The Stigma of Mental Illness: Patients’ Anticipations and Experiences

Background: There are studies that either deal with the stigmatization patients anticipate or with patients’ concrete stigmatization experiences. Up until now, however, research is short of studies that investigate both aspects of subjective stigmatization simultaneously. Aims: This study aims at investigating to what extent patients with schizophrenia or depression anticipate and experience stigmatization and how this is influenced by the type of mental disorder and the social environment. Method: A total of 210 patients with schizophrenia or a depressive episode were interviewed, one half living in a city and the other in a small town. Results: Most of the patients expect negative reactions from the environment, particularly as concerns the access to work. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Even though schizophrenia patients and patients with depression anticipated stigmatization similarly frequently, the former reported concrete stigmatization experiences more frequently than the latter. Conversely, patients living in a small town anticipated stigmatization more frequently than patients from the city, even though both had actually experienced stigmatization at a similar rate. Conclusion: The results underline the necessity to differentiate between anticipated and experienced stigmatization. This is highly relevant for planning interventions aimed at reducing the stigma of mental disorder.

[1]  S. Rosenfield Labeling mental illness : The effects of received services and perceived stigma on life satisfaction , 1997 .

[2]  Bruce G. Link,et al.  The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? , 1991, Journal of health and social behavior.

[3]  E L Struening,et al.  Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. , 2001, Psychiatric services.

[4]  D. Mechanic,et al.  Effects of illness attribution and depression on the quality of life among persons with serious mental illness. , 1994, Social science & medicine.

[5]  O. Wahl Mental health consumers' experience of stigma. , 1999, Schizophrenia bulletin.

[6]  W. Gronfein,et al.  Deinstitutionalization, social rejection, and the self-esteem of former mental patients. , 2000, Journal of health and social behavior.

[7]  J. L. Taylor,et al.  Rural-urban differences in stigma and the use of care for depressive disorders. , 1993, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[8]  B. Pescosolido,et al.  Of Fear and Loathing: The Role of 'Disturbing Behavior,' Labels, and Causal Attributions in Shaping Public Attitudes toward People with Mental Illness , 2000 .

[9]  Bruce G. Link,et al.  Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. , 2001, Psychiatric services.

[10]  M. Angermeyer,et al.  Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany , 1997, Psychological Medicine.

[11]  S. Rosenfield,et al.  Negative and Supportive Social Interactions and Quality of Life Among Persons Diagnosed with Severe Mental Illness , 2001, Community Mental Health Journal.

[12]  Bruce G. Link,et al.  On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. , 1997, Journal of health and social behavior.

[13]  M G Gelder,et al.  Stigmatisation of people with mental illnesses. , 2000, The British journal of psychiatry : the journal of mental science.

[14]  K. Ring,et al.  THE INFLUENCE OF PERCEIVED MENTAL ILLNESS ON INTERPERSONAL RELATIONS. , 1965, Journal of abnormal psychology.

[15]  Bruce G. Link,et al.  Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder , 2001 .

[16]  F. Markowitz,et al.  The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. , 1998, Journal of health and social behavior.

[17]  Bruce G. Link,et al.  Public conceptions of mental illness: labels, causes, dangerousness, and social distance. , 1999, American journal of public health.

[18]  E. Goffman Stigma; Notes On The Management Of Spoiled Identity , 1964 .

[19]  F. Dickerson,et al.  Experiences of stigma among outpatients with schizophrenia. , 2002, Schizophrenia bulletin.

[20]  H. Stuart,et al.  Community Attitudes toward People with Schizophrenia , 2001, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[21]  Bruce G. Link Understanding labeling effects in the area of mental disorders : An assessment of the effects of expectations of rejection , 1987 .

[22]  Bruce G. Link,et al.  A modified labeling theory approach to mental disorders : an empirical assessment , 1989 .

[23]  M. Angermeyer,et al.  Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. , 2003, Social science & medicine.