Abstract
BackgroundThe stigma against people with mental illness is a major barrier to help-seeking in young people for mental health problems. The objective of this study was to investigate the extent of stigma in relation to treatment avoidance in 14 year-old school students in England in relation to how they refer to people with mental illness.MethodsThis is a qualitative, cross-sectional study. The data were gathered as part of the baseline assessment for an intervention study intended to reduce stigma among 14 year old school students. The participating schools were two grammar (selective) schools and three comprehensive (non-selective) schools. At the start of the lesson, the students were asked 'What sorts of words or phrases might you use to describe someone who experiences mental health problems?' Words and terms used to refer to mental illness were enumerated. Using the grounded theory approach, words and terms were grouped in terms of their denotative and connotative meanings. Labels were then derived to capture the key themes attached by the students to the concepts of mental illness. The frequencies of occurrence for each word were also tabulated.Results400 of the 472 participating students (85%) provided 250 words and terms to describe a person with mental illness. Five themes were identified from the data. The first theme called 'popular derogatory terms' (116 items) accounted for nearly half of the words examined. The second theme occurred less often and was described as 'negative emotional state' (61 items). The third theme demonstrated the confusion of young people between physical disabilities, learning difficulties and mental health problems (38 items). The use of psychiatric diagnoses (15 items) and terms related to violence (9 items) were unexpectedly uncommon.ConclusionOur findings suggest the hypothesis that help-seeking by mentally ill young people may be improved by interventions that address both their lack of factual information about mental illness, and those which reduce their strong negative emotional reactions towards people with mental illness.
Highlights
The stigma against people with mental illness is a major barrier to help-seeking in young people for mental health problems
This paper argues that the stigma against mental illness is a powerful contributory factor towards the reluctance of many young people to seek help for mental illness
Our method was intended to allow young people to express what they thought about mental illness in a way that was not pre structured by attitude scales or vignettes
Summary
The stigma against people with mental illness is a major barrier to help-seeking in young people for mental health problems. Most young people who are mentally ill do not seek help [1,2,3,4,5]. Up to half of those who fail to complete secondary school have mental illness [10]. Those who do, more often turn to friends and family for help than to health professionals [11,12]. As few as 4% of young people with a mental illness seek help from a family doctor [14], and consultation rates are especially low among young men [15]. This paper argues that the stigma against mental illness is a powerful (and potentially reversible) contributory factor towards the reluctance of many young people to seek help for mental illness
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