On Revisiting Some Origins of the Stigma Concept as It Applies to Mental Illnesses

  • Bruce G. Link
  • Heather Stuart


It is difficult to imagine a more successful concept than that of stigma. Over the past six decades, it has enjoyed a meteoric rise, moving from an obscure term to one that is evident not only in academic work but in common parlance. It has been applied to a massive number of circumstances ranging from race and ethnic differences to incarceration, sexual minority status, psoriasis, incontinence, and many more. In these circumstances, it has been useful to describe and help explain the shame, social awkwardness, rejection, misunderstanding, and exclusion that people in these situations experience. The concept has been elaborated to help bring to light different aspects of this complex array of circumstances, and researchers have developed a large set of measures to assess those processes. It has been used by those who have felt the afflictions of stigma to identify the psychosocial processes involved and thereby to muster resistance to them. Among all of the circumstances that are stigmatized, one of the most prominent and most studied has been that of mental illness. This chapter provides a selective history of the origins and development of the stigma concept as it pertains to mental illnesses.


Mental Illness Social Distance Mental Hospital Public Mental Health Social Psychological Experiment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Angermeyer MC, Dietrich S (2006) Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand 113:163–179CrossRefPubMedGoogle Scholar
  2. Angermeyer MC, Matschinger H (1996) Public attitude towards psychiatric treatment. Acta Psychiatr Scand 94(5):326–336CrossRefPubMedGoogle Scholar
  3. Angermeyer MC, Matschinger H (1997) Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany. Psychol Med 27(01):131–141CrossRefPubMedGoogle Scholar
  4. Angermeyer MC, Matschinger H (1999) Lay beliefs about mental disorders: a comparison between the western and the eastern parts of Germany. Soc Psychiatry Psychiatr Epidemiol 34(5):275–281CrossRefPubMedGoogle Scholar
  5. Angermeyer MC, Matschinger H (2005a) Causal beliefs and attitudes to people with schizophrenia trend analysis based on data from two population surveys in Germany. Br J Psychiatry 186(4):331–334CrossRefPubMedGoogle Scholar
  6. Angermeyer MC, Matschinger H (2005b) Have there been any changes in the public’s attitudes towards psychiatric treatment? Results from representative population surveys in Germany in the years 1990 and 2001. Acta Psychiatr Scand 111(1):68–73CrossRefPubMedGoogle Scholar
  7. Angermeyer MC, Classen D, Majcher-Angermeyer A, Hofman J (1985) Stigmatisierung psychisch Kranker: stadt versus Land. Psychother Psychosom Med Psychol 35(3–4):99–103PubMedGoogle Scholar
  8. Angermeyer MC, Link BG, Majcher-Angermeyer A (1987) Stigma perceived by patients attending modern treatment settings: some unanticipated effects of community psychiatry reforms. J Nerv Ment Dis 175(1):4–11CrossRefPubMedGoogle Scholar
  9. Angermeyer MC, Held T, Görtler D (1993) Pro and contra: psychotherapy and psychopharmacotherapy attitude of the public. Psychother Psychosom Med Psychol 43(8):286–292PubMedGoogle Scholar
  10. Bogardus ES (1926) Social distance in the city. Proc Publ Am Sociol Soc 20:40–46Google Scholar
  11. Brown GW, Monck EM, Carstairs GM, Wing JK (1962) Influence of family life on the course of schizophrenic illness. Br J Prev Soc Med 16(2):55–68PubMedCentralGoogle Scholar
  12. Clausen JA, Radke Yarrow M (1955) Mental illness and the family. J Soc Issues11(4):3–5Google Scholar
  13. Cohen J, Struening EL (1962) Opinions about mental illness in the personnel of two large mental hospitals. J Abnorm Soc Psychol 64(5):349CrossRefPubMedGoogle Scholar
  14. Corrigan PW, Penn DL (1999) Lessons from social psychology on discrediting psychiatric stigma. Am Psychol 54(9):765CrossRefPubMedGoogle Scholar
  15. Corrigan PW, Watson AC (2002) The paradox of self‐stigma and mental illness. Clin Psychol: Sci Pract 9(1):35–53Google Scholar
  16. Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA (2003) An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 44:162–179CrossRefPubMedGoogle Scholar
  17. Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N (2012) Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 63(10):963–973CrossRefPubMedGoogle Scholar
  18. Crocetti GM, Spiro HR, Siassi I (1974) Contemporary attitudes toward mental illness. University of Pittsburgh Press, PittsburghGoogle Scholar
  19. Crocker J, Major B (1989) Social stigma and self-esteem: the self-protective properties of stigma. Psychol Rev 96(4):608CrossRefGoogle Scholar
  20. Cumming E, Cumming J (1957) Closed ranks; an experiment in mental health education. Cambridge MA: Harvard University PressGoogle Scholar
  21. D’Arcy C, Brockman J (1976) Changing public recognition of psychiatric symptoms? Blackfoot revisited. J Health Soc Behav 17:302–310CrossRefPubMedGoogle Scholar
  22. Evans-Lacko S, Henderson C, Thornicroft G (2013) Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. Br J Psychiatry 202(s55):s51–s57CrossRefGoogle Scholar
  23. Farina A, Ring K (1965) The influence of perceived mental illness on interpersonal relations. J Abnorm Psychol 70(1):47CrossRefPubMedGoogle Scholar
  24. Farina A, Allen JG, Brigid B, Saul B (1968) The role of the stigmatized person in affecting social relationships1. J Pers 36(2):169–182CrossRefPubMedGoogle Scholar
  25. Farina A, Gliha D, Bourdreau LA, Ale JG, Sherman M (1971) Mental illness and the impact of believing others know about it. J Abnorm Psychol 77(1):1CrossRefPubMedGoogle Scholar
  26. Foucault M (1975) Madness and civilization. New York: RoutledgeGoogle Scholar
  27. Freeman HE, Simmons OG (1963) The mental patient comes home. Wiley, New YorkGoogle Scholar
  28. Furnham A, Bower P (1992) A comparison of academic and lay theories of schizophrenia. Br J Psychiatry 161(2):201–210CrossRefPubMedGoogle Scholar
  29. Goffman E (1959) The presentation of self in everyday life. New York: Anchor BooksGoogle Scholar
  30. Goffman E (1961) Asylums: essays on the social situation of mental patients and other inmates. New York: Anchor BooksGoogle Scholar
  31. Gove WR (1975) The labelling of deviance: evaluating a perspective. Wiley, New YorkGoogle Scholar
  32. Gove WR (1982) Deviance and mental illness, vol. 6. Sage PublicationsGoogle Scholar
  33. Handfield WJ (1899) Lunacy law and borderland cases. Br Med J. 1:314Google Scholar
  34. Laing RD (1960) The divided self: an existential study in sanity and madness. Harmondsworth PenguinGoogle Scholar
  35. Lemkau PV, Crocetti GM (1962) An urban population’s opinion and knowledge about mental illness. Am J Psychiatry 118(8):692–700CrossRefGoogle Scholar
  36. Link B (1982) Mental patient status, work, and income: an examination of the effects of a psychiatric label. Am Sociol Rev 47:202–215CrossRefPubMedGoogle Scholar
  37. Link BG (1987) Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection. Am Sociol Rev 52:96–112CrossRefGoogle Scholar
  38. Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27:363–385CrossRefGoogle Scholar
  39. Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP (1989) A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev 54:400–423CrossRefGoogle Scholar
  40. 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 38:177–190CrossRefPubMedGoogle Scholar
  41. Nunnally JC (1961) Popular conceptions of mental health: their development and change. Holt, Rinehart, & Winston, OxfordGoogle Scholar
  42. Park RE (1924) The concept of social distance. J Appl Sociol 8(5):339–344Google Scholar
  43. Perlick DA, Rosenheck RA, Clarkin JF, Sirey JA, Salahi J, Struening EL, Link BG (2001) Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatr Serv 52(12):1627–1632CrossRefPubMedGoogle Scholar
  44. Perlick DA, Miklowitz DJ, Link BG, Struening E, Kaczynski R, Gonzalez J, Manning LN, Wolff N, Rosenheck RA (2007) Perceived stigma and depression among caregivers of patients with bipolar disorder. Br J Psychiatry 190(6):535–536CrossRefPubMedGoogle Scholar
  45. Pescosolido BA (2013) The public stigma of mental illness what do we think; what do we know; what can we prove? J Health Soc Behav 54(1):1–21CrossRefPubMedPubMedCentralGoogle Scholar
  46. Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG (2010) “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry 167(11):1321–1330CrossRefPubMedPubMedCentralGoogle Scholar
  47. Pescosolido BA, Medina TR, Martin JK, Scott Long J (2013) The “backbone” of stigma: identifying the global core of public prejudice associated with mental illness. Am J Public Health 103(5):853–860CrossRefPubMedPubMedCentralGoogle Scholar
  48. Phelan JC (2005) Geneticization of deviant behavior and consequences for stigma: the case of mental illness. J Health Soc Behav 46(4):307–322CrossRefPubMedGoogle Scholar
  49. Phelan JC, Link BG, Stueve A, Pescosolido BA (2000) Public conceptions of mental illness in 1950 and 1996: what is mental illness and is it to be feared? J Health Soc Behav 41:188–207CrossRefGoogle Scholar
  50. Phillips DL (1963) Rejection: a possible consequence of seeking help for mental disorders. Am Sociol Rev 28:963–972CrossRefGoogle Scholar
  51. Rabkin JG, Gelb L, Lazar JB (1980) Attitudes toward the mentally Ill: research perspectives: report of an NIMH workshop, January 24–25, 1980. US Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Division of Scientific and Public InformationGoogle Scholar
  52. Rosenberg M (1984) A symbolic interactionist view of psychosis. J Health Soc Behav 25:289–302CrossRefPubMedGoogle Scholar
  53. Rosenfield S (1997) Labeling mental illness: the effects of received services and perceived stigma on life satisfaction. Am Sociol Rev 64:660–672CrossRefGoogle Scholar
  54. Rosenhan DL (1974) On being sane in insane places. Clin Soc Work J 2:237–256CrossRefGoogle Scholar
  55. Sartorius N (1997) Fighting schizophrenia and its stigma. A new World Psychiatric Association educational programme. Br J Psychiatry 170(4):297–297CrossRefPubMedGoogle Scholar
  56. Sartorius N (1998) Stigma: what can psychiatrists do about it? Lancet 352(9133):1058–1059CrossRefPubMedGoogle Scholar
  57. Sartorius N, Schulze H (2005) Reducing the stigma of mental illness: a report from a global association. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  58. Scheff TJ (1966) Being mentally ill: a sociological study. Chicago: AldineGoogle Scholar
  59. Schwartz, C.G. (1956). The stigma of mental illness. Journal of Rehabilitation, 22:7–29Google Scholar
  60. Sibicky M, Dovidio JF (1986) Stigma of psychological therapy: stereotypes, interpersonal reactions, and the self-fulfilling prophecy. J Couns Psychol 33(2):148CrossRefGoogle Scholar
  61. Signorielli, N. (1989).The stigma of mental illness on television. Journal of Broadcasting and Electronic Media 33:325–331.Google Scholar
  62. Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Stigma as a barrier to recovery: perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric services 52(12):1615–1620CrossRefPubMedGoogle Scholar
  63. Stouffer SA, Lumsdaine AA, Lumsdaine MH, Williams RM Jr, Smith MB, Janis IL, Star SA, Cottrell LS Jr. (1949) The American soldier: combat and its aftermath. Studies in social psychology in World War II, vol. 2 Princeton: Princeton University PressGoogle Scholar
  64. Struening EL, Cohen J (1963) Factorial invariance and other psychometric characteristics of five opinions about mental illness factors. Educ Psychol Meas 23:289CrossRefGoogle Scholar
  65. Stuart H, Arboleda-Flórez J, Sartorius N (2012) Paradigms lost: fighting stigma and the lessons learned. New York: Oxford University PressGoogle Scholar
  66. Szasz TS (1974) The myth of mental illness: foundations of a theory of personal conduct. New York: PellGoogle Scholar
  67. Szasz TS (1977) Psychiatric slavery: when confinement and coercion masquerade as cure. Syracuse, NY: Syracuse University PressGoogle Scholar
  68. Taylor SM, Dear MJ (1981) Scaling community attitudes toward the mentally ill. Schizophr Bull 7(2):225–240CrossRefPubMedGoogle Scholar
  69. Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M, INDIGO Study Group (2009) Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373(9661):408–415CrossRefPubMedGoogle Scholar
  70. Wahl O (1976) Six tv myths about mental illness. TV Guide. 13:4–8Google Scholar
  71. Wahl OF (1989) Schizophrenogenic parenting in abnormal psychology textbooks. Teach Psychol 16(1):31–33CrossRefGoogle Scholar
  72. Wahl OF (1996) Schizophrenia in the news. Psychiatr Rehabil J 20(1):51CrossRefGoogle Scholar
  73. Wahl OF (1997) Media madness: public images of mental illness. Rutgers University PressGoogle Scholar
  74. Wahl OF, Kaye AL (1992) Mental illness topics in popular periodicals. Community Ment Health J 28(1):21–28CrossRefPubMedGoogle Scholar
  75. Wahl OF, Lefkowits JY (1989) Impact of a television film on attitudes toward mental illness. Am J Community Psychol 17(4):521–528CrossRefPubMedGoogle Scholar
  76. Wahl OF, Roth R (1982) Television images of mental illness: results of a metropolitan Washington media watch. J Broadcast Electron Media 26(2):599–605CrossRefGoogle Scholar
  77. Yang LH, Kleinman A, Link BG, Phelan JC, Lee S, Good B (2007) Culture and stigma: adding moral experience to stigma theory. Soc Sci Med 64(7):1524–1535CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of EpidemiologyColumbia UniversityNew YorkUSA
  2. 2.Centre for Health Services and Policy Research, Queen’s UniversityKingstonCanada
  3. 3.Department of Public Health SciencesMental Health Commission of CanadaOttawaCanada

Personalised recommendations