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The Stigma of Severe Mental Illness: Some Potential Solutions for a Recalcitrant Problem

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Abstract

Despite recent advances in the treatment of individuals with severe mental illness (SMI), their full integration into society is hindered by lingering negative attitudes towards them. In this paper, a brief overview is provided on stigmatization towards individuals with SMI, including its' impact on quality of life and self-esteem, as well as the factors which likely underlie it. Research is reviewed showing that lowered negative perceptions towards persons with SMI are associated with previous contact with this population and with presentation of empirically-based information on the association between violence and SMI. Limitations of these findings are discussed with an eye towards developing improved techniques for reducing stigma.

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REFERENCES

  1. Angermeyer MC, Matschinger H: Social distance towards the mentally ill: Results of representative surveys in the Federal Republic of Germany. Psychological Medicine 27:131–141, 1997.

    Google Scholar 

  2. Brockington I, Hall P, Levings J, et al: The community's tolerance of the mentally ill. British Journal of Psychiatry 162: 93–99, 1993.

    Google Scholar 

  3. Greenley J: Social factors, mental illness, and psychiatric care: Recent advances from a sociological perspective. Hospital and Community Psychiatry 35:813–820, 1984.

    Google Scholar 

  4. Hamre P, Dahl A, Malt U: Public attitudes to the quality of psychiatric treatment, psychiatric patients, and prevalence of mental disorders. Norwegian Journal of Psychiatry 4:275–281, 1994.

    Google Scholar 

  5. Monahan J:Mental disorder and violent behavior: Perceptions and evidence. American Psychologist 47:511–521, 1992.

    Google Scholar 

  6. Wolff G, Pathare S, Craig T, et al: Community attitudes to mental illness. British Journal of Psychiatry 168:183–190, 1996.

    Google Scholar 

  7. Weiner B, Perry RP, Magnusson, J:An attributional analysis of reactions to stigmas. Journal of Personality and Social Psychology 55:738–748, 1988.

    Google Scholar 

  8. Skinner LJ, Berry KK, Griffith SE, et al: Generalizability and specificity of the stigma associated with the mental illness label: A reconsideration twenty-five years later. Journal of Community Psychology 23:3–17, 1995.

    Google Scholar 

  9. Corrigan PW, Penn DL: Stigma busting and stereotypes: Lessons from social psychology on discrediting psychiatric stigma. Manuscript under review, 1998.

  10. Link BG, Stueve A: Psychotic symptoms and the violent/illegal behavior of mental patients compared to community controls, in Violence and Mental Disorders: Developments in Risk Assessment. Edited by Monahan J, Steadman, Chicago, Illinois: University of Chicago Press, 1994.

    Google Scholar 

  11. Wahl OF: Media madness: Public images of mental illness. New Brunswick, NJ: Rutgers University Press, 1995.

    Google Scholar 

  12. Farina A, Felner RD: Employment interviewer reactions to former mental patients. Journal of Abnormal Psychology 82:268–272, 1973.

    Google Scholar 

  13. Link BG: Mental patient status, work, and income: An examination of the effects of a psychiatric label. American Sociological Review 47:202–215, 1982.

    Google Scholar 

  14. Page S:Effects of the mental illness label in attempts to obtain accommodation. Canadian Journal of Behavioral Science 9: 84–90, 1977.

    Google Scholar 

  15. Wahl OF, Harman CR: Family views of stigma. Schizophrenia Bulletin 15:131–139, 1989.

    Google Scholar 

  16. Farina A, Thaw J, Loevern JD, et al: People's reactions to a former mental patient moving to their neighborhood. Journal of Community Psychology 2:108–112, 1974.

    Google Scholar 

  17. Link BG, Struening E, Rahav M, et al: On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, in press.

  18. Farina A: Are women nicer people than men? Sex and the stigma of mental disorders. Clinical Psychology Review 1:223–243, 1981.

    Google Scholar 

  19. Link BG: Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review 52:96–112, 1987.

    Google Scholar 

  20. Link BG, Cullen FT, Struening E, et al: A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review 54:400–423, 1989.

    Google Scholar 

  21. Steele CM, Aronson J:Stereotype threat and the intellectual test performance of African-Americans. Journal of Personality and Social Psychology 69:797–811, 1995.

    Google Scholar 

  22. Scheff T: Being mentally ill: A sociological theory. Chicago: Aldine, 1966.

    Google Scholar 

  23. Scheff T:The labeling theory of mental illness. American Sociological Review 39:444–452, 1974.

    Google Scholar 

  24. Link BG, Cullen FT, Frank J, et al: The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology 92:1461–1500, 1987.

    Google Scholar 

  25. Crochetti G, Spiro H, Siassi I: Are the ranks closed?: Attitudinal social distance and mental illness. American Journal of Psychiatry 127:1121–1127, 1971.

    Google Scholar 

  26. Gove WR: The current status of the labeling theory of mental illness. In: Deviance and mental illness, pp. 273–300, edited by Gove, WR, Beverly Hills, CA: Sage, 1982.

    Google Scholar 

  27. Weinstein R: Labeling theory and the attitudes of mental patients: A review. Journal of Health and Social Behavior 24:70–84, 1983.

    Google Scholar 

  28. Piner KE, Kahle LR: Adapting to the stigmatizing label of mental illness: Foregone but not forgotten. Journal of Personality and Social Psychology 47:805–811, 1984.

    Google Scholar 

  29. Socall DW, Holtgraves T: Attitudes toward the mentally ill: The effects of label and beliefs. The Sociological Quarterly 33: 435–445, 1992.

    Google Scholar 

  30. Penn DL, Guynan K, Daily T, et al: Dispelling the stigma of schizophrenia: What sort of information is best? Schizophrenia Bulletin 20:567–578, 1994.

    Google Scholar 

  31. Bellack AS, Morrison RL, Wixted JT, et al: An analysis of social competence in schizophrenia. British Journal of Psychiatry 156:809–818, 1990.

    Google Scholar 

  32. Mueser KT, Bellack AS, Douglas MS, et al: Prevalence and stability of social skill deficits in schizophrenia. Schizophrenia Research 5:167–176, 1991.

    Google Scholar 

  33. Mueser KT, Bellack AS, Morrison RL, et al: Social competence in schizophrenia: Premorbid adjustment, social skill, and domains of functioning. Journal of Psychiatric Research 24:51–63, 1990.

    Google Scholar 

  34. Penn DL, Mueser KT, Doonan R: Physical attractiveness in schizophrenia: The mediating role of social skill. Behavior Modification 21:78–85. 1997.

    Google Scholar 

  35. Eagly AH, Ashmore R, Makhijani MG, et al: What is beautiful is good, but....: A meta-analytic review of research on the physical attractiveness stereotype. Psychological Bulletin 110: 109–128, 1991.

    Google Scholar 

  36. Burns GL, Farina A: The role of physical attractiveness in adjustment. Genetic, Social, and General Psychology Monographs 118:157–194, 1992.

    Google Scholar 

  37. Feingold A: Good-looking people are not what we think. Psychological Bulletin 111: 304–341, 1992.

    Google Scholar 

  38. Desforges DM, Lord CG, Ramsey SL, et al: Effects of structured cooperative contact on changing negative attitudes toward stigmatized social groups. Journal of Personality and Social Psychology 60:531–544, 1991.

    Google Scholar 

  39. Holmes P, Corrigan PW, Williams P: The relation of knowledge and attitudes about persons with severe mental illness. Paper presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Miami, Fl, November, 1997.

  40. Link BG, Cullen FT: Contact with the mentally ill and perceptions of how dangerous they are. Journal of Health and Social Behavior 27:289–303, 1986.

    Google Scholar 

  41. Penn DL, Kommana S, Mansfield M, et al: Dispelling the stigma of schizophrenia: II. The impact of information on dangerousness. Schizophrenia Bulletin, in press.

  42. Barrowclough C, Tarrier N, Watts S, et al: Assessing the functional value of relatives knowledge about schizophrenia: A preliminary report. British Journal of Psychiatry 151:1–8, 1987.

    Google Scholar 

  43. Roman PM, Floyd HH: Social acceptance of psychiatric illness and psychiatric treatment. Social Psychiatry 16:21–29. 1981.

    Google Scholar 

  44. Steadman HJ: Critically reassessing the accuracy of public perceptions of the dangerousness of the mentally ill. Journal of Health and Social Behavior 22:310–316. 1981.

    Google Scholar 

  45. Angermeyer MC, Matschinger H: Impact of violent attacks by psychiatric patients on social distance towards the mentally ill. Paper presented at the International Sociological Association, 1994.

  46. Hiday AY: The social context of mental illness and violence. Journal of Health and Social Behavior, 36, 122–137, 1995.

    Google Scholar 

  47. Marzuk PM: violence, crime, and mental illness: How strong a link? Archives of General Psychiatry 53:481–486, 1996.

    Google Scholar 

  48. Mulvey EP: Assessing the evidence of a link between mental illness and violence. Hospital and Community Psychiatry 45:663–668, 1994.

    Google Scholar 

  49. Swanson JW, Holzer CE, Ganju VK, et al: Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area Surveys. Hospital and Community Psychiatry 41:761–770, 1990.

    Google Scholar 

  50. Taylor PJ: Schizophrenia and the risk of violence, pp. 163–183, in Schizophrenia, edited by Hirsch S, Weinberger D, Oxford: Blackwell, 1995.

    Google Scholar 

  51. Taylor PJ, Monahan J: Commentary: Dangerous patients or dangerous diseases? British Medical Journal 312:967–969, 1996.

    Google Scholar 

  52. Torrey EF: Violent behavior by individuals with serious mental illness. Hospital and Community Psychiatry 45:653–662, 1994.

    Google Scholar 

  53. Wessely S, Taylor P: Madness and crime: Criminology versus psychiatry. Criminal Behaviour and Mental Health 1:193–228, 1991.

    Google Scholar 

  54. Link BG, Andrews H, Cullen FT: The violent and illegal behavior of mental patients reconsidered. American Sociological Review 57:275–292, 1992.

    Google Scholar 

  55. Swanson JW, Holzer CE: Violence and the ECA data. Hospital and Community Psychiatry 42:79–80, 1991.

    Google Scholar 

  56. Swanson JW: Alcohol abuse, mental disorder, and violent behavior. Alcohol Health and Research World 17:123–132, 1993.

    Google Scholar 

  57. Swanson JW, Borum R, Swartz MS, et al: Psychotic symptoms and disorders and the risk of violent behavior in the community. Criminal Behaviour and Mental Health 6:309–326, 1996.

    Google Scholar 

  58. Link BG, Monahan J, Stueve A, et al: Real in their consequences: A sociological approach to understanding the association between psychotic symptoms and violence. Manuscript under review, 1997.

  59. Swanson JW, Estroff S, Swartz M, et al: Violence and severe mental disorder in clinical and community populations: The effects of psychotic symptoms, comorbidity, and lack of treatment. Psychiatry 60:1–22, 1997.

    Google Scholar 

  60. Wessely, S., Buchanan, A., Reed, A, et al: Acting on delusions, I: Prevalence. British Journal of Psychiatry 163:69–76, 1993.

    Google Scholar 

  61. Cumming E, Cumming J: Closed ranks: An experiment in mental health. Cambridge, MA: Harvard University Press, 1957.

    Google Scholar 

  62. Domino G: Impact of the film “One Flew Over the Cuckoo's Nest” on attitudes toward mental illness. Psychological Reports 53:179–182, 1983.

    Google Scholar 

  63. Farina A, Fisher JD, Getter H, et al: Some consequences of changing people's views regarding the nature of mental illness. Journal of Abnormal Psychology 87:272–279, 1978.

    Google Scholar 

  64. Fisher JD, Farina A: Consequences of beliefs about the nature of mental disorders. Journal of Abnormal Psychology 88: 320–327, 1979.

    Google Scholar 

  65. Keane M: Contemporary beliefs about mental illness among medical students: Implications for education and practice. Academic Psychiatry 14:172–177, 1990.

    Google Scholar 

  66. Keane M: Acceptance vs. rejection: Nursing students' attitudes about mental illness. Perspectives in Psychiatric Care 27:13–16, 1991.

    Google Scholar 

  67. Wahl OF, Lefkowits JY: Impact of a television film on attitudes toward mental illness. American Journal of Community Psychology 17:521–528, 1989.

    Google Scholar 

  68. Thornton JA, Wahl OF: Impact of a newspaper article on attitudes toward mental illness. Journal of Community Psychology 24:17–25, 1996.

    Google Scholar 

  69. Sears DO: College sophomores in the laboratory: Influences of a narrow data base on social psychology's view of human nature. Journal of Personality and Social Psychology 51:515–530, 1986.

    Google Scholar 

  70. Mueser KT, Bennett M, Kushner MG: Epidemiology of substance use disorders among persons with chronic mental illness, in Double Jeopardy: Chronic Mental Illness and Substance Use Disorders, edited by Lehman AF, Dixon LB, Chur, Switzerland: Harwood Academic Publishers, 1995.

    Google Scholar 

  71. Mueser KT, Glynn SM, Corrigan PW, et al: What's in a name? The preferences of participants in mental health services. Psychiatric Services 47:760–761, 1996.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803-5501

    David L. Penn

  2. Department of Psychology, Louisiana State University, USA

    James Martin

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Penn, D.L., Martin, J. The Stigma of Severe Mental Illness: Some Potential Solutions for a Recalcitrant Problem. Psychiatr Q 69, 235–247 (1998). https://doi.org/10.1023/A:1022153327316

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