Content area
Full Text
ABSTRACT
Objectives. The authors used nationwide survey data to characterize current public conceptions related to recognition of mental illness and perceived causes, dangerousness, and desired social distance.
Methods. Data were derived from a vignette experiment included in the 1996 General Social Survey. Respondents (n = 1444) were randomly assigned to I of 5 vignette conditions. Four vignettes described psychiatric disorders meeting diagnostic criteria. and the fifth depicted a "troubled person" with subclinical problems and worries.
Results. Results indicate that the majority of the public identifies schizophrenia (88%) and major depression (69%) as mental illnesses and that most report multicausal explanations combining stressful circumstances with biologic and genetic factors. Results also show, however, that smaller proportions associate alcohol (49%) or drug (44"ri`ji(,) abuse with mental illness and that symptoms of mental illness remain strongly connected with public fears about potential violence and with a desire for limited social interaction.
Conclusions. While there is reason for optimism in the public's recognition of mental illness and causal attributions, a strong stereotype of dangerousness and desire for social distance persist. These latter conceptions are likely to negatively affect people with mental illness. (Am J Public Health. 1999;89: 1328-1333)
Several classic studies in social psychiatry have illuminated the important role that cultural beliefs play in shaping societal responses to people with mental illnesses. Hollingshead and Redlich1 introduced the concept of "lay appraisal" to indicate that, long before mental health professionals may become involved, people such as family, friends, coworkers, police, and, of course, the person himself or herself appraise the early signs of mental disorders and make decisions about what (if anything) should be done. Others have provided vivid evidence regarding cultural stereotypes. In Nunnally's2(p51) semantic differential study, for example, respondents typified a mentally ill man as "dangerous, dirty, unpredictable, and worthless."
Still others have provided historical examples that underscore the importance of cultural belief systems in influencing largescale changes in the institutional management of people with mental illnesses. For example, Rothman3 linked the emergence of "asylums" in 19th-century America to cultural beliefs about the importance of rapid urbanization and massive immigration as causes of mental illness. In accordance with these beliefs, asylums were designed to remove people with mental illnesses from the flux and disorder of urban...