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 STIGMA
Community 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 Unit
Calgary Regional Health Authority
Pilot Site for the WPA Campaign Against the Stigma of
Schizophrenia
Comparison
Site
WPA Pilot
Sites
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
1
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%
This is an underestimate. An unknown number of people attended the meeting who were
officials of agencies that serve people with schizophrenia, and were thus not eligible to complete
the questionnaire.
Demographics
Edm
Sex
Male
Female
Schiz
Soc
49.0% 32.5%
51.0% 67.5%
Med
Stud.
50.7%
49.3%
Age
15-29
30-59
60+
25.5% 15.8%
55.3% 63.2%
19.2% 21.1%
90.5%
9.5%
0.0%
Education Elem
0.5% 0.0%
Jr High
5.8% 2.5%
High Sch 40.2% 27.5%
Coll/Tech 22.4% 15.0%
Univ
31.1% 55.0%
0.0%
1.6%
1.6%
0.0%
96.8%
METHODS
Surveys included the following content areas:

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
PERCEIVED CAUSES OF SCHIZOPHRENIA
100%
80%
60%
Community
Schiz Soc
Med Students
40%
20%
0%
Brain
Chem
Genetics
Stress
Trauma Parenting
Abuse
Soc
Values
Poverty
PERCENTAGE OF RESPONDENTS REPORTING A CONDITION TO BE
THE "MOST DISABLING"
80%
60%
Community
40%
Schiz Soc
Med Students
20%
0%
Loss of Mind
Blindness
Bedridden
Disfigured
Note: For the Community sample, "Blindness" also includes "Deafness"
Sex
Percent who would befriend or marry
someone with schizophrenia
Befriend
Community
Schiz. Soc.
83%
87%
Students
79%
Percent who would befriend or marry
someone with schizophrenia
Community
Schiz. Soc.
Befriend
83%
87%
79%
Marry
27%
10%
6%
Students
PROPORTION OF RESPONDENTS IN OPPOSITION TO SELECTED
HYPOTHETICAL "GROUP HOMES"
80%
60%
Schiz Soc
Med Students
40%
Community
20%
0%
Ex Con
Drug Ab
Alcohol
Ab
AIDS
Victim
Schiz Pt
Type of Resident
Ment Hcp
Phys
Disab
PERCEIVED DANGEROUSNESS OF THE MENTALLY ILL AND THE
EFFECTIVENESS OF TREATMENT
100%
90%
Proportion of Respondents
80%
70%
60%
50%
40%
30%
20%
10%
0%
Community
Schiz Soc
Dangerous
Rx Effective
Med Students
Perceptions of the Most and Least Successful Types of
Treatment
Drugs
Alone
Psychosocial
Alone
Both
(Together)
Both (Equally
*
“Worse”)
Schizophrenia
Society (Most)
Med. Students
(Most)
Edmonton
1997 (Most)
Schizophrenia
Society (Least)
Med. Students
(Least)
0
3%
7%
9%
16%
0
0
9%
44%
59%
100%
97%
85%
0
0
---
---
---
47%
25%
Perceptions of the Most and Least Successful Types of
Treatment
Drugs
Alone
Psychosocial
Alone
Both
(Together)
Both (Equally
*
“Worse”)
Schizophrenia
Society (Most)
Med. Students
(Most)
Edmonton
1997 (Most)
Schizophrenia
Society (Least)
Med. Students
(Least)
0
3%
7%
9%
16%
0
0
9%
44%
59%
100%
97%
85%
0
0
---
---
---
47%
25%
PROPORTION IN FAVOUR OF SELECTED ADDITIONAL APPROACHES FOR DEALING WITH
MENTAL ILLNESS
100%
80%
60%
40%
20%
0%
Research
Public
Education
Family/
Friends
Work/
Recreation
Community
Rx
Rx Group
Homes
Community
Schiz Soc
Med Students
Self Help
Drug
Treatment
Mental
Hospitals
PROPORTION OF RESPONDENTS IN FAVOUR OF PAYING MORE TAXES IN
ORDER TO IMPROVE SERVICES FOR PEOPLE WITH SCHIZOPHRENIA
100%
80%
60%
40%
20%
0%
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
Percent Opposed
50%
40%
30%
20%
10%
0%
Live Near
Work With
SOCIAL DISTANCE
Calgary
Closer
Drumheller
Live With