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Alex Capshew
Department of Sociology

Tracy James
IU Media Relations

Last modified: Monday, April 30, 2007

Making a difficult situation worse: Stigma and mental health in children

April 30, 2007

BLOOMINGTON, Ind. -- Children with depression or ADHD and their parents not only face the challenge of an illness, but may confront the stigma that accompanies treatment and social rejection, according to the first-ever national study to examine Americans' views of mental health issues in children.

The four-part study, conducted by sociologists at Indiana University and colleagues from the University of Virginia and Columbia University, found a high level of skepticism regarding psychiatric medications, with 66 percent of respondents saying the medications just delayed solving the "real" behavior-related problems, and 86 percent saying physicians overmedicate children for common behavior problems. Most Americans were concerned about confidentiality and the immediate and long-term effects of treatment on children's futures.

While levels of prejudice appear to be lower than in studies related to adults, the researchers found that Americans report believing children with depression are more likely to behave in a violent manner, compared to their expectations of adults with depression. In fact, Americans see childhood depression as more serious, more in need of treatment and more problematic overall than adult depression .

Bernice Pescosolido

Bernice Pescosolido, stigma expert and director of the Indiana Consortium for Mental Health Services Research

Print-Quality Photo

Regardless of how much truth lies in the stigma, these common perceptions color the support and advice people get from their friends, family and even their physicians. It can create a reluctance to seek help, fears of exclusion for children and their parents, and a feeling of lower self-worth among children, all fears that can make a difficult situation worse.

"These findings are stunning," said Bernice Pescosolido, the IU sociology professor who led the national study. "We see a kinder response toward children than adults with mental health problems. However, the concerns about children's identity and opportunities being spoiled because they had challenges that could be helped by mental health treatment signal delays in treatment, misinformation and stigma."

This first set of results from the National Stigma Study-Children is appearing in a special section of the May issue of Psychiatric Services. The four-part study draws from nationally representative surveys and addresses attitudes toward treatment and medications, perceived danger of children with mental health problems, comparisons between attitudes toward adults with depression verses children, and public awareness and beliefs concerning attention-deficit hyperactivity disorder.

"Given the high level of public and professional discussion about the rise in children's use of psychiatric medication, we knew surprisingly little about what the public thought about child and adolescent disorders, available treatments or the parents and children who experience these disorders," Pescosolido said.

For a copy of the study, contact Alex Capshew, 812-855-6256 or

Most of the findings were based on a 2002 nationally representative survey involving 1,393 adults who were interviewed in person about vignettes involving an 8-year-old child and 14-year-old adolescent. They were interviewed as part of the General Social Survey, which is conducted by the National Opinion Research Center at the University of Chicago. The findings in the article, "Comparison of public attributions, attitudes and stigma in regard to depression among children and adults," also compare responses from the 2002 survey to similar questions in the 1996 GSS.

Below are some key findings:

  • Potential for violence: Forty percent of respondents believed children with depression would be dangerous to others, compared to 30 percent who believed adults with depression would be dangerous to others. The study found that 31 percent of respondents reported believing that children with ADHD would be dangerous to others.
  • Potential for rejection: Forty-five percent believed that rejection at school is a likely consequence of getting treatment and 43 percent believe that stigma associated with childhood treatment will have a negative ramification into adulthood.
  • Negative attitudes toward medications: Most respondents (85 percent) felt that doctors overmedicate children, that medications have "long-term negative effects" on a child's development (68 percent), and that giving children medications "turns kids into zombies" (52 percent) and prevents families from working out problems (56 percent).
  • Attention-deficit hyperactivity disorder: More than half (64 percent) said they had heard of ADHD, but less than half of those respondents (46 percent) were able to provide an answer that indicated specific knowledge of symptoms, causes or medications used to treat it. IUB Sociology Professor Jane Mcleod, the lead of the ADHD analysis, said the lack of knowledge regarding ADHD, its symptoms and its causes makes it difficult for parents, teachers and other adults to make informed decisions about how to help these children. Men, people of color and people with less education were less likely to recognize ADHD. If children are mislabeled or the problem is over-generalized, it hurts the children who actually have ADHD and the children who are mislabeled, she said.
  • Fears about confidentiality: Regardless of laws, 57 percent of respondents reported serious concerns about whether confidentiality would be maintained.

Pescosolido is a Distinguished Professor in the IU Bloomington Department of Sociology and director of the Indiana Consortium for Mental Health Services Research. Co-authors include Jack K. Martin and McLeod, professors in the IUB Department of Sociology; Brea L. Perry and Danielle L. Fettes, doctoral candidates in the department; Peter S. Jensen, director of the Center for the Advancement of Children's Mental Health, Columbia University; and John Monahan, a professor of psychology and psychiatric medicine at the University of Virginia School of Law.

To speak with Pescosolido or any of the other researchers, contact Alex Capshew, 812-855-6256 or To schedule a studio interview, contact Tracy James, 812-855-0084 or

"Stigmatizing attitudes and beliefs about treatment and psychiatric medications for children with mental illness,""Comparison of public attributions, attitudes and stigma in regard to depression among children and adults,""Public knowledge, beliefs and treatment preferences concerning attention-deficit hyperactivity disorder," and "Perceived dangerousness of children with mental health problems and support for coerced treatment," Psychiatric Services, May 2007, 58 (5).