Labeling mental illness: The effects of received services and perceived stigma on life satisfaction

Headnote

LABELING MENTAL ILLNESS:

THE EFFECTS OF RECEIVED SERVICES AND PERCEIVED STIGMA ON LIFE SATISFACTION*

Headnote

Labeling theory proponents and the theory's critics have different views of stigma and thus differ on the consequences of labeling for people with mental illness. The labeling perspective posits that because of stigma, official labeling through treatment contact has negative consequences for mental patients. In contrast, critics of labeling theory claim that stigma is relatively inconsequential. Instead, they argue that because labeling results in receiving needed services, it provides significant benefits for mental patients. Thus far, no study has tested the relative positive and negative effects of labeling. I examine these views by comparing the importance of perceived stigma versus the receipt of services for the quality of life of persons with chronic mental illness. Results show that both stigma and services received are significantly associated with quality of life, but in opposite ways. These findings have important implications for interventions for mental illness.

A conflict between proponents of the labeling perspective on mental illness and their critics has continued for several decades. Labeling theorists examine mental illness as a form of deviance: The label rather than the behavior per se shapes the fate of mentally ill persons, by creating chronic mental illness or by compromising the life chances of those so labeled (Link 1982, 1987; Link et al. 1987; Link et al. 1989; Palamara, Cullen, and Gersten 1986; Scheff 1966, 1974). In contrast, from what is often called the psychiatric perspective, critics of labeling theory view mental illness as a form of individual pathology. The fate of people with mental illness depends primarily on the severity of their illness and their treatment rather than on extra-illness factors, such as labels (Huffine and Clausen 1979; Kirk 1974; Lehman, Possidente, and Hawker 1986; Schwartz, Myers, and Astrachan 1974).

A pivotal difference between these perspectives involves the importance of stigma. From a labeling perspective, the stigma attached to the illness is a central problem. A psychiatric label sets into action cultural stereotypes and negative images about mental illness that are applied to the person by others and by the person to himself or herself (Link 1987; Link et al. 1987; Link et al. 1989; Thoits 1985). These images devalue those with...