EXPLICIT-IMPLICIT DISCREPANCY IN MACRO-LEVEL MENTAL ILLNESS STIGMA IS LINKED TO PREVALENCE AND CARE

Abstract

Introduction: This study explores the associations in the United States between each state's stereotypes about the dangerousness of people with mental illness and important outcomes for people with mental illness. Methods: Implicit association test and questionnaire data from 17,312 online participants were aggregated within states and years. Each state's annual average implicit and explicit stereotypes were used to predict state differences in prevalence, and treatment, unemployment, and homelessness among people with mental illness. Results: Implicit and explicit perceived dangerousness interact such that in states with low explicit perceived dangerousness, implicit perceived dangerousness is positively associated with all outcomes. In states with high explicit perceived dangerousness, implicit perceived dangerousness is negatively associated with homelessness. Discussion: Explicit-implicit discrepancy in macro-level perceived dangerousness is generally associated with worse outcomes for people with mental illness, but the effects are small. Macro-level stereotypes might have larger effects in smaller regions, like counties, than in states.