Mental illness stigma lingers even though people understand it's a brain disease

By Shari Roan, Los Angeles Times

Public perception of mental illness and addiction has changed significantly -- and for the good -- in the last 15 years. That doesn't mean, however, that people feel comfortable working or living near or being friends with someone with mental illness, according to a major new survey.

The study compared people's responses to vignettes involving mental illness and addiction to gauge public understanding of the illness and feelings toward those who are ill or addicted. The surveys took place in 1996 and 2006. The idea, the researchers said, was to assess whether major efforts to improve the treatment of mental conditions and eliminate stigma in the United States is working. Several sweeping efforts have been made in the past two decades to educate Americans on mental illness. A major theme of these campaigns is that mental illnesses and addiction are biological, brain-based, sometimes-genetic illnesses that are each "a disease like any other."

The survey finds the public has embraced that concept, but only to a point. The percentage of people who attributed depression to neurobiological causes increased from 54% of those surveyed in 1996 to 67% in 2006. Those who endorsed psychiatrists to help treat alcoholism increased from 61% to 79% in the 10-year period.

However, the willingness to associate with people with these disorders did not change much. For example, the percentage of people who said they are unwilling to work closely with someone with major depression was 46% in 1996 and 47% in 2006. The percentage of people who considered people with schizophrenia to be a danger to others was 54% in 1996 and 60% in 2006.

Though research and treatment options for people with mental illness or addiction have clearly improved, many could be held back by social stigma, said the authors of the study, led by Indiana University researchers. "Public attitudes matter," they wrote. "Attitudes can translate directly into fear or understanding, rejection or acceptance, delayed service use or early medical attention."

It may take a new approach -- something other than science-based anti-stigma campaigns -- to change public attitudes, the authors said. One such approach is to focus on the "abilities, competencies, and community integration of persons with mental illness and substance use disorders."

(Which brings to mind Los Angeles Laker's star Ron Artest and his efforts to raise money for mental health services by raffling his NBA Championship ring. Artest, who has been treated for depression, has been outspoken about the importance and value of seeking treatment. His "Win My Bling" raffle raised $120,000 in just one day last week.)

In a commentary accompanying the study, Dr. Howard H. Goldman of the University of Maryland points to encouraging signs that people with these diseases can live on equitable terms with those who have not suffered addiction or mental illness.

"We may not have eliminated social stigmatization of symptomatic individuals with mental illness," he wrote. "But improved treatment has helped many of them to make their symptoms and dysfunction less visible and less problematic."

The papers appear in the current issue of the American Journal of Psychiatry.

Suicide Among the Young: How to Try to Prevent It

To the Editor:

Re “After Three Suspected Suicides, a Shaken Cornell Reaches Out” (front page, March 17):

Suicide is a tragedy, made worse when occurring in youth. Many university campuses, not only Cornell, are beleaguered by this excruciatingly painful problem. After all, they have our youth and promise in their classes, seminars and dormitories.

The continuing neglect of the major cause of suicide among youth is shocking. The bulk of coverage in the media largely misses it. It is not only about stress, long winter nights, school challenges or failures, loneliness or social isolation. After all, most people who face these stressors do not kill themselves.

Thus, although stress might precipitate it, it is about mental illness, most commonly mood and substance abuse disorders. Until we as a country face the challenge of reaching our youth and providing high-quality mental health services, until we can reduce the stigma of seeking help for psychiatric conditions, we are crippled in our efforts to stem this scourge.

Our future is our youth. We are duty-bound to reach them and maximize the likelihood not only of their survival but also of their success.

Maria A. Oquendo
New York, March 17, 2010

The writer is a professor of clinical psychiatry and vice chairwoman for education in the department of psychiatry at Columbia University.

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