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Public Stigma of Mental Illness in the United States: A Systematic Literature Review
Open accessAbstract
Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public's stigma toward mental disorders, (2) summarize stigma findings focused on the public's stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public's stigma of mental illness.
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“The aforesaid has great relevance in the global context, where research has shown the presence of high levels of discrimination, stigma, and prejudice toward those impacted by mental health problems, especially schizophrenia and bipolar disorder [6,7].”
From Innovative Technology–Based Interventions to Reduce Stigma Toward People With Mental Illness: Systematic Review and Meta-analysis (2022) · cites this paper as [7]
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“…distance towards individuals with substance abuse in private life (socializing, relationships) and work life, and greater willingness to discriminate against them in terms of employment, housing, and governmental policy (Pescosolido et al., 1999; Parcesepe and Cabassa, 2013; Barry et al., 2014).”
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Mental Health Stigma in the Military
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Predictors of Mental Health Stigma among Police Officers: the Role of Trauma and PTSD
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“Chronic illness stigmatization, most notably characterized in mental health 43–45 and HIV/AIDS 46–48 research, is a common and global social issue.”
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“Furthermore, despite MHS being widely prevalent within the general population (Parcesepe and Cabassa, 2013), few studies have assessed MHS and its consequences within the general population.”
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Gaddis, S. M., Ramirez, D., & Hernandez, E. L. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.11.029 · Cited by 90
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Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions
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Automated Decision-Making and Big Data: Concerns for People With Mental Illness
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“Public stigma against mental illness remains widespread in the workplace in the USA [113, 114].”
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“Despite becoming more sophisticated in understanding MI, a near public majority expresses animosity and endorses exclusion.(6) The battle over parity in insurance, research funding, and services continues.”
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“In addition, there may be other potential confounders for mental-health-related stigma; for example, race, socioeconomic status, and educational qualifications may be relevant factors.(44) While a randomized controlled trial creates strong evidence and theoretically prevents potential confounding effects, it seems to…”
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“Stigma is prevalent, both among the general public and those with mental health training (Kingdon, Sharma, & Hart, 2004; Lyons & Ziviani, 1995; Parcesepe & Cabassa, 2013), is often perpetuated through the media (Chopra & Doody, 2007), and has persisted over the past several decades at a consistent…”
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Stigmatization toward irritable bowel syndrome and inflammatory bowel disease in an online cohort
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Perceived stigma of caregivers: Psychometric evaluation for Devaluation of Consumer Families Scale
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Review of Mobile Health Technology for Military Mental Health
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Self-Compassion: a Protective Factor for Parents of Children with Autism Spectrum Disorder
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“…negative attitudes, beliefs, and behaviours that members of the public have and direct towards persons with disabilities, mental illnesses, and physical illnesses, such as HIV, often motivating individuals to fear, reject, avoid, and discriminate against these groups (Parcesepe and Cabassa 2013).”
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Almost Equal: Consumption under Fragmented Stigma
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“As one of the first countries to establish a mental health policy in 1996, the United States has seen its residents hold increasingly positive attitudes toward seeking professional help for mental health problems over time [15].”
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“…negative stereotypes (e.g. believing people with mental illness are dangerous) and discriminatory behaviors (e.g. avoiding living near people with mental illness), the behavioral component of stigma toward individuals with mental illness has been relatively understudied (Parcesepe & Cabassa, 2013).”
BackgroundKnowledge and attitudes on electroconvulsive therapy in Germany: A web based survey
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“For example, similar typologies, such as intentional care fragmentation, and similar drivers, such as stigma concerns, are likely to be seen in the mental healthcare field, where longstanding prejudicial attitudes about mental illness may lead some individuals to segregate psychiatric or psychological services from ot…”
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“Perceived public stigma is a recognized barrier that affects individuals from engaging in mental healthcare (Parcesepe & Cabassa, 2013).”
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“28,29 33 The worries of prejudices may influence the patient’s efforts to find adequate treatment.”
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“The unaffected majority feels more anxious, less empathic, more socially distant towards affected persons, and is less supportive of policies that benefit people with mental disorders [19,28].”
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“Second, many Americans hold stigmatizing attitudes towards people with mental illness (Parcesepe and Cabassa 2013; Stuber et al. 2014); and these attitudes are inversely correlated with public support for mental health legislation (Barry and McGinty 2014; Corrigan and Watson 2003; Corrigan et al.…”
BackgroundThe Stigma of Mental Illness: Using Segmentation for Social Change
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“While there is an increasing acceptance of the chronic disease model for substance use disorders, there remains more stigmatization when compared to other health conditions.(11,12) While stigma may originate in an effort to discourage unhealthy behaviors, it carries negative consequences.”
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BackgroundInfluentialStigma of Disease and Its Impact on Health
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Townsend, M., Pareja, K., Buchanan-Hughes, A., Worthington, E., Pritchett, D., Brubaker, M., Houle, C. R., Mose, T. N., & Waters, H. C. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s343211 · Cited by 39
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Reed, O. M., Franks, A. S., & Scherr, K. C. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000138 · Cited by 36
Reducing the stigma of mental illness: Current approaches and future directions.
Casados, A. T. (2017) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12206 · Cited by 35
Mezuk, B. R., Needham, B. L., Joiner, K. L., Watkins, D. C., Stoddard, S. A., Burgard, S. A., & Link, B. G. (2020) · Pedagogy in Health Promotion · doi:10.1177/2373379920922871 · Cited by 34
“…disorders including depression, bipolar disorder, and schizophrenia has remained essentially unchanged and substantially negative over the past two decades, and for some conditions, such as substance use disorders, attitudes have worsened over time (Parcesepe & Cabassa, 2013; Pescosolido, 2013).”
BackgroundA systematic review of disease related stigmatization in patients living with prostate cancer
Larkin, D., Birtle, A. J., Bradley, L., Dey, P., Martin, C. R., Pilkington, M., & Romero-Rivas, C. (2022) · PLoS ONE · doi:10.1371/journal.pone.0261557 · Cited by 37
“Chronic illness stigmatization has been explored across numerous health conditions, most notably in HIV/AIDS [14] mental health [15, 16], but has also been explored in cancers such as breast [17, 18], colorectal, skin [19] and lung cancer [20–22] as well as other chronic conditions such as obesity [23].”
BackgroundReturning Individual Research Results from Digital Phenotyping in Psychiatry
Shen, F. X., Baum, M. L., Martinez‐Martin, N., Miner, A. S., Abraham, M. E., Brownstein, C. A., Cortez, N. G., Evans, B. J., Germine, L. T., Glahn, D. C., et al. (2023) · The American Journal of Bioethics · doi:10.1080/15265161.2023.2180109 · Cited by 34
“For instance, there is a deep literature on mental health stigma (Parcesepe and Cabassa 2013; Sickel, Seacat, and Nabors 2014), its serious consequences (Sharac et al. 2010), and efforts to reduce it (Yanos et al. 2015).”
BackgroundRisk of violence among patients in psychiatric treatment: results from a national census
Ose, S. O., Lilleeng, S. E., Pettersen, I., Ruud, T., & van Weeghel, J. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1352024 · Cited by 34
“adherence) and their willingness to seek help (5,6).”
BackgroundPsychology across cultures: Challenges and opportunities
Edge, D., & Lemetyinen, H. (2019) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12229 · Cited by 34
Pederson, A. B., Burnett‐Zeigler, I., Fokuo, J. K., Wisner, K. L., Zumpf, K. B., & Oshodi, Y. (2020) · Pan African Medical Journal · doi:10.11604/pamj.2020.37.5.24898 · Cited by 35
“Even fewer studies of acculturation factors and cultural variations that influence mental health stigma are available [6, 14].”
BackgroundHutson, P., & Hutson, J. (2023) · Journal of Organizational Psychology · doi:10.33423/jop.v23i2.6159 · Cited by 47
Hack, S. M., Muralidharan, A., Brown, C. H., Drapalski, A. L., & Lucksted, A. A. (2019) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000385 · Cited by 33
“Older age, male gender, non-White race, and fewer years of education have been associated with endorsing stigmatizing beliefs (Corrigan & Watson, 2007; Parcesepe & Cabassa, 2013), perceived public stigma, selfstigma, and decreased initiation of mental health services (Wu et al., 2017).”
BackgroundThe mediating role of knowledge on the contact and stigma of mental illness in Hong Kong
Fang, Q., Zhang, T., Wong, Y. L. I., Yau, Y. Y., Li, X., Li, J., CHUI, C. H.-K., Tse, S. S.-K., Chan, C., Chen, E. Y. H., et al. (2020) · International Journal of Social Psychiatry · doi:10.1177/0020764020975792 · Cited by 34
“Numerous studies have documented that negative stereotypes were commonly endorsed by the general public in both Western and nonWestern countries (Corrigan et al., 2015; Parcesepe & Cabassa, 2013; Pescosolido, 2013; Xu et al., 2017).”
BackgroundInternalized Stigma in Persons With Mental Illness in Qatar: A Cross-Sectional Study
Kehyayan, V., Mahfoud, Z. R., Ghuloum, S., Marji, T., & Al-Amin, H. A. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.685003 · Cited by 33
Global cancer stigma research: a U.S. National Cancer Institute workshop report
Heley, K. M., Vanderpool, R. C., & Vedham, V. (2024) · JNCI Monographs · doi:10.1093/jncimonographs/lgad038 · Cited by 32
Collaboration to Support Rural Student Social-Emotional Needs
Nichols, L. M., Goforth, A. N., Sacra, M. M., & Ahlers, K. P. (2018) · The rural educator · doi:10.35608/ruraled.v38i1.234 · Cited by 40
“In general, there are perceptions that individuals with mental health problems are dangerous or that children’s mental health problems are attributed to lack of appropriate parenting (Parcesepe & Cabassa, 2013).”
BackgroundDiebo, B. G., Cherkalin, D., Jalai, C. M., Shah, N. V., POORMAN, G. W., Beyer, G. A., Segreto, F. A., Lafage, V., Naziri, Q., Newman, J. M., et al. (2018) · Journal of Orthopaedics · doi:10.1016/j.jor.2018.02.010 · Cited by 32
Overcoming the Mental Health Stigma Through m-Health Apps: Results from the Healthy Minds Study
Kim, H. M., Xu, Y., & Wang, Y. (2022) · Telemedicine and e-Health · doi:10.1089/tmj.2021.0418 · Cited by 31
“22 Widespread stigma and negative stereotypes include the ideas that having mental health problems such as depression is being weak, inferior, incompetent, or vulnerable, and that the condition is shameful, embarrassing, or socially unacceptable.”
Social Stigma Towards Mental Health Problems in Spain: A Systematic Review
Zamorano, S., Sáez-Alonso, M., González‐Sanguino, C., & Muñoz, M. (2023) · Clínica y Salud · doi:10.5093/clysa2023a5 · Cited by 38
Racial and ethnic disparities in depression treatment
Cardemil, E. V., Nelson, T., & Keefe, K. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.01.021 · Cited by 30
Genetic causal attribution of epilepsy and its implications for felt stigma
Sabatello, M., Phelan, J. C., Hesdorffer, D. C., Shostak, S., Goldsmith, J., Sorge, S. T., Winawer, M. R., Chung, W. K., & Ottman, R. (2015) · Epilepsia · doi:10.1111/epi.13113 · Cited by 29
Handbook of Forensic Mental Health Services
Roesch, R. G., & Cook, A. N. (2017) · Routledge eBooks · doi:10.4324/9781315627823 · Cited by 35
“It is conveyed by the widespread perception among the general public that individuals with mental illnesses are dangerous (Jorm, Reavley, & Ross, 2012; Mestdagh & Hansen, 2014; Parcesepe & Cabassa, 2013; Pescosolido, 2013; Schomerus et al., 2012).”
BackgroundStigmatizing attitudes of Swiss youth towards peers with mental disorders
Dey, M., Castro, R. P., Jorm, A. F., Marti, L., Schaub, M. P., & Mackinnon, A. J. (2020) · PLoS ONE · doi:10.1371/journal.pone.0235034 · Cited by 29
“, in terms of the targeted age group)–stem from the particular mental disorders that were considered in the included studies, since different mental health conditions are stigmatized to different extents [9, 10, 12, 13].”
BackgroundResultCrocker, A. M., Kessler, R. S., van Eeghen, C., Bonnell, L. N., Breshears, R. E., CALLAS, P. W., Clifton, J., Elder, W. G., Fox, C., Frisbie, S., et al. (2021) · Trials · doi:10.1186/s13063-021-05133-8 · Cited by 30
Jankowski, S. E., Yanos, P. T., Dixon, L. B., & Amsalem, D. (2022) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac143 · Cited by 28
Identifying Those Whom Health Promotion Hardly Reaches
Sokol, R., Fisher, E., & Hill, J. (2015) · Evaluation & the Health Professions · doi:10.1177/0163278715605883 · Cited by 30
“…HIV/AIDS (Monteiro, Villela, & Soares, 2013), tuberculosis (Juniarti & Evans, 2011), Hepatitis C (Treloar, Rance, & Backmund, 2013), substance use (van Boekel, Brouwers, van Weeghel, & Garretsen, 2013), and mental health (Ando, Yamaguchi, Aoki, & Thornicroft, 2013; Parcesepe & Cabassa, 2013).”
Self-stigma and treatment effectiveness in patients with anxiety disorders – a mediation analysis
Ocisková, M., Praško, J. P., Vrbová, K., Kasalová, P., Holubová, M., Grambal, A., & Machu, K. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s152208 · Cited by 31
“In accordance with widespread prejudices, the patient may think that he is somehow inferior, weak, unwanted, or unreliable because of his mental issues.(3) As these interpretations tend to be rigidly held, and as they are unrealistically negative and unbalanced (“I am weak, inferior, different, .”
Metadata
- Authors
- Parcesepe, A. M., & Cabassa, L. J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Parcesepe, Angela M.
- Venue
- Administration and Policy in Mental Health and Mental Health Services Research
- Published
- 2012-07-26
- Volume
- 40
- Issue
- 5
- Pages
- 384-399
- ISSN
- 0894-587X (ISSN-L)
- 1573-3289
- PMC
- PMC3835659
- OpenAlex
- W2056883717
- Cited by
- 554
- References
- 69
- Citations by year
- 2026: 25 · 2025: 32 · 2024: 66 · 2023: 64 · 2022: 60 · 2021: 68 · 2020: 51 · 2019: 34 · 2018: 38 · 2017: 48 · 2016: 30 · 2015: 18 · 2014: 6 · 2013: 11 · 2012: 2
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Administration and Policy in Mental Health and Mental Health Services Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01 MH09118, K01MH091118, R25MH080916)
- National Institute on Minority Health and Health Disparities (L60 MD001850)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- public stigma, mental illness, stigma reduction, mental health service utilization, child psychopathology, adults with mental illness, United States
- MeSH terms
- Attitude to Health, Mental Disorders, Humans, Mental Health Services, Prejudice, United States, Social Stigma
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