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Bernice Pescosolido
Department of Sociology

Hal Kibbey
IU Media Relations

Last modified: Thursday, June 9, 2005

$3.5 million grant from NIH funds international study of mental health stigma

Results may improve recovery rate of patients in United States

Bernice Pescosolido

Print-Quality Photo

JUNE 9, 2005

BLOOMINGTON, Ind. -- A greater percentage of people in developing countries recover from mental illness such as schizophrenia or depression than their counterparts in developed countries. This surprising fact, confirmed by numerous medical studies by the World Health Organization and other groups, has led to much debate about why more advanced systems of mental health treatment get worse results.

To find the answer, medical sociologist Bernice Pescosolido is leading the first study comparing how ordinary citizens in 15 countries around the world regard mental illness. Funded with $3.5 million by the National Institutes of Health, the five-year project, called the International Mental Health Stigma Study, is designed to determine the effect of other people's attitudes and behaviors on the recovery rate of the mentally ill. The results of the study may help improve the recovery rate of patients in the United States.

"In each study verifying that mentally ill people in developing countries recover better, at the end the researchers said, 'It must be because of social stigma. We've tested everything else,'" said Pescosolido, Chancellor's Professor of Sociology at Indiana University Bloomington. "Our project is the first study of the effect of social stigma in mental illness."

Depression has become the second-highest global burden of disease, she said.

A survey of people's attitudes toward mental illness is not as straightforward as it might seem. "You can't say to somebody, 'Do you want to live next door to somebody with mental illness?' They know what the right answer is," Pescosolido said.

"So what we do instead is to give people a story of a person, saying, 'Here's what the person is feeling and doing. What do you think is going on with this person?'" she explained.

Stigma is a mark that has a social meaning attached to it, she said. The first problem is to determine what it is about stigmatizing influences that might matter. "People may not recognize mental illness," she pointed out. "You could give one person a story, and another person the same story, and the first person might say, 'Oh, that person is clearly clinically depressed.' And the other person says, 'No, they're just lazy,' or 'They'll get better over time,' or 'Get over it. Pull yourself up by your bootstraps.'"

Another issue could be people's willingness to refer someone for services. Perhaps they are afraid of the mental health system, or they may think that other institutions of society should be helping these people, such as the family or the church or other institutions of assistance.

A third issue is that there may be differences across countries in how accepting people are of those with mental illness, Pescosolido said. "The Netherlands, for example, has innovative programs where people adopt people with mental illnesses and have them living with them in their homes. We don't know whether that's because people there are not as judgmental."