consulting general and specialized health professionals about mental health problems in 28 European countries (N of individuals = 24,881, Eurobarometer 248, 2005–2006). Results: In countries where stigmatizing beliefs are dominant, the likelihood of seeking help from specialized mental health professionals is constrained, and individuals refrain from contacting general practitioners when in need of formal support, regardless of their own personal stigma beliefs. Conclusion: The present study signals the importance of stigma beliefs as shared cultural phenomena, and of personal stigma beliefs to the likelihood of seeking professional care for mental health problems. We therefore propose that most studies on stigma and formal-care seeking underestimate the pervasive effects of stigma beliefs, due to methodological individualism.
... When the stigmatising attitude of society is accepted and internalised by patients with mental illness, it leads to an exponential increase in the distress [2]. Stigma acts as an obstacle to seeking treatment, social restriction, poor quality of life,it also limits the job opportunities and education [3][4][5][6][7][8][9][10][11]. ...
Article
Full-text available
Stigma related to psychiatric illness not only impact the patients but also have adverse consequences on the caregivers. Stigma can lead to poor quality of life, social restriction, and psychological morbidity. Not much data is available on the stigma among the caregivers of patients with Obsessive–Compulsive Disorder (OCD). To evaluate the extent of stigma experienced by the caregivers of patients with OCD and its association with caregiver burden and coping. In a cross-sectional study, 53 caregivers of patients with OCD were evaluated on the Stigma Scale for Caregivers of People with Mental Illness (CPMI), Family Burden Interview (FBI) Schedule, and Family Coping Questionnaire (FCQ). The mean age of the caregivers was 45.9 years, with the number of years of formal education was 8.6 (SD: 5.4) years. Majority of the caregivers were male and married, were the spouse of the patient with a mean duration caregiving at the time of assessment being 122.6 months. In terms of stigma, the highest level of stigma was seen in the affective domain, followed by behavioural domain and least in the cognitive domain of CPMI. On FBI the highest level of burden was seen in the domain of disruption of routine family activities, followed by disruption of family interaction, disruption of family leisure activities, financial burden, the effect on the physical health of others, and effect on mental health others. On FCQ, Positive communication and resignation were the most commonly used coping mechanisms. The least commonly used coping strategy was the patient's social involvement. All the domains of CPMI had a significant positive association with a total objective score of FBI. In terms of coping, a higher level of stigma was associated with lower use of social involvement (all domains of stigma), coercion (cognitive domain and total stigma), and avoidance (all domains except for affective domain) as coping mechanisms. Lower use of positive communication was associated with higher stigma in the behavioural domain. Those with a high objective burden had a higher level of stigma on the cognitive and behaviour domain of the CPMI. Caregivers of patients with OCD experience a high level of stigma. A higher level of stigma is associated with the more use of maladaptive coping like avoidance and higher caregiver burden. Accordingly, it can be said that there is a need to focus on the caregivers of patients with OCD to improve the overall outcome of the patients.
... As with other prejudices, stigma regarding mental illness may be absorbed into one's thinking about oneself. When stigma is internalized, it has additional, manifold negative effects (9,(20)(21)(22)(23), including increased depression and demoralization (20,(24)(25)(26), avoidant coping (20,24,(27)(28)(29), exacerbated ambivalence about mental health care (22,28,30,31), and eroded hope and self-esteem (27,30,(32)(33)(34). Resources are needed to help people protect themselves from the effects of stigma and discrimination, which persist despite efforts to eliminate them. ...
Article
Full-text available
Objective: Ending Self-Stigma is a nine-session group intervention designed to teach individuals experiencing mental illness a set of tools and strategies to effectively deal with self-stigma and its effects. The authors examined the efficacy of Ending Self-Stigma with an active comparison group focused on general health and wellness education (the Health and Wellness intervention) in a cohort of veterans. Methods: Veterans with serious mental illness (N=248) were randomly assigned to either the Ending Self-Stigma or the Health and Wellness intervention. Participants completed assessments of symptoms, internalized stigma, recovery, sense of belonging, and other aspects of psychosocial functioning at baseline, posttreatment, and 6-month follow-up. Repeated-measures, mixed-effects models were used to examine the effects of group × time interactions on outcomes. Results: Individuals in both groups experienced significant but modest reductions in self-stigma and increases in psychological sense of belonging after the treatments. The Ending Self-Stigma and Health and Wellness interventions did not significantly differ in primary (self-stigma) or secondary (self-efficacy, sense of belonging, or recovery) outcomes at posttreatment. Significant psychotic symptoms moderated treatment effects on self-stigma, such that among individuals with significant psychotic symptoms at baseline, those who participated in Ending Self-Stigma had a significantly greater reduction in internalized stigma than those in the Health and Wellness intervention. Conclusions: Interventions directly targeting self-stigma and those that may address it more indirectly may be helpful in reducing internalized stigma. Individuals experiencing psychotic symptoms may be more likely to benefit from interventions that specifically target self-stigma.
... Link and Phelan's (2001) stigma conceptualization was used to operationalize and codify structural stigma in bill language. As their article does not specifically define the five elements of stigma, this study used definitions provided in other literature: (1) Labeling: the bill's language used labels related to MHMI that are associated with certain characteristics that have social significance attached ) (e.g., addicted, severely impaired, behaviorally disabled, insane, consumer, mentally ill, incompetent, etc.); (2) Stereotyping: the bill's language linked these labels to negative attributes ) (e.g., dangerous, responsible for their own conditions, unable to follow social roles, unpredictable, or chronically ill and unable to be treated or recover) (Hayward & Bright, 1997); (3) Separating: (a) the bill's language implied a fundamental difference or conceptual separation between those without MHMI concerns (us) and those with (them) ) (e.g., an individual has cancer vs. an individual is schizophrenic); and/or, (b) the bill's language attempted to literally separate those with MHMI concerns from those attempting to seek other forms of healthcare (e.g., those with MHMI concerns are housed in separate psychiatric facilities and kept away from individuals with physical illnesses); (4) Status loss: (a) the bill's language contained a belief, suggestion, or expectation that individuals with MHMI concerns would lose status ; and/or, (b) those with MHMI concerns were actually lowered or reduced in existing status hierarchies (Link & Phelan, 2001); and (5) Discrimination: the bill's language attempted to disadvantage those with MHMI concerns ) (e.g., restrictions or loss of rights related to employment, involuntary commitment, housing, owning a firearm, etc.). Each of the five elements were coded dichotomously, according to their absence or presence (0 = no, 1 = yes), and were totaled to make a final determination of stigmatic language. ...
Article
Mental healthcare interventions are effective, yet services and access remain limited, as most bills and appropriations fail. Forms of structural stigma exist in mental healthcare policymaking, but research is limited regarding factors affecting their presence. Thus, a content analysis was conducted on mental health-related legislation in order to identify forms of structural stigma as well as any legislative influences. Findings indicated that (1) legislator political party, chamber, and gender were all significantly associated with structural stigma, while (2) Republican party membership was a significant predictor. Mental health advocates may utilize these findings when targeting policymakers in their stigma reduction efforts.
... The existence of stigma towards individuals with schizophrenia (henceforth service-users) is now widely accepted (see Hayward and Bright, 1997, for review). The potentially negative impact of that stigma on people's self-esteem, social functioning and recovery has also been demonstrated through empirical investigations (Wahl, 1999), in-depth qualitative explorations (Knight, Wykes and Hayward, 2003), and first-person accounts (Gallo, 1994). ...
Article
The experience of stigma by individuals with schizophrenia can impact on self-esteem and potential for recovery. Previous attempts to reduce stigma within society have reported variable success. The present study aimed to formulate and evaluate a therapeutic intervention for those who perceive themselves as stigmatized by their mental illness and who suffer low self-esteem. A waiting-list control design with repeated measures within participants was used. Treatment efficacy was evaluated by a principal outcome measure of self-esteem. Ancillary outcome measures included a measure of perceived stigmatization, and two symptom measures. Assessments were completed on four occasions, which covered a waiting list period, a treatment period and a follow-up. All participants (N = 21) received group Cognitive Behavioural Therapy (CBT) focused on stigma and self-esteem. Self-esteem improved significantly following treatment. Levels of depression, positive and negative symptoms of schizophrenia and general levels of psychopathology decreased significantly. A longer-term effect was found for positive and negative symptoms of schizophrenia, and general levels of psychopathology. Participant feedback was predominantly positive. In addition to societal interventions, the potential for limiting the effects of stigma within a therapeutic context should be investigated.
... Con los diagnósticos descriptivos se corre el peligro de que lleguen a convertirse en una explicación tautológica que confunde la concreción del trastorno con el concepto explicativo; lo que conduce a interpretar las características personales, el malestar o la historia vital del paciente de acuerdo al marco de un sistema de creencias orientado a la patología (Ortiz e Ibáñez, 2011). Además, como sostienen Hayward y Bright (1997), el etiquetado es un proceso destructivo en el que la etiqueta de la enfermedad mental llega a ser más perjudicial para el individuo que el trastorno etiquetado. En relación con esto, como recoge Pokorny (1996), es habitual que la etiqueta pueda pasar de describir una conducta que está mostrando una persona a ser considerada una característica de ésta. ...
Article
Full-text available
Despite the known advantages of the classification of psychological disorders, using formal diagnostic could reduce a story of life and way of behaving to a mere diagnostic label, becoming a tautological explanation that ignores the true explanation of the problem and adds iatrogenic functions and stigmatizing. The present study assesses the influence of diagnostic labels in the performance of psychologists who evaluate the intelligence of a group of children. The Goodenough Test is used for instrumental reasons. The different drawings of a human figure, made by children with standardized psychological development, were labeled as if having been drawn by children with mental retardation, giftedness and normal development. The results show that evaluators, unaware of the falsity of the diagnoses, score the drawings differentially depending on the diagnostic label used. That is, the results evidence the negative influence of a diagnostic label about expectations and treatment to the person diagnosed.
... Like in Perry et al (2007) (Farnia, 1998;Hayward & Bright, 1997). Even if some participants did not identify themselves with the other patients (and therefore as someone with a mental health problem), they were worried about being stigmatised due to being associated with people who have a mental health problem (courtesy stigma - Goffman, 1963). ...
...  People with mental illness are dangerous  People with mental illness are unpredictable and unable to fulfill social roles  People with mental illness are responsible for their condition  Mental illnesses are chronic and have a poor prognosis (Hayward & Bright, 1997) Dutch research gives the conclusion that the negative stereotypes in The Netherlands about people with mental disorders aren't that negative. There is a distinction in the various disorders in which the respondents see aggression. ...
... Mental health stigma is a major public health issue having powerful detrimental effects on the lives of people with such conditions [1][2][3]. Research indicate that schizophrenia is one of the most, if not the most, stigmatized mental health condition commonly associated with dangerousness, unpredictability, desire for greater social distance and patients' lowered self-respect and reject from the society [4][5][6]. ...
Article
Full-text available
PurposeThis study aims to investigate use and misuse of the word ‘schizophrenia’ and its derivatives to assess the prevalence of stigmatizing and trivializing attitudes and the meanings attributed to the condition on Turkish Twitter.Methods Using R programming language, we collected Turkish Twitter posts containing the terms used for schizophrenia in Turkish through Twitter’s Search API over a 47-day period between July and June 2019. After removing retweets, we randomly sampled 3000 tweets and manually categorized them in three dimensions: use type (metaphorical/non-metaphorical), topic and attitude. Qualitative analysis on representative tweets were performed and word frequencies were calculated.ResultsIn total 44,266 tweets were collected and after removing retweets, 24,529 tweets were obtained. Overwhelming majority of the tweets (91.7%) used the terms metaphorically and the majority displayed stigmatizing (68.3%) and trivializing (23%) attitudes. Politics was the most common topic (58.2%) followed by everyday/social chatter (28.5%). Only a small number of tweets were part of awareness campaigns (0.2%) or displayed a supportive attitude (0.8%). Terms were often used metaphorically in a stigmatizing manner as personal or political insults, while in everyday/social contexts, they were used in a trivializing manner to label eccentricity, oddness, overthinking and suspiciousness. Popularity and reach metrics show that these tweets were extensively retweeted, liked and reached millions of users.Conclusion This is the first study investigating attitudes towards schizophrenia on Turkish Twitter. Significantly higher rates of stigmatizing attitudes demonstrate the urgent need for public health and social awareness campaigns targeting stigma surrounding schizophrenia in Turkey.
... 261). Hayward and Bright (2009) offer four classifications as to why stigma exists with people who have a mental illness when it does come to stigma itself. They propose that the four explanations include: "dangerousness, attribution of responsibility, poor prognosis and disruption of social interaction" (p. ...
Book
A small book for the potential student who would like to enroll at university, but due to a mental illness/concern, is hesitant. The book describes the services that are on offer at university to help assist students with the transition to undergraduate life when health is disrupted.
... People with mental disorder struggle to heal from illness; yet, they face stigmatization by the society. 2 Stigma is a negative labeling toward a particular group of people, 3 which could have deleterious effects on the sufferers of mental disorder. First, stigma shapes a bad image on mental disorders. ...
Article
Full-text available
Introduction: Mental health problems are serious issues in Indonesia. The prevalence of severe mental disorder in Indonesian population is 1.7‰. In community, people with mental disorder are often stigmatized, while in fact this stigmatization could negatively impact them. One of the most common form of discrimination toward people with mental disorder is the practice of pasung. Method: This research conducted a survey study on 1,269 respondents in East Java (in which the prevalence of severe mental disorder is 2.2‰). The instruments used were Community Attitudes towards Mental Illness (CAMI), Mental Health Knowledge Schedule (MAKS), and a sociodemographic questionnaire. Result: The result shows that better knowledge about mental health was associated with lower public stigma toward people with mental disorder. Significance differences in stigma toward people with mental illness were also found across groups of age, sex, experience of contact, history of mental disorder, attitude toward pasung, marital status, and income level. Conclusion: The finding implies that anti-stigma interventions in Indonesia should consider associated sociodemographic factors and use psychosocial approach to improve literacy and contact with mental health patients.
... Both the general public and persons with psychiatric disorders have been found to have stigmatising attitudes towards mental illness Popular misconceptions about mentally ill people include being dangerous, weak and socially incompetent. Hayward & Bright, (1997) have explained stigma associated with psychiatric disorders as 'the negative effects of a label placed on any group, such as a racial or religious minority, or, in this case, those who have been diagnosed as psychiatric illness. A study by Fleischmann and Saxena, (2013) and Paula et al., (2012) World Health Organization estimated that the prevalence of psychiatric disorders is about 25% of the world population in both developed and developing countries. ...
Article
Full-text available
Background: Mental health literacy is important for all societies, it will be helpful for reducing the treatment gap. Mental health campaigns can reduce the chronic city of psychiatric disorders, illness can treat as earliest as possible. Community awareness of Psychiatric Disorders helps to reduce stigma, discrimination, sensitization, treatment and social inclusion. Aim: Tto assess the literacy level of Mental Illness among the community people. Methodology: The study was conducted at the rural health training centre, Najafgarh, Delhi. Simple survey methods were used for data collection. A total of 306 individuals were selected for the study. The researcher informs community people with help of ASHA workers to come to RHTC, Najafgarh. Participants were asked to complete a questionnaire that was designed specifically for Indian contexts and was translated into Hindi. Tools were used for the study Socio-demographic datasheet and the public perceptions of mental illness questionnaire applied which assess the area of the previous contact with people with mental health issues, understanding of the psychiatric disorder, knowledge of psychiatric illness and attitude towards the individual with mental problems. The questionnaire was translated into Hindi, and independently back-translated by research experts in the mental health field. Results: Results show that the mean age of participants was 33 years, 62% participants male and 37% participants female. Participants understanding of mental health among the community participants negative perception was higher. Less mental Health services availability reported in the community. Conclusion: Mental health awareness is one of the most important phenomenon for increased literacy and reducing the treatment gap-related Mental Health.
... Si les stéréotypes (croyances) associés à la catégorie sociale « malade mentale » sont très majoritairement négatifs (Hayward & Bright, 1997), des études plus récentes rapportent des différences notoires de croyances en fonction de la maladie stigmatisée (Fiske, 2012). Le modèle de contenu du stéréotype voir figure 9). ...
Thesis
Lien vers la thèse : https://tel.archives-ouvertes.fr/tel-03564693/document Infantilisation, manque de coopération au parcours de soin, pessimisme concernant le rétablissement ou encore pratiques violentes : les pratiques en santé mentale sont identifiées comme une source importante de stigmatisation selon les personnes qui ont un diagnostic de schizophrénie et leurs familles. Si la recherche internationale s’intéresse depuis plus de 20 ans à cette question, aucune recherche en France n’était venue interroger le potentiel stigmatisant des pratiques des professionnels de santé mentale. C’est pour répondre au besoin d’amélioration des pratiques que s’est construit le programme de recherche STIGMApro, cadre du travail doctoral présenté. L’objectif de STIGMApro est de créer une intervention visant à réduire la stigmatisation de la schizophrénie dans les pratiques en santé mentale. Pour atteindre ce but, une première étape de recherche fondamentale s’est centrée sur l’examen approfondi de cette stigmatisation. De multiples enquêtes ont eu pour but de décrire précisément la stigmatisation dans les pratiques professionnelles et les facteurs associés. Tout d’abord, une enquête auprès des usagers et des familles d’usagers ayant un diagnostic de schizophrénie a recensé 15 situations concrètes de stigmatisation dans les soins de santé mentale. Ces situations devenaient des cibles pour les interventions anti-stigma. Ensuite, le point de vue des professionnels de santé mentale fut également investigué. Une revue systématique de la littérature a d’abord permis de résumer les résultats de la littérature internationale sur les spécificités de la stigmatisation de la schizophrénie chez les professionnels et les facteurs associés. Ces facteurs associés ont ensuite fait l’objet de deux enquêtes chez les soignants français, l’objectif étant de mettre en évidence les variables associées à moins de stigmatisation et donc les plus pertinentes pour une intervention souhaitant réduire cette stigmatisation dans les pratiques de santé mentale. Enfin, une étude contrôlée randomisée fut conduite avec l’objectif de tester l’efficacité de certaines de ces variables pour réduire les stéréotypes, préjugés et discriminations de la schizophrénie. Ainsi, les variables les plus pertinentes, révélées par cette étape de recherche fondamentale, ont été importée dans l’intervention STIGMApro : sentiment d’utilité professionnelle, pratiques orientées rétablissement, similitudes perçues ou encore approche du continuum. Ce travail doctoral présente les bases de cette intervention.
... Literature suggests that people with mental health conditions that are perceived as chronic and with poorer prognosis are more likely to be stigmatised and socially rejected. 12 Therefore, high scores on these questions could identify this type of stigmatising attitudes. However, we also hypothesised that low scores on these questions could index a different type of stigma, for instance, if a certain condition is seen as easier to recover from because it is not considered to be as severe as others. ...
Article
Full-text available
Background Eating disorders are stigmatised. Little is known about whether stigma has decreased over time and which groups hold more stigmatising beliefs. Aims To explore whether stigma towards eating disorders has changed between 1998 and 2008 and whether it varies by sociodemographic characteristics. Method We used the Office for National Statistics Omnibus surveys 1998 and 2008. As outcomes, we selected four questions eliciting participants’ views on issues of blame and ability to recover, and compared their mean scores across eating disorders, depression and alcohol dependence in both years. We used multivariable linear regressions to investigate associations between sociodemographic characteristics and each stigma domain. Results In total, 2720 participants had data on all variables of interest. Compared with 1998, in 2008 stigmatising views towards eating disorders improved. In both years, participants believed it was easier to recover from eating disorders than depression or alcohol dependence. Respondents believed people with eating disorders were more to blame for their condition than those with depression, but less than those with alcohol dependence. Men, those with less formal education, and those from ethnic minority backgrounds were more likely to place greater blame on individuals for their mental illness. Men were more likely than women to think it was possible to recover from an eating disorder. Conclusions Stigmatising attitudes towards people with eating disorders have improved over time, but are still greater than those observed for other mental illnesses. Improving eating disorder mental health literacy could help to reduce these negative views and lead to improved quality of life, greater help-seeking and better prognosis.
... Stigma has been defined as the negative effect of a label and a product of disgrace that sets a person apart from others. 1 It leads to social devaluation of a person due to his/her personal attributes resulting in an experience of shame, disgrace and social isolation. 2 Stigma towards people with mental illness (PMI) is prevalent in all societies in Western and non-Western cultures. ...
Article
Full-text available
Background: Stigma towards adults with mental illness is a longstanding and widespread phenomenon. Stigmatizing attitudes are prevalent not only among the general population but also among doctors. Negative stereotyping of people with mental illness (PMI) leads to prejudice and discrimination, affecting all aspects of their medical care and well-being. The present study attempted to explore stigmatizing attitudes among doctors towards PMI.Methods: The research was observational and cross-sectional in design carried out on doctors in a medical college. Socio-demographic data including field of specialization, experience, and academic post were recorded. The community attitudes towards mental illness (CAMI) and social distance scale were administered. Social desirability bias was corrected for by using the Marlowe-Crowne social desirability scale.Results: Around 54 doctors from the specializations of medicine (n=24), surgery (n=19), and non-clinical fields (n=11) participated. We found no significant differences in attitudes towards mentally ill and social distance between medical specializations (p-values >0.05) even after adjusting for the effects of social desirability bias. Years of specialization experience (p=0.037) and having a family member or close friend with mental illness (p=0.012) were significantly associated with higher scores in the community mental health ideology sub-scale of CAMI. Higher social restrictiveness (p=0.014) and lower community mental health ideology (p=0.008) were associated with greater social distance from PMI.Conclusions: Doctors are not immune to biases and stigmatizing attitudes towards PMI. These attitudes are present across all fields of medical specialization and must be addressed by mental health professionals to ensure optimal care of this vulnerable population.
... Stigmas were restricted to people involved in misconduct. However, stigma can also apply to physical disabilities (Balter, 2004), gender (Eagly & Steffen, 1984), race (Dovidio, Evans, & Tyler, 1986), obesity (Allon, 1982a(Allon, , 1982b, and mental illness (Hayward & Bright, 1997). In a marketing context, coupon redemption can be viewed as "cheap" (Argo, Dahl, & Manchanda, 2005), a stigma that can be an underlying reason for the low (e.g., less than 2%) coupon redemption rates in the marketplace (Ashworth et al., 2005;Ives, 2005;Donthu & Cherian, 1992;Hernandez, 1988;Tepper, 1994). ...
Article
This study examines the impact of online review picture background and its interplay with product type and review features (e.g., star rating, texts) on consumers' purchase intention. Consumers make inferences about the reviewers' socioeconomic status (SES) from the background of online review pictures. Drawing on the social comparison literature, we find that the review picture background reflecting low SES triggers a stigma effect (threat to self-evaluation) for a mainstream (high-end) product, leading to decreased (enhanced) purchase intention. In addition, the stigma effect for a mainstream product is accentuated when there are multiple low-SES pictures, and when one low-SES picture is coupled with a positive (vs. negative), fit-oriented (vs. quality-oriented) textual review. However, the enhancing effect of one low-SES background picture for a high-end product continues to hold even when it is presented with multiple high-SES background pictures; the effect is reversed when there are multiple low-SES pictures.
... Społeczny odbiór osób, które doświadczają zaburzeń psychicznych lub przeszły w swoim życiu ich epizod jest niestety często negatywny i nacechowany stereotypami [12,13]. Nierówne traktowanie, piętno i dyskryminacja towarzyszące zaburzeniom psychicznym stanowią nie tylko czynniki utrudniające poszukiwanie leczenia [14,15] i opóźniające sam jego proces [16], ale i wpływają szkodliwie na wiele aspektów życia jednostki [17], m.in. ...
Chapter
Full-text available
Celem artykułu jest przybliżenie problematyki postrzegania zaburzeń psychicznych i jego wpływu na zdrowie psychiczne osób chorych. Przybliżono pokrótce zarys historycznego interpretowania i postrzegania zaburzeń psychicznych od starożytności aż po czasy obecne. Następnie przedstawiono sytuację aktualną, rozpoczynając od analizy postaw dyskryminujących i stygmatyzujących osoby z zaburzeniami psychicznymi oraz tego, jaki może mieć to wpływ na ich codzienne funkcjonowanie i podejmowane przez nie próby szukania pomocy. Szczególną uwagę zwrócono na kwestię postrzegania zaburzeń psychicznych w rodzinie osób chorych. Przeanalizowano także relację miedzy postrzeganiem zaburzeń psychicznych przez społeczeństwo a poszukiwaniem profesjonalnej pomocy psychologicznej lub psychiatrycznej. Dokonano również przeglądu prac dotyczących postrzegania zaburzeń poza europejskim kręgiem kulturowym, szczególną uwagą obdarzając Bliski Wschód, Chiny, Afrykę Subsaharyjską i Indie.
... In relation to disease, stigma has been identified across a large range of conditions; for example, mental illness (Hayward and Bright, 1997), chronic pain (Jackson, 2005), and other non-communicable diseases (Rose et al., 2017). However, the contours of stigma in relation to communicable or infectious diseases, such as viral epidemics, are particularly well-delineated. ...
Article
Full-text available
In this article, I propose a novel theoretical framework for conceptualizing pandemic stigma using the metaphor of ‘mutation’. This metaphor highlights that stigma is not a static or fixed state but is enacted through processes of continuity and change. The following three orienting concepts are identified: (a) lineage (i.e. origin narratives and initial manifestations are created in relation to existing stigmas, stereotypes, and outgroups), (b) variation (i.e. stigma changes over time in response to new content and contexts), and (c) strength (i.e. stigma can be amplified or weakened through counter- or de-stigmatizing forces). I go on to use this metaphor to offer an analysis of the emergence of COVID-19 stigma. The lineage of COVID-19 stigma includes a long history of contagious disease, resonant with fears of contamination and death. Origin narratives have stigmatized Asian/Chinese groups as virus carriers, leading to socio-political manifestations of discrimination. Newer ‘risky’ groups have emerged in relation to old age, race and ethnicity, poverty, and weight, whose designation as ‘vulnerable’ simultaneously identifies them as victims in need of protection but also as a risk to the social body. Counter-stigmatizing trends are also visible. Public disclosure of having COVID-19 by high-status individuals such as the actor Tom Hanks has, in some instances, converted ‘testing positive’ into shared rather than shamed behaviour in the West. As discourses concerning risk, controllability, and blame unfold, so COVID-19 stigma will further mutate. In conclusion, the metaphor of mutation, and its three concepts of lineage, variation, and strength, offers a vocabulary through which to articulate emergent and ongoing stigma processes. Furthermore, the concept of stigma mutation identifies a clear role for social scientists and public health in terms of process engagement; to disrupt stigma, remaking it in less deadly forms or even to prevent its emergence altogether.
... International research shows that public stigma has an adverse impact on life opportunities of people with a mental illness. It is associated with diminished quality of life, social isolation, self-stigma, symptom exacerbation and relapse [4][5][6][7]. Furthermore, (anticipated) negative beliefs, exclusion or discrimination may act as a barrier in treatment seeking and for optimal health care for people with mental illnesses [7,8]. ...
Article
Full-text available
Introduction Stigmatization impedes the social integration of persons recovering from mental illnesses. Little is known about characteristics of the stigmatized person that lessen or aggravate public stigma. Purpose This study investigates which characteristics of persons with mental illnesses (i.e. with a depression or a psychotic disorder) might increase or decrease the likelihood of public stigma. Methods Over 2,000 adults read one of sixteen vignettes describing a person with a depressive disorder or a psychotic disorder and answered a set of items measuring social distance. Results The person who was employed (vs. unemployed), or whose neighbors did not experience domestic noise disturbance (vs. disturbance) elicited significantly less social distance. Also persons with a depressive disorder elicited less social distance, vs. persons with a psychotic disorder. Conclusion Employment and good housing circumstances may destigmatize persons coping with mental illnesses. Mental health and social services should encourage paid employment, quality housing and other paths to community integration.
... Stigma merupakan pelabelan negative terhadap sekelompok tertentu (Hayward & Bright, 1997) stigma membuat individu kehilangan harga diri dan efikasi diri serta mencegah mereka mencari pertolongan medis untuk (Corrigan, Kerr, & Knudsen, 2005) stigma mengakibatkan diskriminasi terhadap individu dan mencegah memperoleh tujuan hidup mereka seperti kesempatan kerja dan kesempatan untuk hidup mandiri. Stigma dibagi menjadi dua tipe yaitu pertama, Persepsi stigma, yang dimana mendapatkan stigma dari situasi, individu merasa malu (Alonso, et al., 2008). ...
Article
Full-text available
Sejumlah remaja di Bandung, mengeluh memiliki ciri-ciri gangguan kesehatan mental tetapi, mereka tidak ingin mengungkapkan situasi tersebut kepada profesional kesehatan mental karena takut stigma masyarakat. Penelitian ini adalah deskriptif kualitatif menggunakan metode wawancara dengan rumusan masalah sebagai berikut (1) Apakah seorang individu akan mencari pertolongan dari profesional kesehatan mental jika merasa memiliki gangguan kesehatan mental. (2) Apa stigma yang dikatakan jika mereka mencari bantuan profesional kesehatan mental. Subjek penelitian ini terdiri dari 25 informan , usia 18 hingga 24 tahun. Ada 25 informan yang mengatakan bahwa mereka ada keinginan untuk mencari profesional kesehatan mental tapi mereka takut melakukannya karena stigma.
... Examples: addicted, behaviorally disabled, consumer, incompetent, insane, mentally ill, severely impaired, etc.; (2) Stereotyping: the bill linked these labeled differences to negative attributes (Link et al., 2004). Example attributes: dangerous, unpredictable, unable to follow social roles, responsible for their own conditions, chronically ill, etc. (Hayward & Bright, 1997); (3) Separating: (a) the bill had language implying a conceptual separation (i.e., fundamental difference) between those with MHMI concerns (them) and those without (us) (Link et al., 2004); and/or, (b) the bill sought to physically separate individuals with MHMI concerns from individuals seeking other forms of healthcare. Examples: (a) an individual is schizophrenic versus an individual has cancer; (b) people with MHMI concerns are placed in isolated psychiatric facilities; (4) Status loss: the bill's language had suggestions, beliefs, or expectations for individuals with MHMI concerns to lose status (Link et al., 2004), or individuals with MHMI concerns were reduced in a status hierarchy (Link & Phelan, 2001); and (5) Discrimination: the bill's language sought to disadvantage individuals with MHMI concerns (Link et al., 2004). ...
Article
Mental health interventions are effective, yet mental healthcare remains limited across the country. Gaps could be addressed at the legislative level, but bills and appropriations often fail. Structural stigma exacerbates gaps and adversely affects the policymaking process when policymakers adopt stigmatic public attitudes towards mental healthcare. Factors that influence legislative outcomes are found in the literature, but studies have not explicitly focused on how structural stigma—or other factors—may impact mental health-specific outcomes. Thus, this study examined mental health bills in order to expose current forms of structural stigma as well as identify patterns related to bill outcomes. Using a stratified random sample of mental health-related bills, quantitative content analysis was conducted by transforming textual data into frequencies that were used in binary logistic regression analyses. The study found that structural stigma was present in the language and potential effect of mental health-related bills. Further, political party of the sponsor(s), party majority status, and structurally stigmatic language were all associated with bill passage. Finally, party majority status and structurally stigmatic language predicted bill passage. Findings highlight the extent to which certain factors in the mental health policymaking process, including structural stigma, may influence mental health-related bill outcomes. Advocates can use these findings to better target policymakers in their efforts to reduce stigma, influence bill sponsorship, and impact legislative outcomes.
... Les stéréotypes font références à des croyances largement partagées au sein de la société, au sujet d'un groupe social (Hilton & von Hippel, 1996 (Hayward & Bright, 1997). Les études princeps suggèrent que les personnes souffrant de schizophrénie sont perçue comme dangereuses, incompétentes, imprédictibles, responsables de leur maladie, et ayant un mauvais pronostic (Angermeyer & Matschinger, 2004). ...
Thesis
Full-text available
Selon l’Organisation Mondiale de la Santé (OMS), la stigmatisation est une marque de honte, de disgrâce et de désapprobation, conduisant un individu à être évité et rejeté par les autres. La stigmatisation constitue par conséquent un frein majeur au rétablissement de la schizophrénie. Le rétablissement implique qu’une personne souffrant de maladie mentale puisse vivre sa vie comme elle l’entend, sans souffrir du fardeau de la stigmatisation. La lutte contre la stigmatisation de la maladie mentale est de ce fait une priorité du plan d’action pour la santé mentale 2013-2020 de l’OMS. Cependant, les méta-analyses actuelles indiquent que les interventions visant la réduction de la stigmatisation de soi ne sont pas efficaces, dans leur majorité. La stigmatisation de soi émerge lorsqu’un individu s’applique à lui-même les stéréotypes, les préjugés et les discriminations. Ces interventions se basent le plus souvent sur des modèles qui expliquent de façon insuffisante ou trop imprécise les mécanismes et les conditions d’émergences de la stigmatisation de soi. L’objectif de cette thèse était d’identifier de nouveaux mécanismes par lesquels la stigmatisation de soi opère dans la schizophrénie. Nous avons croisé les apports théoriques et méthodologiques de la neuropsychologie clinique, de la psychologie sociale et de la psychopathologie cognitive. Ce travail doctoral comprend 2 études en population clinique, 2 études en population générale, et une revue systématique de la littérature avec méta-analyses. Nous avons utilisé les méthodes corrélationnelles et expérimentales. Les principaux résultats de ce travail doctoral suggèrent que les croyances de contrôle de soi et de l’environnement (i.e. croire en l’existence d’un libre arbitre), les croyances sur son propre fonctionnement cognitif (i.e. plaintes cognitives / métacognition), et les croyances sur les maladies mentales (i.e. croire que les symptômes de la schizophrénie se distribuent sur un continuum), jouent un rôle dans la stigmatisation de soi dans la schizophrénie. Enfin, un modèle de synthèse de la stigmatisation de soi dans la schizophrénie est proposé, soulignant la nécessité de traiter cette problématique de manière intégrative et individualisée, que ce soit dans le domaine de la recherche ou des pratiques cliniques.
Article
Art reception is a complex process influenced by many factors, both internal and external. A review of the literature shows that knowledge about the artist, including their mental health, has an impact on the general assessment of their artwork. The purpose of this research was to examine the relationship between knowledge about the artist’s mental illness and the perception of the artwork. We focused on the subjective emotional experience and general assessment of ten specific pictures painted by patients diagnosed with schizophrenia. The research followed four cohorts (two groups divided into two subgroups—art experts and laypeople) of students for over a month. The results revealed significant differences between the two general groups as well as between the ‘expert’ and ‘laypeople’ groups. The findings showed that non-aesthetic categories (e.g., knowledge about the mental illness of an artist) were related to artwork perception and support a holistic and dynamic approach to aesthetic emotions.
Article
Full-text available
Art reception is a complex process influenced by many factors, both internal and external. A review of the literature shows that knowledge about the artist, including their mental health, has an impact on the general assessment of their artwork. The purpose of this research was to examine the relationship between knowledge about the artist’s mental illness and the perception of the artwork. We focused on the subjective emotional experience and general assessment of ten specific pictures painted by patients diagnosed with schizophrenia. The research followed four cohorts (two groups divided into two subgroups—art experts and laypeople) of students for over a month. The results revealed significant differences between the two general groups as well as between the ‘expert’ and ‘laypeople’ groups. The findings showed that non-aesthetic categories (e.g., knowledge about the mental illness of an artist) were related to artwork perception and support a holistic and dynamic approach to aesthetic emotions.
Article
The fear of stigmatization by nonmilitary community members has been identified as a significant barrier to care for military members seeking mental health services. Research exploring the constructs that contribute to the stigmatizing views of military-specific mental health issues is absent from current literature. This study examined the predictive value of just world beliefs on specific constructs of stigmatizing attitudes (i.e., mental health ideology, social restriction, benevolence) toward individuals with combat-related posttraumatic stress disorder. The findings provide guidance regarding the development of antistigma interventions and educational campaigns that may reduce levels of stigmatization by community members, with the long-term goal of diminishing military members' fear of community stigmatization as a barrier to seeking mental health services.
Chapter
This chapter explores the construct of stigma and the multiple ways it manifests itself in the work and life experiences of individuals with autism as well as their families. A formal diagnosis of autism may lead to a person experiencing stigma. Individuals who have not been formally diagnosed with ASD may also be stigmatized if they display characteristics of autism. The stigma of individuals with ASD is unique from the stigma felt by individuals with other disabilities. This is because autism is considered an invisible disability. The families of individuals with autism may also experience stigmatization. Individuals with autism may be stigmatized in many phases of their employment.
Article
Full-text available
Introduction: Stigma is associated with poor prognosis of illness and reduced help-seeking behavior, self-esteem and treatment compliance. The aims of this study were to study the reliability and construct validity of the King's et al Stigma Scale, and its association with Illness and Help-Seeking Behaviors scale (IHSBS) scores. Material and methods: One hundred and forty mental health patients filled out the Stigma scale and the Illness and Help-Seeking Behaviors scale. The exploratory factor analysis of the stigma scale was performed, and its reliability studied. The correlation analysis was used and mean differences in Stigma Scale scores among IHSBS groups were explored. Results: The exploratory factor analysis indicated four factors (F): F1-Disclosure, F2-Discrimination, F3-Acceptance and F4-Personal Growth, which showed acceptable/good internal consistency (α from 0.70 to 0.91). Help-seeking behaviors were not associated with stigma. The levels of Discrimination were high in the group with global high-IHSB and in patients with medium/high illness behavior (IB) and health-related worries (HW). Additionally, Disclosure and overall stigma levels were higher in groups with high-HW and with medium-IB scores (when compared with the group with low-IB). The group with low-IB also had lower levels of Acceptance and Personal Growth when compared with the groups with medium-IB and high-IB, respectively. Conclusion: The Stigma Scale (27 items) is a valid, reliable instrument and useful tool to assess stigma in mental health patients.
Article
Background: Research has shown that receiving a psychiatric diagnosis can have both positive and negative consequences for people. The way in which diagnoses are imparted is an under-researched area and may play an important role in reducing stigma and aiding recovery. Aims: The aim of the present study was to get an in-depth understanding of service users’ experience of receiving a diagnosis of bipolar disorder. Methods: Nine service users recently diagnosed with bipolar disorder were interviewed using a semi-structured interview schedule designed to elicit information regarding the positive and negative aspects of receiving their diagnosis. All transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Findings: The findings can be described in terms of three master themes: 1. “Perceived fit between diagnosis and lived experience”, 2. “Evaluating the utility of carrying the diagnostic label” and 3. “The role of diagnosis in searching for solutions to one’s difficulties”. Conclusion: This study draws attention to the importance of evaluating the fit between diagnosis and personal experiences and to the relevance of perceived stigma. The findings also highlight the significance of the client–clinician relationship in establishing fit and instilling hope, which has implications for the acceptance of the diagnosis and engagement with services.
Thesis
Background: Empirical research suggests that shame is a particularly painful emotion that is linked to psychopathology, in particular depression. Shame is considered the affect associated with attacks on the self Given that schizophrenia represents an attack on the self, it was postulated that levels of shame are likely to be high in individuals diagnosed with schizophrenia. The study aimed to examine the relationship between shame and depression in schizophrenia. Method: A total of sixty participants were involved in the study. The experimental group consisted of twenty individuals with a diagnosis of schizophrenia. Two control groups were used. Firstly, in an attempt to control for mental illness and to understand the relationship between depression and shame, twenty individuals who presented to psychiatric services with symptoms of depression acted as a psychiatric control group. Secondly, in an attempt to control for chronic illness, twenty out-patients with a diagnosis of rheumatoid arthritis participated. The participants completed a Stroop task to measure attentional biases to shame words, constructed by the experimenter. This was followed by a series of self-report questionnaires measuring levels of shame and guilt, depression, suicidal ideation, insight and recovery style from an illness. Results: The main findings were: There were no group differences in attentional bias to shame words. The groups differed on measures of shame and guilt. The experimental group and the psychiatric control group had higher levels of global shame. Schizophrenia was also associated with lower levels of trait shame. The high levels of global shame in schizophrenia distinguished those who were depressed from those who were not depressed. Differences in shame between the groups was not due to differences in levels of depression between the groups. Regression analyses suggested that compared with the psychiatric control group, global shame has a greater association with depression in the experimental group. This supports the importance of shame in schizophrenia as speculated in the Introduction. The findings were discussed in relation to the existing literature, their clinical implications and directions for future.
Article
This study adapts and validates a scale designed to measure Attitudes Toward Mentally Disordered Offenders (ATMDO). It is thought that by monitoring and subsequently improving attitudes, negative potentially damaging milieus within criminal justice, forensic mental health, and society in general can be minimized. Participants (N = 364) were recruited via snowball technique and data collected using an online version of the ATMDO. Psychometric properties were assessed. Test-retest and convergent validity was assessed with additional samples A (N = 30) and B (N = 50) respectively. Utilizing a cross-sectional design, differences in ATMDO scores across occupational groups were compared. The ATMDO demonstrates robust internal structure, reliability, and validity. Although ATMDO scores did not differ significantly across occupational groups, some differences were seen at a factorial level. Regression analysis demonstrates the influence of both demographic and occupation-related variables in predicting ATMDO scores. The ATMDO is robust and has clinical utility for comparison of professional groups or institutions, and within recruitment procedures. A model is proposed for the effects of exposure (catalyst factor) and professional certification training (moderating factor).
Article
Full-text available
The city is a unit with various natural and anthropogenic elements. Mainly natural elements undergo various transformations due to human activities, and this has an impact on reducing the city's biodiversity. Important urban refuges can be distinguished in cities, which are represented primarily by green areas, i.e. urban forests, parks, squares, allotments, and home gardens. These areas affect the quality of life of residents, have great ecological and health significance. The article presents the method of nature valorisation in order to identify the diversity of natural values of the city of Tarnów in the context of preserving biodiversity. The studied area was divided into spatial-landscape units, where the main criterion was the coverage of the area by biologically active area. In the valorisation, evaluation criteria were used that relate to natural elements. The assessment uses point bonitation on a scale of 1 point to 3 points. Based on the obtained research results, it was found that the city of Tarnów is diversified in the aspect of natural values. Areas (spatial-landscape units) of high natural value are characterized mainly by urban forests, parks, river valley along with vegetation with little or no buildings. Areas with medium natural values are characterized by the occurrence of tree groups, grassy vegetation as well as areas with allotment gardens and home gardens, as well as the presence of water reservoirs. Areas with low natural values are mainly areas with high building coverage and accompanying greenery as well as synanthropical vegetation. The obtained research results contain important information about the city's natural values, which should be used in further detailed research when formulating indications related to preserving the biodiversity of the studied area. Keywords: natural values, green areas, ecological structure, city
Chapter
Normalization is a technique traditionally used within the context of cognitive behavioural therapy (CBT) based on the idea that the different ways psychopathological or environmental events are viewed and appraised by an individual can differently modulate emotions, behaviours, and underlying psychobiological responses. Normalizing interventions are increasingly used in severe mental diseases (SMDs) including schizophrenia, bipolar disorder, and major depressive disorder and can have a relevant role in achieving adequate clinical outcomes. In the present chapter, an overview on normalization approaches, on their potential clinical use in SMDs, and on related concepts (e.g. psychoeducation, mental health stigmatization, stress-related psychiatric symptoms, decatastrophization, treatment adherence) is provided.
Chapter
Rapid tranquillisation refers to a drug treatment intended to calm down an individual who is supposed to suffer from agitation within a reasonably short time interval. Agitation may be reported by the patient or grossly observable by clinicians (and objectiveness here might be an issue), mainly based on observing activity, which is then compared to a culturally determined range. On one end of the continuum of motor behavioural expression is the extreme sedation and non-response to external stimuli; on the other extreme, there is extreme, uncontrolled agitation that can be assessed through specific rating scales.
Article
Background Despite evidence for high levels of mental health problems in mothers of children with a disability and the potential impact on caring for their child, very little is known about mothers’ experience in accessing professional mental health support. This study aimed to explore mothers’ views and experience on seeking help for their mental health. Methods Semi-structured interviews were conducted with 25 mothers of children with a disability. Thematic analysis was completed. Results Mothers experienced significant barriers when accesing support at the personal, professional and system level. Personal barriers included the need for competency and stigma about mental illness: professional barriers included the lack of discussions about mental health and interpersonal factors that hindered disclosure. System barriers included feeling invisible to the health services, paediatric care focussing on the child rather than the family and limitations to the type of mental health support available. Conclusion Mothers perceive substantial barriers in accessing support for their mental health. It is important that strategies are designed so the importance of mentally healthy mothers is understood and to normalise a need for assistance when you are the mother of a child with additional support needs. Strategies are also needed to encourage mothers to seek help and to assist professionals having discussions about maternal wellbeing. Improvements are also required in the accessibility of service supports.
Article
Religious leaders are often the first recourse for people facing mental health challenges. Efforts have been made to understand faith leaders’ mental health literacy, but little is known about the extent to which faith leaders trust mental health professionals, which likely influences their referral practices. To address this gap, this paper examines faith leaders’ perceptions of mental health professionals using data from interviews with leaders of Christian, Jewish, Buddhist and Sikh communities in Texas and the mid-Atlantic region conducted between 2017 and 2019 (n = 67). Analysis shows that when asked about the extent to which they would trust their members to the care of mental health professionals, faith leaders adopt one of four orientations (1) Unqualified trust; (2) Conditional trust; (3) Distrust and (4) Dismissal. The paper elaborates on each of these four orientations and leaders’ rationales for them, followed by implications for faith leaders and mental health professionals.
Article
Full-text available
Background While it is less common, young onset dementia manifests at a significantly younger age (< 65). Many people with young onset dementia are parents; however, little is known about impact of the condition on children and young adults. A qualitative thematic analysis was conducted to synthesise the literature on the perspectives of children and young adults with a parent living with young onset dementia. Methods Electronic databases were searched in order to identify all peer-reviewed literature in relation to the perspectives of children and young adults with a parent living with young onset dementia. A thematic analysis was conducted on the relevant literature. Results The electronic database search resulted in 15 full texts articles. Four main themes with related subthemes emerged from the thematic analysis. The four main themes were: changing family dynamics; psychological and physical strain; stigma and coping strategies. Conclusion The current synthesis outlines the perspectives of children and young adults with a parent living with young onset dementia. There is a significant lack of research in this area which adds to the stereotypical view of dementia as an older person’s disease. This can lead to children and young adults being impacted by lack of awareness and stigma resulting in significant psychosocial problems. As the number of people living with dementia (including young onset) is set to increase, future research with children and young adults with a parent with young onset dementia is important in order to better support this cohort.
Article
Background : Self-reported data and media suggest youth mental health is declining. To more objectively measure this, we conducted a population-wide investigation of changes in diagnosed point prevalences of anxiety/depression among children and young adults between 1997 and 2017 in Ontario, Canada. Methods : All Ontarians (population approximately 14 million) age 5-25 in each index year were included and grouped as follows: 5-10, 11-15, 16-20, 21-25. As the Canadian medical system is public and universal, all diagnoses can be tracked via billing submissions. The outcome of interest was non-psychotic anxiety/depression diagnosed by any physician in any setting. Using regression analyses, cross-sectional administrative (billing) data for 1997, 2002, 2007, 2012 and 2017 for diagnoses of anxiety/depression were linked to indicators of sex, household income, rurality, and immigrant/refugee status. Outcomes : Point prevalence of anxiety/depression diagnoses increased with age (girls 2•1 to 16•9%, boys 2•9 to 10•6%), particularly from age 11 to 20. Rates, overall, remained stable until 2012 then rose among 11-15 and 16-20 year-olds. This pattern varied by sex. An earlier inverse association with rural residency disappeared by 2017, while immigrant status aligned increasingly with absence of diagnosed anxiety/depression. Lowest household income quintile was associated with higher prevalence of diagnoses. Limitations : Cross-sectional data preclude hypothesising about causes of observed shifts. Conclusion : We found no overall upsurge in youth anxiety/depression, although small increments between 2012 and 2017, and variability with sociodemographic characteristics suggest a possible looming trend and the merit of studying concomitant and potential explanatory shifts in social circumstances.
Article
Full-text available
Recent research shows that the crucial factor determining the rejection of former mental patients is their behavior rather than their stigmantized status. The study reported here, based on a vignette experiment (with a design that varies patient status with the nature of behavior), challenges this conclusion. Like previous research, it indicates that a simple assessment of labelings shows little effect on a social distance scale. However, when a measure of perceived dangerousness of mental patients is introduced, strong labeling effects emerge. Specifically, the data reveal that the lable of "previous hospitalization" fosters high social distance among those who perceive mental patients to be dangerous and low social distance among those who do not see patients as a threat. It appears that past investigators have missed these effects because they have averaged excessively lenient responses with excessively rejecting ones. This suggests that labels play an important role in how former mental patients are p...
Article
Full-text available
Labeling theory posits that people labeled mentally ill experience negative societal reactions. Past research on this question is contradictory, due primarily to methodological problems. This study overcomes some of these problems by having respondents indicate their willingness to interact with a person with a specific mental disorder, or with an identically behaving person with a specific physical disorder. As expected, respondents reject the mentally ill significantly more than identically behaving physically ill persons, as supports labeling theory. Respondents also consider the mentally ill less predictable and to have less positive outcomes than those with physical illness. These beliefs highly correlate with rejection and account for some, but not all, of the effects of label on rejection.
Article
Full-text available
The possible impact of a prime time television film portraying a mentally ill killer was investigated. Groups of college students were shown the film with and without a film trailer reminding viewers that violence is not characteristic of mentally ill persons. A third group viewed a film not about mental illness. Postfilm responses to the Community Attitudes toward the Mentally Ill scale indicated that those who saw the target film expressed significantly less favorable attitudes toward mental illness and community care of mentally ill persons than did those who saw the control film, regardless of whether of not they received the trailer along with the target film. Results support concerns that media depictions add to mental illness stigma and also suggest that corrective information alone may be sufficient to counteract the stigmatizing impact of such audience-involving mass media portrayals.
Article
Full-text available
In two experiments, we examined the perceived controllability and stability of the causes of 10 stigmas. Guided by attribution theory, we also ascertained the affective reactions of pity and anger, helping judgments, and the efficacy of five intervention techniques. In the first study we found that physically based stigmas were perceived as onset-uncontrollable, and elicited pity, no anger, and judgments to help. On the other hand, mental-behavioral stigmas were perceived as onset-controllable, and elicited little pity, much anger, and judgments to neglect. In addition, physically based stigmas were perceived as stable, or irreversible, whereas mental-behavioral stigmas were generally considered unstable, or reversible. The perceived efficacy of disparate interventions was guided in part by beliefs about stigma stability. In the second study we manipulated perceptions of causal controllability. Attributional shifts resulted in changes in affective responses and behavioral judgments. However, attributional alteration was not equally possible for all the stigmas.
Article
Full-text available
The measurement of public attitudes toward the mentally ill has taken on new significance since the introduction of community-based mental health care. Previous attitude scales have been constructed and applied primarily in a professional context. This article discusses the development and application of a new set of four scales explicitly designed to measure community attitudes toward the mentally ill. The scales represent dimensions included in previous instruments, specifically, authoritarianism, benevolence, social restrictiveness, and community mental health ideology, but are expressed in terms of an almost completely new set of items that emphasize community contact with the mentally ill and mental health facilities. Data from a study of community attitudes about neighborhood mental health facilities in Toronto are used to test the internal and external validity of the scales. Results of the analysis provide strong support for the validity of the scales and demonstrate their usefulness as explanatory and predictive variables for studying community response to mental health facilities.
Article
Full-text available
This study investigated what type of information reduces stigmatization of schizophrenia. Subjects were presented with one of six varying descriptions of a hypothetical case in which a target individual had recovered from a mental disorder. Subjects were asked if they knew someone with a mental illness. Those individuals who had no previous contact perceived the mentally ill as dangerous and chose to maintain a greater social distance from them. In general, knowledge of the symptoms associated with the acute phase of schizophrenia created more stigma than the label of schizophrenia alone. In contrast, more information about the target individuals post-treatment living arrangements (i.e., supervised care) reduced negative judgments. Implications for public education and future research are discussed.
Article
Full-text available
The findings from a controlled study of the effect of a public education campaign on community attitudes to mentally ill people are presented. A census of neighbours' attitudes toward mental illness was conducted in two areas before the opening of supported houses for the mentally ill. In one area an educational campaign was conducted. The attitude survey was then repeated in both areas and patients' social contact with neighbours was recorded. Respondents exposed to the didactic component of the campaign showed only a small increase in knowledge about mental illness but there was a lessening of fearful and rejecting attitudes in the experimental area and not in the control area. Neighbours in the experimental area were more likely to make social contact with both staff and patients. It was social contact which was directly associated with improved attitudes rather than education per se. Patients in the experimental area made contact and even friendships with neighbours whereas those in the control area did not. The public education campaign did not lead to significant change in neighbours' knowledge of mental illness. However, their attitudes improved and patients' social integration was enhanced.
Article
Cognitive-behavioral therapy (CBT) in schizophrenia was originally developed to provide additional treatment for residual symptoms, drawing on the principles and intervention strategies previously developed for anxiety and depression. In the 1950s, Aaron Beck1 had already treated a psychotic patient with a cognitive approach, but thereafter the research in this specific area lay dormant for decades. Only after cognitive therapy had been firmly established for depression and anxiety, in the 1990s, did the research into psychological treatments for psychotic conditions gather force—again, with Beck in the forefront. Pharmacologic therapy can leave as many as 60% of psychotic patients with persistent positive and negative symptoms, even when the patients are compliant with their medication instructions.2 Furthermore, medication compliance remains a major problem despite the introduction of modern atypical antipsychotics. Studies have shown treatment discontinuation in an estimated 74% of patients in both outpatient and inpatient settings.3 The evidence for the efficacy of CBT in treating patients with persistent symptoms of schizophrenia has progressed from case studies, case series, and uncontrolled trials to methodologically rigorous, randomized, controlled trials that include patients from both the acute4 and the chronic end of the schizophrenia spectrum.5-7 Subsequent meta-analysis8 and systematic reviews have further strengthened the evidence base. CBT is now recognized as an effective intervention for schizophrenia in clinical guidelines developed in the United States9 and in Europe.10 In spite of the evidence base and absence of side effects, however, the general availability of this treatment approach within community settings is still low.11 This article will examine the procedure of CBT for psychosis, the evidence for its use, and the implications for practicing psychiatrists.
Article
Critics of labeling theory vigorously dispute Scheff's (1966) provocative etiological hypothesis and downplay the importance of factors such as stigma and stereotyping. We propose a modified labeling perspective which claims that even if labeling does not directly produce mental disorder, it can lead to negative outcomes. Our approach asserts that socialization leads individuals to develop a set of beliefs about how most people treat mental patients. When individuals enter treatment, these beliefs take on new meaning. The more patients believe that they will be devalued and discriminated against, the more they feel threatened by interacting with others. They may keep their treatment a secret, try to educate others about their situation, or withdraw from social contacts that they perceive as potentially rejecting. Such strategies can lead to negative consequences for social support networks, jobs, and self-esteem. We test this modified labeling perspective using samples of patients and untreated community residents, and find that both believe that "most people" will reject mental patients. Additionally, patients endorse strategies of secrecy, withdrawal, and education to cope with the threat they perceive. Finally, patients' social support networks are affected by the extent to which they fear rejection and by the coping responses they adopt to deal with their stigmatized status.
Article
The effects of seeking help for problems of disturbed behavior are examined to determine the extent to which attidudes toward an individual exhibiting symptoms of mental illness are predicated on knowledge of the particular help-source that the individual is consulting. The term "help-source" refers to the clergyman, the physician, the psychiatrist, and the mental hospital. A Graeco-Latin Square design, used with 300 respondents, provided a large amount of information from a relatively small number of observations. The findings indicate that individuals described as exhibiting identical behavior are increasingly rejected as they are described as utilizing no help, utilizing a clergyman, a physician, a psychiatrist, or a mental hospital.
Article
This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and social functioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.
Article
As psychiatric facilities move toward a community mental health orientation, it appears vital to understand and measure this new ideological perspective. A valid and reliable 38-item Scale has been developed for this purpose. The Community Mental Health Ideology Scale very effectively discriminates between groups known to be highly oriented to this ideology and random samples of mental health professionals. Other evidence of the Scale's construct validity is presented, and certain correlates of community mental health ideology are described. Further data on the validity of the Scale is required, and additional areas for future research are indicated.
Article
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
Article
Through analysis of data obtained by interviews with female mental patients at a hospital emphasizing short-term care, labeling theory was qualified to include the notion of individual reactions to labels. Some techniques used by mental patients to resist labeling were described. (Author/NQ)
Article
One of the many problems confronted by the ex-mental patient involves the social stigma of mental illness. The stigma of having been a patient has been taken usually to mean that the ex-patient will encounter discrimination, (e.g., in employment opportunities) after discharge from a hospital. Another view holds that such discrimination now does not exist. The present study found, however, that persons identifying themselves as mental patients were refused rooms for rent significantly more often than were persons using no mental illness identification. (French abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The study here reported was completed in 1951. It "represented a concentrated effort to change attitudes toward mental illness and the mentally ill in a single community." Techniques of data collection are described and the theoretical implications of before and after studies are discussed. The unexpected negative findings tend to suggest that "the working principles employed in mental health education may be inadequate and rest on false assumptions." Scales and interview protocols are appended. 95 references. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The focus of this 6-year research summary is on reporting diverse descriptive and experimental studies of "popular concepts of mental illness and how these conceptions vary and change." Also explored are attitudes of mental health specialists and content analyses of mass media. It was noted that the public is uninformed rather than misinformed and that emotional acceptance of mental health messages still awaits development of anxiety reducing, nontechnical terminology. The 73 page appendix includes questionnaires and semantic differential ratings. (15 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Reports 2 studies measuring the impact upon 30 male inpatients and 29 male outpatients of believing others have become aware of their psychiatric history. Ss thought the interest was in determining if another person would behave the same toward mental patients and controls. 1/2 the Ss were told the other person knew they were patients and the remainder that he believed them to be nonpatients. Believing others were aware of their status caused Ss to feel less appreciated, to find a task more difficult, and to perform more poorly, and they were perceived as more tense, anxious, and poorly adjusted by an O. (20 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The 1st and 2nd editions of this book (1966, 1984) presented a sociological theory of mental disorder (MD). Seeing MD from the point of view of a single discipline, the theory was 1-dimensional. Since then, there have been substantial advances in the biology, psychology, and even in the sociology of MD. What is now most needed is an interdisciplinary approach, one that would integrate the disparate viewpoints and findings of the relevant disciplines. Given the need for consilience (i.e., the interlocking of frameworks from the relevant disciplines), is there any point in resurrecting labeling theory, yet another 1-dimensional approach to the complex problem of MD? The author's decision that labeling theory still has value was based on the following ideas. First, while waiting for consilient approaches to be developed, headways can still be made with 1- or 2-dimensional approaches. A 2nd idea is that biopsychiatry, the dominant force in the field, like all disciplines, accentuates the positive. Labeling theory can be considered to be a countertheory, critical of the weakest points in the dominant theory, and focusing on issues that it neglects. This edition attempts to provide a clear statement of a sociological approach to MD and integrate it with other approaches. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The just world hypothesis states that people have a need to believe that their environment is a just and orderly place where people usually get what they deserve. The present article reviews the experimental research that has been generated by the just world hypothesis. Considerable attention is devoted to an experiment by M. J. Lerner and C. H. Simmons (see record 1966-11086-001). In light of the existing empirical findings, an elaboration of the initial hypothesis is offered, and it is suggested that people's need to believe in a just world affects their reaction to the innocent suffering of others. Finally, recurrent conceptual misinterpretations and methodological errors found in the literature are identified. (73 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A community survey conducted by trained lay interviewers assessed the responses of a quota sample of 154 local residents to the presence of a community mental health service in three wards of Northtown. The respondents were asked about their knowledge of mental health facilities, and about their attitudes to mental illness, using some of the same questions from the MORI survey of 1979. As in previous studies the proportion of people who knew about the facility was low, and much lower than other community and health facilities in the same area. The findings suggest that while there is a degree of greater openness about mental illness, stigma remains pervasive, and has changed little over the past ten years. Knowledge about mental illness is clearly greater and better developed in some respondents than others, and people who were less embarrassed by mental illness were more likely to know someone receiving help and treatment at the community facility.
Article
Labeling theory predicts that psychotic patients who accept the label of mental illness will function less well than those who reject their diagnosis. Accepted psychotherapeutic theory suggests the reverse. Two predictive models were tested. Results supported the central hypothesis of the psychotherapeutic model but not that of the labeling model, although some elements of the latter model were affirmed. Besides acceptance of diagnosis, an internal locus of control appears important for good outcome in psychosis.
Article
A random sample of 1,405 respondents were interviewed to determine their attitudes about mental illness and the extent of tolerance for the mentally ill in terms of their willingness to interact with ex-mental patients. The generally accepted proposition that rejection results when a person is labeled as mentally ill was tested. The data did not support or refute this proposition. They do indicate, however, that there is a trend toward greater acceptance of mental illness and the mentally ill by the public.Eine Zufallsstichprobe von 1405 Probanden wurde interviewt, um ihre Einstellung gegenber seelischer Gesundheit und das Ausma von Toleranz gegenber Geisteskranken gem ihrer Bereitwilligkeit zum Kontakt mit frheren psychiatrischen Patienten zu bestimmen. Die allgemein anerkannte Behauptung, da ein Mensch zurckgewiesen wird, wenn er als geisteskrank bezeichnet worden ist, wurde geprft. Weder sttzten die Ergebnisse die Annahme, noch widerlegten sie sie. Sie wiesen jedoch darauf hin, da bei der ffentlichkeit mehr Bereitschaft besteht, seelische Krankheiten und die seelisch Kranken anzuerkennen.On a interview un chantillon de 1'405 personnes choisies au hasard afin de dterminer leur attitude devant la maladie mentale et leur degr de tolrance l'gard des malades mentaux selon leur volont d'avoir des contacts avec d'anciens patients psychiatriques. On a test le principe gnralement admis selon lequel une personne portant l'tiquette de malade mental serait rejete. Les rsultats n'ont ni confirm ni infirm ce principe. Ils montrent, cependant, qu'il y a une tendance vers une plus grande acceptation de la maladie mentale et du malade mental par le public.
Article
Successful re-integration of former psychiatric patients into the community rests upon social acceptance of such persons. A set of empirical studies is widely interpreted as supporting a high degree of indigenous community rejection of the mentally ill. An examination of the conceptual structure underlying these studies indicates bias in favor of a rejection interpretation; the same data can be interpreted as reflecting a high degree of indigenous acceptance. Analysis of new evidence on social acceptance of the mentally ill within a community dominated by the presence of a state mental hospital indicates that social acceptance of the mentally ill is positively related to exposure to psychiatric processing systems. When differences in measurement within the research design are considered, it appears that exposure to inpatient treatment systems may also lead to greater community optimism about the effectiveness of such systems. The analyses support an incremental pattern of community acceptance of psychiatric patients with the accumulation of exposure over time.
Article
A survey of public attitude was conducted to assess the relationship between the degree of past exposure to the mentally ill and expressed levels of social rejection. Attitudes held toward the mentally ill were found not to be uni-dimensional but rather were comprised of two principle factors: a) rejection in social relationships and b) rejection in situations requiring social responsibility. High, Moderate, and Low groups in level of direct experience with the mentally ill, as measured on a Guttman Scale of personal experience, differed significantly in their degree of social rejection of the mentally ill. The more extensive the personal experience with individuals who required psychiatric hospital care, the more favorable the response in accepting them in social activities and in trusting them in situations of social responsibility. Implications of the research findings, in regard to public education efforts and in regard to community placement of ex-patients, are considered. A survey of public attitude was conducted to assess the relationship between the degree of past exposure to the mentally ill and expressed levels of social rejection. Attitudes held toward the mentally ill were found not to be uni-dimensional but rather were comprised of two principle factors: a) rejection in social relationships and b) rejection in situations requiring social responsibility. High, Moderate, and Low groups in level of direct experience with the mentally ill, as measured on a Guttman Scale of personal experience, differed significantly in their degree of social rejection of the mentally ill. The more extensive the personal experience with individuals who required psychiatric hospital care, the more favorable the response in accepting them in social activities and in trusting them in situations of social responsibility. Implications of the research findings, in regard to public education efforts and in regard to community placement of ex-patients, are considered.
Over the past quarter century, studies anlayzing public attitudes toward the mentally ill have shown a notable divergence of results. This paper considers twenty-two of these studies and attempts to give at least partial explanation of the results in methodological terms: the data-collection method, the population sampled, and, basic to these two, the discipline of the researcher(s). The authors have noted a series of significant relationships. First, results of studies conducted solely by social scientists tend to be negative; where medical personnel are involved the results tend to be positive. Second, closed-ended interviews lead to positive results; open-ended interviews (with vignettes) and closed-ended self-response questionnaires lead to negative results, Third, there is a definite preference on the part of each discipline for a different data-collecting technique. In light of the authors' own resurvey of the Cummings' (1951) Closed Ranks study area, readers are cautioned against interpreting the literature as reflecting tremendous increases in positive attitudes. They are also reminded that attitudes toward the mentally ill are multi-faceted, highly complex, and difficult to evaluate. To better understand them there is need for full awareness of the biases and consequences of methodological factors. Even then, it is likely that the “handful” of social distance items used throughout the studies considered here is inadequate to tap all the dimensions of such feelings.
Article
This study set out to measure the degree of social stigma experienced by discharged mental hospital patients and the extent to which these patients were viewed as a burden by family and friends. Predictors of stigma included social class and demographic factors, posthospital situation, emotional functioning, and use of aftercare facilities. However, available measures were able to account for little of the variance in stigma, and further research is suggested to establish more reliable predictors of mental patient stigmatization.
Article
The relationship between insight and adjustment in schizophrenics was examined. Subjects who scored higher on a paper-and-pencil insight test were rated by hospital staff as better adjusted behaviourally but described themselves as more psychologically distressed than presumably less insightful subjects. Results were discussed in relation to the notion that insight in schizophrenics may intensify subjective distress while conducing to behavioural adaptation.
Article
The contact hypothesis predicts that cooperative interaction with members of a disliked group results in increased liking for those members and generalizes to more positive attitudes toward the group. The authors sought to provide evidence consistent with the hypothesis that contact affects attitude in part by eliciting a more positive portrait of the typical group member. Undergraduates participated in a 1-hr dyadic learning session (scripted cooperative learning, jigsaw cooperative learning, or individual study) with a confederate portrayed as a former mental patient. Students initially expected the confederate to display traits similar to those of a typical former mental patient. After the sessions, initially prejudiced students in the 2 cooperative conditions described the typical mental patient more positively and adopted more positive attitudes and wider latitudes of acceptance toward the group. Connections between intergroup attitudes and impression formation are discussed.
Article
Patients admitted to a psychiatric hospital are confronted by complex and, at times, conflicting models and theories about the cause and treatment of their illness. The patient's understanding and experience of this process are analyzed in this phenomenological study. The need for patients' increased understanding of the purpose and functions of hospitalization is underlined as well as the possible discrepancy between the patients' and the hospital's perspectives on treatment objectives.
Article
This paper explores the role of biomedical efficacy in the rehabilitation of the disabled. Ethnographic data are presented from two studies, one concerned with the prevocationally blind, the other with the institutionalized chronically mentally ill. A comparison of rehabilitation for these two groups suggests that when disabilities do not respond well to biomedical interventions, inconsistent and contradictory interpretations and policies about etiology, therapy, and post-treatment prognosis are likely to flourish. These conflicts may, in turn, increase pressure on rehabilitation institutions to maintain control over their clients. This paper addresses these issues in order to stimulate discussion about the relationship of different kinds of disability to stigma and rehabilitation.
Article
Contact between a 'marked' and an 'unmarked' person will modify the preconceptions each has about the stigmatized condition and about its impact on subsequent social interaction. To test this notion, we used two general population samples - one drawn from Macomb, Illinois (N=153) and the other from Cincinnati, Ohio (N=152) - and found a statistically significant inverse association between contact with mental patients' perceptions of how dangerous they are. We find that increased contact is associated with reduced fear among the old and the young, the educated and the less educated, and males and females. Two explanations are possible: contact reduces fear; or perceptions of danger influence the extent to which individuals interact with the mentally ill. We show that when contact is generated by external circumstances so that pre-existing attitudes are unlikely to have brought it on, contact is associated with reduced fear. We interpret this as consistent with the conceptual scheme offered by Jones et al. The implications are optimistic in that former patients may be able to influence attitudes of those they interact with. We note, however, changing others' attitudes may prove problematic in a number of ways for former patients. Finally we indicate some possible policy implications that our results suggest.
Article
The present study investigated the effects of short-term psychiatric treatment on patients' attitudes toward themselves and toward their spouses. Subjects were 48 females, 16 schizophrenics and 32 neurotics who have hospitalized for an average period of 4–5 weeks. They were administered the RBT at the beginning and at termination of treatment. The results suggest improvement of self-imaging in neurotics, at the actual level. Reduction in the discrepancy between actual and ideal levels, as well as between relation to self and to spouse following treatment, were also noted. Alternative explanations of the findings were briefly discussed.
Article
Reviews public attitudes toward mental illness during the past 25 yrs. The historical antecedents of such attitudes are traced back even further. By 1960 it had been established that mental patients were dimly regarded in the public view. The medical model was more accepted by professionals than people in general, and when the label of mental illness was authoritatively assigned, the person so labeled was stigmatized and shunned. Studies since 1960 indicate that people have become much better informed and disposed toward mental patients than they had been, but a major portion of the population continues to be frightened and repelled by the notion of mental illness. Factors influencing public acceptance of mental illness among individuals and in society are cited. It is noted that at a time when professionals are increasingly rejecting the medical model, the public at large is just beginning to accept it. (93 ref) (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Article
A job applicant (male undergraduate) obtained an interview at 32 manufacturing concerns and in 16 of these places he indicated he had been traveling the preceding 9 months while in the others he said he had been in a mental hospital for the same period of time. Each interview was surreptitiously sound recorded. The recordings were rated for friendliness of interviewer behavior and probability that a job might be available there. A history of mental illness led to a trend for fewer jobs to be offered (4 in the traveling condition and 2 in the mental illness condition), less friendly behavior, and lowered estimated probability of finding a job.
Article
This study examines the influence of labeling on people's reactions to the mentally ill. Although the labeling theory of mental illness has received considerable attention, and public attitudes toward the mentally ill have been extensively studied, there is little evidence that labeling the mentally ill makes a significant difference in how people react to them. This study, a survey experiment, presented case vignettes with systematically varied labels, labelers, and behavior to 864 community college students. Subjects' reactions to the vignettes were measured with a social rejection index. A three-way analysis of variance found that labels and labelers did not produce significant effects. Only the behavior of the mentally ill influenced social rejection. This suggests that a key component of labeling theory may need to be abandoned.
Article
This study investigated the sequential changes in stigma expressed by psychiatric patients and those who share their stigma, and the patterns of convergences and divergences in stigmatizing attitudes held by these two classes of individuals. The experiences of the stigmatized were conceptualized as constituting a career, and a scale designed to assess stigma was administered to first-admission prepatients, inpatients, and postpatients, to their significant others, and to patients who had been rehospitalized. The propensity to stigmatize others of like situation was found to be greatest among inpatients of both first admission and readmission status. Postpatients showed significantly less stigma than did patients in any other phase of the career. Significant others were found to reject the mentally ill less than did patients, and were considerably more stable in their attitudes from phase to phase. Patients and their significant others showed the greatest degree of co-orientation during the postpatient phase of the patient career.
Article
The general concern of this study was to see if an "inmate" in a total institution undergoes a process of self-mortification. The specific concern of this study was to see if self-mortification occurs in mental patients in mental hospitals. A panel sample of 50 patients was used. Self-mortification was interpreted to mean a loss in self-esteem and a loss of social identity. The Rosenberg-Guttman scale of self-esteem was used to measure self-esteem, and the Kuhn-McPartland Twenty Statements Test was used to measure social identity. Findings showed that self-mortification did not occur: there was a slight gain in self-esteem and social identity. Changes in depressive affect, as measured by the Rosenberg-Guttman scale of depressive affect, was used to help validate the findings.
Article
Using a vignette format, components of attitudes towards mental illness were assessed in 413 high school students. The results suggest that while attitude components are generally not highly related, perceived severity of mental illness is positively related to attribution to physical causes, and negatively related to social acceptability. Beliefs in psychosocial etiology and psychosocial treatment correlate positively with optimistic beliefs about prognosis. Belief in the appropriateness of psychosocial treatment is also related to greater social acceptance of the mentally ill, whereas belief in medical treatment is negatively related to social acceptance. Additional data suggest that differences between males and females in their social acceptance of the mentally ill may be related to differences in beliefs about psychosocial etiology and perceived appropriateness of psychosocial treatment.
The stigma associated with mental illness is purported to be a major factor in the resistance of rural residents to mental health services. Through mail questionnaires and personal interviews, the authors gathered data from 3,057 rural residents in six Midwestern states on their attitudes toward and knowledge of mental illness and mental health services. They also examined the relationships between the demographic characteristics of the respondents and their knowledge and attitudes. In contrast to the findings of several other studies, the rural respondents in this study reported positive attitudes about treatment of mental illness. They expressed a high level of awareness of a variety of mental health services and appeared satisfied with those services. The authors discuss possible reasons for the discrepancies between the findings of this study and the studies reporting negative attitudes.
Article
For years, critics and proponents of the labeling theory approach to mental illness have quarreled over society's reactions to the mentally ill. Heretofore, their debate has paid little attention to patients' reactions to labeling. This report reviews 35 studies dealing with hospitalized patients' attitudes toward the label of mental illness and ex-patients' attitudes toward the stigma or effects of hospitalization. Data are interpreted within the context of five propositions derived from labeling theory. None of the propositions met the criteria for acceptance. Labeling theory underestimated the degree to which patients and ex-patients think favorably about mental illness and posthospital experiences. Labeling theory also incorrectly predicted that patients' attitudes would become more unfavorable during hospitalization, as well as after discharge, and would be less favorable than nonpatients' attitudes. However, consistent with the theory, patients were strongly negative toward generalized labels of mental illness. The findings suggest that labeling theory in relation to mental illness needs to be reconsidered.