Perceived stigma toward children with emotional and behavioral problems and their families: The Attitudes about Child Mental Health Questionnaire (ACMHQ).

Abstract

Combating the stigma of mental illness is critical to improving the quality of life of persons with mental health disorders and that of their family associates and to reducing barriers to help-seeking. There is concern that stigma toward mental health problems is even more of a barrier in rural communities. However, little research exists and measures to examine this phenomenon about children and their families are needed. This study describes the development and pilot testing of the Attitudes about Child Mental Health Questionnaire (ACMHQ) to assess perceived public stigma and personal stigmatizing attitudes. We worked with an interdisciplinary expert panel using a Delphi consensus-building process to identify and prioritize the critical dimensions for measurement and then conducted focus groups and cognitive interviews before collecting data in a rural pediatric practice. This process resulted in a conceptually grounded and empirically supported self-report questionnaire for measuring three dimensions of perceived public stigma and one of personal stigmatizing attitudes toward children with emotional and behavioral problems (EBP) and their families. The study documents levels of perceived public stigma and personal stigmatized attitudes in a rural community, including the presence of "stigma by association" for families of children with EBP, with strong stigma by association reported for school settings, and the least for church settings. This research lays the groundwork for examining the relationship between stigma and help-seeking, and for developing interventions to reduce stigma and increase access to appropriate services, which should continue to be a priority in children's mental health for both rural and urban populations.

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“…To assess the likability of the target, participants responded to six items drawn from , Heflinger et al (2014), and Pattyn and Bracke (2013). Participants responded to questions such as, "How much do you like this person?"…”

“…(Pattyn & Bracke, 2013), and "Would you rather not have this applicant as a co-worker?" (reverse-coded; Heflinger et al, 2014). Questions were answered on a likert scale ranging from 1 (not at all) to 7 (very much).…”

“…Perceived hireability of the target was measured using a fouritem scale modified from Rudman, Moss-Racusin, and Heflinger et al (2014). Questions included, "If this applicant were applying for a new job, do you think he/she would be hired?"…”

“…and "If you were an employer, would you be reluctant to give this applicant a job?" (reverse-coded; Heflinger et al, 2014). This variable was measured using a likert scale ranging from 1 (not at all) to 7 (very much).…”

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“…Alongside the geographic lateral spread of mental illness stigma is its depth and vertical reach in the lives of individuals with mental illness. For children who have a mental illness, stigma means that they and their families are often ridiculed or blamed for the disorder (Heflinger, Wallston, Mukolo, & Brannan, 2014). Adolescents tend to fare worse, suffering social exclusion from peers and differential treatment by adults in schools (Moses, 2010).…”