Mental Health Workers' Perceptions of Public Mental Health Stigma and Discrimination

Stigma and discrimination by the general public against people with mental illnesses remain serious problems despite community-wide anti-stigma efforts (Corrigan & Penn, 1999). The reduction of stigma, the presence of negative attitudes toward a group, and discrimination, acting on those attitudes in a negative way, are desired outcomes of these efforts. Between 1950 and 1996, the U.S. general public has shown a statistically significant increase in negative beliefs about people with mental illness, including beliefs that they are violent, unstable, unpredictable and irrational (Phelan, Link, Stueve, & Pescosolido, 2000). Members of the general public prefer to avoid people with mental illness; the amount of avoidance is positively correlated with beliefs that people with mental illness are dangerous (Martin, Pescosolido, & Tuch, 2000.) These studies suggest that members of the public negatively stereotype people with mental illness, with adverse consequences for the stereotyped group. Direct service employees in mental health are in a unique position to assist people with mental illnesses in dealing with the effects of stigma and discrimination. Although research about the effects of perceived discrimination based on one's mental health status is not available, research has found that perceiving that one has been subject to racial discrimination is correlated with negative mental health symptoms (e.g., see Banks, Kohn-Wood, & Spencer, 2006; Bhui et al., 2005; Sellers & Shelton, 2003). To what extent are mental health workers aware of these lived experiences? Such awareness can inform practice, so the clinicians and peer employees can assist clients in dealing with discrimination or the worsening of symptoms that may be associated with perceived discrimination. This exploratory study examined the following research questions: How do mental health workers perceive the presence of stigma and discrimination among the general public? How do other factors (e.g., status as a peer employee or licensed clinician, gender, and ethnicity) affect perceptions? Using a non-probability sample, we surveyed 103 mental health system employees using a semi-structured online interview. Participants were 51 peer employees and 52 licensed mental health clinicians in a U.S. southwestern state. Measures included gender, ethnicity, whether the participant was a peer employee or clinician, and the perceived discrimination scale (adapted from Finch, Kolody, & Vega, 2000.) We used SPSS Regression to construct a model of mental health workers' perceptions of stigma and discrimination by the general public. The model had an adjusted R² of .485 (p < .001) with significant predictors of status as a peer employee or clinician, gender, ethnicity and ethnicity's interaction with employee status and gender. We found that mental health clinicians perceived more frequent stigmatizing attitudes and discrimination by the general public than did peer employees, an unexpected finding. Male employees of color perceived the fewest instances of stigma and discrimination, and female clinicians perceived the most stigma and discrimination. Further research is needed to examine the reasons for and consequences of the differences in perception and how these differences relate to worker behavior.