Stigma of mental illness, a public health concern

An international study found that despite widespread acceptance that mental illness is a disease that can be effectively treated, a common "backbone" of prejudice exists that unfairly paints people with conditions such as depression and schizophrenia as undesirable for close personal relationships and positions of authority.

This backbone, say the Indiana University sociologists who led the study, spanned the 16 diverse countries examined. While the findings might be discouraging to mental health advocates, the data can be used to reconfigure public health efforts to reduce stigma and to determine important issues for treatment providers to consider.

"If the public understands that mental illnesses are medical problems but still reject individuals with mental illness, then educational campaigns directed toward ensuring inclusion become more salient," the authors wrote in "The 'Backbone' of Stigma: Identifying the Global Core of Public Prejudice Associated With Mental Illness," published online early in a special issue of the American Journal of Public Health.

The researchers analyzed data from the IU-led Stigma in Global Context - Mental Health Study, which talked with 19,508 study participants about customized vignettes. The vignettes portrayed someone suffering either from depression, schizophrenia or, the control group, asthma. The countries represented a diverse range geographically, developmentally and politically, with at least one country on each inhabitable continent.

Even in countries with cultures more accepting of mental illness, the "backbone" of stigma was detected, encompassing issues involving caring for children, marriage, self-harm and holding roles of authority or civic responsibility. The stigma was even stronger toward people with schizophrenia.

Stigma is considered a major obstacle to effective treatment for many Americans who experience these devastating illnesses. It can produce discrimination in employment, housing, medical care and social relationships, and have a negative impact on the quality of life for these individuals and their families and friends.

"The stereotype of all people with mental illness as 'not able' is just wrong. No data supports this," said Bernice Pescosolido, sociology professor in the IU College of Arts and Sciences and an internationally recognized expert in the field of mental health stigma. "With the prevalence of mental health problems being so high, no individuals or families will go untouched by these issues. They need to understand that recovery is not only possible but has been documented."

Pescosolido chairs the international advisory council for Bring Change 2 Mind, a not-for-profit organization established by actress and activist Glenn Close to reduce the prejudice and discrimination associated with mental illness. BC2M was cited in the journal article, along with Mental Health First Aai, an organization that helps people understand and assist others who might be experiencing a mental health crisis.

"Forward-thinking organizations base their work both on community ties and science -- this works best in terms of making change efforts realistic, effective and resonate with individuals, families, providers and policymakers," Pescosolido said. "Hopefully the work of organizations like these can find the support necessary to create personal and institutional social change.