Laypeople have become somewhat more socially accepting of less severe mental health problems such as depression and anxiety, but are generally reluctant to label these common psychiatric symptoms as mental illnesses. Footnote 17 They are more inclined to attribute genetic causes to, and to identify serious mental disorders as, medical illnesses and these are still associated with significant stigma in the public mind. Footnote 18 Having a medical understanding of mental disorders appears to increase stigma and social distance, perhaps because the illness is perceived as fixed and chronic. Footnote 19
Some research shows that the number of people seeking professional help has increased over the years Footnote 20 although they still represent a minority of those with mental health problems. Footnote 21 The prevalence of mental disorders in the general population means that most people will have close contact with someone with a mental health problem at some point, but they often lack the knowledge and skills to provide helpful responses. Footnote 22 Help seeking appears to be influenced by how people define the problem, what they perceive to be the cause, and the anticipated prognosis. Footnote 23 In general, people prefer self-help, lay support and lifestyle interventions for mental disorders, and they are uncomfortable with medical and especially pharmacological, interventions. Footnote 24 Some studies show that public attitudes about treatment have become more akin to those of mental health professionals over the past few years, perhaps because of public education initiatives. Footnote 25
The range of attitudes among mental health professionals in relation to stigma is similar to that of the general public, and discriminatory behaviour from professionals towards persons with mental illness does occur. Footnote 26 Compared to the public, mental health professionals are generally more negative about prognosis and long-term outcomes of mental disorders, and the likelihood of discrimination. Footnote 27 Mental health professionals vary considerably in their attitudes toward interventions and this variability relates to professional orientation. Footnote 28
The media may bear some responsibility for the reported increase in public perceptions of fear and dangerousness related to mental disorders. Although the relationship between the media and personal attitudes and beliefs is complex, the media does appear to exert some effect, particularly regarding perceptions of dangerousness related to serious mental illnesses like schizophrenia. Footnote 29 Negative media images are of concern because they increase psychological distress and fear of stigma for persons with mental disorders, and they may influence the adoption of punitive legislation or regressive policies. Footnote 30
There are significant cultural variations in how people recognize, explain, experience and relate to mental disorders and treatment. Footnote 31 These variations are closely connected to social and environmental conditions. Footnote 32 For most mental health problems, social context and related personal beliefs appear to be of significance in shaping the form, expression and recognition of the disorder. Footnote 33
There are multiple socioeconomic and environmental determinants of mental health and mental illness, just as there are for physical health and physical illness. Footnote 34 Social determinants of physical health including poverty, education and social support also influence mental health. Footnote 35 Around the world, despite their diverse cultures, Indigenous people have similar mental health problems, which diminish when they regain control of local governments, services and cultural activities. Footnote 36
Return to note 17 Martin et al, 2000; Phelan et al, 2000; Angermeyer and Matschinger, 2001; Jorm et al, 2000b; Prior et al, 2003; Mann and Himelein, 2004
Return to note 18 Pescosolido et al, 1999; Phelan et al, 2000; Prior et al, 2003; Mann and Himelein, 2004; Phelan et al, 2005
Return to note 19 Read and Law, 1999; Martin et al, 2000; Walker and Read, 2002; Lauber et al 2004
Return to note 20 Phelan et al, 2000
Return to note 21 Angermeyer and Matschinger, 1999; Jorm, 2000; Simonds and Thorpe, 2003
Return to note 22 Jorm et al, 2005b; Jorm et al, 2007
Return to note 23 Angermeyer and Matschinger, 1999; Lauber et al, 2003a; Prior et al 2003
Return to note 24 Angermeyer and Matschinger, 1996; Priest et al, 1996; Jorm, 2000; Angermeyer and Matschinger, 2001; Lauber et al, 2001; Hegerl et al, 2002; Hoencamp et al, 2002; Highet et al, 2002; Lauber et al, 2003b
Return to note 25 Goldney et al, 2005; Jorm et al, 2006a; Jorm et al, 2006b
Return to note 26 Gray, 2002; McNair et al, 2002; Mazeh et al, 2003; Patel, 2004
Return to note 27 Jorm et al, 1999; Hugo, 2001
Return to note 28 Caldwell and Jorm, 2000; Tiemeier et al, 2002
Return to note 29 Granello et al, 1999; Olstead, 2002; Anderson, 2003; Stuart, 2003; Clarke, 2004
Return to note 30 Stuart, 2003; Clarke, 2004; Stuart, 2005
Return to note 31 Littlewood, 1998; Kirmayer et al, 2000; Sheikh and Furnham, 2000; Weiss et al, 2000; Jadhav et al, 2001; Moldavsky, 2004; Jorm et al, 2005a
Return to note 32 Kirmayer et al, 2000, Moldavsky, 2004
Return to note 33 Littlewood, 1998; Jadhav et al, 2001
Return to note 34 WHO, 2004b
Return to note 35 Stephens et al, 2001; WHO, 2004
Return to note 36 Chandler and Lalonde, 1998; Kirmayer et al, 2000