Stigma and Rurality: How Community Type Influences Stigmatizing Views Toward Mental Illness

Public stigma, or a set of negative attitudes and beliefs that can contribute to discrimination against those with mental illnesses, negatively affects behavioral health care and may be particularly prevalent in rural communities. The goal of this study was to examine public stigma across rural, suburban, and urban communities, as well as its association with mental health symptoms. An online survey was conducted using Amazon’s Mechanical Turk (MTurk) service as well as the University of Southern Mississippi’s SONA platform. Demographic data, community type, and mental health symptoms were collected via self-report inventories. When looking at the combined SONA (n= 298) and MTurk (n=126) sample (N=424), individuals who identified as belonging to an urban community reported increased perceptions of public stigma compared to those who identified as belonging to rural communities. Urban and suburban groups did not differ. Internalized stigma did not differ between community types. Schizotypal traits were significantly negatively correlated with perceptions of public stigma, while anxiety, depression, and schizotypal traits were positively correlated with internalized stigma. Findings regarding higher rates of public stigma in urban vs. rural communities were against hypotheses. This may be because mental illness is more visible in urban settings due to increased service centers and outreach efforts; higher visibility may lead to greater discussion, including expressions of public stigma. Future work is needed to better understand differential associations of public and internalized stigma with mental health symptoms. Keywords: public stigma, self stigma; mental illness; rural; urban; suburba