Public Stigma And Mental Health

Stigma has many definitions, but was originally defined as a mark or attribute that reduces an individual from a whole and usual person to a tainted, discounted one (E. Goffman 1963). Crocker, Major and Steele (1998) suggest that stigma occurs when a person possesses or is believed to possess some attribute or characteristic that conveys a social identity that is devalued in a particular context. Stigma is heavily associated with individuals whom have a mental illness, which significantly impacts their quality of life in a negative fashion, as well as their ability to seek psychological treatment. Stigma exists on a dimension, and can be present in the form of personal or societal (public) stigma. Public stigma is the phenomenon of large social

groups endorsing stereotypes about and acting against a stigmatised group: in this case, people with mental illness (P. W. Corrigan, A. Kerr and L. Knudsen, 2005). The main focus of the paper will be on societal stigma, the reasons for which mentally disabled individuals often find it challenging to seek help and the strategy of interpersonal contact and how this strategy reduces societal stigma.

Social stigma targets a wide category of individuals, such as the person with the mental illness, the person’s family and friends, (Lefley, 1987; Phelan, Bromet and Link, 1998; Thompson and Doll, 1982) and various mental health service organisations (Dichter, 1992; Dickstein and Hinz, 1992; Fink, 1986; Gabbard and Gabbard, 1992; Persaud, 2000), and has been known to impact various groups negatively.

Non-mentally ill individuals tend to attribute negative characteristics such as psychiatric symptoms (talking aloud to oneself), a lack of social skills and an abnormal exterior to all individuals with a mental illness (Corrigan, 2004). The generalisability of these faulty beliefs, attributes and behaviours of those who are able to be categorised in a minority group, are known as stereotypes (Corrigan and Kleinlein, 2005; Major and O’Brien, 2005), which is what initially fuels societal stigma. The most common stereotypes associated with mentally ill individuals include dangerousness, blameworthiness and incompetence (Jones et al., 1984; Rabiner, Wells, Struening and Schmeidler, 1983). The negative beliefs generated from stereotyping often leads to prejudices about those with a mental illness. Prejudices are very judgmental and often negative opinions or attitudes towards a particular minority group with common examples being fear, authoritarianism and benevolence (Brockington, Hall and Levings, 1993). The act of prejudice can lead to discrimination, which causes an individual to perform potentially harmful actions against a minority group, based on the negative attitudes developed during the prejudicial stage. As a result of stereotyping and prejudice, the labelling theory destroys those with a mental illness and acts as a direct barrier to treatment. The labelling theory occurs when members of the social minority group are thought of in a negative manner and are ‘labelled’ with negative adjectives (Scheff, 1984). The labelling theory is as serious as containing the

potential to perpetuate one’s mental illness (Corrigan and Kleinlein, 2005). Prejudice and discrimination all contribute to societal stigma, in that respective order, but it is discrimination, the behavioural form of negative attitudes and beliefs, which ultimately causes the lack of willingness to seek psychological treatment.

Societal stigma is a problematic issue and acts as a barrier to individuals seeking psychological treatment, as members of the public in positions associated with life opportunities, such as work and home life, have developed negative opinions regarding mentally ill people. Social stigma is particularly prevalent in the workforce, as non-mentally ill workers have developed negative stereotypes and have generalised negative attributes such as psychiatric symptoms (talking aloud to oneself), a lack of social skills and an abnormal physical exterior. Unfortunately, workers in the workface tend to attribute these negative stereotypes to all individuals with a mental illness, regardless of the fact whether they truly fit the stereotype or not. One experiment conducted by Farina and Felner (1973) wanted evidence to support a hypothesis, that in a job interview setting, a non-mentally impaired interviewer would show signs of negative stereotyping if the interviewee mentioned they suffered from a mental illness. A male confederate, applied for a job at 32 different business firms, and in 50% of cases, information about the confederate’s mental illness was supplied. In the cases where information about the mental illness was mentioned, interviewers were distant and discouraging. Farina and Felner (1973) as well as Corrigan et al. (2005) concluded that the negative reactions from the interviewers when conversing with a mentally disabled interviewee, may have been due to prejudices such as fear and authoritarianism and believe that fear leads to discriminatory avoidance in the workplace.

Evidence has shown that the labelling theory can have profound impacts on mentally disabled individuals and their decisions to seek treatment options. One of the current barriers in seeking treatment is the labelling theory. Individuals with a mental illness want to escape the labelling that would surface during the diagnosis with a psychologist or psychiatrist. Those with a mental illness want to feel accepted and they don’t want to be thought of as incompetent or dangerous (Corrigan, 2004; Corrigan and Wassell, 2008). Therefore, it is apparent that members of the general public need to stop generalising and perpetuating stereotypes, prejudices. It is also evident that discriminatory behaviour needs to stop in all aspects of life, whether it may be in the workplace or at a public place, like a park. If the negative attributes were to cease, social stigma would indeed stop, and mentally disabled individuals would not feel ashamed to seek psychological help, as they would not be afraid of being associated with incompetence, blameworthiness and dangerousness. Another barrier to sufficient psychological help is the lack of medical resources and services available for the mentally disabled (Desai et al. 2002, Druss and Rosenheck, 1997). Proficient studies have found that the probability of obtaining the same level of insurance benefits for people with a mental illness, versus people without a mental illness is much smaller. If there is not sufficient medical resources available for the mentally ill, they will never feel inclined or comfortable in seeking the appropriate treatment option.

Reducing societal stigma is a priority, as the levels of stigma in society are alarming and unacceptable. The ways in which we approach the problem of societal stigma is of course different in the way we would approach personal stigma. There are three strategies used for decreasing stigma, which are protest, education and interpersonal contact, however, only interpersonal contact will be discussed. Interpersonal contact is defined as the interaction between members of a social minority group, which in this case are individuals with a mental illness, and members not belonging to the particular social minority group. Interpersonal contact aims to reduce social stigma by creating functional relationships between two social groups. It also aims to disconfirm the negative stereotypes and prejudices that may be held by the non-mentally ill. Interpersonal contact has been recognised as an established form of reducing negative stereotypes and prejudice regarding mentally ill individuals for an elongated period (Allport, 1954; Pettigrew and Tropp, 2000). There have been phenomenal findings in many papers, one of which was published by Corrigan et al. (2001), who found that negative attitude declined at a steeper gradient when participants were subjected to interpersonal contact rather than protesting or education. Results were most significant when the mentally disabled individual was able to show his or her partner that the negative stereotypes and prejudices about mental illnesses, which exist in reality, are far from the truth (Reinke et al. 2004). Results even lead to individuals willing to donate money to groups and organisations advocating for mental illness (Corrigan et al. 2002). There are studies, which also support the notion that interpersonal contact has long-term lasting effects in terms of reducing societal stigma.

Societal stigma does exist at many different levels and affects many different groups within the community. It has become a priority to attack the issue of societal stigma through the various strategies. Although there are promising findings amongst the literature for the interpersonal contact strategy, more strategies, which work towards a solution for societal stigma need to be developed in future research. Perhaps it would be sensible to conduct future research for strategies, which target many cultures, as stigma is not only a problem in the Western world, but affects many people all around the world.