Week 1 Lecture 2 - Mental Illness Stigma

‘Stigma’

Originated with the ancient Greeks, who physically branded criminals, slaves or traitors in order that they may be identified as undesirable and avoided (Goffman, 1963)

Public Stigma

Stigma exhibited by the public towards those with a mental disorder

Manifests in three ways:

1. Stereotyped attitudes and beliefs eg. someone is ‘less than’ - manifest through devaluing language

2. Prejudicial affective responses eg. fear

3. Discriminatory behaviours eg. avoidance of interaction or social exclusion

Perspective of Stigmatiser

Signal → Stereotype → Prejudicial Emotion → Discriminatory Behaviour

Schizophrenia → Dangerous → Fear → Social Distancing

Self-stigma of Mental Illness (Corrigan, 2002, 2006, 2012)

Corrigan’s Paradox: stigma may damage or energise

People may: 1) Experience damaged self-esteem 2) React with protest and righteous anger 3) Seem indifferent

Explained by: Awareness, agreement (context is important), and group affiliation (identity)

How does stigma and discrimination affect Australians?

Stigma decreased about high prevalence disorder like depression and anxiety

Stigma increased about lower prevalence and poorly understood disorders like schizophrenia

14 life domains

• Relationships

• Employment

• Healthcare Services

• Social Media

• Mental Healthcare Services

• Mass Media

• Welfare and Social Services

• Education and Training

• Financial and Insurance Services

• Housing and Homelessness Services

• Cultural, Faith or Spiritual Practices and Communities

• Sports, Community Groups and Volunteering

• Public and Recreational Spaces

• Legal and Justice Services

Perceived Experiences of Stigma and Discrimination in Relationships

“Having my illness dismissed, ignored, unaccommodated and being avoided by potential friends is a constant reality for me”

Anticipation of Stigma and Discrimination in Relationships

“Because of the stigma around mental health, I hide my CPTSD and MDD from everyone as much as I can. Only my husband knows about it and even then I still hide some things from him:

Withdrawal from Opportunity in Relationships

“…When you can tell people are thinking you are weird in some way it makes you want to withdraw more and more because it feels shameful.”

Positive Treatment in Relationships

“Being in a relationship allows me to talk more than I ever have about how I feel. On my own, I never spoke to anyone about the things which consumed me.”

What works to reduce stigma and discrimination?

• Positive contact with people with lived experience

• Psychoeducation improves knowledge and understanding, dispel myth (eg information about genetic risk for children of people with lived experience helps)

• Coping skills training and family capacity building

• Coming out: disclosure? OHP adaptation?

• Connection with community

• Individual and group psychological therapies are useful to address internalisation of stigma, including cognitive, acceptance-based, narrative enhancement, self-compassion approaches

The constructs (and dependent variables) are of interest:

1. Stereotyped beliefs

2. Prejudicial emotional responses

3. Discriminatory behavioural intentions

Perceived Dangerousness Scale (Kvaale & Haslam, 2016)

Questions will ask about your beliefs about the person in the story:

• The person in the vignette is likely to be dangerous

• The person in the vignette is likely to be unpredictable

• The person in the vignette is likely to lack self-control

• The person in the vignette is likely to be violent

Six-point likely response scale: “Strongly Disagree” (1) - “Strongly Agree” (6)

Prejudicial Emotional Responses to Mental Illness Scale (Groot, 2025)

Statement asks about how you would FEEL about people living with psychosis. In other words, questions ask about your EMOTIONS about people living with psychosis.

• I would feel nervous around them

• I would feel safe around them (reverse)

• I would worry about what they might do

• I would feel relaxed if I were alone with them (Reverse)

• I would feel fearful about interacting with them.

Six-point Likert response scale: “Strongly Disagree: (1), “Strongly Agree” (6)

Social Distance Scale - Adapted for Youth (Jorm & Wright, 2008; Yap et al., 2014)

How you would feel about spending time with them as described in each statement

• I would be happy to go out with them on the weekend

• I would be happy to work on a project with them

• I would be happy to invite them around to my house

• I would be happy to develop a close friendship with them

• I would be happy to go to their house

• I would be happy to message or chat online with them

Four-point Likert response scale: “Yes, definitely” (1) “Definitely not” (4)