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Rebecca Young  

Mental Illness, Stigma and Ableist Beliefs

Rebecca Young, Ph.D.

Perhaps you know a friend or colleague who generally appears to be kind-hearted toward others, but acts or speaks differently about individuals with disabilities. Although they may be well-meaning and may not actually be aware of their actions, even small or subtle acts of ableism can have a significant impact on individuals living with disabilities. Ableism, defined as “stereotyping, prejudice, discrimination, and social oppression toward people with disabilities” (Bogart & Dunn, 2019, p. 2) is particularly strong when it comes to mental illness (Guimon, et al., 1999). The stigma of mental illness caused by ableist beliefs is a serious social issue that occurs all over the world (Abdullah & Brown, 2011) and prevents people from receiving needed treatment (Corrigan & Watson, 2002). Fortunately, overt or obvious expressions of ableism toward mental illness have become less common over the years due to the development of anti-stigma campaigns (Stier & Hinshaw, 2007). However, the fact that stigma still exists suggests that people have deeper levels of stigma that are more resistant to change and continue to be expressed in indirect, yet harmful ways perhaps without full awareness or intention (Phelan et al., 2000). It is therefore important for stigma to be examined both explicitly and implicitly in order to fully understand how it operates and determine effective strategies to reduce it.

Borrowing from scholarship on racial prejudice (Gaertner & Dovidio, 1986), we identified a contemporary form of ableism, termed aversive mental illness stigma whereby individuals explicitly reported non-stigmatizing attitudes toward mental illness while also displaying negative implicit ableist beliefs, which impacted their willingness to help individuals with mental illness (e.g., donating less money to a mental illness charity). Because this complex form of stigma is believed to be subtle, deep-rooted, and likely to occur below the level of awareness, it is harder to identify and change. Thus it requires a more nuanced and targeted approach to intervention compared to the traditional anti-stigma campaigns that primarily serve to target explicit forms of stigma (Pearson et al., 2009).

In another study, we developed a novel intervention designed to reduce these implicit and automatic stigmatizing attitudes toward mental illness that perpetuate ableism. The intervention consisted of a combination of education about mental illness—increasing individuals’ awareness of their own automatic biases—and video contact with an individual with mental illness. Overall, the intervention reduced individuals’ implicit negative attitudes toward mental illness including ableist beliefs commonly associated with mental illness (e.g., that individuals with mental illness are dangerous).

This research confirmed that implicit forms of ableism toward mental illness exist. However, it also suggests that it is possible for people to change their automatic stigmatizing attitudes if they are open and willing to do so with increased education, awareness, and contact with mental illness. This research has important implications for social policy in terms of implementing strategies that better identify and change implicit stigmatizing attitudes and behavior toward individuals with mental illness in various social settings where ableism frequently occurs (e.g., schools, workplace, hospitals). Interventions that aim to reduce discrimination and promote inclusion (e.g., hiring individuals with lived experience of mental illness; Corrigan, 2011) can help facilitate long-term change and ultimately improve the lives of individuals with mental illness.

 

Abdullah, T. & Brown, T. L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical Psychology Review, 31, 934–948. doi:10.1016/j.cpr.2011.05.003

Bogart, K. R. and Dunn, D. S. (2019), Ableism special issue introduction. Journal of Social Issues, 75, 650-664. doi:10.1111/josi.12354

Corrigan, P.W. (2011). Best practices: Strategic stigma change (SSC): five principles for social marketing campaigns to reduce stigma. Psychiatric Services, 62, 824-826. doi: 10.1176/ps.62.8.pss6208_0824.

Corrigan, P. W. & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9, 35-53. doi:10.1093/clipsy/9.1.35

Gaertner, S., & Dovidio, J. (1986). The aversive form of racism. In J. Dovidio, & S. Gaertner (Eds.), Prejudice, discrimination, and racism (pp. 61 – 89). Orlando, FL: Academic Press.

Guimon, J., Fischer, W., & Sartorius, N. (Eds.) (1999). The image of madness: The public facing mental illness and psychiatric treatment. Basel, CH: Karger.

Pearson, A. R., Dovidio, J. F., & Gaertner, S. L. (2009). The nature of contemporary prejudice: Insights from aversive racism. Social and Personality Psychology Compass, 3. doi:10.1111/j.1751-9004.2009.00183.x

Phelan, J. C., Link, B. G., Stueve, A., & Pescosolido, B. A. (2000). Public conceptions of mental illness in 1950 and 1996: What is mental illness and is it to be feared? Journal of Health and Social Behavior, 41, 188-207. doi:10.2307/2676305

Stier, A. & Hinshaw, S.P. (2007). Explicit and implicit stigma against individuals with mental illness. Australian Psychologist, 42, 106-117. doi:10.1080/00050060701280599