Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services

  • Bertil Lundberg
  • Lars Hansson
  • Elisabeth Wentz
  • Tommy Björkman



A major goal in mental health research and policy is to identify ways to reduce stigma among persons with mental illness.


The aims of the present study were to (1) investigate the prevalence of rejection and devaluation/discrimination in a cross-sectional sample of 200 individuals with experiences of mental illness and (2) investigate the relationship between sociodemographic and clinical, client characteristics and perceived devaluation/discrimination and experiences of rejection.


A total of 200 subjects in current contact with mental health services or with earlier experiences of this were interviewed regarding beliefs about devaluation/discrimination and rejection experiences.


The results showed that subjects with a higher degree of global functioning perceived less devaluation/discrimination. With regard to rejections experiences associations were found between rejection experiences and global functioning, number of admissions to inpatient psychiatric care and current contact with social services.


Further research should investigate the causal relationship between stigma experiences and psychosocial functioning. To understand what consequences perceived devaluation/discrimination has for the afflicted, a psychological and social approach in the research must be taken into consideration.

Key words

stigma mental illness devaluation discrimination 


  1. 1.
    American psychiatric Association (1987) Diagnostic and statistical manual for mental disorders (3rd ed, rev). APA, Washington, DCGoogle Scholar
  2. 2.
    Andrews G, Henderson S, Hall W (2001) Prevalence, co-morbidity, disability and service utilization. Overview of the Australian National Mental Health Survey. Brit J Psychiat 178:145–153PubMedCrossRefGoogle Scholar
  3. 3.
    Angermeyer MC, Schulze B (2001) Reinforcing stereotypes: how the focus on forensic cases in news reporting may influences public attitudes towards the mentally ill. Int J Law Psychiat 24:469–486CrossRefGoogle Scholar
  4. 4.
    Angermeyer MC, Matschinger H (2005) Labeling-stereotype-discrimination. An investigation of the stigma process. Social Psychiatr and Psychiatr Epidemiol 40:391–395CrossRefGoogle Scholar
  5. 5.
    Björkman T, Svensson B, Lundberg B (2004) Experiences of stigma among people with severe mental illness. Reliability and construct validity of the Swedish versions of two stigma scales measuring devaluation/discrimination and rejection experiences. Nordic J Psychiat (In press)Google Scholar
  6. 6.
    Bordieri J, Drehmer D (1986) Hiring Decisions for Disabled Workers: Looking at the Cause. J Appl Soc Psychol 16:197–208CrossRefGoogle Scholar
  7. 7.
    Byrne P (2001) Psychiatric stigma. Brit J Psychiat 178:281–284CrossRefGoogle Scholar
  8. 8.
    Crisp AH, Gelder AG, Rix S, Meltzer HI, Rowlands OJ (2000) Stigmatisation of people with mental illnesses. Brit J Psychiat 177:4–7PubMedCrossRefGoogle Scholar
  9. 9.
    Corrigan PW, Watson AC, Gracia G, Slopen N, Rasinski K, Hall LL (2005) Newspaper stories as measures of structural stigma. Psychiatr Serv 56:551–556PubMedCrossRefGoogle Scholar
  10. 10.
    Cutcliffe JR, Hannigan B (2001) Massmedia, ‘monsters’ and mental health clients: the need for increased lobbying. J Psychiatr ment Health Nurs 8:315–321PubMedCrossRefGoogle Scholar
  11. 11.
    Dickersson Faith B, Sommerville J, Origoni AE, Ringel NB, Parente F (2002) Experiences of stigma among outpatients with schizophrenia. Schizophr Bull 28:143–155Google Scholar
  12. 12.
    Ertugul A, Ulug B (2004) Perception of stigma among patients with schizophrenia. Soc Psychiatr Epidemiol 39:73–77CrossRefGoogle Scholar
  13. 13.
    Farina A, Felner RD (1973) Employment interviewer reactions to former mental patients. J Abnorm Psychol 82:268–272PubMedCrossRefGoogle Scholar
  14. 14.
    Farina A (1998) Stigma. In: Mueser KT, Tarrier N (eds) Handbook of Social Functioning in schizophrenia. Allyn and Bacon, Needham Heights, pp 247–279Google Scholar
  15. 15.
    Link BG (1987) Understanding labeling effects in the area of mental disorders. An assessment of the effects of expectations of rejection. Am Soc Rev 52:96–112CrossRefGoogle Scholar
  16. 16.
    Link BG, Struening EL, Rahav M, Phelan JC, Nuttbrock L (1997) On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. J Health Soc Behav 38:177–190PubMedCrossRefGoogle Scholar
  17. 17.
    Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27:363–385CrossRefGoogle Scholar
  18. 18.
    Page S (1977) Effects of the mental illness in attempts to obtain accommodation. Can J Behav Sci 9:193–199Google Scholar
  19. 19.
    Penn DL, Guyman K, Daily T, Spaulding WD, Garbin CP, Sullivan M (1994) Dispelling the stigma of schizophrenia: what sort of information is best? Schizophr Bullet 20:567–578Google Scholar
  20. 20.
    Penn DL, Martin J (1998) The stigma of severe mental illness: some potential solutions for a recalcitrant problem. Psychiatr Quart 69:235–247CrossRefGoogle Scholar
  21. 21.
    Penn DL, Kohlmaier JR, Corrigan PW (2000) Interpersonal factors contributing to the stigma of schizophrenia: social skills, perceived attractiveness, and symptoms. Schizophr Res 45:37–45PubMedCrossRefGoogle Scholar
  22. 22.
    Piner KE, Kahle LR (1984) Adapting to the stigmatizing label of mental illness: Forgone but not forgotten. J Pers Soc Psychol 47:805–811PubMedCrossRefGoogle Scholar
  23. 23.
    Rosenfield S (1997) Labeling mental illness: the effects of received services and perceived stigma on life satisfaction. Am Sociol Rev 62:660–672CrossRefGoogle Scholar
  24. 24.
    Schulze B, Angermeyer MC (2003) Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental professionals. Soc Sci Med 56:299–321PubMedCrossRefGoogle Scholar
  25. 25.
    Sirey JA, Bruce ML, Alexopoulus GS, Perlick DA, Raue P, Friedmann SJ, Meyers BS (2001) Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. Am J Psychiatr 158:479–481PubMedCrossRefGoogle Scholar
  26. 26.
    Thompson AH, Stuart H, Bland RC, Arboldea-Florez J, Warner R, Dickson RA (2002) Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Social Psychiatr and Psychiatr Epidemiol 37:475–482CrossRefGoogle Scholar
  27. 27.
    Wahl OF (1999) Mental health consumers’ experience of stigma. Schizophr Bull 25:467–478PubMedGoogle Scholar
  28. 28.
    World Health Organization (1993) International statistical classification of Diseases and Related Health Problems. World Health Organisation, GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Bertil Lundberg
    • 1
  • Lars Hansson
    • 1
  • Elisabeth Wentz
    • 1
  • Tommy Björkman
    • 1
  1. 1.Dept. of Health Sciences, Division of NursingLund UniversityLundSweden

Personalised recommendations