Depression stigma and migration – results of a survey from Germany

Abstract

BackgroundThere are barely any studies focusing on migration in relation to mental illness stigma. We explore present attitudes regarding depression among migrants (either born in Germany or born abroad) and non-migrants in Germany, drawing upon three components of public stigma: stereotypes, emotional reactions and desire for social distance. Furthermore, differences in self-stigma of depression between the two groups are analyzed.MethodsAnalyses are based on a representative telephone survey (N = 2013) in Germany. Respondents were presented with a vignette depicting either someone from Turkey or from Germany affected by depression, followed by questions on stereotypes, emotional reactions and desire for social distance. The (anticipated) self-stigma of depression was also assessed. Analyses of variance tested for differences between migrant and non-migrant respondents, stratified by migrant status in the vignette.ResultsRegarding the depression vignette depicting a non-migrant, there were only few differences between subgroups. However, when presented with a vignette describing someone from Turkey, respondents with migrant background who were foreign-born expressed greater stigmatizing attitudes, e.g. when it comes to stereotypes or desire for social distance. Furthermore, this subsample displayed higher levels of self-stigma of depression, especially regarding the ascription of own responsibility.ConclusionsThe results underline the need to incorporate migration status/ethnicity in stigma research. Differences in attitudes as well as in (anticipated) self-stigma of depression identify foreign-born migrants in Germany as important target groups for tailored anti-stigma interventions, which need to consider diverse cultural backgrounds.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1549-y) contains supplementary material, which is available to authorized users.

Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis

“…There are various definitions of mental illness stigma in the current stigma literature. Recently, the Mental Illness Stigma Framework (MISF) has been proposed (11) emphasising that how stigma is experienced differs depending on the perspective of the general public who often attributes stigma (i.e. stigmatizer) to those who have mental illnesses (i.e.…”

“…stigmatizer) to those who have mental illnesses (i.e. stigmatized) (11). There are also shared perceptions and attributions between stigmatizer and stigmatized (i.e.…”

“…The behavioural mechanisms are named as discrimination such as withholding help, avoidance, segregation or coercion (12). The impact of stigma on individuals` life can be understood in terms of three components: 1) Experienced stigma, referring to the day-to-day experiences of stereotypes, prejudice and discrimination from others, 2) anticipated stigma, the expectation to be a target of a stereotype, prejudice or discrimination, and 3) internalised stigma, which is the application of mental illness stigma to oneself such as believing that they are dangerous to others or they are incompetent (11).…”

“…For instance, in a large scale study representative of the ethnic groups in Singapore, Subramaniam and colleagues found that, those of Indian ethnicity who also had low socio-economic status, perceived individuals with mental illness as more dangerous and unpredictable, and desired more social distance compared to those of Malay and Chinese backgrounds (23). Thus, there is intersectionality in experiences of stigma (11)(12). This perspective emphasises that the consequences of stigma are worse for some racial and/or ethnic groups who have for instance, personal incompetence attributions of mental illness (12) and who also face with other forms of "minority stress" and adversities such as interpersonal and structural discrimination within policies and institutions and low socio-economic background (8)(9)(10).…”

“…To date, there are no prior meta-analysis investigating racial and/or ethnic differences in mental illness stigma. This could be due to the inconsistency in how stigma mechanisms have been defined and measured (11). One implication of this gap in the literature is the lack of information about the evidence base for developing culturally-relevant anti-stigma interventions (24).…”