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In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.
In the Surgeon General's report on mental illness, stigma is highlighted as a major barrier to receiving treatment and to obtaining quality housing and employment among those with mental illness (U.S. Department of Health and Human Services 1999). This theme was echoed in the report of the Presidential Task Force on Employment of Adults with Disabilities (2000), the 1999 White House meeting on mental health and illness hosted by Tipper Gore, and the 2001 meeting on mental illness stigma, organized by the Substance Abuse and Mental Health Services Administration. All of these efforts called for further research that provides a more complete understanding of stigma and its impact on persons with mental illness.
Two currents of sociological research into the stigma associated with mental illness have evolved over the past several decades that correspond with these concerns. One area of study focuses on the experience of persons with mental illness. This research shows how internalized stigma and experience of social rejection lead to social withdrawal and lowered social and economic well-being that in turn increase the symptoms of illness (Link 1987; Link et al. 1987, 1997; Link, Mirotznik, and Cullen 1991; Markowitz 1998, 2001; Rosenfield 1997; Wright, Grofein, and Owens 2000). Another area of research focuses on the attitudes of the general population towards persons with mental illness (Link et al. 1999; Martin, Pescosolido,...