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Stigmatised attitudes towards the ‘stressed’ or ‘ill’ models of mental illness
- Authors:
- LUTY Jason, EASOW Joby Maducolil, MENDES Vania
- Journal article citation:
- Psychiatrist (The), 35(10), October 2011, pp.370-373.
- Publisher:
- Royal College of Psychiatrists
Tackling discrimination, stigma and inequalities in mental health is a major objective of the UK government. This aim of this research was to determine whether there was any difference in stigmatised attitudes towards a fictitious person with a mental illness who was presented either as having a biological illness or a disorder that arose from psychosocial stress to two randomised representative panels of the general public. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes. The two groups were presented with slightly different vignettes describing “Tim” and then asked to complete the questionnaire. Overall, 187 individuals returned their questionnaires (74% response rate). The mean AMIQ stigma score for the ‘ill’ group was 1.4; for the ‘stress’ group was 0.5. The authors conclude that there was no statistical or practical difference in the stigmatised attitudes towards a person with mental illness regardless of whether they were presented as biologically ill or as having an illness that was a response to psychosocial stress. Some limitations of the study are noted: the self-selecting participants, the possibility of social desirability bias and whether the values expressed would be enduring.
The public stigma of mental illness and drug addiction: findings from a stratified random sample
- Authors:
- CORRIGAN Patrick W., KUWABARA Sachiko A., O'SHAUGHNESSY John
- Journal article citation:
- Journal of Social Work, 9(2), April 2009, pp.139-147.
- Publisher:
- Sage
Previous research has shown that people labelled with drug addiction are viewed as more blameworthy and dangerous compared to individuals labelled with mental illness who, in turn, are viewed more harshly than those with physical disabilities. Endorsement of such stereotypes often lead to less helping behaviour and more avoidance of people with drug addiction compared to those with mental illness. In this study, attribution and dangerousness models are tested on a stratified random sample of the US population. The sample was recruited from a national online research panel (N = 815). Research participants read a vignette about a person with one of the three health conditions (mental illness, drug addiction, or physically handicapped in a wheelchair) and were asked to complete items representing attribution and dangerousness judgments about the person. Results found addiction to drugs was seen as more blameworthy and dangerous compared to mental illness.
Stigma and coercion in the context of outpatient treatment for people with mental illnesses
- Authors:
- LINK Bruce, CASTILLE Dorothy M., STUBER Jennifer
- Journal article citation:
- Social Science and Medicine, 67(3), August 2008, pp.409-419.
- Publisher:
- Elsevier
The policies and institutional practices developed to care for people with mental illnesses have critical relevance to the production of stigma as they can induce, minimise or even block it. This article addresses two prominent and competing perspectives on the consequences for stigma of using coercion to insure compliance with outpatient mental health services. The Coercion to Beneficial Treatment perspective holds that the judicious use of coercion facilitates treatment engagement, aids in symptom reduction and, in the long run, reduces stigma. The Coercion to Detrimental Stigma perspective claims that coercion increases stigmatisation resulting in low self-esteem, a compromised quality of life and increased symptoms. The authors examine these differing perspectives in a longitudinal study of 184 people with serious mental illness, 76 of whom were court ordered to outpatient treatment and 108 who were not. They were recruited from treatment facilities in the New York boroughs of the Bronx and Queens. They measure coercion in two ways: by assignment to mandated outpatient treatment and with a measure of self-reported coercion. The longitudinal analysis allows stringent tests of predictions derived from each perspective and finds evidence to support certain aspects of each. Consistent with the Coercion to Beneficial Treatment perspective, they found that improvements in symptoms lead to improvements in social functioning. Also consistent with this perspective, assignment to mandated outpatient treatment is associated with better functioning and, at a trend level, to improvements in quality of life. At the same time the Coercion to Detrimental Stigma perspective is supported by findings showing that self-reported coercion increases felt stigma (perceived devaluation–discrimination), erodes quality of life and through stigma leads to lower self-esteem. Future policy needs not only to find ways to insure that people who need treatment receive it, but to achieve such an outcome in a manner that minimises circumstances that induce perceptions of coercion.
Rethinking theoretical approaches to stigma: a Framework Integrating Normative Influences on Stigma
- Authors:
- PESCOSOLIDO Bernice A., at al.
- Journal article citation:
- Social Science and Medicine, 67(3), August 2008, pp.431-440.
- Publisher:
- Elsevier
A resurgence of research and policy efforts on stigma both facilitates and forces a reconsideration of the levels and types of factors that shape reactions to persons with conditions that engender prejudice and discrimination. Focusing on the case of mental illness but drawing from theories and studies of stigma across the social sciences, the authors propose a framework that brings together theoretical insights from micro, meso and macro level research: Framework Integrating Normative Influences on Stigma (FINIS) starts with Goffman's notion that understanding stigma requires a language of social relationships, but acknowledges that individuals do not come to social interaction devoid of affect and motivation. Further, all social interactions take place in a context in which organisations, media and larger cultures structure normative expectations which create the possibility of marking “difference”. Labelling theory, social network theory, the limited capacity model of media influence, the social psychology of prejudice and discrimination, and theories of the welfare state all contribute to an understanding of the complex web of expectations shaping stigma. FINIS offers the potential to build a broad-based scientific foundation based on understanding the effects of stigma on the lives of persons with mental illness, the resources devoted to the organisations and families who care for them, and policies and programs designed to combat stigma. The authors end by discussing the clear implications this framework holds for stigma reduction, even in the face of conflicting results.
Meta-analysis of stigma and mental health
- Authors:
- MAK Winnie W. S., et al
- Journal article citation:
- Social Science and Medicine, 65(2), July 2007, pp.245-261.
- Publisher:
- Elsevier
Recent research has emphasized the adverse effects of stigma on minority groups’ mental health. Governments and service agencies have put much effort into combating stigma against a variety of conditions. Nevertheless, previous empirical research on the stigma–mental health relationship has yielded inconclusive findings, varying from strong negative to zero correlations. Thus, whether stigma is related significantly to mental health is yet to be confirmed. Using meta-analysis, the associations between stigma and mental health from 49 empirical studies were examined across various stigmatized conditions and mental health indices. Possible moderators were also explored. The mean correlation between stigma and average mental health scores corrected for sampling error, unreliability, and other artifacts was −.28 (N=10,567, k=52). No strong moderators were found, yet meaningful patterns were observed. Implications of the results are discussed.
Believe the hype
- Author:
- GRIFFITHS Sandra
- Journal article citation:
- Mental Health Today, May/June 2013, pp.12-13.
- Publisher:
- Pavilion
- Place of publication:
- Hove
An arts festival is finding new ways to engage people from African and Caribbean communities with mental health issues. The Stereo-Hype Festival 2013, a partnership between Mellow an east London mental health programme, and national anti-stigma campaign Time to Change, took place in Newham, east London. It used drama, film, dance, spoken word, art installations to challenge mental health stereotypes within black communities. (Original abstract)
What do African American youth with a mental illness think about help-seeking and psychiatric medication?: Origins of stigmatizing attitudes
- Authors:
- KRANKE Derrick, et al
- Journal article citation:
- Social Work in Mental Health, 10(1), January 2012, pp.53-71.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Stigma greatly impacts African Americans’ underutilisation of mental health treatment. Stigmatising attitudes are attributed to racial mistrust and familial, religious, and cultural beliefs. However, most research on influences of these attitudes has been conducted with adults. Origins among adolescents may be unique because they have different competing influences relative to development. Identifying these influences is crucial to promoting utilization of psychiatric services as well as positive mental health outcomes among youth. This study explored the origin of stigmatising attitudes among 17 African American adolescents, average age 14, with psychiatric disorders. Adolescents reported similar origins of stigmatising attitudes toward mental illness as adults, and also identified peer perceptions and media messages as influences. The authors concluded that the findings highlight the need to develop family psychoeducation programmes that account for familial, racial, cultural, community, and religious influences.
Challenging the stigma of mental illness
- Authors:
- CORRIGAN Patrick, ROE David, TSANG Hector
- Publisher:
- Wiley
- Publication year:
- 2011
- Pagination:
- 224p.
- Place of publication:
- Chichester
The authors seek to provide a practical text grounded in the experience and narratives of those who have struggled with the impact of the stigma of mental illness. They offer strategies for addressing the harmful effects of stigma attached to mental illness. In doing so they consider both major forms of stigma: public stigma, which is prejudice and discrimination endorsed by the general population; and self-stigma, the loss of self-esteem and efficacy that occurs when an individual internalises prejudice and discrimination. The book contains practical worksheets and intervention guidelines to facilitate the implementation of specific anti-stigma approaches. It is aimed at professionals and volunteers working in any capacity to challenge discrimination against mental illness.
Changing the meaning of help: clinical approaches to reducing stigma among suicidal young adults
- Author:
- DOWNS Marilyn F.
- Journal article citation:
- Families in Society, 93(1), January 2012, pp.22-28.
- Publisher:
- The Alliance for Children and Families
Reducing the stigma associated with mental health problems is an important objective of suicide prevention policies. Whilst the main aim of these efforts is to encourage help-seeking, the problem of stigma does not necessarily end when a person crosses the threshold to treatment. Internalised stigma can affect meanings attached to experiencing a problem or needing help, adding to the burden of mental health difficulties, and perceived stigma by others can inhibit positive social connections and intensify social isolation. This article, drawing on cognitive and relational–cultural theories to discuss psychological and interpersonal consequences of mental illness stigma for depressed and suicidal young adults, presents clinical approaches to addressing stigma. These approaches are demonstrated with a case study of a 19-year-old male college student.
Mental health stigma about serious mental illness among MSW students: social contact and attitude
- Authors:
- COVARRUBIAS Irene, HAN Meekyung
- Journal article citation:
- Social Work: A journal of the National Association of Social Workers (NASW), 56(4), October 2011, pp.317-325.
- Publisher:
- Oxford University Press
Stigma is experienced in all cultures, and stigmatic attitudes towards those living with mental illnesses are prevalent among the general US population. This study investigated the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the north western United States. Stigma was examined with relation to the following factors: participants' level of social contact with SMI populations; adherence to stereotypes about SMI populations; belief in the ability to recover from SMI; and the belief that SMI defines an individual's identity. Seventy one surveys with graduate social work students found that a significant number of participants who engaged in friendships with SMI-diagnosed individuals had less desire for social distance from and restrictions toward SMI populations. Participants who indicated that they believed in stereotypes of dangerousness and believed that SMI defines an individual's identity were more likely to express desire for both social distance and restrictions. The authors concluded that schools of social work interested in the reduction of stigma may benefit from using interventions that aim to decrease stereotypes of dangerousness and challenge the belief that identity is connected to SMI diagnosis.