Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Community Mental Health Journal
Published in: Community Mental Health Journal 3/2022

Open Access 01-04-2022 | Affective Disorder | Original Paper

The Important Role of Stereotypes in the relation between Mental Health Literacy and Stigmatization of Depression and Psychosis in the Community

Authors: Carolin M. Doll, Chantal Michel, Linda T. Betz, Benno G. Schimmelmann, Frauke Schultze-Lutter

Published in: Community Mental Health Journal | Issue 3/2022

Login to get access

Abstract

Increased mental health literacy (MHL) has not reduced stigmatization of people with mental disorder. Thus, we examined the role of stereotypes in the interplay of MHL (correct labelling, causal explanations) and the wish for social distance (WSD) from people with depressive and psychotic symptoms in a community sample of 1526 German-speaking participants in the Swiss ‘Bern Epidemiological At-Risk’ study (age 16–40 years; response rate: 60.1%). Following the presentation of an unlabelled case vignette of depression or psychosis, MHL, stereotypes and WSD were assessed in a questionnaire survey. Their interrelations were studied using structural equation modelling. MHL was not directly linked to WSD, only the psychosocial causal model was directly negatively associated with WSD. Perceived dangerousness particularly increased WSD, this was increased by a biogenetic causal model and decreased by a psychosocial causal model. Awareness-campaigns that, next to biological causes, emphasize psychosocial causes of mental disorders might better reduce stigmatization.
Appendix
Available only for authorised users
Literature
American Association for Public Opinion Research. (2016). Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 9 edition. AAPOR.
Angermeyer, M. C., Daubmann, A., Wegscheider, K., Mnich, E., Schomerus, G., & Knesebeck, O. V. (2015). The relationship between biogenetic attributions and desire for social distance from persons with schizophrenia and major depression revisited. Epidemiology and Psychiatric Sciences, 24(4), 335–341.PubMedCrossRef
Angermeyer, M. C., & Matschinger, H. (1996). The effect of personal experience with mental illness on the attitude towards individuals suffering from mental disorders. Social Psychiatry and Psychiatric Epidemiology, 31(6), 321–326.PubMedCrossRef
Angermeyer, M. C., Matschinger, H., & Corrigan, P. W. (2004). Familiarity with mental illness and social distance from people with schizophrenia and major depression: Testing a model using data from a representative population survey. Schizophrenia Research, 69(2–3), 175–182.PubMedCrossRef
Angermeyer, M. C., Matschinger, H., & Riedel-Heller, S. G. (2001). What to do about mental disorder–help-seeking recommendations of the lay public. Acta Psychiatrica Scandinavica, 103(3), 220–225.PubMedCrossRef
Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013a). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. British Journal of Psychiatry, 203(2), 146–151.CrossRef
Angermeyer, M. C., Millier, A., Rémuzat, C., Refaï, T., & Toumi, M. (2013b). Attitudes and beliefs of the French public about schizophrenia and major depression: Results from a vignette-based population survey. BMC Psychiatry, 13, 313.PubMedPubMedCentralCrossRef
Arboleda-Flórez, J., & Stuart, H. (2012). From sin to science: Fighting the stigmatization of mental illnesses. Canadian Journal of Psychiatry, 57(8), 457–463.PubMedCrossRef
Blanz, M. (2015). Forschungsmethoden und Statistik für die Soziale Arbeit: Grundlagen und Anwendungen. Kohlhammer.
Brijnath, B., Protheroe, J., Mahtani, K. R., & Antoniades, J. (2016). Do web-based mental health literacy interventions Improve the mental health literacy of adult consumers? Results from a systematic review. Journal of Medical Internet Research, 18(6), e165.PubMedPubMedCentralCrossRef
Chamberlain, P. N., Goldney, R. D., Taylor, A. W., & Eckert, K. A. (2012). Have mental health education programs influenced the mental health literacy of those with major depression and suicidal ideation? A comparison between 1998 and 2008 in South Australia. Suicide and Life-Threatening Behavior, 42(5), 525–540.PubMedCrossRef
Clement, S., Williams, P., Farrelly, S., Hatch, S. L., Schauman, O., Jeffery, D., et al. (2015). Mental health-related discrimination as a predictor of low engagement with mental health services. Psychiatric Services, 66(2), 171–176.PubMedCrossRef
Crisp, A., Cowan, L., & Hart, D. (2004). The college’s anti-stigma campaign, 1998–2003. Psychiatric Bulletin, 28, 133–136.CrossRef
Danner, D. (2016). Reliability - The precision of a measurement. GESIS Surveys Guidelines. Mannheim, Germany: GESIS- Leibniz-Institute for the Social Sciences.
Deacon, B. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846–861.PubMedCrossRef
Dey, M., Paz Castro, R., Jorm, A. F., Marti, L., Schaub, M. P., & Mackinnon, A. (2020). Stigmatizing attitudes of Swiss youth towards peers with mental disorders. PLoS ONE, 15(7), e0235034.PubMedPubMedCentralCrossRef
Dietrich, S., Beck, M., Bujantugs, B., Kenzine, D., Matschinger, H., & Angermeyer, M. C. (2004). The relationship between public causal beliefs and social distance toward mentally ill people. Australian and New Zealand Journal of Psychiatry, 38(5), 348–354; discussion 355–347.
Furnham, A., Daoud, Y., & Swami, V. (2009). “How to spot a psychopath”. Lay theories of psychopathy. Social Psychiatry and Psychiatric Epidemiology, 44(6), 464–472.PubMedCrossRef
Gaebel, W., Zäske, H., & Baumann, A. E. (2006). The relationship between mental illness severity and stigma. Acta Psychiatrica Scandinavica Supplement, 429, 41–45.CrossRef
Goldney, R. D., & Fisher, L. J. (2008). Have broad-based community and professional education programs influenced mental health literacy and treatment seeking of those with major depression and suicidal ideation? Suicide and Lifethreatening Behavior, 38(2), 129–142.CrossRef
Goldney, R. D., Fisher, L. J., Dal Grande, E., & Taylor, A. W. (2005). Changes in mental health literacy about depression: South Australia, 1998 to 2004. Medical Journal of Australia, 183(3), 134–137.CrossRef
Hadjimina, E., & Furnham, A. (2017). Influence of age and gender on mental health literacy of anxiety disorders. Psychiatry Research, 251, 8–13.PubMedCrossRef
Hanisch, S. E., Twomey, C. D., Szeto, A. C., Birner, U. W., Nowak, D., & Sabariego, C. (2016). The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review. BMC Psychiatry, 16, 1.PubMedPubMedCentralCrossRef
Haslam, D. (2015). Plan for the unpredictable. The Practitioner, 259(1782), 35.PubMed
Hair, J. F., Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24.CrossRef
Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking, and public health programs. American Journal of Public Health, 103(5), 777–780.PubMedPubMedCentralCrossRef
Hinshaw, S. P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychologyl, 4, 367–393.CrossRef
Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. Journal of Business Research Methods, 6, 53–60.
Jorm, A. F. (2012). Mental health literacy: empowering the community to take action for better mental health. American Psychology, 67(3), 231–243.CrossRef
Jorm, A. F., Christensen, H., & Griffiths, K. M. (2006). The public’s ability to recognize mental disorders and their beliefs about treatment: Changes in Australia over 8 years. Australian & New Zealand Journal of Psychiatry, 40(1), 36–41.CrossRef
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). Public beliefs about causes and risk factors for depression and schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 32(3), 143–148.PubMedCrossRef
Kaiser, H. F. (1974). An index of factorial simplicity. Psychometrika, 39, 31–36.CrossRef
Kasow, Z. M., & Weisskirch, R. S. (2010). Differences in attributions of mental illness and social distance for portrayals of four mental disorders. Psychological Reports, 107(2), 547–552.PubMedCrossRef
Kline, R. B. (2011). Principles and practices of structural equation modelling (3rd ed.). . The Guilford Press.
Kvaale, E. P., Gottdiener, W. H., & Haslam, N. (2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science & Medicine, 96, 95–103.CrossRef
Lanfredi, M., Macis, A., Ferrari, C., Rillosi, L., Ughi, E. C., Fanetti, A., et al. (2019). Effects of education and social contact on mental health-related stigma among high-school students. Psychiatry Research, 281, 112581.PubMedCrossRef
Larkings, J. S., & Brown, P. M. (2018). Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review. International Journal of Mental Health Nursing, 27(3), 928–941.PubMedCrossRef
Lebowitz, M. S. (2019). The implications of genetic and other biological explanations for thinking about mental disorders. Hastings Center Reports, 49(Suppl 1), 82–87.CrossRef
Lebowitz, M. S., & Appelbaum, P. S. (2017). Beneficial and detrimental effects of genetic explanations for addiction. International Journal of Social Psychiatry, 63(8), 717–723.CrossRef
Link, B. G., Cullen, F. T., Frank, J., & Wozniak, J. F. (1987). The social rejection of former mental patients: understanding why labels matter. American Journal of Sociology, 92, 1461–1500.CrossRef
Link, B. G., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511–541.PubMedCrossRef
Longdon, E., & Read, J. (2017). “People with problems, not patients with illnesses”: Using psychosocial frameworks to reduce the stigma of psychosis. Israel Journal of Psychiatry and Related Sciences, 54(1), 24–28.
Mann, C. E., & Himelein, M. J. (2004). Factors associated with stigmatization of persons with mental illness. Psychiatric Services, 55(2), 185–187.PubMedCrossRef
Mackenzie, C. S., Heath, P. J., Vogel, D. L., & Chekay, R. (2019). Age differences in public stigma, self-stigma, and attitudes toward seeking help: A moderated mediation model. Journal of Clinical Psychology, 75(12), 2259–2272.PubMedCrossRef
McCann, T. V., Savic, M., Ferguson, N., Cheetham, A., Witt, K., Emond, K., Bosley, E., Smith, K., Roberts, L., & Lubman, D. I. (2018). Recognition of, and attitudes towards, people with depression and psychosis with/without alcohol and other dru. British Medical Journal Open, 8(12), e023860.
Morgan, A. J., Ross, A., & Reavley, N. J. (2018). Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour. PLoS ONE, 13(5), e0197102.PubMedPubMedCentralCrossRef
Nersessova, K. S., Jurcik, T., & Hulsey, T. L. (2019). Differences in beliefs and attitudes toward Depression and Schizophrenia in Russia and the United States. International Journal of Social Psychiatry, 65(5), 388–398.CrossRef
Norman, R. M., Sorrentino, R. M., Windell, D., & Manchanda, R. (2008). The role of perceived norms in the stigmatization of mental illness. Social Psychiatry and Psychiatric Epidemiology, 43(11), 851–859.PubMedCrossRef
Norman, R. M., Windell, D., & Manchanda, R. (2012). Examining differences in the stigma of depression and schizophrenia. International Journal of Social Psychiatry, 58(1), 69–78.CrossRef
Nyblade, L., Stockton, M. A., Giger, K., Bond, V., Ekstrand, M. L., Lean, R. M., et al. (2019). Stigma in health facilities: Why it matters and how we can change it. BMC Medicine, 17(1), 25.PubMedPubMedCentralCrossRef
Pedersen, C. B., Mors, O., Bertelsen, A., Waltoft, B. L., Agerbo, E., McGrath, J. J., Mortensen, P. B., & Eaton, W. W. (2014). A comprehensive nationwide study of the incidence rate and lifetime risk for treated mental disorders. JAMA Psychiatry, 71(5), 573–581.PubMedCrossRef
Pescosolido, B. A. (2013). The public stigma of mental illness: what do we think; what do we know; what can we prove? Journal of Health and Social Behavior, 54(1), 1–21.PubMedPubMedCentralCrossRef
Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167(11), 1321–1330.CrossRef
Raykov, T. (1997). Estimation of Composite Reliability for Congeneric Measures. Applied Psychological Measurement, 21, 173–184.CrossRef
Read, J. (2007). Why promoting biological ideology increases prejudice against people labelled ‘“schizophrenic.”’ Australian Psychologist, 42, 118–128.CrossRef
Read, J., & Harré, N. (2001). The role of biological and genetic causal beliefs in the stigmatization of ’mental patients’. Journal of Mental Health, 10, 223–235.CrossRef
Read, J., Haslam, N., Sayce, L., & Davies, E. (2006). Prejudice and schizophrenia: A review of the “mental illness is an illness like any other” approach. Acta Psychiatrica Scandinavica, 114(5), 303–318.PubMedCrossRef
Reavley, N. J., McCann, T. V., Cvetkovski, S., & Jorm, A. F. (2014). A multifaceted intervention to improve mental health literacy in students of a multicampus university: A cluster randomised trial. Social Psychiatry and Psychiatric Epidemiology, 49(10), 1655–1666.PubMedCrossRef
Revelle, W., & Zinbarg, R. (2009). Coefficients alpha, beta, omega, and the glb: Comments on Sijtsma. Psychometrika, 74, 145–154.CrossRef
Rüsch, N., Todd, A. R., Bodenhausen, G. V., & Corrigan, P. W. (2010). Biogenetic models of psychopathology, implicit guilt, and mental illness stigma. Psychiatry Research, 179(3), 328–332.PubMedPubMedCentralCrossRef
Sartorius, N., & Schulze, H. (2005). Reducing the Stigma of Mental Illness. A Report from a Global Programme of the World Psychiatric Association. Cambridge University Press.CrossRef
Schneeweiss, H., & Mathes, H. (1995). Factor analysis and principal components. Journal of Multivariate Analysis, 55, 105–124.CrossRef
Schnyder, N., Michel, C., Panczak, R., Ochsenbein, S., Schimmelmann, B. G., & Schultze-Lutter, F. (2018). The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community: A structural equation model. European Psychiatry, 51, 48–56.PubMedCrossRef
Schnyder, N., Panczak, R., Groth, N., & Schultze-Lutter, F. (2017). Association between mental health-related stigma and active help-seeking: Systematic review and meta-analysis. British Journal of Psychiatry, 210(4), 261–268.CrossRef
Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2014). Causal beliefs of the public and social acceptance of persons with mental illness: A comparative analysis of schizophrenia, depression and alcohol dependence. Psychological Medicine, 44(2), 303–314.PubMedCrossRef
Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G., et al. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis***. Acta Psychiatrica Scandinavica, 125(6), 440–452.PubMedCrossRef
Schultze-Lutter, F., Michel, C., Ruhrmann, S., & Schimmelmann, B. G. (2014). Prevalence and clinical significance of DSM-5 –attenuated psychosis syndrome in adolescents and young adults in the general population: The Bern Epidemiological At-Risk (BEAR) Study. Schizophrenia Bulletin, 40, 1499–1508.PubMedCrossRef
Schultze-Lutter, F., Michel, C., Ruhrmann, S., & Schimmelmann, B. G. (2018a). Prevalence and clinical relevance of interview-assessed psychosis-risk symptoms in the young adult community. Psychological Medicine, 48(7), 1167–1178.PubMedCrossRef
Schulze, B. (2007). Stigma and mental health professionals: a review of the evidence on an intricate relationship. International Review of Psychiatry 19(2), 137–155.PubMedCrossRef
Sijtsma, K. (2009). On the use, the misuse, and the very limited usefulness of Cronbach’s alpha. Psychometrika, 74(1), 107.PubMedCrossRef
Sijtsma, K., & van der Ark, L. A. (2015). Conceptions of reliability revisited and practical recommendations. Nursing Research, 64(2), 128–136.PubMedCrossRef
Speerforck, S., Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2017). Treatment recommendations for schizophrenia, major depression and alcohol dependence and stigmatizing attitudes of the public: Results from a German population survey. European Archives of Psychiatry and Clinical Neuroscience, 267(4), 341–350.PubMedCrossRef
Speerforck, S., Schomerus, G., Pruess, S., & Angermeyer, M. C. (2014). Different biogenetic causal explanations and attitudes towards persons with major depression, schizophrenia and alcohol dependence: Is the concept of a chemical imbalance beneficial? Journal of Affective Disorders, 168, 224–228.PubMedCrossRef
Svensson, B., & Hansson, L. (2016). How mental health literacy and experience of mental illness relate to stigmatizing attitudes and social distance towards people with depression or psychosis: A cross-sectional study. Nordic Journal of Psychiatry, 70(4), 309–313.PubMedCrossRef
Trani, J. F., Ballard, E., & Peña, J. B. (2016). Stigma of persons with disabilities in Afghanistan: Examining the pathways from stereotyping to mental distress. Social Science & Medicine, 153, 258–265.CrossRef
Tsang, W. H., Tam, K.C. P., Chan, F., et al. (2003). Stigmatizing attitudes towards individuals with mental illness in Hong Kong: Implications for their recovery. Journal of Community Psychology, 31, 383–396.CrossRef
Van Brakel, W. H. (2006). Measuring health-related stigma—a literature review. Psychology, Health & Medicine, 3, 307–334.CrossRef
Von Lersner, U., Gerb, J., Hizli, S., Waldhuber, D., Wallerand, A. F., Bajbouj, M., et al. (2019). Stigma of mental illness in germans and turkish immigrants in Germany: The effect of causal beliefs. Frontiers in Psychiatry, 10, 46.CrossRef
Wahl, O. F. (1999). Mental health consumers’ experience of stigma. Schizophrenia Bulletin, 25(3), 467–478.PubMedCrossRef
Wang, P. S., Angermeyer, M., Borges, G., Bruffaerts, R., Tat Chiu, W., Girolamo, D. E., G., , et al. (2007). Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 6(3), 177–185.PubMedPubMedCentral
Metadata
Title
The Important Role of Stereotypes in the relation between Mental Health Literacy and Stigmatization of Depression and Psychosis in the Community
Authors
Carolin M. Doll
Chantal Michel
Linda T. Betz
Benno G. Schimmelmann
Frauke Schultze-Lutter
Publication date
01-04-2022
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 3/2022
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-021-00842-5

Other articles of this Issue 3/2022

Community Mental Health Journal 3/2022 Go to the issue

Original Paper

Community Mental Health Center Visits and Community Mobility of People with Serious Mental Illnesses: A Facilitator or Constraint?

Original Paper

Behavioral Health Provider Attitudes and Beliefs about Sexuality and Intimacy: Findings from a Mixed Method Design

Original Paper

Saving Lives: A Systematic Review on the Efficacy of Theory-Informed Suicide Prevention Programs

Original Paper

Complicated Grief, Depression, Health and Attachment Style in First Degree Relatives of Individuals with a Chronic Psychotic Disorders

Brief Report

Low Rates of Clinician Monitoring for Second Generation Antipsychotic Medications in Community Pediatric Practice

Original Paper

Perspectives of Patients and Providers in Using Shared Decision Making in Psychiatry