Stigmatization Against Mental Illness: All Disorders Are Not Stigmatized Equally
A Knowledge Translation Piece by Bryce J. M. Bogie
If someone has a problem with their vision, they see an optometrist or an ophthalmologist. If someone has a problem with their mental health, they see a psychologist or a psychiatrist. In both examples, a patient is simply trying to improve their health by receiving treatment from a trained professional. So why is it that only the patient with mentally-related health concerns experiences stigmatization from society? This issue — the stigmatization against mental illness — has been a pervasive problem in society for many decades. For example, patients with a diagnosis of mental illness, psychology and psychiatry as scientific and medical specializations, and mental health professionals themselves are persistently disparaged and stigmatized against because of their connection to the study and treatment of mental illness. In an attempt to reduce society’s stigma against individuals diagnosed with a mental illness, many anti-stigma interventions have been developed and implemented over the past decade. Although these have produced some positive results, stigmatization remains high. For example, recent international surveys have demonstrated that, over the past decade, society’s stigmatization against individuals diagnosed with a mental illness has generally not changed significantly, and for some disorders — such as schizophrenia — it has actually gotten worse. Considering the negative impact that stigma has on individuals with a mental illness, research continues to investigate ways of improving society’s misperceptions of mental illness.
Researchers studying stigmatization are typically interested in investigating the effects of society’s stereotyping, prejudice and discrimination against the mentally ill. One way to investigate these complex sociological phenomena is to study the subjective perspectives and experiences, or “personal stigma,” of an individual diagnosed with a mental illness. This is accomplished by separating “personal stigma” into four components: perceived stigma (one’s beliefs about society’s stigmatization of their illness), experienced stigma (one’s first-hand experiences of discrimination on the basis of their illness), self-stigma (one’s internalization, or acceptance, of society’s stigmatizing views of their illness) and the psychosocial impact of stigma (the effects of stigma on quality of life, relationships etc.) Because different mental disorders are characterized by different symptoms, it is conceivable that stigmatization would have a different impact on the “personal stigma” of individuals diagnosed with different disorders. With this in mind, the current study (Świtaj et al., 2016) sought to identify specific variables associated with “personal stigma” in two clinical populations: schizophrenia and affective (i.e., mood) disorders.
What did the researchers do?
The researchers recruited individuals with a diagnosis of schizophrenia, bipolar disorder and recurrent depressive disorder who were currently receiving psychiatric treatment. Participants diagnosed with schizophrenia constituted the “Schizophrenia Group,” while participants with bipolar disorder and recurrent depressive disorder constituted the “Affective Disorders Group.” All participants completed the Inventory of Stigmatizing Experiences questionnaire. This questionnaire assesses how intensely stigma has affected participants on a number of psychosocial variable. It also evaluates the other dimensions of “personal stigma” (perceived, experienced and self-stigma).
What did the researchers find?
The researchers reported that the factors associated with the greatest psychosocial impact of stigma for both groups were: a diagnosis of schizophrenia, current inpatient treatment, experienced stigma and self-stigma. However, when the researchers analyzed factors within each group separately, they found that self-stigma had a significantly greater impact in the Schizophrenia Group, and that current inpatient treatment and experienced stigma had a significantly greater impact in the Affective Disorders Group. Finally, the psychosocial impact of stigma was found to be completely unrelated to symptom severity and illness duration; therefore, differences in the psychosocial impact of stigma are not caused by difference in the severity or nature of the patient’s psychiatric symptoms.
Important take-away points from this research:
These researchers showed that all mental illnesses are not stigmatized equally. The psychosocial impact of stigma clearly varies with diagnosis, and this must be considered when addressing the issue of stigmatization against mental illness. For example, these results can be used to develop interventions aimed at educating and urging society not to group all mental disorders under the umbrella term, “mental illness.” Doing so encourages the idea that all people diagnosed with a mental illness are “mentally ill,” thereby stereotyping everyone into one group. This ultimately increases the public’s misconceptions about the nature of different mental disorders, perpetuating the widespread stigma of mental illness.
The findings from this research highlight the need for anti-stigma programs that target the specific stigma-related factors affecting each unique disorder, rather than an all-encompassing intervention aimed at reducing stigma against “mental illness.”
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Sources:
Świtaj, P., Chrostek, A., Grygiel, P., Wciórka, J., & Anczewska, M. (2016). Exploring factors associated with the psychosocial impact of stigma among people with schizophrenia or affective disorders. Community Mental Health Journal, 52(3), 370–378.
