Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries

• Published in: Psychological medicine 2012-08, Vol.42 (8), p.1741-1752
• Main Authors: Evans-Lacko, S., Brohan, E., Mojtabai, R., Thornicroft, G.
• Format: Article
• Language: English
• Subjects: Adult; Attitude towards mental illness; Attitudes; Biological and medical sciences; Data Collection - methods; European Union - statistics & numerical data; Female; Health Knowledge, Attitudes, Practice; Humans; Interpersonal Relations; Knowledge; Male; Medical sciences; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental illness; Mentally ill people; Models, Statistical; Patient Acceptance of Health Care - statistics & numerical data; Power, Psychological; Psychiatric disorders; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public Opinion; Self Concept; Selfesteem; Social Change; Social Discrimination - psychology; Social Discrimination - statistics & numerical data; Social psychiatry. Ethnopsychiatry; Social psychology; Social Stigma; Stigmatization
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291711002558

Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.