Is it okay to be not okay? Review of research on attitudes towards people with mental disorders

291

Abstract

The prevalence of mental disorders in the modern world is constantly increasing. Along with it, people's awareness of the specifics of various mental disorders is growing, but it does not lead to a decrease in negative perceptions about their carriers. Most often in modern social sciences, these ideas are investigated in the context of stigmatization of people with mental disorders. This is a complex phenomenon which consists of labelling and stereotyping, exclusion and discrimination, which co-occur in the presence of status differences between groups. Stigmatization influences almost all spheres of life: family life (interpersonal relationships with relatives and friends and participation in their lives), occupational activity (hiring perspectives, relationships with management and colleagues), therapy (relationships with medical staff, treatment quality). Special attention in comprehensive literature is paid to self-stigmatization, which does not only stem from stigmatization, but also enhances its other consequences. The purpose of this review is to summarize and analyze the results of modern foreign studies of stigmatization and self-stigmatization of people with mental disorders, as well as to highlight the consequences of these processes both for people with mental disorders themselves within different levels and in various spheres of life (personal, occupational) and for society in general.

General Information

Keywords: mental disorders; stigmatization; self-stigmatization; stereotypes; discrimination; exclusion

Journal rubric: Social Psychology

Article type: review article

DOI: https://doi.org/10.17759/jmfp.2023120311

Funding. The reported study is an output of a research project implemented as part of the Basic Research Program at the National Research University Higher School of Economics (HSE University).

Acknowledgements. The author is grateful for assistance in improving this work to Agadullina E.R., Sarieva I.R., Prusova I.S.

Received: 13.02.2023

Accepted:

For citation: Romanova M.O. Is it okay to be not okay? Review of research on attitudes towards people with mental disorders [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2023. Vol. 12, no. 3, pp. 115–125. DOI: 10.17759/jmfp.2023120311. (In Russ., аbstr. in Engl.)

References

  1. World Health Organization. Doklad o psikhicheskom zdorov'e v mire [World Mental Health Report] [Elektronnyi resurs]: okhrana psikhicheskogo zdorov'ya preobrazovaniya v interesakh vsekh lyudei. Kratkii obzor. Geneva: World Health Organization, 2022. 32 p. URL: https://mental-health-russia.ru/wp-content/uploads/2022/06/9789240051942-rus.pdf?ysclid=lmgi13bdgs751789751 (Accessed 30.08.2023). (In Russ.).
  2. Psikhicheskie rasstroistva [Mental disorders] [Elektronnyi resurs]. Vsemirnaya Organizatsiya Zdravookhraneniya = World Health Organization. 2022. URL: https://www.who.int/ru/news-room/fact-sheets/detail/mental-disorders (Accessed 30.08.2023). (In Russ.).
  3. Sotsial'naya distantsiya [Social distance] [Elektronnyi resurs]. Levada Center[1]. 2020. URL: https://www.levada.ru/2020/04/20/sotsialnaya-distantsiya-2/ (Accessed 30.08.2023). (In Russ.).
  4. Shizofreniya: boleznennyi strakh [Schizophrenia: morbid fear] [Elektronnyi resurs]. VTsIOM = VСIOM. 2023. URL: https://wciom.ru/analytical-reviews/analiticheskii-obzor/shizofreniya-boleznennyj-strakh- (Accessed 30.08.2023). (In Russ.).
  5. Fiske S.T., Cuddy A.J.C., Glick P., Xu J. A model of (often mixed) stereotype content: Competence and warmth respectively follow from perceived status and competition. Journal of Personality and Social Psychology, 2002. Vol. 82, no. 6, pp. 878—902. DOI:10.1037/0022-3514.82.6.878
  6. Villotti P., Corbière M., Dewa C.S., Fraccaroli F., Sultan-Taïeb H., Zaniboni S., Lecomte T. A serial mediation model of workplace social support on work productivity: the role of self-stigma and job tenure self-efficacy in people with severe mental disorders. Disability and Rehabilitation, 2018. Vol. 40, no. 26, pp. 3113—3119. DOI:10.1080/09638288.2017.1377294
  7. Fujii T., Hanya M., Kishi M., Kondo Y., Cates M.E., Kamei H. An internet-based survey in Japan concerning social distance and stigmatization toward the mentally ill among doctors, nurses, pharmacists, and the general public. Asian Journal of Psychiatry, 2018. Vol. 36, pp. 1—7. DOI:10.1016/j.ajp.2018.05.017
  8. Minas H., Zamzam R., Midin M., Cohen A. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes. BMC Public Health, 2011. Vol. 11, no. 1, article ID 317. 10 p. DOI:10.1186/1471-2458-11-317
  9. Boysen G.A. Exploring the relation between masculinity and mental illness stigma using the stereotype content model and BIAS map. The journal of social psychology, 2017. Vol. 157, no. 1, pp. 98—113. DOI:10.1080/00224545.2016.1181600
  10. Coelho M.S., Pereira H. The Impact of Stigmatizing Experiences and Self-Stigma on Mental Health and Suicidal Behavior: Results from the Community of Portuguese Language Countries. International journal of psychology and psychological therapy, 2022. Vol. 22, no. 2, pp. 185—196. DOI:10.25279/sak.1138655
  11. Chang C.C., Wu T.H., Chen C.Y., Lin C.Y. Comparing Self-stigma Between People With Different Mental Disorders in Taiwan. The Journal of Nervous and Mental Disease, 2016. Vol. 204, no. 7, pp. 547—553. DOI:10.1097/NMD.0000000000000537
  12. Stuber J.P., Rocha A., Christian A., Link B.G. Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public. Psychiatric Services, 2014. Vol. 65, no. 4, pp. 490—497. DOI:10.1176/appi.ps.201300136
  13. Corrigan P.W., Watson A.C. The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice. 2002. Vol. 9, no. 1, pp. 35—53. DOI:10.1093/clipsy.9.1.35
  14. Crandall C.S., Eshleman A., O’Brien L. Social norms and the expression and suppression of prejudice: The struggle for internalization. Journal of Personality and Social Psychology, 2002. Vol. 82, no. 3, pp. 359—378. DOI:10.1037/0022-3514.82.3.359
  15. Morgan A.J., Reavley N.J., Jorm A.F., Beatson R. Discrimination and support from friends and family members experienced by people with mental health problems: findings from an Australian national survey. Social Psychiatry and Psychiatric Epidemiology, 2017. Vol. 52, no. 11, pp. 1395—1403. DOI:10.1007/s00127-017-1391-z
  16. Lauber C., Nordt C., Braunschweig C., Rössler W. Do mental health professionals stigmatize their patients? Acta Psychiatrica Scandinavica, 2006. Vol. 113, no. s429, pp. 51—59. DOI:10.1111/j.1600-0447.2005.00718.x
  17. Dubreucq J., Plasse J., Franck N. Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences. Schizophrenia Bulletin, 2021. Vol. 47, no. 5, pp. 1261—1287. DOI:10.1093/schbul/sbaa181
  18. Boysen G.A., Isaacs R.A., Tretter L., Markowski S. Evidence for blatant dehumanization of mental illness and its relation to stigma. The Journal of Social Psychology, 2020. Vol. 160, no. 3, pp. 346—356. DOI:10.1080/00224545.2019.1671301
  19. Ferrie J., Miller H., Hunter S.C. Psychosocial outcomes of mental illness stigma in children and adolescents: A mixed-methods systematic review. Children and Youth Services Review, 2020. Vol. 113, article ID 104961. 16 p. DOI:10.1016/j.childyouth.2020.104961
  20. University of Washington. GBD Results [Elektronnyi resurs]. IHME: GHDx. 2019. URL: https://vizhub.healthdata.org/gbd-results (Accessed 29.08.2023).
  21. Lasalvia A., Zoppei S., Van Bortel T. et al. Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. The Lancet: A Journal of British and Foreign Medicine, Surgery, Obstetrics, Physiology, Pathology, Pharmacology, Public Health and News, 2013. Vol. 381, no. 9860, pp. 55—62. DOI:10.1016/S0140-6736(12)61379-8
  22. Cremonini V., Pagnucci N., Giacometti F., Rubbi I. Health Care Professionals Attitudes Towards Mental Illness: Observational Study Performed at a Public Health Facility in Northern Italy. Archives of Psychiatric Nursing, 2018. Vol. 32, no. 1, pp. 24—30. DOI:10.1016/j.apnu.2017.09.007
  23. O’Connor C., Brassil M., O'Sullivan S., Seery C., Nearchou F. How does diagnostic labelling affect social responses to people with mental illness? A systematic review of experimental studies using vignette-based designs. Journal of Mental Health, 2022. Vol. 31, no. 1, pp. 115—130. DOI:10.1080/09638237.2021.1922653
  24. Van Beukering I.E., Smits S.J.C., Janssens K.M.E., Bogaers R.I., Joosen M.C.W., Bakker M., van Weeghel J., Brouwers E.P.M. In What Ways Does Health Related Stigma Affect Sustainable Employment and Well-Being at Work? A Systematic Review. Journal of Occupational Rehabilitation, 2022. Vol. 32, no. 3, pp. 365—379. DOI:10.1007/s10926-021-09998-z
  25. Livingston J.D., Boyd J.E. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 2010. Vol. 71, no. 12, pp. 2150—2161. DOI:10.1016/j.socscimed.2010.09.030
  26. Major B., O’Brien L.T. The Social Psychology of Stigma. Annual Review of Psychology, 2005. Vol. 56, no. 1, pp. 393—421. DOI:10.1146/annurev.psych.56.091103.070137
  27. McArdle S., Meade M.M., Burrows E. Service Providers’ Attitudes Toward Athletes With Eating Disorders. Clinical Journal of Sport Medicine, 2018. Vol. 28, no. 1, pp. 51—55. DOI:10.1097/JSM.0000000000000406
  28. Mental health [Elektronnyi resurs]. World Health Organization. 2022. URL: https://www.who.int/health-topics/mental-health (Accessed 29.08.2023).
  29. Hansson L., Jormfeldt H., Svedberg P., Svensson B. Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness? International Journal of Social Psychiatry, 2011. Vol. 59, no. 1, pp. 48—54. DOI:10.1177/0020764011423176
  30. Abi Hana R., Arnous M., Heim E. et al. Mental health stigma at primary health care centres in Lebanon: qualitative study. International Journal of Mental Health Systems, 2022. Vol. 16, no. 1, article ID 23. 14 p. DOI:10.1186/s13033-022-00533-y
  31. Chambers M., Guise V., Välimäki M., Botelho M.A.R., Scott A., Staniuliené V., Zanotti R. Nurses’ attitudes to mental illness: A comparison of a sample of nurses from five European countries. International Journal of Nursing Studies, 2010. Vol. 47, no. 3, pp. 350—362. DOI:10.1016/j.ijnurstu.2009.08.008
  32. Østerud K.L. Mental illness stigma and employer evaluation in hiring: Stereotypes, discrimination and the role of experience. Sociology of Health & Illness, 2023. Vol. 45, no. 1, pp. 90—108. DOI:10.1111/1467-9566.13544
  33. Ottewell N. The association between employers’ mental health literacy and attitudes towards hiring people with mental illness. Work, 2019. Vol. 64, no. 4, pp. 743—753. DOI:10.3233/WOR-193036
  34. Parcesepe A.M., Cabassa L.J. Public Stigma of Mental Illness in the United States: A Systematic Literature Review. Administration and Policy in Mental Health and Mental Health Services Research, 2013. Vol. 40, pp. 384—399. DOI:10.1007/s10488-012-0430-z
  35. Alonso J., Buron A., Rojas-Farreras S. et al. Perceived stigma among individuals with common mental disorders. Journal of Affective Disorders, 2009. Vol. 118, no. 1—3, pp. 180—186. DOI:10.1016/j.jad.2009.02.006
  36. Pescosolido B.A., Martin J.K. The Stigma Complex. Annual review of sociology, 2015. Vol. 41, pp. 87—116. DOI:10.1146/annurev-soc-071312-145702
  37. Almeida B., Samouco A., Grilo F., Pimenta S., Moreira A.M. Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners. International Journal of Social Psychiatry, 2022. Vol. 68, no. 4, pp. 708—717. DOI:10.1177/00207640211002558
  38. Wood L., Birtel M., Alsawy S., Pyle M., Morrison A. Public perceptions of stigma towards people with schizophrenia, depression, and anxiety. Psychiatry Research, 2014. Vol. 220, no. 1—2, pp. 604—608. DOI:10.1016/j.psychres.2014.07.012
  39. Hamilton S., Pinfold V., Cotney J. et al. Qualitative analysis of mental health service users’ reported experiences of discrimination. Acta Psychiatrica Scandinavica, 2016. Vol. 134, no. S446, pp. 14—22. DOI:10.1111/acps.12611
  40. Quintero Johnson J.M., Riles J. “He acted like a crazy person”: Exploring the influence of college students’ recall of stereotypic media representations of mental illness. Psychology of Popular Media Culture, 2018. Vol. 7, no. 2, pp. 146—163. DOI:10.1037/ppm0000121
  41. Reavley N.J., Jorm A.F. Stigmatizing Attitudes towards People with Mental Disorders: Findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian & New Zealand Journal of Psychiatry, 2011. Vol. 45, no. 12, pp. 1086—1093. DOI:10.3109/00048674.2011.621061
  42. Ross C.A., Goldner E.M. Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature. Journal of Psychiatric and Mental Health Nursing, 2009. Vol. 16, no. 6, pp. 558—567. DOI:10.1111/j.1365-2850.2009.01399.x
  43. Sadler M.S., Kaye K.E., Vaughn A.A. Competence and warmth stereotypes prompt mental illness stigma through emotions. Journal of Applied Social Psychology, 2015. Vol. 45, no. 11, pp. 602—612. DOI:10.1111/jasp.12323
  44. Sadler M.S., Meagor E.L., Kaye K.E. Stereotypes of mental disorders differ in competence and warmth. Social Science & Medicine, 2012. Vol. 74, no. 6, pp. 915—922. DOI:10.1016/j.socscimed.2011.12.019
  45. Sönmez B., Karaoğlu K.M. Contents of stereotypes toward mental illness. Current Psychology, 2022. 10 p. DOI:10.1007/s12144-022-03693-9
  46. Cuddy A.J.C., Fiske S.T., Kwan V.S.Y. et al. Stereotype content model across cultures: Towards universal similarities and some differences. British Journal of Social Psychology, 2009. Vol. 48, no. 1, pp. 1—33. DOI:10.1348/014466608X314935
  47. O’Reilly C.L., Paul D., McCahon R., Shankar S., Rosen A., Ramzy T. Stigma and discrimination in individuals with severe and persistent mental illness in an assertive community treatment team: Perceptions of families and healthcare professionals. International Journal of Social Psychiatry, 2019. Vol. 65, no. 7—8, pp. 570—579. DOI:10.1177/0020764019867358
  48. González-Torres M.A., Oraa R., Arístegui M., Fernández-Rivas A., Guimon J. Stigma and discrimination towards people with schizophrenia and their family members. Social Psychiatry and Psychiatric Epidemiology, 2007. Vol. 42, no. 1, pp. 14—23. DOI:10.1007/s00127-006-0126-3
  49. Yang L.H., Wong L.Y., Grivel M.M., Hasin D.S. Stigma and substance use disorders: an international phenomenon. Current Opinion in Psychiatry, 2017. Vol. 30, no. 5, pp. 378—388. DOI:10.1097/YCO.0000000000000351
  50. Husain M.O., Zehra S.S., Umer M. et al. Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan. BJPsych Open, 2020. Vol. 6, no. 5, article ID e81. 6 p. DOI:10.1192/bjo.2020.66
  51. Vaccari P., Ramírez-Vielma R., Saldivia S., Cova F., Vielma-Aguilera A., Victoriano V., Ulloa-Vidal N., Grandón P. Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile. International Journal of Mental Health Systems, 2020. Vol. 14, article ID 6. 11 p. DOI:10.1186/s13033-020-0340-5
  52. Vistorte A.O.R., Ribeiro W.S., Jaen D., Jorge M.R., Evans-Lacko S., Mari J. Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review. The International Journal of Psychiatry in Medicine, 2018. Vol. 53, no. 4, pp. 317—338. DOI:10.1177/0091217418778620
  53. Stuart H. Mental illness and employment discrimination. Current Opinion in Psychiatry, 2006. Vol. 19, no. 5. pp. 522—526. DOI:10.1097/01.yco.0000238482.27270.5d
  54. Brohan E., Henderson C., Wheat K., Malcolm E., Clement S., Barley E.A., Slade M., Thornicroft G. Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace. BMC Psychiatry, 2012. Vol. 12, no. 1, article ID 11. 14 p. DOI:10.1186/1471-244X-12-11
  55. Teachman B.A., Wilson J.G., Komarovskaya I. Implicit and Explicit Stigma of Mental Illness in Diagnosed and Healthy Samples. Journal of Social and Clinical Psychology, 2006. Vol. 25, no. 1, pp. 75—95. DOI:10.1521/jscp.2006.25.1.75
  56. Tanriverdi D., Kaplan V., Bilgin S., Demir H. The comparison of internalized stigmatization levels of patients with different mental disorders. Journal of Substance Use, 2020. Vol. 25, no. 3, pp. 251—257. DOI:10.1080/14659891.2019.1675790
  57. Corrigan P.W., Bink A.B., Fokuo J.K., Schmidt A. The public stigma of mental illness means a difference between you and me. Psychiatry Research, 2015. Vol. 226, no. 1, pp. 186—191. DOI:10.1016/j.psychres.2014.12.047
  58. Hipes C., Lucas J., Phelan J.C., White R.C. The stigma of mental illness in the labor market. Social Science Research, 2016. Vol. 56, pp. 16—25. DOI:10.1016/j.ssresearch.2015.12.001
  59. Krupa T., Kirsh B., Cockburn L., Gewurtz R. Understanding the stigma of mental illness in employment. Work, 2009. Vol. 33, no. 4, pp. 413—425. DOI:10.3233/WOR-2009-0890
  60. Corrigan P.W., Bink A.B., Schmidt A., Jones N., Rüsch N. What is the impact of self-stigma? Loss of self-respect and the “why try” effect. Journal of Mental Health, 2016. Vol. 25, no. 1, pp. 10—15. DOI:10.3109/09638237.2015.1021902
  61. Russinova Z., Griffinb S., Blocha P., Wewiorskic N.J., Rosoklijad I. Workplace prejudice and discrimination toward individuals with mental illnesses. Journal of Vocational Rehabilitation, 2011. Vol. 35, no. 3, pp. 227—241. DOI:10.3233/JVR-2011-0574

Information About the Authors

Marina O. Romanova, Research assistant in Laboratory for Psychology of Social Inequality, HSE University, Moscow, Russia, ORCID: https://orcid.org/0000-0002-5240-407X, e-mail: moromanova@hse.ru

Metrics

Views

Total: 283
Previous month: 29
Current month: 5

Downloads

Total: 291
Previous month: 10
Current month: 3