Mental Health Stigma
TL;DR: It is shown that differential under-reporting of depression is correlated with age, gender, and ethnicity and that these characteristics also predict a lower probability of mental health treatment, suggesting that stigma can play an important role in determining health-seeking behavior.
About: This article is published in Economics Letters.The article was published on 2017-10-01 and is currently open access. It has received 174 citations till now. The article focuses on the topics: Mental health & Stigma (botany).
Summary (1 min read)
1 Introduction
- The fear of being stigmatized or socially sanctioned and disgraced governs many aspects of human behavior.
- In many cases, the fear of stigma does not result in actual behavior change but rather leads individuals to simply hide certain behaviors or actions (for example, smoking in secrecy).
- The authors compare survey self-reports on diagnoses and mental health drug use to administrative data on prescription drug use in a sample of more than 250,000 individuals.
- These papers however, do not focus on mental health reporting.
- Hence, while it may be intuitive and taken for granted that there is stigma in mental health, empirically documenting its existence using a large administrative database is novel.
2 Methods and data
- For the empirical analysis, the authors use a unique data set from Australia.
- In the administrative records, the authors can observe whether an individual has filled any prescriptions for depression drugs from September 2005 until the survey date.
- To evaluate the extent of under-reporting of mental illness, the authors calculate the proportion of individuals observed filling prescriptions for depression drugs who do not report that they have been diagnosed with depression or anxiety.
- The authors also estimate the under-reporting rates of drugs used for treatment of the following other conditions: cardiovascular and blood diseases (hypertension, congestive heart failure, high blood cholesterol, and thrombosis), diabetes, and other diseases (heartburn, gout, and thyroid disease).
3 Results
- Table 1 presents the estimated under-reporting rates of mental disorders and other conditions.
- First, the authors address the possibility that their results are driven by doctor, rather than patient, behavior.
- The sample consists of individuals who take drugs for mental illness as well as cardiovascular disease and/or diabetes.
- The differences between the under-reporting rates of respective condition and mental illnesses in square brackets.
4 Concluding remarks
- Conditional on taking prescription medication, the authors find that individuals are significantly more likely to under-report mental health ailments, compared to other conditions.
- The authors interpret the additional misreporting in mental health conditions as evidence of the stigma of mental health.
- In Columns (1) and (4), the dependent variable is the number of GP visits in the next 12 months from the survey date and presented figures are OLS coefficients.
Did you find this useful? Give us your feedback
Figures (3)
Table 2: Within-individual differences in the under-reporting rates of mental illnesses (MI) and other conditions 
Table 1: The under-reporting rates of mental illness (MI) and other conditions 
Table 3: Variation in health care seeking by predicted probability of under-reporting of mental illness and other conditions
Citations
More filters
TL;DR: The complex elements of stigma are reviewed in order to understand its impact on participating in care and public policy considerations in seeking to tackle stigma in orderto improve treatment engagement are summarized.
Abstract: Treatments have been developed and tested to successfully reduce the symptoms and disabilities of many mental illnesses. Unfortunately, people distressed by these illnesses often do not seek out services or choose to fully engage in them. One factor that impedes care seeking and undermines the service system is mental illness stigma. In this article, we review the complex elements of stigma in order to understand its impact on participating in care. We then summarize public policy considerations in seeking to tackle stigma in order to improve treatment engagement. Stigma is a complex construct that includes public, self, and structural components. It directly affects people with mental illness, as well as their support system, provider network, and community resources. The effects of stigma are moderated by knowledge of mental illness and cultural relevance. Understanding stigma is central to reducing its negative impact on care seeking and treatment engagement. Separate strategies have evolved for counteracting the effects of public, self, and structural stigma. Programs for mental health providers may be especially fruitful for promoting care engagement. Mental health literacy, cultural competence, and family engagement campaigns also mitigate stigma's adverse impact on care seeking. Policy change is essential to overcome the structural stigma that undermines government agendas meant to promote mental health care. Implications for expanding the research program on the connection between stigma and care seeking are discussed.
938 citations
University of Colorado Boulder1, University of North Carolina at Chapel Hill2, University of Notre Dame3, University of South Florida4, Columbia University5, University of California, Irvine6, Rutgers University7, Stony Brook University8, University of Pittsburgh9, Yale University10, University of Oregon11, University of California, Berkeley12, Boston University13, Vanderbilt University14, University of Miami15, University of Minnesota16, Fordham University17, Harvard University18, Cornell University19, University of Michigan20, University of Central Florida21, University of California, Los Angeles22, University of Virginia23, Brown University24
TL;DR: COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training.
Abstract: COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
359 citations
Cites background from "Mental Health Stigma"
...Despite far greater public knowledge about mental illness over recent decades, public stigma related to mental and neurodevelopmental disorders remains quite high (Martinez & Hinshaw, 2016)....
[...]
TL;DR: The quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements, but most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system.
Abstract: Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10–19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis. Ninety studies meet the inclusion criteria for this review for barrier and facilitators (n = 54) and interventions (n = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.
185 citations
Cites background from "Mental Health Stigma"
...Help-seeking barriers Stigma Stigma is defined as the fear of being socially sanctioned or disgraced leading to hiding or preventing certain actions or behaviours, including the misreporting of mental health problems [81]....
[...]
TL;DR: The results indicate the urgent need for depression prevention and treatment in China (particularly in the economically less developed regions) through the expansion of primary mental health care resources and a reduction of socioeconomic inequalities.
127 citations
References
More filters
TL;DR: In this article, the authors discuss the relationship between information control and personal identity, including the Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering.
Abstract: CONTENTS 1. Stigma and Social Identity Preliminary Conceptions The Own and the Wise Moral Career 2. Information Control and Personal Identity The Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering 3. Group Alignment and Ego Identity Ambivalence Professional Presentations In-Group Alignments Out-Group Alignments The Politics of Identity 4. The Self and Its Other Deviations and Norms The Normal Deviant Stigma and Reality 5. Deviations and Deviance
17,631 citations
Book•
01 Jan 1963
TL;DR: In this article, the authors discuss the relationship between information control and personal identity, including the Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering.
Abstract: CONTENTS 1. Stigma and Social Identity Preliminary Conceptions The Own and the Wise Moral Career 2. Information Control and Personal Identity The Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering 3. Group Alignment and Ego Identity Ambivalence Professional Presentations In-Group Alignments Out-Group Alignments The Politics of Identity 4. The Self and Its Other Deviations and Norms The Normal Deviant Stigma and Reality 5. Deviations and Deviance
13,742 citations
TL;DR: Recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link and implications for the development of antistigma programs that might promote care seeking and participation are reviewed.
Abstract: Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.
2,975 citations
"Mental Health Stigma" refers background in this paper
...While a large and vibrant literature in psychology and psychiatry has examined the existence of stigma in mental health (see examples in Corrigan (2000)) the approach of using relative misreporting of mental health in a heterogenous sample of about a quarter...
[...]
...Hence, stigma could prevent individuals from seeking care (Corrigan, 2004), leading to more intense (and perhaps less successful) and expensive treatment options later (Kupfer, Frank, and Perel, 1989)....
[...]
Book•
28 Jan 2011
TL;DR: The theory behind this experiment is that the person who is forced to improvise a speech convinces himself, and some evidence is presented, which is not altogether conclusive, in support of this explanation.
Abstract: A test of some hypotheses generated by Festinger's theory of cognitive dissonance, viz, that “if a person is induced to do or say something which is contrary to his private opinion, there will be a tendency for him to change his opinion so as to bring it into correspondence with what he has done or
2,453 citations
"Mental Health Stigma" refers background in this paper
...9For a classic reference see Festinger and Carlsmith (1959)....
[...]
TL;DR: The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment) and a lack of longitudinal research in this area of study has inhibited the clinical relevance of findings related tointernalized stigma.
1,263 citations
"Mental Health Stigma" refers background in this paper
...A recent meta analysis of internalized stigma finds that stigma of mental illness does not seem to systematically (and in a statistically significant way) vary by gender, age, education, employment, and ethnicity (Livingston and Boyd, 2010)....
[...]
...Finally, there is evidence that non-Caucasian individuals are more likely to feel stigmatized than Caucasian individuals (Livingston and Boyd, 2010)....
[...]