Changes of stigma over time

Abstract

This chapter reviews time trend studies on changes of stigma over the last 25 years. There has been a broad trend towards more biological illness explanations over the last 25 years, but psychosocial explanations, particularly current stress, continue to enjoy high popularity. There is evidence linking biological causal models to increased stigma. Hospital and office based psychiatric treatment is clearly more accepted now than it was 25 years ago. Few studies examine acceptance of community psychiatric services, showing more indifference and less enthusiasm today than in the 1990s. There is little indication that individual attitudes towards persons with mental illness among the general population improve. With regard to schizophrenia, there are consistent findings from many countries that stigmatizing attitudes have even become worse, particularly during the 1990s and early 2000s, and that negative stereotypes like dangerousness or unpredictability prevail. Studies on public attitudes towards resource allocation in health care show particularly schizophrenia and alcohol use disorder persistently at risk for structural discrimination. Only the perceived stigma of someone with a history of mental illness has diminished in Germany between 1990 and 2011. Time trend analyses of mental health related public attitudes thus provide us with a complex picture of attitude change over the last 25 years. They show that the stigma of mental illness is far from being extinct, but even seems to have worsened in some respect.