Measuring Stigma of Mental Illness

Measuring Stigma of Mental Illness

Stigma about mental illness may determine how – and even whether – people seek help for mental health problems, their level of engagement with treatment, and the outcome of their problems.

(March 1, 2007) -- By Royal College of Psychiatrists, [RxPG] A new self-report questionnaire, which can be completed in 5-10 minutes, may help us to understand more about the role of stigma, both in treating patients with psychiatric illness and in research.

Stigma is the negative evaluation of a person as tainted or discredited on the basis of attributes such as mental illness, ethnicity, drug misuse or physical disability. Such prejudice has major social, political, economic and psychological consequences for stigmatised people.

The research, carried out by Professor Michael King, UCL Department of Mental Health Sciences, is published in the March 2007 issue of the British Journal of Psychiatry. It sets out to design a standardised measure of the stigma of mental illness that takes into account the experiences of mental health service users, and to test its relationship to a measure of self-esteem.

The researchers used qualitative data from previous interviews with 46 mental health services users to develop a pilot scale with 42 questions relating to stigma. Examples of statements with which they were asked to agree or disagree on a 5-point scale ranging from ‘strongly agree’ to ‘strongly disagree’ are:

The way people have treated me upsets me
I have been discriminated against by police because of my mental health problems
People have been understanding of my mental health problems
I avoid telling people about my mental health problems
The media take a balanced view about mental health problems

193 service users were recruited to standardise the scale. 109 were men and 82 women (2 respondents did not state their gender). The first 93 were asked to complete the stigma questionnaire on 2 occasions. 60 of them complied, and 33 completed it only once.

A further 100 participants were asked to complete the questionnaire once in order to boost the sample size for analysis. Participants also completed the ‘Self-Esteem Scale’, which is a reliable test of psychological well-being and self-efficacy.

It was found that most participants had received a diagnosis of schizophrenia, bipolar affective disorder, depression and/or mixed anxiety and depression. Most had received more than one diagnosis. One third of participants reported that they had been admitted to a psychiatric unit compulsorily.

After analysis, a 28-item stigma scale was developed with a 3-factor structure: the first concerning discrimination, the second disclosure, and the third the potential positive aspects of mental illness.

As the researchers had hypothesised, the higher the scores on the Stigma Scale, the lower they were on the Self-Esteem Scale.

They comment that a major strength of the study is that the content of the stigma scale arose directly from earlier qualitative research into patients’ direct experiences of mental illness. Further, data collection was carried out by service users, which gave respondents the chance to express their feelings frankly.

Stigma about mental illness may determine how – and even whether – people seek help for mental health problems, their level of engagement with treatment, and the outcome of their problems.

The Stigma Scale now needs further assessment in clinical and research populations. The researchers believe that it may contribute to our understanding of processes that affect help-seeking, treatment uptake and outcome of mental illness.

By Royal College of Psychiatrists
Reviewed by: Dr. Venkat Yelamanchili
Source: RxPG News

Last updated: 03/07

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Measuring Stigma of Mental Illness