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The repentant sinner: methods to reduce stigmatised attitudes towards mental illness

^*South Essex Partnership NHS Trust, Honorary Consultant in Addictions Psychiatry, Cambridge & Peterborough Mental Health NHS Trust, The Taylor Centre, Queensway House, Essex Street, Southend-on-Sea SS12RB, e-mail: sl006h3607{at}blueyonder.co.uk

Harish Rao, Specialist Registrar in Psychiatry

Peter Bruff Unit, Clacton and District Hospital, Clacton on Sea

Sujaa Mary Rajagopal Arokiadass, Specialist Registrar in Forensic Psychiatry

Runwell Hospital, Wickford

Joby Maducolil Easow, Registrar in Psychiatry

The Taylor Centre

Arghya Sarkhel, Specialist Registrar in Psychiatry

The Taylor Centre, Southend-on-Sea, Essex

Declaration of interest

None.

AIMS AND METHOD

To devise a simple technique to reduce stigmatised attitudes of the general public towards those with mental disorder (schizophrenia and substance misuse). Members of the general public (n=400) completed a questionnaire to measure stigmatised attitudes towards people with schizophrenia and substance misuse disorders. Participants were randomised to receive either a short, ‘upbeat’ leaflet with a description of a patient in remission and a photograph of a man in a business suit; or a simple description of a fictional patient. The 5-item Attitudes to Mental Illness Questionnaire (AMIQ) was used to measure the effect of the various procedures on stigmatised attitudes (score range –10 to +10).

RESULTS

Results were received for 310 (77%) participants. The leaflet produced a large, statistically significant reduction in stigmatised attitudes towards people with opiate dependence (effect size 1.53, CI 1.23-1.82, P<0.0001; median change 4 units) and alcohol dependence (effect size 1.41, CI 1.12-1.70, P<0.0001; median change 4 units) but less so towards people with schizophrenia (effect size 0.54, CI 0.27-0.80, P=0.0002; median change 2 units). There was no difference between participants in respect of the control group at 4-week follow-up (233 responses received; 78% response rate).

CLINICAL IMPLICATIONS

A short illustrated leaflet can be used to reduce stigmatised attitudes towards substance misuse disorders if patients are presented in a positive manner. This is less effective for attitudes towards people with schizophrenia, possibly because people have a more generous attitude towards patients who have overcome substance misuse disorders.