Mental Illness Stigma in Turkish and Greek Cypriot Communities Living in Cyprus: A Pilot Study

Abstract

1.IntroductionPublic stigma has been defined by Corrigan, Rowan, Green, Lundin, River, Uphoff-Wasowski, White, and Kubiac, (2003) as a status loss and discrimination of individuals with mental health problems due to negative prejudice from the general public. Norman, Sorrentino, Gawronski, Szeto, Ye and Windell (2010) further explained stigma as a complex process that is cognitive and behavioural which takes place between the general public and mentally ill individuals. Stereotypes refer to the beliefs that are negative and associated with mentally ill individuals such as dangerousness and unpredictability (public stigma) and incompetency (self-stigma) (Pingani, Forghieri, Ferrari, Ben-Zeev, Artoni, Mazzi, and Corrigan, 2011). Prejudice, such as fear (public stigma) and low self-esteem (self-stigma) are cognitive and emotional responses that are activated by the stereotypes. These may then lead to discrimination, which is a behavioural response to prejudice; not employing someone due to his or her mental health problem (public stigma) or not applying for a job due to having a mental illness (self stigma).Two main theoretical models on stigma have been developed in an effort to explain how it forms; labelling (Link et al., 1987) and attribution theories (Corrigan, 2000). Scheff's original theory of labelling suggested that stereotypes about mental illness are learnt at an early age through social interactions and media, which are then internalized and applied to self in the case of mental illness. Individuals diagnosed with mental illness are aware of these roles that expected from them by the public, they therefore, start acting in such way. According to this theory, once someone is diagnosed with mental illness a new identity of a "psychiatric patient" and a social status is created for that individual. Stigma is then formed which is expressed as labelled individual being excluded form the daily interactions (Link et al., 1987). Another theory that sought to understand the stigma of mental illness is attribution theory (Heider, 1958). Corrigan (2000) developed Weiner's original attribution theory and applied it specifically to stigma of mental illness. According to him, there are 3 constructs of mental illness stigma; signalling event, cognitive and affective responses and behavioural reaction. There are signals such as poor social skills, which may indicate that there may be something unusual or alarming about the individual. Similar to Weiner, Corrigan also suggested that if the illness is attributed to an external factor the person is more likely to receive pity, therefore, help and less negative attitudes. This is opposite for those who are held responsible for their illness which in turn receive more anger and punishing behaviour consequently more stigma.Furthermore, a widely used social-psychology model has further been developed which adopted aspects from both attribution and labelling theories (Angermeyer and Matschinger, 2003, Angermeyer, Matschinger and Corrigan, 2003; Corrigan, Edwards, Green, A., Diwan, and Penn , 2001). Corrigan et al., (2000) suggested that this model claims that stigmatizing attitudes are constructed due to ones previous experience and knowledge which then leads to a behavioural response. A casual pathway model consists of experience, perception, affect and response (See Figure 1).In detail, this model considers perceptions and affects as attribution, which in turn results in discrimination as a behavioural response (Emmerton, 2010). Unlike the labelling and the attribution theories this model also considers other factors, which are identified as contributors to the stigma of mental illness; demographics and familiarity.According to the researchers stigma commonly results in economical, personal, political and social challenges for those who have such health conditions (Halter, 2008). Attitudes that are stigmatizing may also result in discriminative behaviour; restriction of someone's everyday life practices as well as prospects in public and private institutions. …