Public attitudes toward mental illness create a cultural reality, defining what it means to deal with mental illness in a given place at a particular time. Time-trend studies show how the cultural conception of mental illness is changing, guiding our efforts to reduce the stigma of mental illness. Over the past decades, similar trends have emerged in several countries: Whereas professional treatment has become more and more popular for all mental disorders, attitudes toward persons with mental disorders have not generally improved. Looking at depression and schizophrenia, there are indications for a dissimilar development: Although someone with depression is met with increasing empathy and tolerance, and funding for depression treatment enjoys growing support among the public, people with schizophrenia face growing fear and rejection. Support for coercion like involuntary hospital admission also has increased. Attitudes toward people with substance use disorders have generally not changed and are particularly problematic. Whereas an overall broadening conception of mental health problems among the public seems to have improved attitudes toward people with common mental disorders, it is unclear whether this has had any positive effect on attitudes toward people with severe mental illness. The apparent divide in attitudes toward common versus severe mental illness poses a new challenge to future anti-stigma efforts.