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transcript
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 STIGMACommunity 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 UnitCalgary Regional Health Authority
Pilot Site for the WPA Campaign Against the Stigma of Schizophrenia
WPA PilotSites
ComparisonSite
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 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%
1 This is an underestimate. An unknown number of people attended the meeting who wereofficials of agencies that serve people with schizophrenia, and were thus not eligible to completethe questionnaire.
Demographics
Edm SchizSoc
MedStud.
Sex Male 49.0% 32.5% 50.7%Female 51.0% 67.5% 49.3%
Age 15-29 25.5% 15.8% 90.5%30-59 55.3% 63.2% 9.5%60+ 19.2% 21.1% 0.0%
Education Elem 0.5% 0.0% 0.0%Jr High 5.8% 2.5% 1.6%High Sch 40.2% 27.5% 1.6%Coll/Tech 22.4% 15.0% 0.0%Univ 31.1% 55.0% 96.8%
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
METHODS
Surveys included the following content areas:
PERCEIVED CAUSES OF SCHIZOPHRENIA
0%
20%
40%
60%
80%
100%
BrainChem
Genetics Stress Trauma Parenting Abuse SocValues
Poverty
Community
Schiz Soc
Med Students
PERCENTAGE OF RESPONDENTS REPORTING A CONDITION TO BE THE "MOST DISABLING"
0%
20%
40%
60%
80%
Loss of Mind Blindness Bedridden Disfigured Sex
Note: For the Community sample, "Blindness" also includes "Deafness"
Community
Schiz Soc
Med Students
Percent who would befriend or marrysomeone with schizophrenia
Community Schiz. Soc. Students
Befriend 83% 87% 79%
Percent who would befriend or marrysomeone with schizophrenia
Community Schiz. Soc. Students
Befriend 83% 87% 79%
Marry 27% 10% 6%
PROPORTION OF RESPONDENTS IN OPPOSITION TO SELECTED HYPOTHETICAL "GROUP HOMES"
0%
20%
40%
60%
80%
Ex Con Drug Ab AlcoholAb
AIDSVictim
Schiz Pt Ment Hcp PhysDisab
Type of Resident
Schiz Soc
Med Students
Community
PERCEIVED DANGEROUSNESS OF THE MENTALLY ILL AND THE EFFECTIVENESS OF TREATMENT
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Community Schiz Soc Med Students
Prop
ortio
n of
Res
pond
ents
Dangerous Rx Effective
SchizophreniaSociety (Most)
Med. Students(Most)
Edmonton1997 (Most)
SchizophreniaSociety (Least)
Med. Students(Least)
DrugsAlone 0 3% 7% 9% 16%
PsychosocialAlone 0 0 9% 44% 59%Both
(Together) 100% 97% 85% 0 0Both (Equally
“Worse”) * --- --- --- 47% 25%
Perceptions of the Most and Least Successful Types of Treatment
SchizophreniaSociety (Most)
Med. Students(Most)
Edmonton1997 (Most)
SchizophreniaSociety (Least)
Med. Students(Least)
DrugsAlone 0 3% 7% 9% 16%
PsychosocialAlone 0 0 9% 44% 59%Both
(Together) 100% 97% 85% 0 0Both (Equally
“Worse”) * --- --- --- 47% 25%
Perceptions of the Most and Least Successful Types of Treatment
PROPORTION IN FAVOUR OF SELECTED ADDITIONAL APPROACHES FOR DEALING WITH MENTAL ILLNESS
0%
20%
40%
60%
80%
100%
Research PublicEducation
Family/Friends
Work/Recreation
CommunityRx
Rx GroupHomes
Self Help DrugTreatment
MentalHospitals
Community Schiz Soc Med Students
PROPORTION OF RESPONDENTS IN FAVOUR OF PAYING MORE TAXES IN ORDER TO IMPROVE SERVICES FOR PEOPLE WITH SCHIZOPHRENIA
0%
20%
40%
60%
80%
100%
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
0%
10%
20%
30%
40%
50%
Live Near Work With Live With
SOCIAL DISTANCE Closer
Per
cent
Opp
osed
Calgary Drumheller