Are Mental Health Professionals Immune to Stigmatizing Beliefs?

To the Editor: The stigma of mental illness is a major obstacle to recovery of persons with severe mental illnesses (1,2). Stigma affects an individual's self-esteem, increases dysfunction, and poses problems to patients with regard to housing and employment (1,3). Stigma is a culturally induced barrier to recovery. Although studies have examined experiences of stigma by users of mental health services and stigmatizing attitudes in the general public, little attention has been paid to the experiences and attitudes of mental health professionals.

To examine this issue we conducted a simple survey at Catawba Hospital in Virginia, a 110-bed state psychiatric facility that provides care for adults and geriatric patients with severe mental illnesses. Permission for the staff survey was obtained from the facility director and chief of staff. Fifty clinical staff, including psychiatrists, psychologists, social workers, adjunctive therapists, and nursing staff, were randomly approached at their work stations over a two-day period. Staff members were chosen on the basis of availability, until a total of 50 respondents were obtained. No staff member refused to participate. A written questionnaire was used to ask two simple yes-or-no questions: "If you were to be diagnosed with schizophrenia, would you be uncomfortable talking about it to a nonprofessional (such as friends or acquaintances)?" "If you answered 'Yes,' is it because of stigma?" The responses were obtained anonymously. Thirty respondents (60 percent) said that they would be uncomfortable talking about it to friends and acquaintances. Seventeen (34 percent) said that it was because of stigma.

This brief survey highlights the feelings of discomfort even professionals experience with a psychiatric diagnosis such as schizophrenia. It is interesting that a third of the respondents would perceive stigma. We may be practicing a double standard—expecting consumers and the public to cast off their stigmatizing beliefs but harboring those beliefs ourselves. Obviously there is a need to conduct more elaborate studies to examine our own attitudes and beliefs as professionals—how they arise and how they might influence our role as care providers. Our educational efforts should not stop at targeting the public and consumers of mental health services; professionals should also be included. Transformation of the mental health system and implementation of a key recommendation of the President's New Freedom Commission (2)—"Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention"—should also address stigmatizing beliefs of mental health professionals.