Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study

Abstract

Purpose

This study contrasts the medicalized conceptualization of mental illness with psychologizing mental illness and examines what the consequences are of adhering to one model versus the other for help seeking and stigma.

Methods

The survey “Stigma in a Global Context–Belgian Mental Health Study” (2009) conducted face-to-face interviews among a representative sample of the general Belgian population using the vignette technique to depict schizophrenia (N = 381). Causal attributions, labeling processes, and the disease view are addressed. Help seeking refers to open-ended help-seeking suggestions (general practitioner, psychiatrist, psychologist, family, friends, and self-care options). Stigma refers to social exclusion after treatment. The data are analyzed by means of logistic and linear regression models in SPSS Statistics 19.

Results

People who adhere to the biopsychosocial (versus psychosocial) model are more likely to recommend general medical care and people who apply the disease view are more likely to recommend specialized medical care. Regarding informal help, those who prefer the biopsychosocial model are less likely to recommend consulting friends than those who adhere to the psychosocial model. Respondents who apply a medical compared to a non-medical label are less inclined to recommend self-care. As concerns treatment stigma, respondents who apply a medical instead of a non-medical label are more likely to socially exclude someone who has been in psychiatric treatment.

Conclusions

Medicalizing mental illness involves a package deal: biopsychosocial causal attributions and applying the disease view facilitate medical treatment recommendations, while labeling seems to trigger stigmatizing attitudes.

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Acknowledgments

We wish to thank Bernice Pescosolido for the opportunity to collaborate on this project. This project was supported by a grant from the Research Foundation (FWO) Flanders and from the Special Research Fund of Ghent University (BOF).

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Correspondence to E. Pattyn.

Appendix

Appendix

The psychosis vignette was as follows:

Jan/Marie/Ahmed/Fatima are a Belgian/Turkish man/woman. Up until a year ago, life was pretty okay for NAME. But then, things started to change. He thought that people around him/her were making disapproving comments, and talking behind his/her back. NAME was convinced that people were spying on him/her and that they could hear what she/he was thinking. NAME last his/her drove to participate in his/her usual work and family activities and retreated to his/her home, eventually spending most of his/her time on his/her own. NAME became so preoccupied with what she/he was thinking that she/he skipped meals and stopped bathing regularly. At night, when everyone else was sleeping, she/he was walking back and forth at home. NAME was hearing voices even though no one else was around. These voices told him/her what to do and what to think. She/he has been living this way for six months.

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Pattyn, E., Verhaeghe, M., Sercu, C. et al. Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study. Soc Psychiatry Psychiatr Epidemiol 48, 1637–1645 (2013). https://doi.org/10.1007/s00127-013-0671-5

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Keywords

  • Public opinion survey
  • Mental Illness
  • Help seeking
  • Stigma
  • Schizophrenia