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

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

doi:10.1007/s10597-021-00842-5

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.

Highlights

Every 4th European adult experiences a mental illness each year (World Health Organization, 2019)
As structural equation modelling (SEM) models have the advantage to show direct and indirect effects, we examined the interplay between mental health literacy (MHL) and stereotypes, with respect to personal stigmatization in terms of wish for social distance (WSD), in the context of schizophrenia and depression, in a large representative Swiss community sample using a SEM approach (Fig. 1)
Our model indicates that this apparent contradiction may have resulted from assuming a direct link between MHL and WSD when important mediators such as stereotypes had not been considered

Summary

Introduction

Every 4th European adult experiences a mental illness each year (World Health Organization, 2019). Patients suffer from their symptoms and related disabilities, and experience stigmatization in the community (Alonso et al, 2009; Tsang, 2003; Wahl, 1999) and, in mental health care facilities MHL is defined as the knowledge about symptoms, causes, treatment, and prevention of mental disorders. This includes effective self-help strategies for mild mental problems and first-aid skills to help others (Jorm, 2012). MHL is frequently considered an important target in campaigns to improve help-seeking for mental problems (Henderson et al, 2013). MHL can vary depending on the mental disorder, for example people were more likely to correctly label symptoms of depression rather than symptoms of schizophrenia (Furnham et al, 2009; Jorm et al, 1997)

Methods

Results

Conclusion