Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-05T08:36:48.496Z Has data issue: false hasContentIssue false
  • English
  • Français

The economic impact of mental health stigma and discrimination: A systematic review

Published online by Cambridge University Press:  11 April 2011

Jessica Sharac ,
Paul Mccrone ,
Sarah Clement  and
Graham Thornicroft
Jessica Sharac
Affiliation:
Centre for the Economics of Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London (United Kingdom)
Paul Mccrone*
Affiliation:
Centre for the Economics of Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London (United Kingdom)
Sarah Clement
Affiliation:
Section of Community Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London (United Kingdom)
Graham Thornicroft
Affiliation:
Section of Community Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London (United Kingdom)
*
Address for correspondence: Dr. P. McCrone, PO24 CEMH, Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF (United kingdom). Fax: +44 (0) 20 7277 1462 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

People with mental illness face stigma and discrimination in a variety of settings which can have an economic impact. Aim – The aim of this paper was to identify literature on the economic impact of mental illness stigma. Methods – A systematic review of the literature identified 30 papers from 27 studies by searching electronic databases and hand searching reference lists. Results – Mental illness stigma/discrimination was found to impact negatively on employment, income, public views about resource allocation and healthcare costs. Conclusions – Stigma and discrimination regarding mental health problems lead to adverse economic effects for people with these conditions. Interventions that reduce stigma may therefore also be economically beneficial.

Declaration of Interest: This study was funded in relation to a National Institute for Health Research (NIHR) Applied Programme grant awarded to the South London and Maudsley NHS Foundation Trust, and in relation to the NIHR Specialist Mental Health Biomedical Research Centre at the Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust. There is no conflict of interest in connection with the submitted article.

Keywords

systematic reviewmental disordersattitude to healthcost of illnessdiscriminationstigmaemployment.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 19 , Issue 3 , September 2010 , pp. 223 - 232
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baldwin, M. & Marcus, S. C. (2006). Perceived and measured stigma among workers with serious mental illness. Psychiatric Services 57, 388–392.CrossRefGoogle ScholarPubMed
Beck, M., Dietrich, S., Matschinger, H. & Angermeyer, M. C. (2003). Alcoholism: Low standing with the public? Attitudes towards spending financial resources on medical care and research on alcoholism. Alcohol and Alcoholism 38, 602–605.CrossRefGoogle ScholarPubMed
Bieliauskas, V. J. & Wolfe, H. E. (1960). The attitude of industrial employers toward hiring of former state mental hospital patients. Journal of Clinical Psychology 16, 256–259.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Brand, R. C. & Clairborn, W. L. (1976). Two studies of comparative stigma: employer attitudes and practices toward rehabilitated convicts, mental and tuberculosis patients. Community Mental Health Journal 12, 168–175.CrossRefGoogle ScholarPubMed
Corrigan, P. W., Watson, A. C., Warpinski, A. C. & Gracia, G. (2004). Stigmatizing attitudes about mental illness and allocation of resources to mental health services. Community Mental Health Journal 40, 297–307.CrossRefGoogle ScholarPubMed
Farina, A. & Felner, R. D. (1973). Employment interviewer reactions to former mental patients. Journal of Abnormal Psychology 82, 268–272.CrossRefGoogle ScholarPubMed
Goldberg, S. G., Killeen, M. B. & O'Day, B. (2005). The disclosure conundrum: how people with psychiatric disabilities navigate employment. Psychology, Public Policy, and Law 11, 463–500.CrossRefGoogle Scholar
Gove, W. R. & Fain, T. (1973). The stigma of mental hospitalization. An attempt to evaluate its consequences. Archives of General Psychiatry 28, 494–500.CrossRefGoogle ScholarPubMed
Hand, C. & Tryssenaar, J. (2006). Small business employers’ views on hiring individuals with mental illness. Psychiatric Rehabilitation Journal 29, 166–173.CrossRefGoogle ScholarPubMed
Herzig, H. & Thole, B. (1998). Employers’ attitudes towards employment of people with mental illnesses in Mzuzu, Malawi. East African Medical Journal 75, 428–431.Google ScholarPubMed
Landy, D. & Griffith, W. D. (1958). Employer receptivity toward hiring psychiatric patients. Mental Hygiene 42, 383–390.Google ScholarPubMed
Lee, S., Chiu, M. Y., Tsang, A., Chui, H. & Kleinman, A. (2006). Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science & Medicine 62, 1685–1686.CrossRefGoogle ScholarPubMed
Link, B. (1982). Mental patient status, work, and income: an examination of the effects of a psychiatric label. American Sociological Review 47, 202–215.CrossRefGoogle ScholarPubMed
Link, B. (1987). Understanding labelling effects in the area of mental disorders: an assessment of the effects of expectation of rejection. American Sociological Review 52, 96–112.CrossRefGoogle Scholar
Link, B. G., Cullen, F. T., Struening, E. L. & Shrout, P. E. (1989). A modified labeling theory approach to mental disorders: an empirical assessment. American Sociological Review 54, 400–423.CrossRefGoogle Scholar
Manning, C. & White, P. D. (1995). Attitudes of employers to the mentally ill. Psychiatric Bulletin 19, 541–543.CrossRefGoogle Scholar
Matschinger, H. & Angermeyer, M. C. (2004). The public's preferences concerning the allocation of financial resources to health care: results from a representative population survey in Germany. European Psychiatry 19, 478–482.CrossRefGoogle ScholarPubMed
McSween, J. L. (2002). The role of group interest, identity, and stigma in determining mental health policy preferences. Journal of Health Politics, Policy, and Law 27, 773–800.CrossRefGoogle ScholarPubMed
McCrone, P., Knapp, M., Henri, M. & McDaid, D. (in press). The economic impact of initiatives to reduce stigma: demonstration of a modelling approach. Epidemiologia e Psichiatria Sociale.Google Scholar
Ministry of Health (2007). Like Minds, Like Mine National Plan 2007–2013: Programme to Counter Stigma and Discrimination Associated with Mental Illness. Ministry of Health: Wellington.Google Scholar
Olshansky, S., Grob, S. & Malamud, I.T. (1958). Employers’ attitudes and practices in the hiring of ex-mental patients. Mental Hygiene 3, 391–401.Google Scholar
Ozawa, A. & Yaeda, J. (2007). Employer attitudes toward employing persons with psychiatric disability in Japan. Journal of Vocational Rehabilitation 26, 105–113.Google Scholar
Peterson, D., Pere, L., Sheehan, N. & Surgenor, G. (2007). Experiences of mental health discrimination in New Zealand. Health and Social Care in the Community 15, 18–25.Google ScholarPubMed
Roeloffs, C., Sherbourne, C., Unutzer, J., Fink, A., Tang, L. & Wells, K. B. (2003). Stigma and depression among primary care patients. General Hospital Psychiatry 25, 311–315.CrossRefGoogle ScholarPubMed
Sartorius, N. & Schulze, H. (2005). Reducing the Sigma of Mental Illness: A Report from a Global Programme of the World Psychiatric Association. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Schomerus, G., Matschinger, H. & Angermeyer, M. C. (2006). Preferences of the public regarding cutbacks in expenditure for patient care: Are there indications of discrimination against those with mental disorders? Social Psychiatry and Psychiatric Epidemiology 41, 369–377.CrossRefGoogle ScholarPubMed
Schomerus, G., Matschinger, H. & Angermeyer, M. C. (2007). Familiarity with mental illness and approval of structural discrimination against psychiatric patients in Germany. Journal of Nervous & Mental Disease 195, 89–92.CrossRefGoogle ScholarPubMed
See Me Scotland (2006). See me so far: a review of the first four years of the Scottish anti-stigma campaign. Retrieved March 4, 2007, from http://www.seemescotland.org.uk/Google Scholar
Skitka, L. & Tetlock, P. (1992). Allocating scarce resources: A contingency model of distributive justice. Journal of Experimental Social Psychology 28, 491–522.CrossRefGoogle Scholar
Skitka, L. & Tetlock, P. (1993). Providing public assistance: Cognitive and motivational processes underlying liberal and conservative policy preferences. Journal of Personality & Social Psychology 65, 1205–1223.CrossRefGoogle Scholar
Thompson, A. H., Stuart, H., Bland, R. C., Arboleda-Florez, J., Warner, R. & Dickson, R. A. (2002). Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Social Psychiatry and Psychiatric Epidemiology 37, 475–482.CrossRefGoogle ScholarPubMed
Tsang, H. W., Tam, P. K., Chan, F. & Cheung, W. M. (2003). Sources of burdens on families of individuals with mental illness. International Journal of Rehabilitation Research 26, 123–130.Google ScholarPubMed
Tsang, H. W., Angell, B., Corrigan, P. W., Lee, Y. T., Shi, K., Lam, C. S., Jin, S. & Fung, K.M. (2007). A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery. Social Psychiatry and Psychiatric Epidemiology 42, 723–733.CrossRefGoogle ScholarPubMed
Webber, A. & Orcutt, J. D. (1984). Employers’ reactions to racial and psychiatric stigmata: A field experiment. Deviant Behaviour 5, 327–336.CrossRefGoogle Scholar
World Health Organisation (2008). The Global Burden of Disease: 2004 Update. World Health Organisation: Geneva.Google Scholar
Zrihen, I., Ashkenazi, I., Lubin, G. & Magnezi, R. (2007). The cost of preventing stigma by hospitalizing soldiers in a general hospital instead of a psychiatric hospital. Military Medicine 172, 686–689.CrossRefGoogle Scholar