Stigma in Global Context - Mental Health Study

Mental Illness ranks among the most critical health problems in the global burden of disease, and the stigma associated with it is reported to be at the center of both individual (e.g., low service use, hindered progress toward recovery) and system problems (e.g., inadequate funding of research and treatment infrastructures). In fact, studies such as the World Health Organization's International Study of Schizophrenia (ISOS) have suggested that documented differential outcomes for persons with one of the most serious forms of mental illnessis due, in part, to the differing cultural norms, attitudes, and behaviors toward persons with mental illness across societies. Yet, we know relatively little about whether and how the public's reaction to mental illness varies across countries. This study a theoretically-based and methodologically coordinated attempt to understand the extent to which mental illness is understood and stigmatized across countries. 

Using a multi-disciplinary and multi-level theoretical framework and a subset of International Social Survey Program (ISSP) member countries, the Stigma in Global Context - Mental Health Study (SGC-MHS) is a 16-country comparative study of the levels and correlates of the stigma of major depression and schizophrenia. The study comprises three specific aims. First, we derived a comprehensive theoretical model of the etiology of the stigma of mental illness that is informed by an interdisciplinary synthesis of research on the causes and correlates of stigmatizing responses to persons with mental illness. Second, we developed and tested an instrument based on this framework in collaboration with an international set of mental health and survey research experts. Collected data came from face-to-face interviews with a nationally representative sample (n=1,000 - 1,500) of adults in each country. This provided national and international descriptive profiles of the public's knowledge of, familiarity with, beliefs about, and stigmatizing responses toward mental illness. Third, we empirically examined hypotheses proposed under the theoretical model, both nationally and cross-nationally. By understanding the public's reaction to different types of serious mental illness, clinicians and researchers will be in a better position to account for the observed heterogeneity in outcomes of persons with serious mentail illness within and across countries. This knowledge can provide the scientific base for public health and treatment system interventions to mitigate the devastating negative effects of stigma on the lives of persons with serious mental illness.