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Stigma and different kinds of mental disorders

A study on stigma was conducted in 2013 by the Administration and Policy in Mental Health and Mental Health Services Research in the form of systematic literature review of population studies from 1996, 1998, 2002, and 2006, respectively. The study gathered 36 articles spanning between the listed time period and included a vast demography of participants, including age, gender, and ethnicity. According to the results of this review, individuals with serious mental health disorders, such as depression, schizophrenia, and substance abuse disorders, were perceived as more dangerous and violent towards others than individuals with “normal” issues and physical disabilities. Likewise, both adults and children viewed children with depression and ADHD as more dangerous and violent towards their peers than children with “normal” issues and physical disabilities. For adults, individuals with substance abuse disorders and schizophrenia are viewed as more dangerous than those with depression, and for children, individuals with depression are viewed as more dangerous than those with ADHD. As for race, African American, Asian or Pacific Islander, and Hispanic adults and children are more likely to view any mental illness as dangerous than White adults and children. On the other hand, the relationship between increased contact and decreased stigma of mental illness was observed only in White adults and children, and not in any other race.

The same study also took actions pertaining to stigmatizing mental illness into consideration, using the same 36 articles and participants. According to the review, social distance was observed with adults with severe mental disorders more prominently than adults with “normal” issues and physical disabilities, while adults with substance abuse disorders were subjected to the most social distance. Likewise, social distance was observed with children with ADHD more prominently than children with depression, “normal” issues, and physical disabilities.

Prevalence and stigma by race/ethnicity

There has been an increase in the number of studies conducted to support the US Surgeon General’s claim on the effects of stigma. For example, according to the 2017 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Administration, approximately 46.6 million American adults, ages 18-25, have been diagnosed with any mental illness. In the same survey, approximately 42.6% of these adults received some form of mental health services. By race/ethnicity within the same 46.6 million American adults with any mental illness: 32.6% of Hispanic adults, 30.6% of Black adults, and 20.2% of Asian adults received some form of mental health services, as opposed to 48.0% of White adults. Likewise, the same survey also shows a smaller percentage of minority adults seeking a diagnosis than White adults. According to the survey: 15.2% of all Hispanic adults, 16.2% of all Black adults, and 14.5% of all Asian adults have been diagnosed with any mental illness, as opposed to 20.4% of all White adults.

A study conducted in 2018 by researchers in the University of Houston-Downtown showed a correlation between perceived and personal stigmas and efforts to seek treatment, relationships with others with mental health illnesses, and views on mental health illnesses. The main participants in this study were all young adult college students, who identified as either African American or Latino. According to the results, both African American and Latino students experienced higher anxiety when interacting with individuals with mental health illnesses. Correlating with these results, both groups of students had more of both personal stigma and perceived stigma. From previous findings, most African Americans, although not all, tend to view individuals having mental health illnesses and seeking treatment for them as having serious mental issues, and that tends to lead to a higher negative perception of mental health illnesses.

Reducing stigma

This could be seen as one of the reasons why, in the 2017 National Survey on Drug Use and Health, there is a significantly lower percentage of young African American adults who seek mental health services than young White adults, although there needs to be more research done in this area to confirm this. In the University of Houston-Downtown study, both African American and Latino college students had less personal stigma and less perceived stigma if they know that mental health services are more beneficial than detrimental. This is also seen when both groups also think that mental health illnesses will not become detrimental to a relationship. With these results, it could be inferred that college students that have been exposed to education on and experiences of mental health care may have less negative perceptions of mental health disorders. Therefore, one way of alleviating stigma can be to increase funding for education on mental health disorders, as well as their respective symptoms and treatments.

A study was conducted by Transcultural Psychiatry in Poland, which focused on patients who experience stigmas in a variety of ways, rather than the views of individuals who do not have any mental health disorders. Out of the 442 participants, about 20% of them were told to lower their life goals expectations due to their treatment in a psychiatric hospital, and about a third were viewed as less competent than their peers in various social settings due to their treatment in a psychiatric hospital. Also, the majority of the participants viewed their mental health disorders and their subsequent treatment as burdens, and are the reasons why they experience unemployment and social distance more than individuals with physical disabilities. While the authors suggested a variety of tactics on alleviating the issue of stigma on mental health disorders, the tactics can be generalized into educating the public and interventions for individuals with mental health disorders. The authors concluded that, based on the study's results, there needs to be more publicity on mental health disorders in an attempt to reduce the public's negative perception towards patients. Meanwhile, they also concluded that there needs to be more research on individuals responsible for reinforcing stigmatizing practices, such as employers, physicians, family members, and co-workers, to come up with more beneficial interventions.

Parcesepe, Angela M, and Leopoldo J Cabassa. “Public Stigma of Mental Illness in the United States: a Systematic Literature Review.” Administration and Policy in Mental Health, U.S. National Library of Medicine, Sept. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3835659/.

Substance Abuse and Mental Health Services Administration. “Mental Illness.” National Institute of Mental Health, U.S. Department of Health and Human Services, 2017, www.nimh.nih.gov/health/statistics/mental-illness.shtml.

DeFreitas, Stacie Craft, et al. “Perceived and Personal Mental Health Stigma in Latino and African American College Students.” Frontiers, Frontiers, 8 Feb. 2018, www.frontiersin.org/articles/10.3389/fpubh.2018.00049/full#B50

Świtaj, Piotr, et al. “Experiences of Stigma and Discrimination among Users of Mental Health Services in Poland - Piotr Świtaj, Jacek Wciórka, Paweł Grygiel, Marta Anczewska, Ewa Schaeffer, Krzysztof Tyczyński, Artur Wiśniewski, 2012.” SAGE Journals, Transcultural Psychiatry, 26 June 2007, journals.sagepub.com/doi/pdf/10.1177/1363461511433143.