Goffman (Stigma: Notes on the management of spoiled identity, Prentice-Hall Inc., Englewood Cliffs, NH, 1963) distinguished stigmatized groups as discredited (with relatively obvious marks such as people of color or gender) or discreditable (without obvious marks, causing stigma to be largely hidden). Like gay men and lesbians, people with various mental illnesses can opt to stay in the closet about these conditions in order to avoid corresponding prejudice and discrimination. In this study, we completed semi-structured interviews with 13 gay men and lesbians in order to better understand the personally perceived consequences that guide the coming out process. This information would, in turn, help us to better comprehend the process of coming out for people with mental illnesses. Interview participants identified specific benefits and costs. Benefits that promote disclosure include acceptance, community, and comfort and happiness. Costs that diminish coming out decisions include shame and conformity as well as harm and discrimination. We then postulated how these consequences might manifest themselves in the disclosure process of people with serious mental illnesses. Finally, implications for stigma management and change were considered.

In Our Own Voice (IOOV) is a 90-min anti-stigma program that comprises face-to-face stories of challenges of mental illness and hopes and dreams commensurate with recovery. We pared down IOOV to a 30-min version, using information from two focus groups. In this study, effects of 90- versus 30-min IOOV are contrasted with 30 min of education. Two hundred research participants were randomly assigned to one of these three conditions and completed a measure of stigmatizing perceptions and recollections. People in the education group remembered more negatives than the two IOOV groups. To control for overall response rate, a difference ratio was determined (difference in positive and negative recollection divided by overall recollections). Results showed the two IOOV conditions had significantly better ratios than education. These findings suggest the 30 min version of IOOV is as effective as the 90 min standard.

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