Public Stigma of Mental Illness in the United States: A Systematic Literature Review

  • Angela M. ParcesepeEmail author
  • Leopoldo J. Cabassa
Original Article


Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public’s stigma toward mental disorders, (2) summarize stigma findings focused on the public’s stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public’s stigma of mental illness.


Public stigma Mental illness Systematic literature review 



An earlier version of this paper was presented at the Society for Social Work and Research Annual Conference, January 2010, Tampa, FL. This work was supported in part by the New York State Office of Mental Health, New York State Center of Excellence for Cultural Competence at the New York State Psychiatric Institute, National Institutes of Health Grant K01 MH09118 (PI: Cabassa) and the Implementation Research Institute (IRI) at the George Warren Brown School of Social Work, Washington University in St. Louis through an award from the National Institute of Mental Health (R25 MH080916-01A2) and the Department of Veterans Affairs, Health Services Research and Development, Quality Enhancement Research Initiative (QUERI). The authors would like to acknowledge the support of our research assistant, Rebeca Aragón, and the helpful comments of the journal reviewers.


  1. Angermeyer, M. C., Holzinger, A., & Matschinger, H. (2009). Mental health literacy and attitude towards people with mental illness: A trend analysis based on population surveys in eastern part of Germany. European Psychiatry, 24, 225–232.PubMedCrossRefGoogle Scholar
  2. Anglin, D. M., Alberti, P. M., Link, B. G., & Phelan, J. C. (2008). Racial differences in beliefs about the effectiveness and necessity of mental health treatment. American Journal of Community Psychology, 42(1–2), 17–24. doi: 10.1007/s10464-008-9189-5.PubMedCrossRefGoogle Scholar
  3. Anglin, D. M., Link, B. G., & Phelan, J. C. (2006). Racial differences in stigmatizing attitudes toward people with mental illness. Psychiatric Services, 57(6), 857–862. doi: 10.1176/ Scholar
  4. Blumner, K. H., & Marcus, S. C. (2009). Changing perceptions of depression: Ten-year trends from the general social survey. Psychiatric Services, 60(3), 306–312. doi: 10.1176/ Scholar
  5. Boyd, J. E., Katz, E. P., Link, B. G., & Phelan, J. C. (2010). The relationship of multiple aspects of stigma and personal contact with someone hospitalized for mental illness, in a nationally representative sample. Social Psychiatry and Psychiatric Epidemiology, 45(11), 1063–1070. doi: 10.1007/s00127-009-0147-9.PubMedCrossRefGoogle Scholar
  6. Cabassa, L. J., Lester, R., & Zayas, L. H. (2007). “It’s like being in a labyrinth:” Hispanic immigrants’ perceptions of depression and attitudes toward treatments. Journal of Immigrant and Minority Health, 9(1), 1–16.PubMedCrossRefGoogle Scholar
  7. Cabassa, L. J., Molina, G., & Baron, M. (2010). Depression Fotonovela: Development of a depression literacy tool for Latinos with limited English proficiency. Health Promotion Practice. doi: 10.1177/1524839910367578.
  8. Coleman, D., Walker, J. S., Lee, J., Friesen, B. J., & Squire, P. N. (2009). Children’s beliefs about causes of childhood depression and ADHD: A study of stigmatization. Psychiatric Services, 60(7), 950–957.PubMedCrossRefGoogle Scholar
  9. Corbiere, M., Zaniboni, S., Lecomte, T., Bond, G., Gilles, P. Y., Lesage, A., et al. (2011). Job acquisition for people with severe mental illness enrolled in supported employment programs: A theoretically grounded empirical study. Journal of Occupational Rehabilitation, 21(3), 342–354. doi: 10.1007/s10926-011-9315-3.PubMedCrossRefGoogle Scholar
  10. Corrigan, P. W. (2011). Best practices: Strategic stigma change (SSC): Five principles for social marketing campaigns to reduce stigma. Psychiatric Services, 62(8), 824–826. doi: 10.1176/ Scholar
  11. Corrigan, P. W., Kuwabara, S. A., & O’Shaughnessy., J. (2009). Public stigma of mental illness and drug addiction. Journal of Social Work, 9(2), 139–147.CrossRefGoogle Scholar
  12. Corrigan, P. W., Larson, J. E., Watson, A. C., Boyle, M., & Barr, L. (2006). Solutions to discrimination in work and housing identified by people with mental illness. The Journal of Nervous and Mental Disease, 194(9), 716–718. doi: 10.1097/ Scholar
  13. Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765–776.PubMedCrossRefGoogle Scholar
  14. Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30(8), 907–922. doi: 10.1016/j.cpr.2010.06.004.PubMedCrossRefGoogle Scholar
  15. Corrigan, P. W., & Watson, A. C. (2007). The stigma of psychiatric disorders and the gender, ethnicity, and education of the perceiver. Community Mental Health Journal, 43(5), 439–458. doi: 10.1007/s10597-007-9084-9.PubMedCrossRefGoogle Scholar
  16. Corrigan, P. W., Watson, A. C., Gracia, G., Slopen, N., Rasinski, K., & Hall, L. L. (2005). Newspaper stories as measures of structural stigma. Psychiatric Services, 56(5), 551–556. doi: 10.1176/ Scholar
  17. Croghan, T. W., Tomlin, M., Pescosolido, B. A., Schnittker, J., Martin, J., Lubell, K., et al. (2003). American attitudes toward and willingness to use psychiatric medications. Journal of Nervous & Mental Disease, 191(3), 166–174.Google Scholar
  18. Diala, C. C., Muntaner, C., Walrath, C., Nickerson, K. J., LaVeist, T. A., & Leaf, P. J. (2000). Racial differences in attitudes toward professional mental health care and in the use of services. The American Journal of Orthopsychiatry, 70(4), 455–464.PubMedCrossRefGoogle Scholar
  19. Diala, C. C., Muntaner, C., Walrath, C., Nickerson, K., LaVeist, T., & Leaf, P. (2001). Racial/ethnic differences in attitudes toward seeking professional mental health services. American Journal of Public Health, 91(5), 805–807.PubMedCrossRefGoogle Scholar
  20. Gilner, J. A., Haber, E., & Weise, J. (1999). Use of controlled vignettes in evaluation: Does type of response method make a difference? Evaluation & Program Planning, 22, 313–322.CrossRefGoogle Scholar
  21. Gonzalez, J. M., Alegria, M., & Prihoda, T. J. (2005). How do attitudes toward mental health treatment vary by age, gender, and ethnicity/race in young adults. Journal of Community Psychology, 33(5), 611–629.CrossRefGoogle Scholar
  22. Gonzalez, J. M., Alegria, M., Prihoda, T. J., Copeland, L. A., & Zeber, J. E. (2009). How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race, and education. Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-009-0168-4.PubMedGoogle Scholar
  23. Hogan, M. F. (2003). The President's New Freedom Commission: recommendations to transform mental health care in America. Psychiatric Services, 54(11), 1467–1474.PubMedCrossRefGoogle Scholar
  24. Jorm, A. F., & Griffiths, K. M. (2008). The public’s stigmatizing attitudes towards people with mental disorders: How important are biomedical conceptualizations? Acta Psychiatrica Scandinavica, 118(4), 315–321.PubMedCrossRefGoogle Scholar
  25. Klin, A., & Lemish, D. (2008). Mental disorders stigma in the media: Review of studies on production, content, and influences. Journal of Health Communication, 13(5), 434–449.PubMedCrossRefGoogle Scholar
  26. Kumar, A. & Nevid, J. S. (2010). Acculturation, enculturation and perceptions of mental disorders in Asian Indian immigrants. Cultural Diversity and Ethnic Minority Psychology, 16(2), 274–283.PubMedCrossRefGoogle Scholar
  27. Kuppin, S., & Carpiano, R. M. (2006). Public conceptions of serious mental illness and substance abuse, their causes and treatments: Findings from the 1996 general social survey. American Journal of Public Health, 96(10), 1766–1771.PubMedCrossRefGoogle Scholar
  28. Lau, A., & Takeuchi, D. T. (2001). Help-seeking for child behavior problems: Value orientation, affective responding, and severity appraisals among chinese-american parents. Journal of Community Psychology, 29(6), 675–692.CrossRefGoogle Scholar
  29. Leaf, P. J., Bruce, M. L., Tischler, G. L., & Holzer, C. E., I. I. I. (1987). The relationship between demographic factors and attitudes toward mental health services. Journal of Community Psychology, 15(2), 275–284.PubMedCrossRefGoogle Scholar
  30. Link, B. G., Phelan, J. C., Bresnahan, M., Stueve, A., & Pescosolido, B. A. (1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89(9), 1328–1333.PubMedCrossRefGoogle Scholar
  31. Link, B. G., Struening, E. L., Rahav, M., Phelan, J. C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38(2), 177–190.PubMedCrossRefGoogle Scholar
  32. Link, B. G., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511–541.PubMedCrossRefGoogle Scholar
  33. Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks, CA: Sage.Google Scholar
  34. Martin, J. K., Pescosolido, B. A., Olafsdottir, S., & McLeod, J. D. (2007). The construction of fear: Americans’ preferences for social distance from children and adolescents with mental health problems. Journal of Health and Social Behavior, 48(1), 50–67.PubMedCrossRefGoogle Scholar
  35. Martin, J., Pescosolido, B., & Tuch, S. (2000). Of fear and loathing: The role of ‘disturbing behavior’, labels, and causal attributions in shaping public attitudes toward people with mental illness. Journal of Health and Social Behavior, 41(2), 208–223.CrossRefGoogle Scholar
  36. McLeod, J. D., Fettes, D. L., Jensen, P. S., Pescosolido, B. A., & Martin, J. K. (2007). Public knowledge, beliefs, and treatment preferences concerning attention-deficit hyperactivity disorder. Psychiatric Services, 58(5), 626–631.PubMedCrossRefGoogle Scholar
  37. McLeod, J. D., Pescosolido, B. A., Takeuchi, D. T., & White, T. F. (2004). Public attitudes toward the use of psychiatric medications for children. Journal of Health and Social Behavior, 45(1), 53–67.PubMedCrossRefGoogle Scholar
  38. Mojtabai, R. (2007). Americans’ attitudes toward mental health treatment seeking: 1990–2003. Psychiatric Services, 58(5), 642–651. doi: 10.1176/ Scholar
  39. Mojtabai, R. (2009). Americans’ attitudes toward psychiatric medications: 1998–2006. Psychiatric Services, 60(8), 1015–1023. doi: 10.1176/ Scholar
  40. Mukolo, A., & Heflinger, C. A. (2011). Factors associated with attributions about child health conditions and social distance preference. Community Mental Health Journal, 47, 286–299. doi: 10.1007/s10597-010-9325-1.PubMedCrossRefGoogle Scholar
  41. New Freedom Commission on Mental Health. (2003). Achieving the Promise: Transforming Mental Health Care in America. Final Report. Rockville, MD: US Department of Health and Human Service. DHHS publication SMA-03-3832.Google Scholar
  42. Perry, B. L., Pescosolido, B. A., Martin, J. K., McLeod, J. D., & Jensen, P. S. (2007). Comparison of public attributions, attitudes, and stigma in regard to depression among children and adults. Psychiatric Services, 58(5), 632–635.PubMedCrossRefGoogle Scholar
  43. Pescosolido, B. A., Fettes, D. L., Martin, J. K., Monahan, J., & McLeod, J. D. (2007a). Perceived dangerousness of children with mental health problems and support for coerced treatment. Psychiatric Services, 58(5), 619–625.PubMedCrossRefGoogle Scholar
  44. Pescosolido, B. A., Jensen, P. S., Martin, J. K., Perry, B. L., Olafsdottir, S., & Fettes, D. (2008). Public knowledge and assessment of child mental health problems: Findings from the national stigma study-children. Journal of the American Academy of Child and Adolescent Psychiatry, 47(3), 339–349.PubMedCrossRefGoogle Scholar
  45. Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry, 167(11), 1321–1330. doi: 10.1176/appi.ajp.2010.09121743.PubMedCrossRefGoogle Scholar
  46. Pescosolido, B. A., Monahan, J., Link, B. G., Stueve, A., & Kikuzawa, S. (1999). The public’s view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health, 89(9), 1339–1345.PubMedCrossRefGoogle Scholar
  47. Pescosolido, B. A., Perry, B. L., Martin, J. K., McLeod, J. D., & Jensen, P. S. (2007b). Stigmatizing attitudes and beliefs about treatment and psychiatric medications for children with mental illness. Psychiatric Services, 58(5), 613–618.PubMedCrossRefGoogle Scholar
  48. Phelan, J. C., Link, B. G., Stueve, A., & Pescosolido, B. (2000). Public conceptions of mental illness in 1950 and 1996: What is mental illness and is it to be feared? Journal of Health and Social Behavior, 41(2), 188–207.CrossRefGoogle Scholar
  49. Phelan, J. C., Yang, L. H., & Cruz-Rojas, R. (2006). Effects of attributing serious mental illnesses to genetic causes on orientations to treatment. Psychiatric Services, 57(3), 382–387. doi: 10.1176/ Scholar
  50. Ritterfeld, U., & Jin, S. (2006). Addressing media stigma for people experiencing mental illness using an entertainment-education strategy. Journal of Health Psychology, 11(12), 247–267.PubMedCrossRefGoogle Scholar
  51. Schnittker, J., Freese, J., & Powell, B. (2000). Nature, nurture, neither, nor: Black-white differences in beliefs about the causes and appropriate treatment of mental illness. Social Forces, 78(3), 1101.Google Scholar
  52. Shim, R. S., Compton, M. T., Rust, G., Druss, B. G., & Kaslow, N. J. (2009). Race-ethnicity as a predictor of attitudes toward mental health treatment seeking. Psychiatric Services, 60(10), 1336–1341. doi: 10.1176/ Scholar
  53. Singhal, A., & Rogers, E. (1999). Entertainment-education: A communication strategy for social change. Mahwah: Lawrence Erlbaum Associates.Google Scholar
  54. Sood, S. (2002). Audience involvement and entertainment-education. Communication Theory, 12, 153–172.Google Scholar
  55. Stuart, H. (2009). Opening minds, an initiative of the Mental Health Commission of Canada: Selection of anti-stigma programs, summary and results. Mental Health Commission of Canada.Google Scholar
  56. Swindle, R., Jr, Heller, K., Pescosolido, B., & Kikuzawa, S. (2000). Responses to nervous breakdowns in America over a 40-year period. Mental health policy implications. The American Psychologist, 55(7), 740–749.PubMedCrossRefGoogle Scholar
  57. Thornicroft, G., Brohan, E., Kassam, A., & Lewis-Holmes, E. (2008). Reducing stigma and discrimination: Candidate interventions. International Journal of Mental Health Systems, 2(1), 3.PubMedCrossRefGoogle Scholar
  58. Unger, J. B., Cabassa, L. J., Molina, G. B., Contreras, S., & Baron, M. (2012). Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults. Journal of Immigrant and Minority Health. doi: 10.1007/s10903-012-9623-5.
  59. U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.Google Scholar
  60. Walker, J. S., Coleman, D., Lee, J., Squire, P. N., & Friesen, B. J. (2008). Children’s stigmatization of childhood depression and ADHD: Magnitude and demographic variation in a national sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 912–920.PubMedCrossRefGoogle Scholar
  61. Whaley, A. L. (1997). Ethnic and racial differences in perceptions of dangerousness of persons with mental illness. Psychiatric Services, 48(10), 1328–1330.PubMedGoogle Scholar
  62. Wirth, J. H., & Bodenhausen, G. V. (2009). The role of gender in mental-illness stigma: A national experiment. Psychological Science, 20(2), 169–173. doi: 10.1111/j.1467-9280.2009.02282.x.PubMedCrossRefGoogle Scholar
  63. Wong, Y. J., Tran, K. K., Kim, S., Kerne, V. V. & Calfa, N. A. (2010). Asian Americans’ lay beliefs about depression and professional help seeking. Journal of Clinical Psychology, 66(3), 317–332.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.School of Social WorkColumbia UniversityNew YorkUSA
  3. 3.New York State Center of Excellence for Cultural CompetenceNew York State Psychiatric InstituteNew YorkUSA

Personalised recommendations