Organizationsand programs have been set up all over the globe in the hopes of urging people to end prejudice. According to a research article, which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science, such programs may actually increase prejudices.
In experiment one; participants were randomly assigned one of two brochures to read: an autonomy brochure or a controlling brochure. These brochures discussed a new campus initiative to reduce prejudice. A third group was offered no motivational instructions to reduce prejudice. The authors found that, ironically, those who read the controlling brochure later demonstrated more prejudice than those who had not been urged to reduce prejudice. Those who read the brochure designed to support personal motivation showed less prejudice than those in the other two groups.
In experiment two, participants were randomly assigned a questionnaire, designed to stimulate personal or controlling motivation to reduce prejudice. The authors found that those who were exposed to controlling messages regarding prejudice reduction showed significantly more prejudice than those who did not receive any controlling cues.
Legault stresses the need to focus less on the requirement to reduce prejudices and start focusing more on the reasons why diversity and equality are important and beneficial to both majority and minority group members.
More than half of people with mental illness don't receive help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood. That's because stigma, prejudice and discrimination against people with mental illness are still very much a problem.
Stigma often comes from lack of understanding or fear. Inaccurate or misleading media representations of mental illness contribute to both those factors. A review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness.
Stigma around mental illness especially an issue in some diverse racial and ethnic communities and it can be a major barrier to people from those cultures accessing mental health services. For example, in some Asian cultures, seeking professional help for mental illness may be counter to cultural values of strong family, emotional restraint and avoiding shame. Among some groups, including the African American community's, distrust of the mental healthcare system can also be a barrier to seeking help. (See more on mental health in Diverse Populations.)
Media representations of people with mental illness can influence perceptions and stigma, and they have often been negative, inaccurate or violent representations. A study published by Scarf, et. al. in 2020 looked at a recent example, the popular film Joker (2019), which portrays the lead character as a person with mental illness who becomes extremely violent. The study found that viewing the film "was associated with higher levels of prejudice toward those with mental illness." Additionally, the authors suggest, "Joker may exacerbate self-stigma for those with a mental illness, leading to delays in help seeking."
The stigma of mental illness is universal. A 2016 report on stigma concluded "there is no country, society or culture where people with mental illness have the same societal value as people without mental illness."
Stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment. A recent extensive review of research found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illnesses. Effects can include:
A 2017 study by Oexle et al involving more than 200 individuals with mental illness over a period of two years found that greater self-stigma was associated with poorer recovery from mental illness after one and two years.
An editorial in the Lancet notes that the impacts of stigma are pervasive, affecting political enthusiasm, charitable fundraising and availability, support for local services and underfunding of research for mental health relative to other health conditions.
Stigma around mental illness is especially an issue in some diverse racial and ethnic communities, and it can be a major barrier to people from those cultures accessing mental health services. For more information, please see Mental Health Disparities: Diverse Populations.
Substantial research shows that knowing or having contact with someone with mental illness is one of the best ways to reduce stigma. Individuals speaking out and sharing their stories can have a positive impact. When we know someone with mental illness, it becomes less scary and more real and relatable.
Teens are searching for health information online and mental health issues are among the top searches, according to a national survey from Hope Lab (Hope Lab, 2021). About four in 10 teens said they have looked for people with similar health concerns. Many celebrities, such as Demi Lovato, Dwayne "The Rock" Johnson, Michael Phelps, Taraji P. Henson and Lady Gaga have publicly shared their stories of mental health challenges and brought the discussion much more into the general media and everyday conversation. Young people are looking for information and for these personal stories online.
Recent studies have also shown the effectiveness of brief videos in reducing stigma. One study tracked more than 700 students across two years in a randomized controlled trial and found that watching videos of people sharing their personal experiences and videos with information on mental health improved students' mental health care access (da Conceio, et al 2023). The researchers found that the intervention was particularly effective for those in need, enabling them to recognize their need for care and behave accordingly. Another study found that a video featuring an actor sharing a story was as effective as a person with lived experience. (Amsalem, et al 2023).
Social marketing campaigns can also be effective. For example, a research study looked at the effectiveness of an anti-stigma social marketing campaign in California and found that the campaign increased service use by helping people better understand symptoms of distress and increasing awareness that help is available. (Collins, et al 2019). The researchers suggest that widespread exposure to the mental health campaign could significantly increase access to treatment.
Studies of race and health frequently invoke racism, prejudice, and discrimination as possible reasons for high levels of morbidity and mortality among black (Jackson et al., 1996; Krieger, 1999; Williams and Neighbors, 2001) and among other racial and ethnic minorities (e.g., Amaro et al., 1987; Salgado de Snyder, 1987). Definitions of these terms vary, and no definitions are universally accepted (Clark, 2004). For our purposes, we use these terms somewhat interchangeably as indicating negative attitudes toward or biased treatment of one group by another (Williams et al., 2003).
Various types of racism have been described (Jones, 1997): personal, which may be considered the same as prejudice (Allport, 1958); institutional, involving a set of environmental conditions, such as housing market conditions, that favors one group over another; and cultural, referring to shared beliefs about the superiority of one group over another. Racism also often involves control by one group over resources that another group wants or needs (Jones, 1997).
Prejudice, discrimination, and racism could affect health in several ways. First, discrimination could determine a group's living conditions and life chances, affecting such areas as education, employment, and housing. As we note above, low socioeconomic status is one of the most important predictors of adverse changes in health status (Anderson and Armstead, 1995; Williams, 1990; Williams and Collins, 1995), though the specific mechanisms by which low status compromises health have yet to be adequately elucidated (Anderson and Armstead, 1995; Clark et al., 1999). Similarly, all the mechanisms by which discrimination limits economic and social opportunities still need to be fully accounted for (Williams and Collins, 2001), but that it has historically had an effect on minority socioeconomic status is unquestioned.
Second, discrimination could lead to differences in access to and quality of health care (Blendon et al., 1989; Council on Ethical and Judicial Affairs, 1990; Institute of Medicine, 2002), a possibility we examine in Chapter 10. Third, the experience of specific incidents of unfair treatment on the basis of race or ethnicity may generate psychic distress and other changes in physiological processes that adversely affect health (Clark, 2004; Clark et al., 1999; Landrine and Klonoff, 1996; McNeilly et al., 1996). Fourth, some of the coping strategies that people use as they grapple with inequitable living conditions and a hostile psychosocial environment, such as internalizing negative stereotypes (White et al., 2000) or using drugs and alcohol (Jackson and Ramon, 2002), may also impair physical and psychological functioning (Clark, 2004).
Early literature on black health, especially mental health, reflects a clear consensus that racism and discrimination have adverse effects (e.g., McCarthy and Yancey, 1971). That some degree of discrimination continues is clear: for example, audit studies continue to document discrimination in housing and employment (Fix and Struyk, 1993). However, there have been comparatively few attempts to explore empirically the health effects of such discrimination among blacks, whether on children, adolescents, or adults (Jackson et al., 1996; Landrine and Klonoff, 1996; Thompson, 1996; Utsey and Ponterotto, 1996). There have been even fewer empirical studies of any kind on other racial and ethnic groups (Williams et al., 2003). Researchers have continued to note that discrimination is an important factor in understanding black health status, and some suggest that it may account for particular patterns of association (Landrine and Klonoff, 1996). Fernando (1984) even proposed that racial discrimination does not just add to stress; it is an actual pathogen. Nevertheless, these constructs and arguments have received limited empirical attention (Harrell et al., 1998; Krieger, 1999), especially as they relate to the life course and aging.
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