Racial and ethnic minorities are significantly more likely than whites to delay or forego needed mental health care, and, if they do seek treatment, they are more likely than whites to drop out (McGuire and Miranda, 2008). Mental illness stigma and discrimination are thought to contribute to these racial/ethnic disparities in service utilization (U.S. Department of Health and Human Services, 2001). The negative attitudes, beliefs, and behaviors that the public holds toward people with mental illness (i.e., public stigma) may lead people to deny or conceal their mental health symptoms and avoid treatment (Clement et al., 2015; Corrigan, 2004). Moreover, when people with mental health challenges internalize negative societal beliefs about mental illness (i.e., self-stigma), this can lead to feelings of hopelessness or the “why try” effect, whereby individuals give up on treatment, employment, or other important endeavors that are integral to recovery (Corrigan, Larson, and Rüsch, 2009).
A limited number of studies have examined whether mental illness is more highly stigmatized in racial/ethnic minority communities. Studies conducted with samples representative of general populations in the United States have yielded mixed findings; racial and ethnic minorities have been found to have higher (Anglin, Link, and Phelan, 2006; Collins et al., 2014; Whaley, 1997), lower (Anglin, Link, and Phelan, 2006), or no different levels of stigma than whites (Kobau et al., 2010; Martin, Pescosolido, and Tuch, 2000). Fewer still are studies of representative samples of the general U.S. population that have examined racial/ ethnic differences in stigma and discrimination among individuals who are experiencing mental health challenges
To address the gaps in our understanding of how mental illness stigma affects racial and ethnic minorities, the present study capitalized on data collected for the California Well-Being Survey (CWBS), a RAND survey conducted with a representative sample of California adults who are experiencing psychological distress. The CWBS was developed and administered in 2014 to track exposure to, and the impact of, prevention and early intervention (PEI) activities administered by the California Mental Health Services Authority (CalMHSA). With funding from California’s Mental Health Services Act (Proposition 63), CalMHSA implemented three statewide PEI initiatives focusing on mental illness stigma and discrimination reduction (SDR), suicide prevention, and student mental health that began in 2011. The CWBS assesses a wide variety of factors that may influence how individuals would respond if they were to experience mental health challenges, including perceptions of public stigma, recovery beliefs, treatment attitudes, self-recognition of mental health problems, mental health service utilization, and exposure to PEI activities. The CWBS is also the first study to assess the pervasiveness of self-stigma (i.e., negative feelings about one’s own mental illness) and experiences of mental illness–related discrimination using a sample that is representative of individuals who are at risk for or are experiencing mental health problems.
Population of focus: Adults in California
Organization: RAND Corporation