Stigma is one of the most important problems encountered by individuals with severe mental illness.
Updated March 2011
SUMMARY: Stigma is one of the most important problems encountered by individuals with severe psychiatric disorders. It lowers self-esteem, contributes to disrupted family relationships, and adversely affects the ability to socialize, obtain housing, and become employed. In December 1999, the Surgeon General’s Report on Mental Health called stigma "powerful and pervasive," and the Secretary of Health and Human Services added: "Fear and stigma persist, resulting in lost opportunities for individuals to seek treatment and improve or recover."
Recent studies have demonstrated that stigma against people with mental illnesses has increased over the past half century and is still increasing. Multiple studies have also shown that the major cause of this stigma is the perception that some individuals with mental illnesses are dangerous. Given this fact, it seems self-evident that stigma will not be decreased until we decrease violent behavior committed by mentally ill persons, and this can only be done by ensuring that they receive treatment.
Thus, campaigns to decrease stigma by simply trying to educate people will not work. The current situation finds an average commuter riding a bus to work, facing an anti-stigma poster proclaiming that “mentally ill persons make good neighbors,” and simultaneously reading a newspaper detailing the most recent violent act committed by a mentally ill person.
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I. Stigma against mentally ill persons is increasing
- In 2010, Pescosolido et al. assessed stigma against mentally ill persons using a 2006 survey that had been done similarly to a survey in 1996. They reported that stigma had increased during that 11-year period and that “significantly more respondents in the 2006 survey than the 1996 survey reported an unwillingness to have someone with schizophrenia as a neighbor. . . . Our most striking finding is that stigma among the American public appears to be surprisingly fixed, even in the face of anticipated advances in public knowledge.”
Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry 2010;167:1321–1330.
- Previously, these same researchers had compared the public perception of stigma in 1996 compared to a similar survey carried out in 1950. They reported that, despite an increased understanding of the causes of mental illness in 1996, stigma had increased. This finding was also reflected in the 1999 Surgeon General’s report on mental health: “Stigma in some ways intensified over the past 40 years even though understanding improved.”
Phelan JC, Link BG, Stueve A, Pescosolido BA. Public conceptions of mental illness in 1950 and 1996: what is mental illness and is it to be feared? Journal of Health and Social Behavior 2000;41:188–207.
US Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
II. Violence is the major cause of this stigma
- In 2008, a Harris poll reported that a majority of the public believes that violent behavior is a symptom of schizophrenia, and “roughly one in four Americans say they would feel uncomfortable around adults who have been treated for schizophrenia.”
Schizophrenics battle stigma, myths in addition to disease. USA Today, June 8, 2008.
- In 1999, a man with schizophrenia killed two people in a library in Salt Lake City. According to a newspaper account, within hours Valley Mental Health began getting calls from frightened clients. “Clients were just sobbing,” said Connie Hines, public relations director for Valley Mental Health. They were afraid, she said, that the public would want to retaliate against them and that whatever progress had been made in the de-stigmatization of mental health had been set back years by the shooting.
Jarvik E. Mental health clients fear growing stigma. The Deseret News [Salt Lake City, Utah], April 24, 1999.
- In 1999, a study reported that 61 percent of adults believed that an individual with schizophrenia was “very likely” (13 percent) or “somewhat likely” (48 percent) to do “something violent to others.”
Pescosolido BA, Monahan J, Link BG et al. The public’s view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health 1999;89:1339–1345.
- In 1996, a study of American university students reported that reading a newspaper article reporting a violent crime committed by a mental patient led to increased “negative attitudes toward people with mental illness.”
Thornton JA, Wahl OF. Impact of a newspaper article on attitudes toward mental illness. Journal of Community Psychology 1996;24:17–24.
- In 1995, a study in Germany reported that, following two attempts on the lives of prominent politicians by mentally ill individuals in 1990, “there occurred a marked increase in social distance towards the mentally ill among the German public.” Although this social distance slowly decreased over the following two years, “it had not yet completely returned to its initial level by the end of 1992.”
Angermeyer MC, Matschinger H. Violent attacks on public figures by persons suffering from psychiatric disorders: their effect on the social distance towards the mentally ill. European Archives of Psychiatry and Clinical Neuroscience 1995;245:159–164.
- A 1994 survey of Utah residents reported that 38 percent agreed that “people with mental illness are more dangerous than the rest of society.”
Fraser ME. Educating the public about mental illness: what will it take to get the job done? Innovations and Research 1994;3:29–31.
- A 1993 survey reported that more than half of people agreed with the statement that “those with mental disorders are more likely to commit acts of violence.”
Clements M. What we say about mental illness. Parade Magazine, October 31, 1993.
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