Stigma and mental illness: A comparative study of attitudes and personal constructs

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Evidence suggests that people with mental illness experience discrimination by being stigmatised both by the general public and by healthcare professionals. The experience of stigma may result in a delay in seeking professional help, loss of self-esteem and is a serious inhibitor to recovery and social inclusion. Stigma and discrimination are pervasive and despite a number of UK based campaigns, there appears to be no reduction in prevalence. This research compared public attitudes towards mental illness and the mentally ill with mental health service users’ perceptions of stigma, identified perceptions of stigma by mental health service users, quantified and qualified these perceptions alongside reported accounts of being stigmatised and made recommendation for strategies to reduce the stigma experienced by people with mental illness. A cross-sectional survey was undertaken and involved the use of a 35-item attitude scale, employed with 132 members of the public and 132 self-selecting service users. Semi-structured interviews and Personal Construct Psychology Repertory Grid techniques were employed with subsets of the sample. Qualitative data was subjected to Interpretative Phenomenological Analysis. Quantitative data was analysed using inferential statistical tests and Principal Component Analysis. The perception of stigma amongst service users was relatively high and appeared to be pervasive. Male service users reported higher perceptions of stigma than females. The combination of being stigmatised by mental health professionals and the general public appeared to result in self stigma and social exclusion. Recommendations include addressing the causes and mechanism of stigmatisation, the inclusion of service users’ perspectives in research and raising awareness, amongst mental health professionals, on how their practice may impact on service users. Further research should address why there is a higher perception of stigma amongst male service users