Cited by 314Mental Health Treatment and AccessPsychology and Mental HealthChild and Adolescent Psychosocial and Emotional Development

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Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders

Moses, Tally·2010·Social Science & Medicine

DOI 10.1016/j.socscimed.2009.12.022

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Abstract

Stigma directed at adolescents diagnosed with emotional and behavioral disorders by individuals in their interpersonal network likely undermines their wellbeing, yet little is known about their subjective stigma experiences. In particular, the prospect of diagnosed youth experiencing prejudice and discrimination by family members has not previously been examined. This study examines adolescents' perceptions of being treated 'differently' because of mental health problems by family members, peers, and school staff. Qualitative analysis of narratives from mixed method interviews with 56 adolescents in a mid-western US city demonstrated variation in the perceived extent and nature of stigma and in contextual factors perceived as promoting or protecting from stigmatization, depending on the interpersonal domain. The greatest number of participants experienced stigmatization in relationships with peers (62%); this often led to friendship losses and transitions. Participants reporting no peer stigmatization often reported socializing with others "in the same boat" or concealing problems--methods of avoiding potentially stigmatizing interactions. Close to half (46%) described experiencing stigmatization by family members, which often took the form of unwarranted assumptions, distrust, avoidance, pity, and gossip. About one third (35%) of participants reported stigma perpetrated by school staff, who expressed fear, dislike, avoidance, and under-estimation of their abilities. Fortunately, 22% reported "different" treatment by school staff, but this treatment was interpreted as positive and supportive. Results showed that perceived stigmatization in one domain was associated with perceived stigma in other domains. The results suggest that efforts to combat stigmatization of youth with mental health disorders must help family members, peers, and school staff overcome their inclinations to make negative assumptions and discriminate against these youth.

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“associated with an adolescent’s emotional adjustment and academic success (Demaray & Malecki, 2002; Moses, 2010).”
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“In line with the existing literature [36, 40, 49], we identified that youth often fear judgement or misunder-standing from their peers, family, and society.”
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Albuquerque, S., Carvalho, Á., de Sousa, B., da Costa, L. P., & Beato, A. F. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14041394 · Cited by 5
“Adolescents are especially susceptible to stigma, since social image, peer acceptance, and relationships strongly influence their self-esteem and identity [22–24].”
RETRACTED: “Adolescents who feel depressed are rejected but do not withdraw: A longitudinal study of ethnically diverse friendship networks in England, Sweden, and Germany”
Aronson, O., & Bergh, D. (2021) · SSM - Population Health · doi:10.1016/j.ssmph.2021.100889 · Cited by 5
Retracted
Estigma social hacia la enfermedad mental: factores relacionados y propiedades psicométricas del Cuestionario de Atribuciones-revisado
Rodríguez‐Meirinhos, A., & Suárez, L. A. (2020) · Universitas Psychologica · doi:10.11144/javeriana.upsy19.esem · Cited by 4
Exploring Emotional Dysregulation and Avoidance with Caregivers as the Mechanisms Linking Social Communication Understanding and Aggressive Behaviours
Thompson, E. L., Gillespie‐Smith, K., Mair, A. P. A., & Obsuth, I. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06276-8 · Cited by 5
“However, sensitivity should be taken when informing caregivers of these findings as caregivers of adolescents with developmental disabilities often experience blame or stigma (Francis, 2012), or hold themselves responsible (Moses, 2010) for their adolescent’s difficulties.”
Adolescent Friendship Formation and Mental Health: A Stochastic Actor-Based Model of Help-Seeking Behavior
Mundt, M., & Zakletskaia, L. I. (2019) · Journal of Social Structure · doi:10.21307/joss-2019-006 · Cited by 5
“Roughly 60% of adolescents with mental health needs perceive that they are treated differently or rejected by peers in their social networks (Moses, 2010).”
BackgroundResult
The responsibility of knowledge: Identifying and reporting students with evidence of psychological distress in large-scale school-based studies
Kern, M. L., Cahill, H., Morrish, L., Farrelly, A., Shlezinger, K., & Jach, H. K. (2020) · Research Ethics · doi:10.1177/1747016120952511 · Cited by 5
“Depending on the background, beliefs and experiences of the young person’s parent, such disclosures can also lead to repercussions at home (Kokanovic et al., 2006; Moses, 2010).”
Background
Perceptions of Personal Well-Being Among Youth Accessing Residential or Intensive Home-Based Treatment
Preyde, M., Watkins, H., Ashbourne, G., Lazure, K., Carter, J., Penney, R., White, S., Frensch, K. M., & Cameron, G. (2012) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2012.725372 · Cited by 4
“Moses (2010a) also conducted a study to investigate the perceptions of self-stigma among adolescents with various mental health disorders and their parents.”
BackgroundInfluential
‘It feels as if time has come to a standstill’: Institutionalised everyday lives among youth with a mental illness
Kessing, M. L., & Ravn, S. (2017) · Journal of Youth Studies · doi:10.1080/13676261.2016.1273523 · Cited by 4
“…on non-institutionalised youth and how they experience and negotiate illness-related stigma in social interactions (Hinshaw 2005; Leavey 2005; Moses 2009, 2010; Whitley and Campbell 2014) as well as their understanding of the illness and their management strategies (O’Reilly 2009; Issakainen…”
Background
Assessment of illness representations in mental disorders: A mini review
Averous, P., Charbonnier, É., & Dany, L. (2021) · L Encéphale · doi:10.1016/j.encep.2020.09.011 · Cited by 4
A mixed‐method systematic review of the perspectives of young people, carers and professionals on psychiatric diagnosis in childhood and adolescence
Gill, J., Jones, A., Price, K., Goodison, E., & Tyson, P. J. (2024) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12459 · Cited by 2
Stigma within families: impact of parental attitudes on youth’s mental health
Ranwa, R., & Arora, R. (2025) · Mental Health and Social Inclusion · doi:10.1108/mhsi-01-2025-0023 · Cited by 3
Family Spillover Effects of Marginal Diagnoses: The Case of ADHD
Persson, P., Qiu, X., & Rossin‐Slater, M. (2025) · American Economic Journal Applied Economics · doi:10.1257/app.20230303 · Cited by 3
Girls Tolerate Girls, men condemn men: Gender differences in the impact of beautification strategies on trustworthiness and morality evaluation
He, X., Liang, F., Wang, X., Liu, Y., Zhang, J., & Luo, J. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e20365 · Cited by 3
“It Was a Real Eye-Opener”
Shephard, M. T., & Garrison, K. (2024) · School Libraries Worldwide · doi:10.29173/slw8714 · Cited by 3
Blueprint for destigmatizing depression and increasing openness to treatment among adolescents using brief social contact-based videos: a qualitative study
DiGiovanni, M. J., Jankowski, S. E., Dixon, L. B., Martin, A., & Amsalem, D. (2024) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2024.1386284 · Cited by 3
Contrasting disclosure practices and experiences of school support for Australian adolescents with cancer, cystic fibrosis and anorexia nervosa: parent perspectives
Bowtell, E., Aroni, R., Green, J. B., & Sawyer, S. M. (2017) · International Journal of Inclusive Education · doi:10.1080/13603116.2017.1362049 · Cited by 3
“…of cancer treatment such as hair loss or amputation (Rechis et al. 2011), stigma and identity issues remain a particular focus for families and professionals contending with adolescents with mental health conditions such as anorexia nervosa (Kranke and Floersch 2009; Quinn et al. 2009; Moses 2010).”
Background
Thwarting Stigma and Dehumanization Through Empathy
Luna, A. M., Jurich, E., & Quintana, F. (2019) · Springer eBooks · doi:10.1007/978-3-030-29876-0_16 · Cited by 3
A Matter of Trust
Bonanno, R., & Veselak, K. (2020) · Advances in Social Work · doi:10.18060/22970 · Cited by 3
“Adolescents with emotional or behavioral difficulties have reported perceived negative attitudes and poor treatment by peers, family members, and school staff (Moses, 2010).”
Background
Examining Alternative Treatment Settings for Adolescents With Suicidal Thoughts During the COVID-19 Pandemic
Combs, J., Lin, P., DelBello, M. P., Carle, A. C., Bridge, J. A., Axelson, D., Fornari, V., Feuer, V., Emslie, G. J., Kennard, B. D., et al. (2024) · JAACAP Open · doi:10.1016/j.jaacop.2024.10.005 · Cited by 4
Delivering Diagnoses: Parents as Translators and Withholders of Children’s Mental Health Diagnoses
Bringewatt, E. H. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0709-5 · Cited by 3
Students seeking help for mental health problems Do Australian university websites provide clear pathways
Laws, T. A., & Fiedler, B. (2013) · Adelaide Research & Scholarship (AR&S) (University of Adelaide) · Cited by 3
A measure of perceived family stigma: Validity in a military sample.
Zhou, A. Q., Whealin, J. M., Wang, C., & Lee, R. M. (2016) · Psychological Assessment · doi:10.1037/pas0000416 · Cited by 3
“As such, it is important that we look at perceived family stigma as its own unique construct both due to how perceived family stigma may be experienced differently than other forms of perceived stigma (Moses, 2010) and the saliency of family in veteran and military cultures.”
Background
Constructions of Stigma
O’Reilly, M. J., & Lester, J. N. (2017) · The Language of Mental Health · doi:10.1007/978-3-319-60095-6_6 · Cited by 3
Self-Change in Facilitating Empowerment
Kranke, D. A. (2020) · Advances in Social Work · doi:10.18060/22535 · Cited by 4
“Some studies estimate that 46%-90% of these adolescents are stigmatized by a family member, peer, or educator (Kranke, Floersch, Townsend, & Munson, 2010; Moses, 2010).”
Background
Humanity-Oriented Character Strengths as Differential Predictors of Stigma Towards People with Special Educational Needs
Datu, J. A. D., Tang, R. L., & Xiaoying, W. (2021) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2021.1885014 · Cited by 3
“Stigma may cause fear of seeking medical help (Corrigan, 2004) and perceived social exclusion (Moses, 2010; Thompson et al., 2004).”
Background
Living in fear at the unpredictability of mental health issues in the classroom: a phenomenological study of secondary school teachers in encountering students with mental health issues
Liang, M., Ho, G. W. K., & Christensen, M. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1367660 · Cited by 4
Knowledge, Attitude, and Stigma Among Adolescents: Effect of Mental Health Awareness and Destigmatisation (MHAD) Program
Manjari, A. S., & Sudhesh, N. T. (2024) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.70003 · Cited by 4
Children’s experiences of living with their mental ill-health - a scoping review
Gotting, E.-K., Darcy, L., Israelsson‐Skogsberg, Å., Sundler, A. J., & Lalloo, E. C. (2025) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2025.2501682 · Cited by 4
“Being ignored or overly monitored by teachers, treated differently or given leniency compared to peers without mental ill-health led to feelings of awk-wardness (Moses, 2010; Mulfinger et al., 2019).”
Influential
Post-traumatic stress disorder in German youth: representative claims data pre- vs. intra-COVID-19-pandemic
Leickert, J., Zillmer, S., Bachmann, C., Vivirito, A., Enders, D., Correll, C. U., & Jaite, C. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2512683 · Cited by 2
“…a reduced utilisation due to (subjectively) perceived barriers to healthcare (e.g. prioritisation of ambulatory care in the provision of healthcare services, unless in more severely ill subgroups, fear of/self-stigma, poor family functioning) (e.g. Chandra & Minkovitz, 2006; Moses, 2010a, 2010b).”
Stéréotypes et préjugés à l’égard de personnes atteintes de cancer : étude auprès d’une population générale et de professionnels de santé
Taillandier‐Schmitt, A., & Michinov, E. (2015) · Pratiques Psychologiques · doi:10.1016/j.prps.2015.02.003 · Cited by 2
Predicting Women’s Utilization of Primary Care Mental Health Services in Mexico City
Mendoza, K., Ulloa, A., Saavedra, N., Galván, J., & Berenzon, S. (2016) · Journal of Primary Care & Community Health · doi:10.1177/2150131916678497 · Cited by 2
Investıgatıon in to psychometric properties of self stigma scale by seeking psychological help in adolescent students
Özbıçakçı, Ş., & Salkım, Ö. Ö. (2023) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2023.07.015 · Cited by 2
Worlds apart: Students' perception of teachers’ responses to their mental health issues
Zhou, X., & Ying, O. (2024) · Teaching and Teacher Education · doi:10.1016/j.tate.2023.104440 · Cited by 3
Perspectives of mental health professionals on kinship care for persons with mental illness in Ghana
Abekah‐Carter, K., Ayim, M., Cudjoe, E., Abdullah, A., & Chiu, M. Y.-L. (2024) · International Journal of Mental Health · doi:10.1080/00207411.2024.2377754 · Cited by 2
“Such negative interactions between family members and the person with mental illness could impact their wellbeing (Chan & Tsui, 2023; Moses, 2010) and even negatively affect their mental health recovery.”
Pengaruh Stigma Teman Sebaya Terhadap Hubungan Interpersonal
Telaumbanua, J., Zebua, E., Damanik, H. R., & Lase, F. (2024) · Wibawa Jurnal Manajemen Pendidikan · doi:10.57113/wib.v4i2.395 · Cited by 2
The Role of Caregivers in Promoting Connectedness in Youth with Mental Health Concerns
Andrews, B., Krishnamoorthy, G., Dallinger, V. C., & Maybery, D. J. (2024) · Children · doi:10.3390/children11121469 · Cited by 3
The effects of brief indirect contact on mental illness stigma: Preliminary evidence from an Italian vocational rehabilitation center
Atal, Z., Wang, S., & Biella-Battista, R. (2017) · Journal of Vocational Rehabilitation · doi:10.3233/jvr-170876 · Cited by 2
“Amongstadolescents,only30%seek outmentalhealthcare;andtheirdecisiontodosois signiﬁcantlyinﬂuencedbytheopinionsoftheirpeers and elders (Moses, 2010; U.S. Department of Health and Human Services, 1999, 2000).”
Perceptions of School by Students with Emotional and Behavioral Disorders: A Qualitative Investigation of School Connectedness within a Substantially Separate Classroom
Champine, K. E. (2017) · ProQuest LLC eBooks · Cited by 2
Measuring Mental Health Literacy in Education
Hatcher, A. K. (2018) · Scholarship@Western (Western University) · Cited by 2

Authors: Moses, T.
Affiliations: University of Wisconsin–Madison (US)
Corresponding author: Moses, Tally
ORCID: Moses, Tally
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2010-04
Volume: 70
Issue: 7
Pages: 985-993
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2009.12.022
OpenAlex: W1963733748
Cited by: 314
References: 50
Citations by year: 2026: 17 · 2025: 17 · 2024: 22 · 2023: 25 · 2022: 18 · 2021: 15 · 2020: 36 · 2019: 26 · 2018: 18 · 2017: 33 · 2016: 23 · 2015: 19 · 2014: 14 · 2013: 13 · 2012: 9
FWCI: 13.12
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: stigma, adolescents, mental illness, emotional and behavioral disorders, family stigma, peer stigma, school staff, discrimination, friendship loss, interpersonal relationships
MeSH terms: Adolescent, Psychology, Adolescent, Mental Disorders, Child, Cross-Sectional Studies, Faculty, Family, Female, Humans, Interpersonal Relations, Interviews as Topic, Male, Peer Group, Schools, Social Environment, Social Perception, Social Support, Stereotyping, United States, Qualitative Research

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Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders

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