“A Disease Like Any Other”? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence

By Bernice A. Pescosolido, Jack K. Martin, J. Long, Tait R. Medina, J. Phelan, Bruce G. Link. American Journal of Psychiatry, 2010

1,168 citations recorded by the source corpus.

Objective Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice. Method The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma. Results In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection. Conclusions More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.

Subfields: General Health Professions, Psychiatry and Mental health, Social Psychology

View Paper: https://www.semanticscholar.org/paper/e4938719b0871557dc31287d0d470f4964b2f8c9

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Citations in the corpus

Resisting the Stigma of Mental Illness (2011, background): “…from the 1950s to the present, along with a steady desire to keep social distance from such people, despite educational campaigns (Link et al. 1999; Martin, Pescosolido, and Tuch 2000; Pescosolido et al. 1999, 2010; Phelan et al. 2000; Rabkin 1980; Stout, Villegas, and Jennings 2004; Wahl 1995).”
Reducing the stigma of mental disorders at work: A review of current workplace anti-stigma intervention programs (2010, background): “Some research has indeed found positive consequences of the biological/chemical imbalance model of mental disorders, such as increases for supporting treatment (Pescosolido et al., 2010) or reducing blame for causing the mental disorder (Deacon & Baird, 2009).”
Evolution of public attitudes about mental illness: a systematic review and meta‐analysis (2012, background): “symptoms, biochemical and genetic etiological theories and to the basic argument that the mental illnesses are diseases no different from other diseases, amenable to effective medical treatment (1).”
Implicit and Explicit Stigmatizing Attitudes and Stereotypes About Depression (2011, background): “Depressed persons are perceived as less dangerous than people with schizophrenia, alcohol dependence, and substance dependence (Crisp et al., 2000; Crisp et al., 2005; Link et al., 1999; Pescosolido et al., 1999; Pescosolido et al., 2010; Phelan & Basow, 2007).”
Mental health literacy: empowering the community to take action for better mental health. (2012, background): “…is historical evidence from repeat community surveys in Australia, Germany, and the United States that attitudes toward treatment, including psychiatric medications, have become more positive over time (Angermeyer & Matschinger, 2005; Jorm et al., 2006b; Mojtabai, 2007; Pescosolido et al., 2010).”
The stigma of alcohol dependence compared with other mental disorders: a review of population studies. (2011, background): “11 USA 2006 21+ 71 1523 Vignette S, D X X X X (Pescosolido et al., 2010; Schnittker, 2008)”
Countries and Cultural Differences in the Stigma of Mental Illness: The East–West Divide (2020, background): “In the end, our analyses suggest that reducing stigma on a global scale may ultimately require culturally tailored intervention strategies—targeting the emphasis on moral attributions or disclosure spillover concerns in the East but not in the West where their impact on change appears to be minimal ”