Stigma and schizophrenia: Attitudes of the general public, Schizophrenia Society members, and medical

students

Angus H. Thompson

Department of Psychiatry and Alberta Centre for Injury Control &

Research, University of Alberta

Invited address to the 1st International Congress on Reducing Stigma & Discrimination Because of Schizophrenia, World Psychiatric Association, Leipzig, September 2, 2001.

WPA CAMPAIGN AGAINST STIGMACommunity Attitudes Project

Colleagues:

Julio Arboleda Florez, MD, PhD Chair, Psychiatry Queens University

Roger Bland, MB Chair, Psychiatry University of Alberta

Ruth Dickson , MD Dir., Psychiatry P. Lougheed Hospital

Heather Stuart, PhD Assoc. Prof. Queens University

Richard Warner, MD Medical Director Boulder MH Ctr, USA

ACKNOWLEDGEMENTS

• Alberta (Canada) Mental Health Board

• Eli Lilly Canada

• Population Health UnitCalgary Regional Health Authority

Pilot Site for the WPA Campaign Against the Stigma of Schizophrenia

WPA PilotSites

ComparisonSite

PURPOSE

• Comparison with Pilot Site findings

PURPOSE

• Comparison with Pilot Site findings

• Compare stigma of addicts, criminals, ...

PURPOSE

• Comparison with Pilot Site findings

• Compare stigma of addicts, criminals, ...

• Examine attitudes of advocates

PURPOSE

• Comparison with Pilot Site findings

• Compare stigma of addicts, criminals, ...

• Examine attitudes of advocates

• Examine medical student attitudes

METHODS

Survey Samples

Study N Subject Selection Mode Ret.

Edmonton 420 Random within sex/age Telephone 72%

Schiz. Society 40 Meeting attendees Paper & Pencil 44%1

Med. Students 67 Enrolees Paper & Pencil 100%

1 This is an underestimate. An unknown number of people attended the meeting who wereofficials of agencies that serve people with schizophrenia, and were thus not eligible to completethe questionnaire.

Demographics

Edm SchizSoc

MedStud.

Sex Male 49.0% 32.5% 50.7%Female 51.0% 67.5% 49.3%

Age 15-29 25.5% 15.8% 90.5%30-59 55.3% 63.2% 9.5%60+ 19.2% 21.1% 0.0%

Education Elem 0.5% 0.0% 0.0%Jr High 5.8% 2.5% 1.6%High Sch 40.2% 27.5% 1.6%Coll/Tech 22.4% 15.0% 0.0%Univ 31.1% 55.0% 96.8%

Symptoms of schizophrenia Causes of mental illness

Relative seriousness of schizophrenia Acceptability of community residences

Social distance Befriend/marry one with schizophrenia?

Perceived dangerousness Rx and dangerousness

Taxes and better services What should be done

Medication and/or psychosocial Rx

METHODS

Surveys included the following content areas:

PERCEIVED CAUSES OF SCHIZOPHRENIA

0%

20%

40%

60%

80%

100%

BrainChem

Genetics Stress Trauma Parenting Abuse SocValues

Poverty

Community

Schiz Soc

Med Students

PERCENTAGE OF RESPONDENTS REPORTING A CONDITION TO BE THE "MOST DISABLING"

0%

20%

40%

60%

80%

Loss of Mind Blindness Bedridden Disfigured Sex

Note: For the Community sample, "Blindness" also includes "Deafness"

Community

Schiz Soc

Med Students

Percent who would befriend or marrysomeone with schizophrenia

Community Schiz. Soc. Students

Befriend 83% 87% 79%

Percent who would befriend or marrysomeone with schizophrenia

Community Schiz. Soc. Students

Befriend 83% 87% 79%

Marry 27% 10% 6%

PROPORTION OF RESPONDENTS IN OPPOSITION TO SELECTED HYPOTHETICAL "GROUP HOMES"

0%

20%

40%

60%

80%

Ex Con Drug Ab AlcoholAb

AIDSVictim

Schiz Pt Ment Hcp PhysDisab

Type of Resident

Schiz Soc

Med Students

Community

PERCEIVED DANGEROUSNESS OF THE MENTALLY ILL AND THE EFFECTIVENESS OF TREATMENT

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Community Schiz Soc Med Students

Prop

ortio

n of

Res

pond

ents

Dangerous Rx Effective

SchizophreniaSociety (Most)

Med. Students(Most)

Edmonton1997 (Most)

SchizophreniaSociety (Least)

Med. Students(Least)

DrugsAlone 0 3% 7% 9% 16%

PsychosocialAlone 0 0 9% 44% 59%Both

(Together) 100% 97% 85% 0 0Both (Equally

“Worse”) * --- --- --- 47% 25%

Perceptions of the Most and Least Successful Types of Treatment

SchizophreniaSociety (Most)

Med. Students(Most)

Edmonton1997 (Most)

SchizophreniaSociety (Least)

Med. Students(Least)

DrugsAlone 0 3% 7% 9% 16%

PsychosocialAlone 0 0 9% 44% 59%Both

(Together) 100% 97% 85% 0 0Both (Equally

“Worse”) * --- --- --- 47% 25%

Perceptions of the Most and Least Successful Types of Treatment

PROPORTION IN FAVOUR OF SELECTED ADDITIONAL APPROACHES FOR DEALING WITH MENTAL ILLNESS

0%

20%

40%

60%

80%

100%

Research PublicEducation

Family/Friends

Work/Recreation

CommunityRx

Rx GroupHomes

Self Help DrugTreatment

MentalHospitals

Community Schiz Soc Med Students

PROPORTION OF RESPONDENTS IN FAVOUR OF PAYING MORE TAXES IN ORDER TO IMPROVE SERVICES FOR PEOPLE WITH SCHIZOPHRENIA

0%

20%

40%

60%

80%

100%

Community Schiz Soc Med Students

Discussion

1. It would appear that the mentally ill are not held in the same negative regard as they were 20 or 30 years ago.

Discussion

1. It would appear that the mentally ill are not held in the same negative regard as they were 20 or 30 years ago.

2. The results do not support the view that medical students are particularly prone to negative attitudes.

Discussion

1. It would appear that the mentally ill are not held in the same negative regard as they were 20 or 30 years ago.

2. The results do not support the view that medical students are particularly prone to negative attitudes.

3. The results do not support the utility of a broad approach for an anti-stigma campaign, but rather point to a more specific focus, such as perceived dangerousness.

Discussion

1. It would appear that the mentally ill are not held in the same negative regard as they were 20 or 30 years ago.

2. The results do not support the view that medical students are particularly prone to negative attitudes.

3. The results do not support the utility of a broad approach for an anti-stigma campaign, but rather point to a more specific focus, such as perceived dangerousness.

4. It may be better to focus on a clearly definable problem (e.g. housing, relationships, employment), rather than treating stigma as if it is the primary issue.

FIN

OPPOSITION TO WORK OR LIVING ARRANGEMENTS FOR THOSE WITH SCHIZOPHRENIA

0%

10%

20%

30%

40%

50%

Live Near Work With Live With

SOCIAL DISTANCE Closer

Per

cent

Opp

osed

Calgary Drumheller