Mental health consumers encounter numerous barriers that complicate their lives such as housing, employment, social support, and resulting low self-esteem. Stigma has been found to be a primary deterrent for individuals who need mental health services as well as impacting those already receiving services (Hinshaw, 2007). What has not been clear in the research is how stigma varies across psychiatric disorders. Also, the deinstitutionalization movement has led to increase in the number of consumers who live in the community so consequently, a better conceptualization of the attitudes held by the general public toward mental health consumers is critical in understanding how these consumers are ultimately treated by others. Studies have shown that the public learns about mental illness primarily through the media, particularly newspapers (Corrigan, 2005; Wahl, 1995). Negative stories far outnumber positive ones and the message being delivered to the public is that people with mental illness are dangerous and are to be feared.
The current study used deception by not informing respondents as to the true purpose of the study until debriefing and measuring their impression management to control for self-selection and socially desirable responses. This study simulated a phenomenon popular in media today: a newspaper article featuring a man with mental illness who committed murder. Six vignettes were created and all featured a fictitious person who assaulted another man who later died from head trauma. The perpetrator had a wife, children and a part-time job and was being charged with murder. The only difference between vignettes was the diagnostic label (schizophrenia, bipolar disorder, panic disorder without agoraphobia, major depressive disorder, cancer, and control) of the perpetrator. The independent variable was vignette type, and dependent variables were the Social Distance Scale and the four subscales (authoritarianism, benevolence, social restrictiveness, community mental health ideology) of the Community Attitudes toward Mental Illness (CAMI).
Labeling theory has been utilized as a framework to explain the impact of the label “mental illness” through the works of Scheff and Goffman and more recently, Link. By varying only the diagnostic label in this study, it provided further evidence as to the power of a psychiatric label to affect attitudes which serve as a proxy for behavior.
A convenience sample of adults (N=313) was obtained from a public science center in a large Midwestern city. Participants were randomly assigned to read one of six vignettes and were presented a packet with materials in the following order: vignette, CAMI, Social Distance Scale, Impression Management Scale, and a demographics questionnaire. MANCOVA analyses revealed no difference between vignette type on any of the four subscales of the CAMI. However, there was a statistically significant difference between groups on the Social Distance Scale, and post-hoc analyses found that panic disorder without agoraphobia and major depressive disorder were different. Major depressive disorder was associated with the highest social distance indicating least favorable attitudes whereas panic disorder without agoraphobia was associated with the most favorable attitudes. Results suggest that there may be different factors contributing to social distance other than fear.