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“A Disease Like Any Other”? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence
Open accessAbstract
OBJECTIVE: Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice. METHOD: The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma. RESULTS: In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection. CONCLUSIONS: More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.
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“These same brain areas show accelerated breakdown of monoamine neurotransmitters, 309 increased neuro-inflammation, 310 reduced grey matter, 311 and heightened reactivity to mood-relevant stimuli 312 in individuals with depression.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [310]
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“Negative public attitudes, opinions, and intentions persist and are reported across diverse global contexts [80–83].”
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Metadata
- Authors
- Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G.
- Affiliations
- Indiana University (US)
- Venue
- American Journal of Psychiatry
- Published
- 2010-11
- Volume
- 167
- Issue
- 11
- Pages
- 1321-1330
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4429867
- OpenAlex
- W2130559519
- Cited by
- 1,262
- References
- 42
- Citations by year
- 2026: 36 · 2025: 61 · 2024: 64 · 2023: 73 · 2022: 65 · 2021: 64 · 2020: 75 · 2019: 99 · 2018: 79 · 2017: 118 · 2016: 98 · 2015: 100 · 2014: 90 · 2013: 97 · 2012: 84
- FWCI
- 97.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH074985)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- public attitudes toward mental illness, schizophrenia, major depressive disorder, alcoholism, mental health stigma, treatment support, social distance, perceived danger, psychiatrists, community acceptance, mental health service utilization, General Social Survey
- MeSH terms
- Adult, Alcoholism, Character, Dangerous Behavior, Data Collection, Major Depressive Disorder, Female, Health Policy, Hospitalization, Humans, Male, Middle Aged, Morals, Neurobiology, Patient Care Team, Prejudice, Psychiatry, Public Opinion, Schizophrenia, Schizophrenic Psychology, Social Behavior Disorders, Psychological Distance, Social Support, United States, Causality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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