[Social stigma in mental illness: A review of concepts, methods and empirical evidence].

Abstract

Sixty years are coming close since the first edition of the book by Goffman on social stigma, and research that connects it with mental illness has produced significant knowledge across different scientific fields, such as psychiatry and social sciences. This paper aims at providing a review of that scientific knowledge published over the last decades, and covers the following topics: a) basic theoretical concepts related to social stigma, such as public stigma, self-stigma, structural stigma and stigma by courtesy, b) representative findings of international empirical studies in regard to public attitudes towards mental illness, c) the measurement of social stigma in mental illness and the development of methodologies, such as scales and vignettes, d) the understanding of social stigma as a mechanism of producing and reproducing social inequalities in a form of symbolic power, e) the psychological and social consequences of social stigma on people' s lives-targets of social stigma, themselves and their families, and, finally, the public campaigns designed and delivered to fight social stigma. Recent advances in the theory of social stigma, as proposed by Pescosolido & Martin, conceptualize social stigma as a dialectic process enacted within a specific socio-historical context of power relations and Link & Phelan give insights of the processes through which social stigma, either implicitly or explicitly, produced and legitimated by institutional practices. International evidence drawn by public surveys on attitudes towards mental illness show that despite the overall negative attitudes, there are some positive changes that are related to people's openness and willingness to share their mental health difficulties with others and to seek professional help. Multi-dimensional and concept specific measures are most appropriate to use. Campaigns designed and delivered to fight stigma in mental illness needs to regenerate their contents and their strategy towards the recovery model communicating to the general public messages of hope and prospect.