Preference For Social Distance Research Articles

Too close for comfort? Social distance and emotion perception in remitted bipolar I disorder

Introduction: Bipolar disorder (BD) is a chronic psychiatric disorder that is associated with heightened and persistent positive emotion (Gruber, 2011; Johnson, 2005). Yet, we know little about how troubled emotion responding may translate into dynamic face-to-face interactions involving others, especially in contexts where automatic social regulation of personal distance from others is key to maintaining social boundaries. Method: Using a novel social distance paradigm adapted from a prior work (Kennedy et al., 2009), participants with a clinical history of bipolar I disorder (n = 30) and healthy controls (CTL; n = 31) provided online measurements of social distance preferences in response to positive, negative, and neutral facial images, as well as subsequent social judgment and emotion perception ratings. Results: Results suggest no group differences on social distance, social perception, or general emotion perception ratings. However, exploratory analyses suggest that the BD group rated positive images higher in happiness, but lower in amusement, compared to the CTL group. Conclusion: These findings contribute to a growing literature on socioemotional processes in BD.

Pharmacy and nursing students' stigma and perceptions toward individuals with mental illness impacted through interaction with a website featuring lived experiences

AbstractIntroductionDespite its high prevalence and negative impact, mental illness is often sub‐optimally treated, in part, due to stigma among health care professionals. Future health care professionals are at the forefront of a potential solution for the provision of stigma‐free, equitable mental health care. Innovative approaches to reducing the stigma toward individuals with mental illness are needed. One approach is utilization of the SNAP the Stigma website (www.snapthestigma.com), a collection of photos and reflections by individuals with lived experiences with mental illness.ObjectiveThis study was conducted to address the question: Does interacting with the SNAP the Stigma website impact pharmacy and nursing students' perceptions and social distance preference toward an individual with mental illness?MethodsA pre‐ and post‐survey employed the Bogardus social distance scale (SDS) to assess stigma toward a vignette individual before and after website interaction. In the post‐survey, participants reflected on one or more posts from the website that impacted them. A qualitative analysis was performed to identify themes from the responses.ResultsA statistically significant reduction in total SDS scores occurred as a result of interaction with SNAP. Three themes were derived including symbolism of mental illness, increased empathy/reduced stereotyping, and lessons regarding what a health care professional can do and offer.ConclusionThese findings suggest that use of the SNAP website as a stigma‐reduction intervention could be a valuable tool for current and future health care professionals to decrease stigma toward those with mental illness and to build intentionality toward empathic and non‐discriminatory behavior in health care practice.

A mixed method comparison of stigma toward autism and schizophrenia and effects of person-first versus identity-first language.

While stigma toward autistic individuals has been well documented, less is known about how autism is perceived relative to other stigmatized disabilities. As a highly stigmatized condition with similar social cognitive features to autism, schizophrenia may offer a useful comparison for stigma. Previous studies have found that autistic people may be perceived more favorably than those with schizophrenia, but little is known about the underlying volitional thoughts that contribute to differences in how these conditions are perceived. The present study utilizes a mixed-methods approach, allowing for a detailed understanding of how young adults perceive different diagnostic labels. 533 college undergraduates completed questionnaires reflecting their perceptions of one of eight diagnostic labels: four related to autism (autism, autistic, autism spectrum disorder, or Asperger's), two related to schizophrenia (schizophrenia or schizophrenic), and two related to an unspecified clinical condition (clinical diagnosis or clinical disorder). Participants also completed an open-ended question regarding their thoughts about, and exposure to, these labels. Responses were compared across broader diagnostic categories (autism, schizophrenia, general clinical condition), with thematic analysis used to assess the broader themes occurring within the open-ended text. While perceptions did not differ significantly for person-first and identity-first language within labels, several differences were apparent across labels. Specifically, quantitative results indicated greater prejudice towards autism and schizophrenia than the generic clinical condition, with schizophrenia associated with more perceived fear and danger, as well as an increased preference for social distance, compared to autism. Patterns in initial codes differed across diagnostic labels, with greater variation in responses about autism than responses about schizophrenia or the general clinical condition. While participants described a range of attitudes toward autism (patronizing, exclusionary, and accepting) and schizophrenia (fear, prejudice, and empathy), they refrained from describing their attitudes toward the general clinical label, highlighting the centrality of a cohesive group identity for the development of stigma. Finally, participants reported a number of misconceptions about autism and schizophrenia, with many believing features such as savant syndrome to be core characteristics of the conditions. These findings offer a more detailed account of how non-autistic individuals view autism and may therefore aid in the development of targeted programs to improve attitudes toward autism.

Validating the feeling thermometer as a measure of partisan affect in multi-party systems

Affective polarization is increasingly studied comparatively, and virtually all studies that do so operationalize it using the feeling thermometer. Yet this survey instrument has not yet been validated in a multi-party context. We argue that for the thermometer to be a valid measure of partisan affect also in multi-party systems, it needs to capture sentiment towards partisans and to correlate with other measures of affective polarization. Using panel study fielded throughout Israel’s elections in 2019–2020, we show that both requirements hold. We use text analysis to substantiate that thermometer scores reflect sentiment towards party supporters, and demonstrate that they go hand-in-hand with preferences for social distance and discrimination in economic games. We discuss implications for the study of affective polarization.

Effect of Exposure to Visual Campaigns and Narrative Vignettes on Addiction Stigma Among Health Care Professionals

Stigma toward people with opioid use disorder (OUD) is pervasive in clinical settings, impeding delivery of high-quality care. To date, no study has evaluated the effect of different stigma-reduction messages or messengers among health care professionals. To evaluate the effect of OUD-related messages delivered by different messengers on stigma and attitudes toward people with OUD among health care professionals. This randomized clinical trial examined the effects of OUD-related messages delivered by a visual campaign alone or in combination with a written narrative vignette from the perspective of 1 of 3 messengers. Health care professionals in the US were recruited from 2 national online survey panels (Ipsos KnowledgePanel and SurveyHealthcareGlobus). A total of 1842 participants completed a web-based survey measuring stigma toward people with OUD from November 13 to 30, 2020. Eight groups were exposed to 1 of 2 message frames. One frame (Words Matter) emphasized the harm of stigmatizing language, and the other (Medication Treatment Works) focused on the effectiveness of medications approved by the US Food and Drug Administration for the treatment of OUD. Message frames were communicated through either a visual campaign alone or a visual campaign in combination with a written narrative vignette from the perspective of a simulated patient with OUD, a clinician, or a health care system administrator. Dimensions of stigma toward people with OUD were measured on 5-point Likert scales that included items about desire for social distance from people with OUD, perception of individual blame for OUD, perspective of OUD as a medical condition, and support for increased governmental spending on OUD treatment. The level of warmth felt toward people with OUD was measured by a feeling thermometer (range, 0-100 points). Among 1842 participants, the mean (SD) age was 47 (13) years; 1324 participants (71.9%) were female, 145 (7.9%) were Hispanic, 140 (7.6%) were non-Hispanic Black, 1344 (73.0%) were non-Hispanic White, and 213 (11.6%) were of other non-Hispanic race (ie, individuals who did not self-report race as Black or White and did not self-report ethnicity as Hispanic). Compared with nonexposure, exposure to the combination of visual campaign and narrative vignette communicating the importance of nonstigmatizing language from the perspective of a patient with OUD was associated with a lower probability (difference, -16.8 percentage points, 95% CI, -26.1 to -7.4; P < .001) of unwillingness to have a person with OUD marry into the family (a measure of social distance preference) and a 7.2-point (95% CI, 3.2-11.1; P < .001) higher warmth rating. Participants exposed to the combined visual campaign and patient vignette about the value of medication treatment for OUD also had significantly lower levels of stigma compared with those in the nonexposed control group (eg, unwillingness to have a person with OUD as a neighbor: difference, -15.3 percentage points; 95% CI, -24.6 to -6.0; P = .001). In this study, messages about nonstigmatizing language and effective medication for OUD reduced stigma among health care professionals. Stigma-reduction efforts targeting health care professionals may improve health care system capacity to serve people with OUD. ClinicalTrials.gov Identifier: NCT05127707.

Pharmacists’ stigma toward patients engaged in opioid misuse: When “social distance” does not mean disease prevention

Background: Health professionals may stigmatize and prefer social distance from patients with opioid misuse, leading to poorer quality of care provided. The degree to which pharmacists prefer social distance from patients with opioid misuse and opioid use disorder (OUD) is not known. Methods: Pharmacists (n = 187) completed a survey comprised of demographics, attitudinal, and Social Distance Scale (SDS) questions based on a vignette patient who displayed opioid misuse. SDS question responses and total scores (maximum of 30; higher scores representing great preference for social distance) were tallied and associations with attitudes and demographics were examined. Results: Mean SDS total score was 16.32 (range 9–23). More than 59% of respondents had an SDS score >15, indicating overall lack of willingness to interact with the vignette patient. Females had a higher mean SDS score vs male pharmacists (16.58 vs. 15.36, respectively; p = 0.023). Pharmacists were more likely to prefer social distance from the vignette patient in personal situations (i.e. renting a room) than work-related interactions (i.e. providing patient education). Pharmacists with >10 years of experience, those without personal experience with a substance use disorder, those who strongly agreed that patients with OUD require excessive time and effort, and those who agreed that some people lack self-discipline to use prescription pain medication without becoming addicted had significantly higher SDS scores than pharmacists without these characteristics. Conclusions: Pharmacists expressed significant preference for social distance indicating stigmatization of patients with opioid misuse. Pharmacists were comfortable performing pharmacy tasks with patients with opioid misuse, but were less comfortable forming therapeutic relationships, an important tenet of patient-centered care. Efforts are needed to examine contributions to social distance preferences and implement measures to reduce them. Targeting of pharmacists with >10 years’ experience and without personal experience with OUD may also be most beneficial.

Mental health stigma among community members in Afghanistan: A cross-sectional survey.

Stigma is a barrier to mental healthcare. Understanding context-specific stigma is important in designing mental health interventions. This study explored the nature and patterns of mental health stigma among community members in Afghanistan. Using cross-sectional data (n = 718), descriptive and inferential analyses were conducted. Multivariable linear regression identified determinants of stigma, as reflected by: (1) preference for social distance in relation to depression and psychosis, and (2) intended stigmatising behaviours in relation to mental illness. In descriptive analyses, stigma toward depression and psychosis, especially regarding work and marriage, was found. The label of 'mental illness' was especially stigmatising. Most respondents would disclose a mental health problem to family only. Findings of inferential analyses included: stigma was positively associated with higher socioeconomic status, depression and belief in dangerousness; and negatively associated with urban location, female gender, familiarity and belief in a positive prognosis. This study provides new insights on stigma, to inform action in Afghanistan, an under-researched context. Further research and actions must prioritise supportiveness at the family level, especially in remote regions and address cultural issues of the social cost of associating with mental illness. More culturally appropriate, non-stigmatising language surrounding mental illness should be developed.

Stigma towards individuals with schizophrenia: Examining the effects of negative symptoms and diagnosis awareness on preference for social distance

Social exclusion towards individuals with schizophrenia can occur as a result of stigmatizing attitudes towards the diagnosis or as a response to observing atypical behaviours resulting from symptoms. The present study examined social exclusion towards schizophrenia as a function of diagnosis awareness and presence of negative symptoms. 64 healthy participants watched four different videos of confederates who were either labelled / not labelled with schizophrenia and displayed / did not display negative symptoms. Participants ranked their preference for social interaction with individuals in ten different activities and were told that they would complete the activities based on their rankings. A significant interaction between label and symptoms was found as knowledge of diagnosis increased desire for social distance if symptoms were absent and decreased desire for social distance if symptoms were present. A main effect of symptom presence was also found as participants displayed greater desire to complete activities with individuals not displaying symptoms than participants displaying symptoms but there was no effect of diagnostic label. Social exclusion appears to be dependent on both presence of negative symptoms and knowledge of diagnosis. It may be useful to focus on increasing public acceptance of specific symptom presentations in public mental health campaigns.

The Effectiveness of Two Potential Mass Media Interventions on Stigma: Video-Recorded Social Contact and Audio/Visual Simulations.

Two approaches that may be particularly well suited for mass media (large scale) stigma interventions are video-recorded social contact and simulations, but research is rather limited. The purpose of this study was to evaluate two potential mass media interventions on different facets of stigma. Participants (N = 244) completed stigma measures prior to, immediately following, and 1 week following the random assignment of: (1) video-recorded social contact, (2) an audio/visual simulation, or (3) no intervention. The video-recorded social contact led to decreases on preference for social distance and negative emotions across 1 week, but only a temporary decrease on perceptions of dangerousness. In contrast, no significant changes in stigma were noted following the simulation. In sum, video-recorded social contact appears promising and offers many advantages for mass media implementation including low cost, minimal resources, and ease of dissemination. In contrast, further evaluation of audio/visual simulations is warranted before implementation.

Relationships among self‐construal, gender, social dominance orientation, and interpersonal distance

AbstractThe present research focuses on the cognitive embodiment of physical proximity, through interpersonal distance’s relationship with self‐construal, gender, and social dominance orientation. Previous work showed that more independent self‐construal was associated with higher distancing preferences of participants, and that females tend to have higher interdependent self‐construal that lead them to prefer less interpersonal distance. We expected to replicate these findings. However, due to the relationship between power and interpersonal distance, it was argued that gender and perceptions regarding the social hierarchy would also play a role in predicting interpersonal distance. More specifically, it was predicted that while females who accept social hierarchies between males and females would prefer more distance when interacting with males, males would not differ in their preference for social distance. One hundred participants (67 female) completed the Comfortable Interpersonal Distance Scale, Independent and Interdependent Self‐Construal Scales and the Social Dominance Orientation Scale. Interdependent self‐construal was negatively correlated with overall preferred interpersonal distance. Moreover, females high on social dominance orientation preferred larger interpersonal distance from male adult strangers than from female adult strangers. The findings provide further support for the embodiment of self‐construal by showing that psychological closeness and heteronomy are related to physical closeness. The findings also highlight the importance of investigating communal sharing and authority ranking dimensions simultaneously when focusing on interpersonal distance as well as differentiating females’ interpersonal sensitivity due to low power with their high affiliation.

An internet-based survey in Japan concerning social distance and stigmatization toward the mentally ill among doctors, nurses, pharmacists, and the general public

Despite the improving mental health literacy of the public over recent years, people's attitudes towards people with the diagnosis of mental illness do not appeared to have changed. Long-term studies are scarce and mainly limited to Northwestern Europe. Given that no study has ever been carried out in Hungary, the present study examined attitudinal trends towards mentally ill people in the country, and evaluated its determinants using one item of the Social Distance Scale to assess social rejection towards others. National representative surveys of Hungarian adults were conducted in 2001, 2003, 2007 and 2015 (n = 7605). By means of interview and a self-administered questionnaire, socio-demographic information, preferences for social distance, and familiarity with mental illnesses were assessed. Trend analysis demonstrated that no meaningful change had occurred in the desire for social distance over a period of 15 years. Being a woman, having low education level, and lower familiarity with mental illnesses were all related to higher preferences for social distance. However, the explanatory power of these factors was very small (4.2%). As found in other countries, attitudes towards mentally ill people have not changed in Hungary. More effort is needed to understand better and overcome social rejection concerning mental illness.

Social rejection towards mentally ill people in Hungary between 2001 and 2015: Has there been any change?

Despite the improving mental health literacy of the public over recent years, people's attitudes towards people with the diagnosis of mental illness do not appeared to have changed. Long-term studies are scarce and mainly limited to Northwestern Europe. Given that no study has ever been carried out in Hungary, the present study examined attitudinal trends towards mentally ill people in the country, and evaluated its determinants using one item of the Social Distance Scale to assess social rejection towards others. National representative surveys of Hungarian adults were conducted in 2001, 2003, 2007 and 2015 (n = 7605). By means of interview and a self-administered questionnaire, socio-demographic information, preferences for social distance, and familiarity with mental illnesses were assessed. Trend analysis demonstrated that no meaningful change had occurred in the desire for social distance over a period of 15 years. Being a woman, having low education level, and lower familiarity with mental illnesses were all related to higher preferences for social distance. However, the explanatory power of these factors was very small (4.2%). As found in other countries, attitudes towards mentally ill people have not changed in Hungary. More effort is needed to understand better and overcome social rejection concerning mental illness.

P.3.002 - Stigmatic attitudes towards mentally ill patients in Hungary between 2001 and 2015: results of a time-trend analysis

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.

The facial width‐to‐height ratio determines interpersonal distance preferences in the observer

Facial width-to-height ratio (fWHR) is correlated with a number of aspects of aggressive behavior in men. Observers appear to be able to assess aggressiveness from male fWHR, but implications for interpersonal distance preferences have not yet been determined. This study utilized a novel computerized stop-distance task to examine interpersonal space preferences of female participants who envisioned being approached by a man; men's faces photographed posed in neutral facial expressions were shown in increasing size to mimic approach. We explored the effect of the men's fWHR, their behavioral aggression (measured previously in a computer game), and women's ratings of the men's aggressiveness, attractiveness, and masculinity on the preferred interpersonal distance of 52 German women. Hierarchical linear modelling confirmed the relationship between the fWHR and trait judgements (ratings of aggressiveness, attractiveness, and masculinity). There were effects of fWHR and actual aggression on the preferred interpersonal distance, even when controlling statistically for men's and the participants' age. Ratings of attractiveness, however, was the most influential variable predicting preferred interpersonal distance. Our results extend earlier findings on fWHR as a cue of aggressiveness in men by demonstrating implications for social interaction. In conclusion, women are able to accurately detect aggressiveness in emotionally neutral facial expressions, and adapt their social distance preferences accordingly.

Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: Results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial.

Most interventions to reduce stigma in health professionals emphasize education and social contact-based strategies. We sought to evaluate a novel skill-based approach: the British Columbia Adult Mental Health Practice Support Program. We sought to determine the program's impact on primary care providers' stigma and their perceived confidence and comfort in providing care for mentally ill patients. We hypothesized that enhanced skills and increased comfort and confidence on the part of practitioners would lead to diminished social distance and stigmatization. Subsequently, we explored the program's impact on clinical outcomes and health care costs. These outcomes are reported separately, with reference to this article. In a double-blind, cluster randomized controlled trial, 111 primary care physicians were assigned to intervention or control groups. A validated stigma assessment tool, the Opening Minds Scale for Health Care Providers (OMS-HC), was administered to both groups before and after training. Confidence and comfort were assessed using scales constructed from ad hoc items. In the primary analysis, no significant differences in stigma were found. However, a subscale assessing social distance showed significant improvement in the intervention group after adjustment for a variable (practice size) that was unequally distributed in the randomization. Significant increases in confidence and comfort in managing mental illness were observed among intervention group physicians. A positive correlation was found between increased levels of confidence/comfort and improvements in overall stigma, especially in men. This study provides some preliminary evidence of a positive impact on health care professionals' stigma through a skill-building approach to management of mild to moderate depression and anxiety in primary care. The intervention can be used as a primary vehicle for enhancing comfort and skills in health care providers and, ultimately, reducing an important dimension of stigma: preference for social distance.

Public Attitudes toward Persons with Alcohol Use Disorders (AUDs): The Role of Social Contact and Treatment-Seeking Behavior

For more than 60 years sociologists have examined public attitudes toward persons with alcohol use disorders (AUDs), but there is little recent data on this topic. Using responses to vignettes administered in a 2003 national computer-assisted telephone survey (N = 1394) of employed Americans, this paper examines three research questions: (1) How willing are Americans to interact with persons with AUDs? (2) How are preferences for social distance shaped by known contact with a problem drinker? (3) How does treatment-seeking behavior of a known problem drinker influence such preferences? Results indicate that respondents are reluctant to interact with persons with AUDs, especially in the context of work and family life. Multivariate analyses reveal that respondents who knew a relative or coworker with a drinking problem were more likely to desire social distance from the alcohol dependent vignette person. Consistent with the social contact thesis, respondents who reported spending more time with a known problem drinker, were less likely to desire social distance from persons with AUDs, as were respondents who reported that the known problem drinker received treatment from a counselor, psychiatrist, or physician. These results suggest that stigma associated with AUDs may be decreased through formal treatment for AUDs, as well as by greater diffusion of knowledge about the positive effects of treatment.

Associations between stigma and help-seeking intentions and beliefs: Findings from an Australian national survey of young people

To reduce stigma and improve help seeking by young people for mental illness, we need a better understanding of the associations between various dimensions of stigma and young people's help-seeking intentions and helpfulness beliefs for various sources of help and for different disorders. This study assessed stigmatizing attitudes and help-seeking intentions and helpfulness beliefs via a national telephone survey of 3021 youths aged 15–25. Five stigma scales were used: social distance, personally held weak-not-sick and dangerousness beliefs, and weak-not-sick and dangerousness beliefs perceived in others. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, depression with alcohol abuse, post-traumatic stress disorder, social phobia, or psychosis. Beliefs that mental illness is a sign of personal weakness and preference for social distance were associated with less intention to seek professional help and less endorsement of their helpfulness. In contrast, dangerousness/unpredictability beliefs were associated with more intention to seek professional help and more endorsement of their helpfulness. Findings highlight the importance of examining the associations between different dimensions of stigma with different sources of help, specifically for various mental disorders, to better inform future efforts to reduce stigma and increase help seeking in young people.

Biogenetic explanations and public acceptance of people with eating disorders

It has been assumed that biogenetic causal models may improve public attitudes toward people with mental illnesses. The present study examines whether biogenetic attributions are positively associated with acceptance of people suffering from these disorders. Population surveys were conducted in two large German cities. Respondents were presented with a vignette depicting a young female suffering from either anorexia nervosa (N = 680) or bulimia nervosa (N = 667), followed by a fully structured interview including questions on causal attributions, emotional reactions and desire for social distance. Attribution to hereditary factors showed hardly any relationship with attitudes toward people with symptoms of eating disorders. Respondents who endorsed brain disease as a cause tended more to hold those afflicted responsible for their condition, they also expressed more negative emotions and a stronger preference for social distance. Our results do not support the notion that promulgating biogenetic causal models of eating disorders helps decrease the stigma surrounding these illnesses; it may even entail the risk of increasing it.

Americans’ Attitudes toward Mental Illness and Involuntary Psychiatric Medication

This study uses data from the Mental Health Modules of the General Social Survey (1996 and 2006) to understand why some Americans endorse the involuntary use of psychiatric medication. Results indicated that in 1996 and 2006, 28 percent of Americans believed that people with mental illness should be forced by law to take psychiatric medication. The belief that people with mental illness are dangerous significantly contributed to Americans’ endorsement of this form of mandated treatment. Interestingly, the belief that mental illness is caused by stress increased the odds of support for mandated medication in 1996 and then reduced the odds of support in 2006. Moreover, stigmatizing preferences for social distance from those with mental illness were no longer contributing factors in 2006. It is still imperative, however, that public policy makers promote anti-stigma initiatives to reduce barriers to psychiatric treatment and counteract the public’s lingering fear of people with mental illness.

Changing Knowledge and Attitudes with a Middle School Mental Health Education Curriculum

PURPOSE: This research tested the effectiveness of a widely used mental health education curriculum in changing knowledge and attitudes about mental illness. METHOD: Middle school students from four schools were provided the Breaking the Silence: Teaching the Next Generation About Mental Illness mental health instruction while students from other classes at the same schools received usual class instruction. Students completed questionnaires assessing knowledge, attitudes, and social distance preferences before, immediately after, and six weeks after the instruction was given. RESULTS: Students given the Breaking the Silence instruction showed improvements in knowledge about mental illness, attitudes toward mental illness, and willingness to interact with people with mental illnesses. Students in the comparison classes showed no changes. CONCLUSIONS: Breaking the Silence was an effective means of improving the knowledge and attitudes of middle school students about mental illness. IMPLICATIONS: An easy-to-administer and effective curriculum, Breaking the Silence is available to teachers and schools to help improve understanding and acceptance of people with mental illness. Such a curriculum, introduced during childhood and adolescence, may help to prevent the negative attitudes and misunderstanding that characterize adult perceptions of mental illness.