Sunday, September 19, 2010

Do mental health messages actually increase the stigma of mental illness?

From the Orlando Sentinel:

The message that “mental illness is just a disease” isn’t reducing stigma. It’s actually making the stigma worse.

That’s the conclusion of researchers who examined the attitudes people hold about schizophrenia, depression, and substance abuse over a ten year period.

Though more people now believe that illnesses like schizophrenia and depression are caused by chemical imbalances in the brain, they are not more willing to be live near or work next to people with a mental illness, sociologists published this week in the American Journal of Psychiatry.

The researchers compared surveys of about 1700 people from 1996 and 2006 about mental health attitudes.

Survey-takers read a vignette about someone with either schizophrenia, depression, or alcohol dependence. They were asked how likely it was that the person was experiencing a “mental illness” as opposed to “the normal ups and downs of life”.

They were also asked to pick the possible causes of the person’s behavior: “a genetic or inherited problem”, “a chemical imbalance in the brain”, “his or her own bad character”, and/or “the way he or she was raised.”

In 2006, 80 percent of people chose answers that reflected a biological basis of depression, up from 67 percent in 1996; 86 percent thought schizophrenia was inheritable, up from 76 percent.

But spending time with the character in the vignette was a different story. Survey-takers were asked how willing they’d be to 1) work closely with them on a job; 2) live next door; 3) spend an evening socializing; 4) marry into the family; and 5) be their friend. They also answered whether they thought the person might be violent.

More people believe that schizophrenics would act violently and fewer would be willing to be in close proximity, the authors found. The percent of people unwilling to live next to someone with schizophrenia rose 11 percentage points (from 34 to 45 percent) and rose between 4 to 6 percentage points in the other categories. However, fewer people were unwilling to spend time with people with depression.

Many people hold inaccurate stereotypes about schizophrenics and people with other mental illnesses, like they they are more violent, according to sociologist Bernice Pescosolido at Indiana University, one of the study’s authors. But that’s usually only true if they are also abusing drugs and alcohol, said Pescosolido.

“They incorrectly assume a set of characteristics to those people that are not accurate, because we have images from movies and the media,” said Pescosolido.

Because the genetic explanation of mental illness implies the illness can’t be changed, people might not want to marry into a family with mental disorders, she said. About half of respondents would be unwilling to have someone with depression marry into the family and 69 percent would be unwilling to have a schizophrenic marry into the family.

One reason the public attitude toward mental health matters because it affects whether people with illnesses feel comfortable disclosing them. Even though 47 percent of people don’t want to work with some with depression and 62 percent wouldn’t want to work closely with someone with schizophrenia, the irony is that “they probably do work next to someone with a mental illness,” said Pescosolido.

She thinks the public health messages haven’t been helping reduce stigma either. Instead of emphasizing how different people with mental disorders are, especially when the scientific field has many open questions, she said messages should acknowledge that everyone struggles with ups and downs.

“I think if we flip it on its head and say that everyone has some issues we’re grappling with, it puts us together in a common pool even though we know there are differences in everybody,” she said. “Everybody has something.”