Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 9, pp 1459–1473 | Cite as

Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China

  • Lawrence H. Yang
  • Graciete Lo
  • Ahtoy J. WonPat-Borja
  • Daisy R. Singla
  • Bruce G. Link
  • Michael R. Phillips
Original Paper
First Online:
Received:
Accepted:

Abstract

Purpose

As mental illness stigma contributes to poor outcomes for schizophrenia in China, locating strategies to reduce public stigma is imperative. It is currently unknown whether diagnostic labeling and contact with different help-seeking sources increase or decrease public stigma in China. Further, it remains unresolved whether prior personal contact acts to reduce stigma in this context. Advancing understanding of these processes may facilitate stigma-reduction strategies.

Methods

We administered an experimental vignette randomly assigning one of four labeling conditions to respondents to assess social distance towards a psychotic vignette individual in a sample of 160 Northern, urban Chinese community respondents.

Results

As expected, respondents given a “non-psychiatric, indigenous label” + “lay help-seeking” condition endorsed the least social distance. Unexpectedly, the labeling condition with a “psychiatric diagnostic label” + “lay help-seeking” condition elicited the greatest social distance. Unlike Western studies, personal contact did not independently decrease community stigma. However, prior contact reduced social distance to a greater extent in the labeling condition with a “non-psychiatric, indigenous label” + “lay help-seeking” condition when compared with all other labeling conditions.

Conclusion

The results indicate that cultural idioms do provide some protection from stigma, but only among respondents who are already familiar with what mental illness is. Our finding that the condition that depicted untreated psychosis elicited the greatest amount of stigma, while the “treated psychosis” condition was viewed relatively benignly in China, suggests that improved access to mental health services in urban China has the potential to decrease public stigma via labeling mechanisms.

Keywords

Stigma Culture China Schizophrenia Attitudes 
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Notes

Acknowledgments

The study was supported by National Institutes of Mental Health Grant K01 MH73034-01, which was awarded to the first author. This study was also supported, in part, by the Asian American Center on Disparities Research (National Institute of Mental Health grant P50MH073511). The authors thank Xiaoli Zhang for her assistance in creating the vignettes. We also wish to thank Ms. Nina Huynh for her assistance in formatting the manuscript.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Lawrence H. Yang
    • 1
  • Graciete Lo
    • 2
  • Ahtoy J. WonPat-Borja
    • 3
  • Daisy R. Singla
    • 4
  • Bruce G. Link
    • 5
  • Michael R. Phillips
    • 6
    • 7
  1. 1.Department of EpidemiologyColumbia UniversityNew YorkUSA
  2. 2.Department of PsychologyFordham UniversityBronxUSA
  3. 3.Department of EpidemiologyColumbia UniversityNew YorkUSA
  4. 4.Psychology DepartmentMcGill UniversityMontrealCanada
  5. 5.Department of Epidemiology/Sociomedical SciencesColumbia UniversityNew YorkUSA
  6. 6.Suicide Research and Prevention Center and Research Methods Consulting CenterShanghai Mental Health Center, Shanghai Jiaotong University School of MedicineShanghaiPeople’s Republic of China
  7. 7.Emory University School of MedicineAtlantaUSA

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