Familiarity With and Social Distance From People Who Have Serious Mental Illness

Corrigan, Patrick W.; Green, Amy; Lundin, Robert; Kubiak, Mary Ann; Penn, David L.

doi:10.1176/appi.ps.52.7.953

Cited by 434 publications

(378 citation statements)

References 47 publications

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“…This finding suggests that the relationship between stigma and utilization may have changed as a result of treatment experiences. Such an explanation is broadly consistent with research on social distance, wherein exposure to the stigmatized context (that is, treatment) can lead to decreases in desired social distance (19). Second, the results are also consistent with research showing that levels of stigma change in association with treatment (31).…”

Section: Discussionsupporting

confidence: 81%

“…This balance permitted us to draw from existing knowledge and simultaneously incorporate constructs specific to a particular ethnic minority group. Of the four measures, three have been studied previously—Perceived Discrimination-Devaluation (PDD), Stigma Concerns About Mental Health Care (SCMHC), and Social Distance (SD) (19–21)—and one—the Latino Scale for Antidepressant Stigma (LSAS)—was generated specifically for Latinos on the basis of qualitative work (18). The analyses used depression treatment utilization outcomes to examine the measures’ internal consistency reliability, convergent validity, construct validity, and criterion-related validity.…”

mentioning

confidence: 99%

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Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

Psychiatric Services

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Objectives Stigma associated with mental illness is an important yet understudied issue among Latinos. This study examined the psychometric properties of four stigma measures with a sample of Spanish-speaking Latino primary care patients. The study evaluated the scale for Perceived Discrimination Devaluation (PDD), Stigma Concerns About Mental Health Care (SCMHC), the Latino Scale for Antidepressant Stigma (LSAS), and the Social Distance (SD) scale. Methods Participants (N=200) were low-income Latinos who were screened for depression with the Patient Health Questionnaire (PHQ-2) and asked about their depression treatment history, and they completed the four stigma measures at two time points. The four stigma measures were examined for internal consistency, convergent validity, construct validity, and criterion-related validity. Results The factor-analytic results generally provided support for the construct validity of the measures. The four stigma measures also demonstrated internal consistency between two time points. Patients who reported greater social distance from individuals with depression were more likely to have been receiving treatment for emotional care in the past three months (OR=.70, p<.05). Also, Latinos who scored high on the SCMHC (OR=.64, p<.05) and LSAS (OR=.77, p<.05) were less likely to have been taking antidepressant medications. Conclusions The SCMHC, LSAS, and SD scales received support for their reliability and construct validity. Results also showed some support for their criterion-related validity. A more mixed picture emerged for the PDD. Stigma ratings were associated with depression treatment utilization. Stigma ratings changed over time and were associated with treatment experiences.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

Psychiatric Services

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“…55 Stigma and shame have been heavily implicated in poor help-seeking behaviour. 56 The fear of being labelled 'mad' or being perceived as mentally ill can lead to sufferers distancing themselves from others in their social roles and interactions. 56 Social distance is a measurement of an individual's readiness to inter-relate with a target person in a variety of relationships.…”

Section: Stigma and Shamementioning

confidence: 99%

“…56 The fear of being labelled 'mad' or being perceived as mentally ill can lead to sufferers distancing themselves from others in their social roles and interactions. 56 Social distance is a measurement of an individual's readiness to inter-relate with a target person in a variety of relationships. 57 Studies have shown that those with previous extensive communications with individuals experiencing mental health problems feel the need for less social distance than those with limited or no experience of such difficulties.…”

Section: Stigma and Shamementioning

confidence: 99%

Ethnicity, detention and early intervention: reducing inequalities and improving outcomes for black and minority ethnic patients: the ENRICH programme, a mixed-methods study

Singh

Islam

Brown

et al. 2013

Programme Grants for Applied Research

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BackgroundBlack and minority ethnic (BME) service users experience adverse pathways into care. Ethnic differences are evident even at first-episode psychosis (FEP); therefore, contributory factors must operate before first presentation to psychiatric services. The ENRICH programme comprised three interlinked studies that aimed to understand ethnic and cultural determinants of help-seeking and pathways to care.Aims and objectivesStudy 1: to understand ethnic differences in pathways to care in FEP by exploring cultural determinants of illness recognition, attribution and help-seeking among different ethnic groups. Study 2: to evaluate the process of detention under the Mental Health Act (MHA) and determine predictors of detention. Study 3: to determine the appropriateness, accessibility and acceptability of generic early intervention services for different ethnic groups.MethodsStudy 1: We recruited a prospective cohort of FEP patients and their carers over a 2-year period and assessed the chronology of symptom emergence, attribution and help-seeking using semistructured tools: the Nottingham Onset Schedule (NOS), the Emerging Psychosis Attribution Schedule and the ENRICH Amended Encounter Form. A stratified subsample of user–carer NOS interviews was subjected to qualitative analyses. Study 2: Clinical and sociodemographic data including reasons for detention were collected for all MHA assessments conducted over 1 year (April 2009–March 2010). Five cases from each major ethnic group were randomly selected for a qualitative exploration of carer perceptions of the MHA assessment process, its outcomes and alternatives to detention. Study 3: Focus groups were conducted with service users, carers, health professionals, key stakeholders from voluntary sector and community groups, commissioners and representatives of spiritual care with regard to the question: ‘How appropriate and accessible are generic early intervention services for the specific ethnic and cultural needs of BME communities in Birmingham?’ResultsThere were no ethnic differences in duration of untreated psychosis (DUP) and duration of untreated illness in FEP. DUP was not related to illness attribution; long DUP was associated with patients being young (< 18 years) and living alone. Black patients had a greater risk of MHA detention, more criminal justice involvement and more crisis presentations than white and Asian groups. Asian carers and users were most likely to attribute symptoms to faith-based or supernatural explanations and to seek help from faith organisations. Faith-based help-seeking, although offering comfort and meaning, also risked delaying access to medical care and in some cases also resulted in financial exploitation of this vulnerable group. The BME excess in MHA detentions was not because of ethnicity per se; the main predictors of detention were a diagnosis of mental illness, presence of risk and low level of social support. Early intervention services were perceived to be accessible, supportive, acceptable and culturally appropriate. There was no demand or perceived need for separate services for BME groups or for ethnic matching between users and clinicians.ConclusionsStatutory health-care organisations need to work closely with community groups to improve pathways to care for BME service users. Rather than universal public education campaigns, researchers need to develop and evaluate public awareness programmes that are specifically focused on BME groups.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…Of the three levels at which stigma operates, public stigma (defined as the phenomenon whereby large social groups have negative attitudes towards and beliefs about, and even act against those with a disenfranchised trait -like mental illness (Corrigan and Watson 2002)) has received the greatest attention. Public stigma related to mental illness has been investigated in a broad range of groups including the general public Kobau et al 2009), students (Brown 2008;Chan et al 2009;Corrigan et al 2001;Faigin and Stein 2008;Mann and Himelein 2008;Penn et al 1994;Reinke et al 2004) police , and mental health workers Schulze 2007). In all groups in which public stigma has been investigated, negative beliefs about, and attitudes and behaviors towards individuals with mental illness have been identified.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Documentary Film on Public Stigma Related to Mental Illness Among Genetic Counselors

Anderson

Austin

2011

Journal of Genetic Counseling

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Many people, including genetic counselors (GCs), have been found to hold stigmatizing attitudes towards people with mental illnesses. We aimed to determine whether these attitudes could be changed by exposing GCs/GC students to a documentary film about people with mental illness. We screened the documentary at the 2010 North American conferences for GCs. Immediately before (T1), immediately after (T2), and one month after (T3) watching the documentary, participants self-rated their comfort with asking patients about mental illness, and completed scales measuring two aspects of stigma: stereotype endorsement (SE) and desire for social distance (SD). A total of 87 T1 and T2 questionnaires, and 39 T3 questionnaires were returned. At T2 and T3, 34.5% and 48.7% respectively reported feeling more comfortable to ask patients about mental illness. Scores on SD and SE scales decreased significantly from T1 to T2, but returned to initial levels at T3. The documentary increased GC/GC students' comfort with asking about mental illness and temporarily decreased stigmatizing attitudes.

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Familiarity With and Social Distance From People Who Have Serious Mental Illness

Abstract: Approaches to social change that increase the public's familiarity with serious mental illness will decrease stigma. Further studies are warranted that focus on how contact between members of the general public and persons who have serious mental illness may be facilitated.

Cited by 434 publications

References 47 publications

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Ethnicity, detention and early intervention: reducing inequalities and improving outcomes for black and minority ethnic patients: the ENRICH programme, a mixed-methods study

Effects of a Documentary Film on Public Stigma Related to Mental Illness Among Genetic Counselors

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