Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-27T16:53:34.488Z Has data issue: false hasContentIssue false
  • English
  • Français

An online intervention using information on the mental health-mental illness continuum to reduce stigma

Published online by Cambridge University Press:  23 March 2020

G. Schomerus ,
M.C. Angermeyer ,
S.E. Baumeister ,
S. Stolzenburg ,
B.G. Link  and
J.C. Phelan
G. Schomerus*
Affiliation:
Department of Psychiatry, Greifswald University, Greifswald, Germany Helios Hanseklinikum Stralsund, Stralsund, Germany
M.C. Angermeyer
Affiliation:
Center for Public Mental Health, Gösing, Austria Department of Public Health, University of Cagliari, Cagliari, Italy
S.E. Baumeister
Affiliation:
Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany Institute for Community Medicine, University of Greifswald, Greifswald, Germany
S. Stolzenburg
Affiliation:
Department of Psychiatry, Greifswald University, Greifswald, Germany Helios Hanseklinikum Stralsund, Stralsund, Germany
B.G. Link
Affiliation:
Columbia University, New York, USA University of California Riverside, USA
J.C. Phelan
Affiliation:
Columbia University, New York, USA
*
*Corresponding author. Klinik und Poliklinik für Psychiatrie, Universitätsmedizin Greifswald, Rostocker Chaussee 70, 18437 Stalsund, Germany. Tel.: +49 3831 452109; fax: +49 3831 452105. E-mail address: [email protected] (G. Schomerus).
Get access

Abstract

Background

A core component of stigma is being set apart as a distinct, dichotomously different kind of person. We examine whether information on a continuum from mental health to mental illness reduces stigma.

Method

Online survey experiment in a quota sample matching the German population for age, gender and region (n = 1679). Participants randomly received information on either (1) a continuum, (2) a strict dichotomy of mental health and mental illness, or (3) no information. We elicited continuity beliefs and stigma toward a person with schizophrenia or depression.

Results

The continuum intervention decreased perceived difference by 0.19 standard deviations (SD, P < 0.001) and increased social acceptance by 0.18 SD (P = 0.003) compared to the no-text condition. These effects were partially mediated by continuity beliefs (proportion mediated, 25% and 26%), which increased by 0.19 SD (P < 0.001). The dichotomy intervention, in turn, decreased continuity beliefs and increased notions of difference, but did not affect social acceptance.

Conclusion

Attitudes towards a person with mental illness can be improved by providing information on a mental health-mental illness continuum.

Keywords

Social stigmaIntervention studySchizophreniaDepression
Type
Original article
Information
European Psychiatry , Volume 32 , February 2016 , pp. 21 - 27
Copyright
Copyright © European Psychiatric Association 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Link, B.G., Stuart, H.On revisiting some origins of the stigma concept as it applies to mental illnessesGaebel, W.Rössler, W.Sartorius, N.The Stigma of Mental Illness – End of the Story?; Heidelberg: Springer; 2015. [in press]Google Scholar
Angermeyer, M.C., Matschinger, H., Schomerus, G.Attitudes towards psychiatric treatment and people with mental illness: changes over two decades. Br J Psychiatry 2013; 203: 146–51.CrossRefGoogle ScholarPubMed
Pescosolido, B.A., Martin, J.K., Long, J.S., Medina, T.R., Phelan, J.C., Link, B.G.A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry 2010; 167: 1321–30.CrossRefGoogle Scholar
Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P.W., Grabe, H.J., Carta, M.G., et al.Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand; 2012; 125: 440–52.CrossRefGoogle Scholar
Schomerus, G., Matschinger, H., Angermeyer, M.C.Attitudes towards alcohol dependence and affected individuals: persistence of negative stereotypes and illness beliefs between 1990 and 2011. Eur Addict Res 2014; 20: 293–9.CrossRefGoogle ScholarPubMed
Schomerus, G., Van der Auwera, S., Matschinger, H., Baumeister, S.E., Angermeyer, M.C.Do attitudes towards persons with mental illness worsen during the course of life? An age-period-cohort analysis. Acta Psychiatr Scand 2015; 132: 357–64.CrossRefGoogle ScholarPubMed
Johns, L.C., van Os, J.The continuity of psychotic experiences in the general population. Clin Psychol Rev 2001; 21: 1125–41.CrossRefGoogle ScholarPubMed
Hankin, B.L., Fraley, R.C., Lahey, B.B., Waldman, I.D.Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. J Abnorm Psychol 2005; 114: 96–110.CrossRefGoogle ScholarPubMed
Saha, T.D., Chou, S.P., Grant, B.F.Toward an alcohol use disorder continuum using item response theory: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med 2006; 36: 931–42.CrossRefGoogle ScholarPubMed
Kingdon, D.Everybody gets stressed. It's just the way we react that differs. Psychiatric Bulletin 2009; 33: 441–2.CrossRefGoogle Scholar
Link, B.G., Phelan, J.C.Conceptualizing stigma. Ann Rev Sociol 2001; 27: 363–85.CrossRefGoogle Scholar
Link, B.G., Yang, L.H., Phelan, J.C., Collins, P.Y.Measuring mental illness stigma. Schizophr Bull 2004; 30: 511–41.CrossRefGoogle ScholarPubMed
Schomerus, G., Matschinger, H., Angermeyer, M.C.Continuum beliefs and stigmatizing attitudes towards persons with schizophrenia, depression and alcohol dependence. Psychiatry Res 2013; 209: 665–9.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Millier, A., Remuzat, C., Refai, T., Schomerus, G., Toumi, M.Continuum beliefs and attitudes towards people with mental illness: Results from a national survey in France. Int J Soc Psychiatry; 2015; 61: 297–303.CrossRefGoogle Scholar
Wiesjahn, M., Brabban, A., Jung, E., Gebauer, U.B., Lincoln, T.M.Are continuum beliefs about psychotic symptoms associated with stereotypes about schizophrenia?. Psychosis 2014; 6: 50–60.CrossRefGoogle Scholar
Braithwaite, R.Medicalisation of stress belittles major mental illness. Psychiatrist 2010; 34: 115–20.CrossRefGoogle Scholar
Gergel, T.L.Too similar, too different: the paradoxical dualism of psychiatric stigma. Psychiatric Bull 2014; 38: 148–51.CrossRefGoogle ScholarPubMed
Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A., Pescosolido, B.A.Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health 1999; 89: 1328–33.CrossRefGoogle ScholarPubMed
Jorm, A.F., Oh, E.Desire for social distance from people with mental disorders. Aust N Z J Psychiatry 2009; 43: 183–200.CrossRefGoogle ScholarPubMed
European Medicines Agency, Guideline on adjustment for baseline covariates. 2015.Google Scholar
MacKinnon, D.P., Fairchild, A.J., Fritz, M.S.Mediation analysis. Annu Rev Psychol 2007; 58: 593–614.CrossRefGoogle ScholarPubMed
VanderWeele, T.Explanation in causal inference: methods for mediation and interaction. Oxford University Press; 2015.CrossRefGoogle Scholar
Valeri, L., Vanderweele, T.J.Mediation analysis allowing for exposure-mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods 2013; 18: 137–50.CrossRefGoogle ScholarPubMed
Carpenter, J., Kenward, M.Multiple imputation and its application. John Wiley & Sons; 2012.CrossRefGoogle Scholar
Seaman, S.R., White, I.R.Review of inverse probability weighting for dealing with missing data. Stat Methods Med Res 2013; 22: 278–95.CrossRefGoogle ScholarPubMed
Clement, S., Jarrett, M., Henderson, C., Thornicroft, G.Messages to use in population-level campaigns to reduce mental health-related stigma: consensus development study. Epidemiol Psichiatr Soc 2010; 19: 72–9.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Schulze, B.Reinforcing stereotypes: how the focus on forensic cases in news reporting may influence public attitudes towards the mentally ill. Int J Law Psychiatry 2001; 24: 469–86.CrossRefGoogle ScholarPubMed
Lewison, G., Roe, P., Wentworth, A., Szmukler, G.The reporting of mental disorders research in British media. Psychol Med 2012; 435–41.CrossRefGoogle Scholar
Holzinger, A., Matschinger, H., Drexler, V., Angermeyer, M.C.[“What do you think a psychiatrist's work is like. And what about a psychotherapist?.”]. Psychiatr Prax 2010; 37: 329–34.CrossRefGoogle Scholar
Satcher, D.Mental health: a report of the Surgeon General – Executive summary. Prof Psychol Res Pract 2000;31:5.CrossRefGoogle Scholar
Van Os, J., Linscott, R., Myin-Germeys, I., Delespaul, P., Krabbendam, L.A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med 2010; 39: 179–95.CrossRefGoogle Scholar
Cannon, T.D., Cadenhead, K., Cornblatt, B., Woods, S.W., Addington, J., Walker, E., et al.Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry; 2008; 65: 28–37.CrossRefGoogle Scholar
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-5®): American Psychiatric Pub;. 2013.CrossRefGoogle Scholar
Cuthbert, B.N.The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 2014; 13: 28–35.CrossRefGoogle ScholarPubMed
Bahlmann, J., Schomerus, G., Angermeyer, M.C.[Not quite the same: illness beliefs regarding burnout and depression among the general population]. Psychiatrische Praxis 2015; 42: 443–7.Google Scholar
Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M.G., Angermeyer, M.C.The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol 2011; 46: 105–12.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Schomerus et al. supplementary material

Table S1-S5

Download Schomerus et al. supplementary material(PDF)
PDF 65 KB
Submit a response

Comments

No Comments have been published for this article.