Background Stigmatic attitudes towards people with the diagnosis of mental illness are widespread in the general public [1] and are the major obstacle for successful treatment, rehabilitation and reintegration of patients into the society [2]. Given the magnitude of this issue, and in the effort to develop effective anti stigma intervention programs, trend analysis studies were conducted, examining the changes in attitudes over the years [3]. The construct of social distance, which involves the desire to avoid contact with a particular group of people was commonly used to assess stigma. These studies have consistently reported that despite the improvement in mental health literacy of the public, social distance preferences concerning mentally ill patients have not changed over the last 20 years, and in some cases have even increased [3]. However, the number of studies using trend analysis is scarce and mainly limited to wealthier countries because such studies are both costly and time intensive. Consequently, most studies to date have been carried out in North Western Europe whereas data from Central and Eastern European countries, especially from former communist countries, is lacking [4,5]. Objective In the face of underfinanced mental health system and the lack of any national anti-stigma programs or research, the aim of this study is to shed light into mental illness stigma in Hungary. More specifically, this study aimed to explore for the first time, potential changes concerning attitudes of the Hungarian population towards mentally ill patients. Method National representative surveys (N=7605) of adults aged 18-53 years were carried out in Hungary in 2001, 2003, 2007 and 2015. An interview was conducted, asking for socio-demographic information and participants' desire for social distance from mentally ill patients, measured by Bogardus social distance scale. In order to put into context the stigmatic attitudes towards mentally ill patients, participants were also asked to report on their social distance preferences towards other minorities in the Hungarian society. Trend analysis was performed to examine the trends of social distance. Results Time-trend analysis indicated a significant (positive) trend in public preferences for social distance towards more accepting attitudes during the years of 2001-2015. However, closer examination reveals that the effect size is very small (0.05) and the 2015 rejection level is still high (57%) compared to over 60% in both 2001 and 2003. Moreover, during a period of 15 years, mentally ill patients are among the three most rejected groups in the society (with only alcoholics and drug users being more rejected). Conclusions As was found in other countries around the world, in Hungary as well, stigmatic attitudes towards mentally ill patients are highly prevalent, and have not changed over the last decade. While stressing a worrisome reality in Hungary, where no efforts to tackle mental illness stigma were done, this study also verifies the enormity of the stigma phenomenon. It is evident, maybe more than anything, that much effort is needed in Hungary, but also worldwide, in order to understand and defeat mental illness stigma.
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