243417 Unintended consequences of public campaigns for mental health literacy and stigma reduction: A national study

Monday, October 31, 2011: 9:30 AM

Bernice Pescosolido, PhD , Department of Sociology/ICMHSR, Indiana University, Bloomington, IN
Tait Medina, Doctoral Candidate , Department of Sociology, Indiana University, Bloomington, IN
At least since the Decade of the Brain, there has been a concerted effort to educate the American public toward recognizing mental illness, understanding its biological and chemical roots, and supporting the use of treatment. Under theories of brain plasticity and with a greater emphasis on recovery, the goal of mental health literacy has been to decrease the gap between need and service use, between recognition and treatment, and between medical recommendations and adherence. However, the question of the impact of these efforts remains. Here, we follow up on our recent findings (Am. J. Psychiatry Nov2010) on changes in public conceptions in light of the “Disease Like Any Other” message. Specifically, we focus on a ten year comparison of the public's response to vignettes meeting DSM-IV criteria for schizophrenia and depression with another that describes a person with problems in living that do not signal clinical need. We conceptualize the possible outcomes as “hitting the mark”, “overshooting the mark” and “missing the mark”. Using data from the 1996 and 2006 General Social Surveys we find that overwhelmingly, efforts directed toward the public have resulted in “overshooting the mark”. That is, while there has been an increase in the public's identification, biomedical attributions, and treatment support for both schizophrenia and depression, there has also been a greater tendency to see non-clinical problems as mental illness, as due to neurobiological causes, and in need of formal treatment. The implications of these findings for an already strained public mental health system are considered.

Learning Areas:
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Analyze changes in mental health literacy among the U.S. public regarding two cases of mental illness (schizophrenia and depression). 2) Describe changes in how the U.S. public responds to a subclinical case presenting mental health problems. 3) Compare the changes in the two sets of stimuli and assess the potential manifest and latent consequences of current program policy efforts on the public mental health system.

Keywords: Mental Illness, Mental Health Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My stigma research addresses the socio-environmental context at the national level by challenging the all-too-common statement in both medical and social science research that stigma is decreasing in the U.S. With support from the MacArthur Foundation and NIMH, teams from IU and Columbia U. found public knowledge surrounding mental illness had increased, but no great decrease in stigma from 1950s and 1970s to the 1990s (Pescosolido et al. 2000). My colleagues and I initiated the National Stigma Study – Children (PI Pescosolido), the first national study of stigma towards children with mental health problems; the findings appeared in JAACAP, JHSB, a series of papers in Psychiatric Services, and in several translational documents for consumers and providers (e.g., The Brown University Child and Adolescent Behavior Letter). . Further stigma studies carried out under my leadership include a 10-year follow-up of U.S.-based public stigma (which is the subject of this presentation; initial findings published in the Am. J. Psychiatry Nov 2010); the first theoretically and methodologically coordinated international study of stigma (includes 18 countries; challenging ideas that stigma is lower in “developing” countries; Pescosolido et al 2008); and an ongoing multi-method study of stigma and media that assesses attitudinal and physiological effects of media (including SAMHSA’s “What a Difference a Friend Makes” PSA campaign).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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