Stigma is common toward persons with mental health problems and can be defined as a label that sets a person apart from others, links her or him with undesirable characteristics and leads to avoidance by others in society. To aid in the planning of effective and well-targeted initiatives to reduce stigma I examined in my dissertation the prevalence of stigmatizing attitudes of a general population and the factors associated with stigmatizing of people with mental disorders in western Finland. Further, because only a minority of persons with depression are actually treated for their disorder it was also highly interesting to identify the role stigma might have on the use of mental health services. The statistical analyses made use of two large cross-sectional data sets from a Finnish population survey.
The results showed that although the majority of respondents believed that people with depression are not responsible for their illness, a majority still believed that they were respons
ible for their recovery. A lot of negative characteristics were linked with people with mental disorders and negative consequences were linked with the disclosure of the disorders. Women were less likely to hold negative stereotypes towards people with depression as were those with a higher education and people with Swedish as their mother language. A stronger sense of mastery and higher perceived social support predicted more positive attitudes. In addition, a person’s own depressive symptoms and knowing someone who has had mental health problems were also related to more favourable attitudes towards people with depression.
Factors which significantly predicted a stronger desire for social distance included higher age, the female gender, having Swedish as ones native language, lower sense of mastery, milder depression, less familiarity with people with mental health problems and most strongly negative stereotypical beliefs held.
People with depression showed more social tolerance toward people with mental problems; they also carried more positive views about antidepressants. Those with depression were more pessimistic about the usefulness of care and the prognosis for mental problems on the whole. They were afraid of becoming stigmatized in the health care system and agreed with a stereotype that said depression can be seen as a stigmatizing and shameful disease. Among those with depression, users of mental health services carried less desire for social distance to people with mental health problems as compared to non-users and had more positive views about the effects of antidepressants. More severe depression predicted more active use of services. Among those with depression, users of mental health services, as compared to non-users, were more pessimistic about recovery. Personal agreement with seeing depression as a stigmatizing disease was associated with use of mental health services. Personal agreement with the stereotype that people with mental health problems are unpredictable was linked to less use of mental health services.
These results suggest that the message “Depression is a real medical condition” is insufficient in anti-stigma campaigns. It is important to emphasize that depression is not one’s own fault, and that people do not have to manage depression on their own. The results also suggest that older people and those who are unfamiliar with mental health problems are potential target groups for reducing stigma. When planning interventions to eliminate negative stereotypes, one potential target group could be men with low sense of life control and poor social networks. Although those with depression are afraid of becoming stigmatized within the health care system and may stigmatize themselves, this does not necessarily prevent professional service use if depression is serious and views about antidepressant medication are realistic.
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