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.
This is a preview of subscription content,to check access.
Access this article
Similar content being viewed by others
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.
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.
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/appi.ps.57.6.857.
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/appi.ps.60.3.306.
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.
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.
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.
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.
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.
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/appi.ps.62.8.824.
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.
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:10.1097/01.nmd.0000235782.18977.de.
Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765–776.
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.
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.
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/appi.ps.56.5.551.
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.
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.
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.
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.
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.
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.
Hogan, M. F. (2003). The President's New Freedom Commission: recommendations to transform mental health care in America. Psychiatric Services, 54(11), 1467–1474.
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.
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.
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.
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.
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.
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.
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.
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.
Link, B. G., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511–541.
Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks, CA: Sage.
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.
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.
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.
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.
Mojtabai, R. (2007). Americans’ attitudes toward mental health treatment seeking: 1990–2003. Psychiatric Services, 58(5), 642–651. doi:10.1176/appi.ps.58.5.642.
Mojtabai, R. (2009). Americans’ attitudes toward psychiatric medications: 1998–2006. Psychiatric Services, 60(8), 1015–1023. doi:10.1176/appi.ps.60.8.1015.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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/appi.ps.57.3.382.
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.
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.
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/appi.ps.60.10.1336.
Singhal, A., & Rogers, E. (1999). Entertainment-education: A communication strategy for social change. Mahwah: Lawrence Erlbaum Associates.
Sood, S. (2002). Audience involvement and entertainment-education. Communication Theory, 12, 153–172.
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.
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.
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.
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.
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.
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.
Whaley, A. L. (1997). Ethnic and racial differences in perceptions of dangerousness of persons with mental illness. Psychiatric Services, 48(10), 1328–1330.
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.
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.
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.
About this article
Cite this article
Parcesepe, A.M., Cabassa, L.J. Public Stigma of Mental Illness in the United States: A Systematic Literature Review. Adm Policy Ment Health 40, 384–399 (2013). https://doi.org/10.1007/s10488-012-0430-z