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Running head: PREJUDICE TOWARDS MENTAL ILLNESS

Prejudice Towards Mental Illness

Katelyn Alderson

6460919

Department of Psychology, Brock University

Psychology of Prejudice and Discrimination – PSYC 4P71

Dr. Gordon Hodson

Thursday, November 18, 2021

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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
Prejudice Towards Mental Illness

Mental illness is a term used towards disorders that change one’s thinking, emotion, and

behaviour (Parekh, 2018). Parekh (2018) indicates how mental illness is common and how 19%

of American adults per year have been diagnosed with mental illness and 4.1% of American

adults per year are diagnosed with severe mental illness. Although these statistics reveal that

mental illness is common, individuals with mental illness still experience stigma, prejudice, and

discrimination, which is a reason why people who believe they have a mental illness are hesitant

to receive help. They fear being treated differently by society and fear adapting to this change in

their lifestyle (Borenstein, 2020). In today’s society, it is apparent that there is prejudice towards

mental illness. One can observe this prejudice by looking at an individual’s implicit and explicit

attitudes, intergroup anxiety, and social dominance orientation towards mental illness. Although

there is research that brings evidence of prejudice towards mental illness through these

influences, there are also weaknesses and theories that conflict, which will be discussed, as well

as ways to improve this research for years to come.

One way that individuals express their prejudice towards mental illness is through their

implicit and explicit processes and attitudes. Implicit processes are unconscious and

unintentionally activated. On the other hand, explicit processes are conscious, deliberate, and

controllable. O’Driscoll et al. (2012) researched how children and adolescents use explicit and

implicit stigmas towards their peers with mental illness, specifically attention deficit

hyperactivity disorder (ADHD) and depression. When looking at explicit stigmas, compared to

the “typical children”, children with mental illness received more negative responses. However,

O’Driscoll et al. (2012) found that children were more accepting and had less explicit biases
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
towards individuals with mental illness, compared to adolescents. These results can be explained

through the fact that adolescents have more preference for social order and would isolate

individuals who would “disrupt” this normal functioning (O’Driscoll et al., 2012). O’Driscoll et

al. (2012) also found that adolescents were less likely to socially distance themselves from

individuals with mental illness, contrary to what explicit attitudes would predict. When

observing the dependent factor of gender, O’Driscoll et al. (2012) found that males were less

accepting of mental illness and perceived mental illness to be the individual’s fault. Some

interesting findings about explicit and implicit biases were that boys were more accepting of

their peers with ADHD and girls were more accepting of their peers with depression (O’Driscoll

et al., 2012). This is suggested to be because boys are more likely to be diagnosed with ADHD,

whereas girls are more likely to be diagnosed with depression, therefore, this mental illness may

be seen as more normative behaviours, depending on the gender of the individual. When looking

at implicit stigmas, O’Driscoll et al. (2012) found that both children and adolescent males were

more negative in their responses. This provides information on changes in implicit attitudes from

childhood to adolescents, especially in females. Peris et al. (2008) researched implicit and

explicit biases towards individuals with mental illness among different individuals with different

mental health training. The following groups included mental health professionals, health care

workers, social service professionals, undergraduate students, and the public. It was found that

individuals with mental health training viewed people with mental illness more positively in both

implicit and explicit forms compared to the people with less experience. They also found that

individuals with mental health training also had the explicit attitude that people with mental

illness are competent, whereas individuals with less experience did not have this explicit attitude.

This can be explained by familiarity, as the more familiar one is with an outgroup, the less likely
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they are to stigmatize them. However, Peris et al. (2008) also looked at these biases and how

they could predict clinical decision-making. It was found that explicit biases predicted more

negative patient prognoses and implicit biases predicted overdiagnoses (Peris et al., 2008). This

means that even individuals with mental health training have this negative implicit influence,

even if they are unconscious about it, and it effects the way they diagnose people with mental

illness.

Although the research on implicit and explicit attitudes towards individuals with mental

illness show prominent strengths, there are still weaknesses to them. When looking at research

done by O’Driscoll et al. (2012), they used self-report measures instead of actual behaviour.

Since implicit biases are unconscious, it would not be completely accurate for individuals to rate

themselves on implicit measures, as they are truly unknown what they would do in certain

situations. As well, in the procedure, the person with the mental illness was the same gender as

the participant. The results indicated that girls were more understanding of girls with depression,

and boys were more understanding of boys with ADHD. To understand how children would act

towards others with mental illness, they would need to observe how they act towards children of

both genders, not just their own. Peris et al. (2008) also indicated some of the weaknesses in their

research, such as the task they used the indicate implicit biases was relative, and it is not possible

to interpret the evaluations of the people with mental illness independently.

Along with weaknesses, there is also other research that conflicts with the findings of

O’Driscoll et al. (2012) and Peris et al. (2018). For instance, FitzGerald & Hurst (2017) did

research on implicit biases of healthcare professionals, which found that healthcare professionals
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
have the same level of implicit biases as the general population. This conflicts with the findings

of Peris et al. (2008), as that research indicated that health care professionals had more positive

explicit and implicit biases towards mental illness because they are more familiar with the

outgroup. Dabby et al. (2015) also did research on explicit and implicit attitudes of psychiatrists

towards individuals with mental illness. Dabby et al. (2015) found that some psychiatrists had

positive attitudes towards mental illness, but many health care professionals share the general

public’s belief that individuals with mental illness are dangerous and are hesitant to include these

individuals in their social circles. This proves that mental health care professionals do also have

these negative implicit and explicit biases, even though they may not be shown in the workplace.

Research by O’Driscoll et al. (2012) brought useful evidence on implicit and explicit

attitudes affecting prejudice towards mental illness, however, there are ways this research could

be improved. For one, to truly understand the biases, future research should look at how each

gender also responds to mental illness of different sex peers instead of just their own. This could

allow one to know if these biases are more prominent in one’s own gender or if it is not

dependent. Also, O’Driscoll et al. (2012) only used the mental illnesses of ADHD and

depression, one of which is mostly seen in males and the other in females. It would be interesting

if the researchers also included a mental illness that was prominent in both genders to see how

children would react. For example, is anxiety is common in both genders, would males react the

same as looking at males with ADHD, since it is common, or would they have more negative

attitudes because it is common in females as well. Regarding research by Peris et al. (2008), they

found that psychiatrists had more positive attitudes than social workers and other health care

workers. Future steps in this research should examine this ranking and see which professions of
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
health care are most likely to have these positive biases. This can allow researchers to know if

these results are consistent and if there seems to be a ranking of what professions have the least

amount of biases, or if this ranking is significant enough to predict each health care worker's

attitudes towards mental illness. This seems to be a likely result, as psychiatrists have more

experience with mental illness, therefore show less intergroup anxiety.

Intergroup anxiety is another way one can predict prejudice, and it is relevant to

predicting prejudice towards mental illness. Factors that influence intergroup anxiety include the

amount of time spent with the outgroup as well as the type of contact one has with this outgroup.

If an individual has spent a lot of time, resulting in good outcomes, with a specific outgroup, they

are more likely to decrease in social distance and prejudice of this outgroup because they are

more comfortable with them. Anagnostopoulos & Hantzi (2011) researched this by looking at

how people who are familiar with mental illness react versus people who are unfamiliar. It was

found that the participants who were more familiar with mental illness were less likely to

socially distance themselves from them (Anagnostopoulos & Hantzi, 2011). These results

suggest that in this case, people with mental illness are not perceived as an outgroup, resulting in

less intergroup anxiety and more positive emotions towards them. This supports the intergroup

anxiety theory, as intergroup contact improves attitudes towards the perceived outgroup.

Anagnostopoulos & Hantzi (2011) also found that the more familiar participants were with

mental illness, the greater they believed these individuals need support and that the

stigmatizations towards people with mental illness is unfair. Research by Corrigan et al. (2001)

showed similar results. Corrigan et al. (2001) observed how familiarity with mental illness would

change individuals’ likelihood to socially distance and have stigmatizing attitudes towards severe
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
mental illness. The findings supported that the more familiar individuals were with mental

illness, the less likely they were to stigmatize people with severe mental illness as dangerous.

This was also associated with less fear and social distance of the individuals with severe mental

illness. Corrigan et al. (2001) concluded that people who were familiar with mental illness were

less likely to stigmatize severe mental illness as dangerous, resulting in less social distance and

discrimination towards them.

Both articles help provide evidence that familiarity with mental illness can decrease

prejudice, but there are some limitations to this research. For one, when looking at the research

done by Anagnostopoulos & Hantzi (2011), they found that most of the participants were female

university students. Anagnostopoulos & Hantzi (2011) and O’Driscoll et al. (2012) both

indicated that females are less likely to stigmatize people with mental illness, especially as they

grow older. If the study included an equal number of males, the results may have been different.

As shown in the research done by O’Driscoll et al. (2012), males still stigmatize mental illness

during adolescents, and for some, this stigmatization could join them in university. Had they had

an equal amount of male and female university participants, the results may have differed. As

well, both research by Anagnostopoulos & Hantzi (2011) and Corrigan et al. (2001) was towards

severe mental illness, rather than general, or specific types of mental illness. Participants may

believe that they are more in danger with certain types of illness over others, making some

mental illnesses provoke more intergroup anxiety than others.

The research on intergroup anxiety and familiarity relating to prejudice towards mental

illness has shown to be strong, however, there is research that conflicts with these findings.
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
Peterson (2016) researched how individuals who have been and know someone who has been

diagnosed with a mental illness would stigmatize. The results conflict with intergroup anxiety

theory, as it was found that these individuals were more stigmatizing towards mental illness,

making these surprising results, as one would assume that the more familiar an individual is with

mental illness, the more understanding they would be towards this outgroup (Peterson., 2016).

However, Peterson (2016) claims this may be a result of self-stigmatization, especially when

individuals who have mental illness know how the general population perceives them. Similar

results to Peterson (2016) were shown in research by Chang et al. (2017). This research observed

how medical and nursing students acted towards stigmas towards mental illness. Although the

results indicated that most of the health care students held positive attitudes towards individuals

with mental illness, they indicated that they would not want to work with patients who have

mental illness as they believe these individuals are dangerous and unpredictable (Chang et al.,

2017). These results conflict with intergroup anxiety, as the more familiar one is with an

outgroup, the more comfortable they should be with this outgroup. Regardless of how familiar

they are with mental illness, they still have anxiety towards these individuals' dangerousness.

To better the findings of Anagnostopoulos & Hantzi (2011) and Corrigan et al. (2001),

one should look at the differences of intergroup anxiety when observing severe and general

mental illness. As suggested by Corrigan et al. (2001), some individuals may have more anxiety

towards specific mental illnesses, which can be based on their experiences and contact these

individuals. This would be interesting research if one looks at overall intergroup anxiety towards

each individual mental illness. As stated above, one also needs to make sure when doing research

to include a mostly equal amount of each gender, as males are more likely to have intergroup
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Running head: PREJUDICE TOWARDS MENTAL ILLNESS
anxiety towards mental illness and therefore, decide to socially distance themselves. More

research should observe in depth the gender differences of prejudice and social distance towards

individuals with mental illness. When looking at social distance from individuals with mental

illness, one can observe other ideas as to why this might happen, such as social dominance

orientation.

Social dominance orientation (SDO) is another explanation for why individuals show

prejudice to an outgroup and explains why they show prejudice to individuals with mental

illness. Social dominance orientation explains an individual’s support for the social hierarchy of

the ingroup and their belief that they are superior to outgroups. Ingroups can support their

attitudes toward this hierarchy through legitimizing myths. Foster (2021) researched how

socioeconomic status (SES) can impact the mental illness stigma (MIS) through SDO. This

research also observed how legitimizing myths have an impact on whether the ingroup believes

that mental illness is controllable. Foster et al. (2021) found that higher SES was related to

higher levels of mental illness stigmatization as well as SDO. They also found that the link

between SES and mental illness stigmatization can be explained through SDO and the

legitimizing myth of controllability (the feelings that mental illness brings are controllable).

Foster (2021) evidence suggests that higher scores of SES can be related to negative attitudes,

such as low prosocial behaviour. Evidence was also found that individuals of high SES and high

SDO may use the legitimizing myth of mental illness being controllable to justify their high

status in society (Foster, 2021). This legitimizing myth is also related to people of high SES and

SDO showing less support to mental health organizations. Follmer & Jones (2017) also

researched SDO as a moderator between the relationship of the stereotype of competence and
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mental illness (specifically depression, anxiety, and bipolar disorder) when looking at how one

socially distances themself from employees with mental illness. The results from this study

supported SDO being a moderator of the stereotype of competence and individuals socially

distancing themselves from employees with anxiety and bipolar disorder (Follmer & Jones,

2017). If an individual was low on SDO beliefs, they perceived the employee as more competent

and decreased in socially distancing themselves from this employee. On the contrary, people

who scored high on SDO beliefs were more likely to believe the employee with anxiety or

bipolar disorder was less competent, therefore, they socially distanced themselves from this

employee. These results agree with social dominance orientation theory because people high in

SDO believe they are above people with mental illness, and therefore try to distance themself.

Even though the following articles show strong evidence of SDO being a reasonable

explanation for individuals’ prejudice toward mental illness, there are still parts to the research

that serve as weaknesses. In the research done by Foster (2021), they indicated that most of the

participants in the study were White, which is a weakness, as White people are shown to have

high SDO because of their status in society. Therefore, there might be an inflation in the SDO

results. Had Foster (2021) used a more diverse sample for their research, it may have shown

different results, as it could examine if people who do not naturally have a high SDO still feel

above people with mental illness. As well, in the research done by Follmer & Jones (2017), they

found that SDO was a moderator for the stereotype of competence against employees with

anxiety and bipolar disorder, but not depression. Individuals did not socially distance themselves

from employees with depression. This suggested that people may view depression differently

than they view anxiety and bipolar disorder. Follmer & Jones (2017) indicate that this could be
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because people may believe depression is not a serious mental illness and that the employees

with depression could recover from it. This is considered a weakness, as SDO was not found the

be a predictor of all mental illnesses, only specific ones.

Research by Peterson (2016) showed conflicting results about SDO affecting prejudice

towards individuals with mental illness. It was found that SDO did not predict an individual’s

stigma towards mental illness, especially towards a less controllable disorder (ex, schizophrenia).

Interestingly, Peterson (2016) also found that individuals lower in SDO stigmatized individuals

more than people higher in SDO, which contradicts the findings of both Foster (2021) and

Follmer & Jones (2017). Foster (2021) observed how socioeconomic status can impact mental

illness through social dominance orientation. In the research they found that people of low SES

had low SDO, making them have fewer stigmatizations towards mental illness. Research by

Potts & Henderson (2020) found contradicting results. They found that individuals of low SES

had more negative stigmas towards individuals who have a mental illness. These results are

interesting because people who are low in SES have more familiarity with people who have

mental illnesses, which also contradicts intergroup anxiety and familiarity (Potts & Henderson.,

2020).

The sample of participants has been stated to be a weakness of the research done by

Foster (2021), which is why to strengthen this research, one should look at minority groups and

their SDO towards mental illness. Also, people of high SES are usually the ones who get to make

decisions, because of their wealth, which can include decisions about funding. If people of high

SES have high SDO towards individuals of mental illness, and stigmatize them more, they may
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be less inclined to want to help. This can be detrimental to health care sources for people with

mental illness, as the people who would fund these projects don’t want to help because of their

legitimizing myth that mental illness is controllable. It would be important to do research on how

mental health organizations are positively or negatively affected by people of high SES, and if

negatively, how can we help these individuals lower their SDO and MIS towards individuals

with mental illness. When looking at the research done by Follmer & Jones (2017), people high

in SDO believed that their employees with mental illness were less competent but did not

observe whether this association between mental illness and competence is relevant. Future

research should look at how employees with mental illness affect the outcomes of the company

as well as the types of interactions they have with their fellow employees. As well, combining

the research of Foster (2021) and Follmer & Jones (2017), it would be interesting to see the

association between types of careers that individuals with mental illness choose and if they are in

careers that allow them to be of high SES. If they are of this high SES status, do they also have

high SDO towards others who have mental illness but are considered low SES. This would be

interesting research as it connects workplace, SES, SDO, and prejudice towards mental illness.

           In conclusion, it is evident that there is prejudice towards mental illness, especially when

observing individuals' implicit and explicit attitudes, intergroup anxiety, and social dominance

orientation. The following articles show evidence of prejudice towards mental illness through

these ideas, along with how future research can strengthen this evidence and help hinder the

theories that conflict. Individuals need to be aware of their prejudice towards mental illness, as it

is affecting whether people with mental illness will seek help and support. Individuals with

mental illness should not be afraid to use resources that will help them because others might
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discriminate against them. If others are aware of how they might be affecting the well-being of

individuals with mental illness, they might try to be more supportive and do their own research

of ways they could discriminate less. Mental illness is becoming more and more common, which

is why it is important to try to change people's attitudes towards it as so as we can.

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References

Anagnostopoulos, F., & Hantzi, A. (2011). Familiarity with and social distance from people with

mental illness: Testing the mediating effects of prejudiced attitudes. Journal of Community

& Applied Social Psychology, 21(5), 451–460. https://doi.org/10.1002/casp.1082

Borenstein, J. (2020, August). Stigma, Prejudice and Discrimination Against People with Mental

Illness. American Psychiatric Association . Retrieved November 14, 2021, from

https://www.psychiatry.org/patients-families/stigma-and-discrimination.

Chang, S., Ong, H. L., Seow, E., Chua, B. Y., Abdin, E., Samari, E., Teh, W. L., Chong, S. A., &

Subramaniam, M. (2017). Stigma towards mental illness among medical and nursing

students in Singapore: A cross-sectional study. BMJ Open, 7(12).

https://doi.org/10.1136/bmjopen-2017-018099

Corrigan, P. W., Green, A., Lundin, R., Kubiak, M. A., & Penn, D. L. (2001). Familiarity with

and social distance from people who have serious mental illness. Psychiatric Services,

52(7), 953–958. https://doi.org/10.1176/appi.ps.52.7.953

Dabby, L., Tranulis, C., & Kirmayer, L. J. (2015). Explicit and implicit attitudes of Canadian

psychiatrists toward people with mental illness. The Canadian Journal of Psychiatry,

60(10), 451–459. https://doi.org/10.1177/070674371506001006

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic

review. BMC Medical Ethics, 18(1). https://doi.org/10.1186/s12910-017-0179-8

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Follmer, K. B., & Jones, K. S. (2017). Stereotype content and social distancing from employees

with mental illness: The moderating roles of gender and Social Dominance Orientation.

Journal of Applied Social Psychology, 47(9), 492–504. https://doi.org/10.1111/jasp.12455

Foster, S. (2021). Socioeconomic status and mental illness stigma: How income level and social

dominance orientation may help to perpetuate stigma. Stigma and Health, 6(4), 487–493.

https://doi.org/10.1037/sah0000339

O’Driscoll, C., Heary, C., Hennessy, E., & McKeague, L. (2012). Explicit and implicit stigma

towards peers with mental health problems in childhood and adolescence. Journal of Child

Psychology and Psychiatry, 53(10), 1054–1062. https://doi.org/10.1111/j.1469-

7610.2012.02580.x

Parekh, R. (2018, August). What Is Mental Illness? What is mental illness? Retrieved November

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Peris, T. S., Teachman, B. A., & Nosek, B. A. (2008). Implicit and explicit stigma of mental

illness. Journal of Nervous & Mental Disease, 196(10), 752–760.

https://doi.org/10.1097/nmd.0b013e3181879dfd

Peterson, K. F. (2016). Explaining Mental Health Stigma Through Controllability, Just World

Beliefs, and Social Dominance Orientation. ProQuest.

Potts, L. C., & Henderson, C. (2020). Moderation by socioeconomic status of the relationship

between familiarity with mental illness and stigma outcomes. SSM - Population Health, 11,

100611. https://doi.org/10.1016/j.ssmph.2020.100611