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Open Access 01-12-2021 | Research

Sociodemographic correlates of public stigma about mental illness: a population study on Hong Kong’s Chinese population

Authors: Lincoln Lik Hang Lo, Yi Nam Suen, Sherry Kit Wa Chan, Min Yi Sum, Cheung Charlton, Christy Lai Ming Hui, Edwin Ho Ming Lee, Wing Chung Chang, Eric Yu Hai Chen

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Individuals with psychiatric disorders are often unwilling to seek help or often follow treatment regimens, fearing public stigma. This study identified the sociodemographic correlates of public stigma while accounting for mental health literacy and life satisfaction.

Methods

This study analysed data for 1514 individuals who participated in a population-based random telephone survey conducted in 2018. Sociodemographic characteristics included gender, age, education level, and occupation. Data on public stigma, mental health literacy, and life satisfaction were also collected. Multiple linear regression was conducted to examine the effects of sociodemographic characteristics on public stigma. A moderation analysis was performed to investigate the role of age and education in the relationship between mental health literacy and public stigma.

Results

Sociodemographic characteristics, such as female gender, older age, lower education, and occupation (particularly retired and homemakers), were associated with a higher public stigma. The association between public stigma and mental health literacy was the most significant among individuals aged 50 years and above with lower education levels.

Conclusions

This study showed that certain population subgroups, based on their sociodemographic profile, have a higher stigma about mental illnesses. Understanding the differential effects of sociodemographic factors on public stigma is imperative to developing effective anti-stigma campaigns.

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Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004;59(7):614–25. https://doi.org/10.1037/0003-066X.59.7.614.CrossRefPubMed

Shechtman Z, Vogel DL, Strass HA, Heath PJ. Stigma in help-seeking: the case of adolescents. Brit J Guid Couns. 2018;46(1):104–19. https://doi.org/10.1080/03069885.2016.1255717.CrossRef

Vogel DL, Wade N, Hackler AH. Perceived public stigma and the willingness to seek counseling: the mediating role of self-stigma and attitudes toward counseling. J Couns Psychol. 2007;54(1):40–50. https://doi.org/10.1037/0022-0167.54.1.40.CrossRef

Chan JY, Mak WW, Law LS. Combining education and video-based contact to reduce stigma of mental illness: “the same or not the same” anti-stigma program for secondary schools in Hong Kong. Soc Sci Med. 2009;68(8):1521–6. https://doi.org/10.1016/j.socscimed.2009.02.016.CrossRefPubMed

Tsoi OYY, Chan SKW, Chui AHC, Hui CLM, Chang WC, Lee EHM, et al. Effect of brief social contact video compared with expert information video in changing knowledge and attitude towards psychosis patients among medical students. Early Interv Psychiatry. 2020; Epub 2020-02-11.

Grandon P, Saldivia S, Vaccari P, Ramirez-Vielma R, Victoriano V, Zambrano C, et al. An integrative program to reduce stigma in primary healthcare workers toward people with diagnosis of severe mental disorders: a protocol for a randomized controlled trial. Front Psychiatry. 2019;10:110. https://doi.org/10.3389/fpsyt.2019.00110.CrossRefPubMedPubMedCentral

Mukesh K, Palayat AM, Yesudas KF, Divakaran B. Attitude towards mental illness among staff nurses in a tertiary care hospital-a hospital-based cross-sectional study. J Evol Med Dent Sci. 2017;6(27):2231+.CrossRef

Jorm AF, Kitchener BA, Sawyer MG, Scales H, Cvetkovski S. Mental health first aid training for high school teachers: a cluster randomized trial. BMC Psychiatry. 2010;10(1):51. https://doi.org/10.1186/1471-244X-10-51.CrossRefPubMedPubMedCentral

Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet. 2016;387(10023):1123–32. https://doi.org/10.1016/S0140-6736(15)00298-6.CrossRefPubMed

10.

Thornicroft G, Brohan E, Kassam A, Lewis-Holmes E. Reducing stigma and discrimination: candidate interventions. Int J Ment Heal Syst. 2008;2(1):3. https://doi.org/10.1186/1752-4458-2-3.CrossRef

11.

Corrigan PW. Target-specific stigma change: a strategy for impacting mental illness stigma. Psychiatr Rehabil J. 2004;28(2):113–21. https://doi.org/10.2975/28.2004.113.121.CrossRefPubMed

12.

Gronholm PC, Henderson C, Deb T, Thornicroft G. Interventions to reduce discrimination and stigma: the state of the art. Soc Psychiatry Psychiatr Epidemiol. 2017;52(3):249–58. https://doi.org/10.1007/s00127-017-1341-9.CrossRefPubMedPubMedCentral

13.

Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rusch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63(10):963–73. https://doi.org/10.1176/appi.ps.201100529.CrossRefPubMed

14.

Ward EC, Wiltshire JC, Detry MA, Brown RL. African American men and women's attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nurs Res. 2013;62(3):185–94. https://doi.org/10.1097/NNR.0b013e31827bf533.CrossRefPubMedPubMedCentral

15.

Yuan Q, Abdin E, Picco L, Vaingankar JA, Shahwan S, Jeyagurunathan A, et al. Attitudes to mental illness and its demographic correlates among general population in Singapore. PLoS One. 2016;11(11):e0167297. https://doi.org/10.1371/journal.pone.0167297.CrossRefPubMedPubMedCentral

16.

Bradbury A. Mental health stigma: the impact of age and gender on attitudes. Community Ment Health J. 2020;56(5):933–8. https://doi.org/10.1007/s10597-020-00559-x.CrossRefPubMed

17.

Chan SK, Tam WW, Lee KW, Hui CL, Chang WC, Lee EH, et al. A population study of public stigma about psychosis and its contributing factors among Chinese population in Hong Kong. Int J Soc Psychiatry. 2016;62(3):205–13. https://doi.org/10.1177/0020764015621941.CrossRefPubMed

18.

Suen YN, KWS C, LTT S, LHL L, Cheung C, LMC H, et al. Relationship between stressful life events, stigma and life satisfaction with the willingness of disclosure of psychotic illness: A community study in Hong Kong. Early Interv Psychiatry. 2020;2020:06–24.

19.

Jang Y, Chiriboga DA, Okazaki S. Attitudes toward mental health services: age-group differences in Korean American adults. Aging Ment Health. 2009;13(1):127–34. https://doi.org/10.1080/13607860802591070.CrossRefPubMedPubMedCentral

20.

Hartini N, Fardana NA, Ariana AD, Wardana ND. Stigma toward people with mental health problems in Indonesia. Psychol Res Behav Manag. 2018;11:535–41. https://doi.org/10.2147/PRBM.S175251.CrossRefPubMedPubMedCentral

21.

Yin H, Wardenaar KJ, Xu G, Tian H, Schoevers RA. Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study. BMC Psychiatry. 2020;20(1):323. https://doi.org/10.1186/s12888-020-02705-x.CrossRefPubMedPubMedCentral

22.

Lopez V, Sanchez K, Killian MO, Eghaneyan BH. Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. BMC Public Health. 2018;18(1):646. https://doi.org/10.1186/s12889-018-5516-4.CrossRefPubMedPubMedCentral

23.

Griffiths KM, Carron-Arthur B, Parsons A, Reid R. Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry. 2014;13(2):161–75. https://doi.org/10.1002/wps.20129.CrossRefPubMedPubMedCentral

24.

Crowe A, Kim T. Ethnicity, life satisfaction, stress, familiarity, and stigma toward mental health treatment. J Couns Dev. 2020;98(1):83–93. https://doi.org/10.1002/jcad.12302.CrossRef

25.

Corrigan PW, Penn DL. Lessons from social psychology on discrediting psychiatric stigma. Am Psychol. 1999;54(9):765–76. https://doi.org/10.1037/0003-066X.54.9.765.CrossRefPubMed

26.

Census and Statistics Department. 2016 Hong Kong Population By-census 2017 [Available from: https://www.bycensus2016.gov.hk/en/index.html.

27.

Chan KW, Lee KW, Hui CLM, Chang WC, Lee HME, Chen EYH. Gender effect on public stigma changes towards psychosis in the Hong Kong Chinese population: a comparison between population surveys of 2009 and 2014. Soc Psychiatry Psychiatr Epidemiol. 2017;52(3):259–67. https://doi.org/10.1007/s00127-016-1317-1.CrossRefPubMed

28.

Chan KW, Li WTO, Hui CLM, Chang WC, HME L, EYH C. The effect of media reporting of a homicide committed by a patient with schizophrenia on the public stigma and knowledge of psychosis among the general population of Hong Kong. Soc Psychiatry Psychiatr Epidemiol. 2018.

29.

American Association for Public Opinion Research. Response Rates - An Overview. 2020 [Available from: https://www.aapor.org/Education-Resources/For-Researchers/Poll-Survey-FAQ/Response-Rates-An-Overview.aspx.

30.

Cheung F, Lucas RE. Assessing the validity of single-item life satisfaction measures: results from three large samples. Qual Life Res. 2014;23(10):2809–18. https://doi.org/10.1007/s11136-014-0726-4.CrossRefPubMedPubMedCentral

31.

Evans-Lacko S, Rose D, Little K, Flach C, Rhydderch D, Henderson C, et al. Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure. Epidemiol Psychiatr Sci. 2011;20(3):263–71. https://doi.org/10.1017/S2045796011000308.CrossRefPubMed

32.

Evans-Lacko S, Little K, Meltzer H, Rose D, Rhydderch D, Henderson C, et al. Development and psychometric properties of the mental health knowledge schedule. Can J Psychiatr. 2010;55(7):440–8. https://doi.org/10.1177/070674371005500707.CrossRef

33.

Hayes AF. Introduction to mediation, moderation, and conditional Process analysis, second edition: a regression-based approach: Guilford publications; 2017.

34.

Girma E, Tesfaye M, Froeschl G, Moller-Leimkuhler AM, Muller N, Dehning S. Public stigma against people with mental illness in the Gilgel gibe field research center (GGFRC) in Southwest Ethiopia. PLoS One. 2013;8(12):e82116. https://doi.org/10.1371/journal.pone.0082116.CrossRefPubMedPubMedCentral

35.

Blay SL, Toledo Pisa Peluso E. Public stigma: the community’s tolerance of Alzheimer disease. Am J Geriatr Psychiatry. 2010;18(2):163–71. https://doi.org/10.1097/JGP.0b013e3181bea900.CrossRefPubMed

36.

Mullen P, Crowe A. Self-stigma of mental illness and help seeking among school counselors. J Couns Dev. 2017;95(4):401–11. https://doi.org/10.1002/jcad.12155.CrossRef

37.

Essler V, Arthur A, Stickley T. Using a school-based intervention to challenge stigmatizing attitudes and promote mental health in teenagers. J Ment Health. 2006;15(2):243–50. https://doi.org/10.1080/09638230600608669.CrossRef

38.

Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe HJ, Carta MG, et al. Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand. 2012;125(6):440–52. https://doi.org/10.1111/j.1600-0447.2012.01826.x.CrossRefPubMed

39.

Angermeyer MC, Holzinger A, Carta MG, Schomerus G. Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. Br J Psychiatry. 2011;199(5):367–72. https://doi.org/10.1192/bjp.bp.110.085563.CrossRefPubMed

40.

Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry. 2010;167(11):1321–30. https://doi.org/10.1176/appi.ajp.2010.09121743.CrossRefPubMedPubMedCentral

41.

Suen YN, Yeung ETW, Chan SKW, Hui CLM, Lee EHM, Chang WC, et al. Integration of biological and psychological illness attributional belief in association with medication adherence behaviour: a path analysis. Early Interv Psychiatry. 2021. https://doi.org/10.1111/eip.13114.

42.

Hu Y, Scott J. Family and gender values in China: generational, Geographic, and Gender Differences. J Fam Issues. 2014;37(9):1267–93.CrossRef

43.

Chandra A, Minkovitz CS. Stigma starts early: gender differences in teen willingness to use mental health services. J Adolesc Health. 2006;38(6):754 e1–8.CrossRef

44.

Chandra A, Minkovitz CS. Factors that influence mental health stigma among 8th grade adolescents. J Youth Adolesc. 2007;36(6):763–74. https://doi.org/10.1007/s10964-006-9091-0.CrossRef

45.

Kramer EJ, Kwong K, Lee E, Chung H. Cultural factors influencing the mental health of Asian Americans. West J Med. 2002;176(4):227–31.PubMedPubMedCentral

46.

Yang LH. Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singap Med J. 2007;48(11):977–85.

47.

Hsu LKG, Wan YM, Chang H, Summergrad P, Tsang BYP, Chen H. Stigma of depression is more severe in chinese americans than caucasian americans. Psychiatry. 2008;71(3):210–22.CrossRef

48.

Taormina RJ, Gao JH. Maslow and the motivation hierarchy: measuring satisfaction of the needs. Am J Psychol. 2013;126(2):155–77. https://doi.org/10.5406/amerjpsyc.126.2.0155.CrossRefPubMed

49.

Chiu S, Jiang N, editors. The future of telephone surveys in Hong Kong: A comparison of fixed line surveys with cellular phone surveys 2017.

50.

Evans-Lacko S, Courtin E, Fiorillo A, Knapp M, Luciano M, Park AL, et al. The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature. Eur Psychiatry. 2014;29(6):381–9. https://doi.org/10.1016/j.eurpsy.2014.02.007.CrossRefPubMed

51.

World Health Organization. Expert opinion on barriers and facilitating factors for the implementation of existing mental health knowledge in mental health services. 2007 [Available from: https://apps.who.int/iris/bitstream/handle/10665/44808/WHO_NMH_MSD_07.1_eng.pdf?sequence=1&isAllowed=y.

Title: Sociodemographic correlates of public stigma about mental illness: a population study on Hong Kong’s Chinese population
Authors: Lincoln Lik Hang Lo
Yi Nam Suen
Sherry Kit Wa Chan
Min Yi Sum
Cheung Charlton
Christy Lai Ming Hui
Edwin Ho Ming Lee
Wing Chung Chang
Eric Yu Hai Chen
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03301-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sociodemographic correlates of public stigma about mental illness: a population study on Hong Kong’s Chinese population

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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