Tuesday, December 21, 2021

Stigma Surrounding Depression Falls, But Not for Other Mental Health Disorders

Public stigma toward people with depression appears to be decreasing, but not toward people with schizophrenia and/or those with alcohol dependence, suggests a report published today in JAMA Network Open. The findings were based on interviews with adults aged 18 and older living in the continental United States.

“Stigma, the prejudice and discrimination attached to devalued conditions, has been consistently cited as a major obstacle to recovery and quality of life among people with psychiatric disorders,” wrote Bernice A. Pescosolido, Ph.D., of Indiana University and colleagues.

To better understand the nature and magnitude of public stigma over two decades for major mental illnesses, the researchers analyzed data from the 1996, 2006, and 2018 U.S. National Stigma Studies, which are part of the General Social Survey. The participants were randomly assigned to one vignette describing a fictitious person with behaviors meeting DSM-4 criteria for schizophrenia, major depression, or alcohol dependence or a control. During face-to-face interviews, the respondents were asked questions about the person described in the vignette, including those listed below:

  • The cause of the behaviors: How likely it is that the person in the vignette is experiencing “a mental illness,” as well as how likely the situation might be caused by “a genetic or inherited problem,” “a chemical imbalance in the brain,” and “his or her own bad character”?
  • Social distance: How willing would you be to have the person described in the vignette work closely with you on a job, live next door, spend an evening socializing, marry into the family, and as a friend? How willing would you be to live near a group home that serves the person described in the vignette?
  • Dangerousness: How likely is it that the person in the vignette would “do something violent toward other people” and/or “do something violent toward him/herself”?

The responses of 4,129 people (average age 45; 55% women) were included in the analysis. The researchers found that from 1996 to 2006, respondents reported increasing beliefs that schizophrenia, depression, and alcohol dependence are caused by genetics or disruptions in the brain. From 2006 to 2018, there was a significant drop in the percentage of respondents who expressed a desire for social distance from people with depression; however, also during this same period, the percentage of respondents reporting it was likely a person with schizophrenia would do something violent to self or others grew, as did those attributing alcohol dependence to “his or her own bad character.”

There were no significant attitudinal differences among respondents on the basis of race, ethnicity, sex, and education level. However, differences were noted between age groups, with those born before World War II and millennials being more progressive.

“First and foremost, the results of this study suggest that public stigma can change … [but] we must be realistic because societies change slowly, and change efforts must be persistent and sustainable,” Pescosolido and colleagues wrote. “[S]trategies to identify factors associated with the decrease in stigma for depression, to address stagnation or regression in other disorders, and to reach beyond current scientific limits are essential to confront mental illness’s contribution to the global burden of disease and improve population health.”

For related information, see the American Journal of Psychiatry article “Sustained Effect of a Brief Video in Reducing Public Stigma Toward Individuals With Psychosis: A Randomized Controlled Trial of Young Adults.”

(Image: iStock/franckreporter)

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