Stigmatizing attitudes towards people with

mental disorders: findings from an Australian

National Survey of Mental Health Literacy and
Stigma
Nicola J. Reavley, Anthony F. Jorm

Objective: This paper reports findings from a national survey on stigmatizing attitudes towards people with depression, anxiety disorders and schizophrenia/psychosis.
Method: In 2011 telephone interviews were carried out with 6019 Australians aged 15
or over. Participants were presented with a case vignette describing either depression,
depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social
phobia or post-traumatic stress disorder. Questions were asked about stigmatizing attitudes,
including perceptions of discrimination, personal and perceived stigma and desire for social
distance.
Results: Chronic schizophrenia was most likely to be associated with dangerousness,
unpredictability and a preference for not employing someone with the problem, while
social phobia was most likely to be seen as due to personal weakness. Attitudes concerning
dangerousness and social distance were greater in relation to men with mental disorders
compared to women. Other people were perceived as more likely to hold stigmatizing
attitudes than the respondents reported for themselves.
Conclusions: Anti-stigma interventions are more likely to be successful if they focus on
individual disorders rather than on mental illness in general. Such interventions may need
to address perceptions of social phobia as being due to weakness and those of dangerousness in people with more severe disorders. Such interventions should also focus on bringing
beliefs about public perceptions in line with personal beliefs.
Key words: anxiety disorders, depression, schizophrenia, stigma, mental health literacy,
survey.
Australian and New Zealand Journal of Psychiatry 2011; 45:10861093
DOI: 10.3109/00048674.2011.621061

Stigma is often nominated as a central concern for

people with mental disorders [1,2]. Stigmatizing attitudes
may inhibit help seeking, may compound the experience
of psychological distress and may also adversely affect
personal relationships and the ability to achieve educational
and vocational goals [35]. In spite of recent progress in the
development of evidence-based treatments and increased
Nicola J. Reavley, Research Fellow (Correspondence); Anthony F. Jorm,
Professorial Fellow
Orygen Youth Health Research Centre, University of Melbourne,
Parkville, Victoria 3052, Australia. Email: nreavley@unimelb.edu.au

2011 The Royal Australian and New Zealand College of Psychiatrists

public knowledge about mental disorders, many people

report direct experiences of stigma and discrimination
and it remains a significant issue [6,7].
Studies from a number of countries have examined
stigmatizing attitudes towards people with mental disorders, including participants beliefs about those with the
disorders (known as personal or, alternatively, public
stigma) [8,9], participants beliefs about the attitudes of
others (perceived stigma) [10], or a desire for social distance [11]. In Australia, such studies include the 2003
2004 National Survey of Mental Health Literacy in the

N. J. REAVLEY, A. F. JORM

adult population, in which stigmatizing attitudes were

examined towards a person described in one of four
vignettes: depression, depression with suicidal thoughts,
early schizophrenia and chronic schizophrenia [12]. Consistent with survey findings from other countries, the
results showed that Australians were more likely to endorse
stigmatizing statements about schizophrenia, particularly
the items concerning dangerousness and unpredictability,
a desire for social distance and the perception that the
person would be discriminated against [13].
As such research has tended to focus on mental illness
broadly, or specifically on depression and schizophrenia,
relatively little is known about stigmatizing attitudes
towards anxiety disorders, despite their high prevalence
rates [14]. As evidence suggests that it is not appropriate
to generalize stigmatizing attitudes about depression or
schizophrenia to anxiety disorders, there is a need to
explore specific attitudes to these disorders [15,16].
Moreover, stigma is a multidimensional construct, the
various aspects of which may operate differently according to circumstances such as age, gender and culture
[10,17,18]. There is a need to explore various aspects of
stigma in relation to a range of mental disorders in order
to better understand how to target stigma reduction interventions. The aim of the study was to carry out a national
survey in order to assess stigmatizing attitudes towards
depression, anxiety disorders and schizophrenia/psychosis.

1087

latter two, which were used for the first time, are given
elsewhere [19].
After being presented with the vignette, respondents
were asked what, if anything, they thought was wrong with
the person described in the vignette and a series of questions about the likely helpfulness of a wide range of interventions, their health, knowledge of causes and risk factors
and contact with people like those in the vignette. Data
relating to these questions is reported elsewhere [19]. The
focus of this paper is respondents beliefs about the stigma
and discrimination associated with mental disorders.
Personal and perceived stigma

The survey involved computer-assisted telephone interviews (CATI) with a national sample of 6019 members of
the general community aged 15 . The survey was carried
out by the survey company Social Research Centre (Melbourne, Victoria). The sample was contacted by randomdigit dialling of both landlines and mobile phones covering
the whole country from January to May 2011. Further details
of the methods are given in an accompanying paper [19].

Stigmatizing attitudes were assessed with two sets of

statements, one assessing the respondents personal attitudes towards the person described in the vignette (personal stigma) and the other assessing the respondents
beliefs about other peoples attitudes towards the person
in the vignette (perceived stigma) [9]. The personal
stigma items were: (i) People with a problem like John/
Jennys could snap out of it if they wanted, (ii) A problem
like John/Jennys is a sign of personal weakness, (iii)
John/Jennys problem is not a real medical illness, (iv)
People with a problem like John/Jennys are dangerous,
(v) It is best to avoid people with a problem like John/
Jennys so that you dont develop this problem, (vi) People with a problem like John/Jennys are unpredictable,
(vii) If I had a problem like John/Jennys I would not tell
anyone, (viii) I would not employ someone if I knew they
had a problem like John/Jennys, (ix) I would not vote for
a politician if I knew they had suffered a problem like
John/Jennys.
The perceived stigma items covered the same statements but started with Most other people believe that
Ratings of each were made on a 5-point Likert scale ranging from strongly agree to strongly disagree. For these
analyses the agree and strongly agree categories were
combined.

Survey interview

Social distance

The interview was based on a vignette of a person with

a mental disorder. On a random basis, respondents were
read one of six vignettes: depression, depression with
suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia and post-traumatic stress disorder
(PTSD). Respondents were also randomly assigned to
receive either male (John) or female (Jenny) versions
of the vignette. All vignettes were written to satisfy the
diagnostic criteria for either major depression or schizophrenia according to DSM-IV and ICD-10.The first four
vignettes have been published previously [20] and the

Self-reported willingness to have contact with the person described in the vignette was measured using the
5-item scale developed by Link et al. [21]. The items
rated the persons willingness to (i) move next door to
John/Jenny, (ii) spend an evening socializing with John/
Jenny, (iii) make friends with John/Jenny, (iv) work
closely with John/Jenny on a job, (v) have John/Jenny
marry into their family. Each item was rated on a 4-point
scale ranging from definitely willing to definitely unwilling. For these analyses the definitely unwilling and probably unwilling categories were combined.

Methods

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NATIONAL SURVEY OF MENTAL HEALTH LITERACY AND STIGMA

Perceived discrimination
Perceived discrimination was examined by asking if
respondents thought the person in the vignette was likely
to be discriminated against by others in the community.
Possible responses were yes, no and I dont know.
Statistical analysis
The data were analysed using percentage frequencies
and 95% confidence intervals. A pre-weight was applied
to adjust for the dual frame design and the respondent
chance of selection. The achieved sample was close to
the Australian national population in terms of geographic distribution; however, there was an underrepresentation of men and of younger adults, and an
over-representation of university educated people and
people with an English-speaking background. A population weight was used to adjust for these biases. Differences between percentage frequencies could be
considered statistically significant if there is no overlap
between the 95% confidence intervals for the relevant
percentages. With n 1000 per vignette, a percentage
difference of 5% is always statistically significant at
the p 0.05 level.
Design-based chi-square analyses (or the F statistic
in the case of continuous variables) were used to
examine the differences in attitudes according to the
gender of the person described in the vignette. All
analyses were performed using Intercooled Stata 10
(StataCorp, TX).
Results
When asked if the person described in the vignette was
likely to be discriminated against, between 40.1% (PTSD
vignette) and 84.1% (chronic schizophrenia vignette)
thought this was likely to be the case (see Table 1). When
Table 1. Percentage (and 95%CI) of respondents
who think the person described in the vignette
would be discriminated against
Vignette
Depression (n 1016)
Depression with suicidal thoughts
(n 1008)
Early schizophrenia (n 1002)
Chronic schizophrenia (n 993)
Social phobia (n 992)
PTSD (n 1008)

% (95%CI)
58.5 (55.062.0)
59.9 (56.363.3)
73.9 (70.776.9)
84.1 (81.386.6)
55.8 (52.259.3)
40.1 (36.743.5)

beliefs about discrimination were analysed according to

the gender of the person described in the vignette, there
were no significant differences.
Personal stigma
Respondents personal agreement with statements
reflecting attitudes to those with mental illness are given
in Table 2, which shows that avoiding the person was the
statement with which respondents were least likely to
agree. This applied to all vignettes. People with this
problem are unpredictable was the statement with which
respondents were most likely to agree. This was particularly notable for the schizophrenia vignettes with approximately 70% of people agreeing or strongly agreeing with
the statement. Endorsement of personal stigma items
relating to dangerousness, unpredictability, not employing someone with the problem and not voting for a politician with the problem was generally highest for the
chronic schizophrenia vignette, while beliefs in the problem as a sign of personal weakness or not a real medical
illness were generally higher for social phobia than for
other disorders. Willingness to disclose was highest for
PTSD (17.1%) and lowest for chronic schizophrenia
(33.3%).
When personal attitudes were analysed according to
the gender of the person described in the vignette, for the
depression vignette, men were more likely to be seen as
dangerous (men: 25.7% (95%CI 21.730.3), women:
18.2% (95%CI 14.522.6), p 0.013). This was also the
case for the early schizophrenia vignette (men: 40.1%
(95%CI 35.445.1), women: 33.2% (95%CI 28.738.0),
p 0.043). For the chronic schizophrenia vignette, men
were more likely to be seen as best avoided (men: 7.0%
(95%CI 4.510.8), women: 2.6% (95%CI 1.54.6),
p 0.006). For the social phobia vignette, men were
more likely to be seen as best avoided (men: 7.1% (95%CI
4.610.8), women: 3.4% (95%CI 2.05.7), p 0.029),
unpredictable (men: 45.9% (95%CI 40.951.0), women:
37.6% (95%CI 32.842.7), p 0.023) and not to be
employed (men: 19.9% (95%CI 16.024.6), women:
12.7% (95%CI 9.716.4), p 0.014). For the PTSD
vignette, men were more likely to be seen as dangerous
(men: 21.4% (95%CI 17.525.8), women: 14.8% (95%CI
11.418.9), p 0.021) and unpredictable (men: 53.5%
(95%CI 48.558.5), women: 45.2% (95%CI 40.350.2),
p 0.021).
Perceived stigma
Respondents personal agreement with statements
reflecting perceived attitudes to those with mental illness
are given in Table 3. Perceived stigma items received much

N. J. REAVLEY, A. F. JORM

1089

Table 2. Percentage (and 95%CI) of respondents who agree or strongly agree with statements about personal
attitudes to mental disorders
Statement about
personal belief
Person could snap
out of the
problem
Problem is a sign
of personal
weakness
Problem is not a
real medical
illness
People with this
problem are
dangerous
Avoid people with
this problem
People with this
problem are
unpredictable
If I had this
problem I
wouldnt tell
anyone
I would not employ
someone with
this problem
I would not vote
for a politician
with this problem

Depression

Depression with
suicidal thoughts

Early
schizophrenia

Chronic
schizophrenia

20.1 (17.223.4)

18.1 (15.321.3)

13.9 (11.516.7)

11.6 (9.414.3)

20.5 (17.623.7) 19.9 (17.123.1)

13.9 (11.516.8)

15.8 (13.218.8)

12.1 (9.914.8)

13.6 (11.216.5)

16.5 (13.819.5)

13.2 (10.816.1)

10.7 (8.513.2)

8.8 (6.811.3)

10.4 (8.312.9)

16.3 (13.719.2) 14.9 (12.517.8)

22.0 (19.225.1)

27.9 (24.831.2)

36.6 (33.340.0)

36.8 (33.440.3)

15.5 (12.918.5) 18.0 (15.420.9)

4.2 (2.96.2)

4.8 (3.36.9)

53.1 (49.556.6) 58.7 (55.262.2)

73.6 (70.476.5)

76.2 (73.079.1)

22.7 (20.025.7) 23.0 (20.126.1)

29.9 (26.833.2)

33.3 (30.136.7) 29.5 (26.432.9) 17.1 (14.520.0)

23.4 (20.526.6) 23.6 (20.626.8)

27.5 (24.530.8)

37.0 (33.640.6)

27.0 (23.830.3) 24.0 (21.027.3)

29.7 (26.633.1)

40.1 (36.643.7) 26.1 (23.029.5) 20.2 (17.423.3)

6.4 (4.88.6)

5.9 (4.47.9)

higher rates of agreement than personal stigma items. For

all vignettes, respondents were most likely to agree or
strongly agree with the statements about other peoples
belief in unpredictability, the belief that most other people
would not tell anyone and the belief that most other people
would not employ someone with the problem. As with
personal stigma, endorsement of perceived stigma items
relating to dangerousness, unpredictability, not employing
someone with the problem and not voting for a politician
with the problem was generally highest for the chronic
schizophrenia vignette, while beliefs in the problem as a
sign of personal weakness or not a real medical illness
were generally highest for social phobia.
When perceived attitudes were analysed according to
the gender of the person described in the vignette, for the
depression vignette, men were more likely to be seen as
best avoided (men: 41.1% (95%CI 36.346.2), women:
32.0% (95%CI 27.536.9), p 0.009) and not to be
employed (men: 73.9% (95%CI 69.378.0), women:
67.1% (95%CI 62.071.8), p 0.041). For the depression
with suicidal thoughts vignette, men were more likely to
be seen as dangerous (men: 54.5% (95%CI 49.559.4),
women: 44.7% (95%CI 39.849.8), p 0.007) and not to

Social phobia

5.2 (3.77.3)

PTSD

12.1 (9.914.8)

2.9 (1.94.5)

41.7 (38.245.3) 49.3 (45.852.8)

16.2 (13.719.2) 15.4 (13.018.1)

be voted for as a politician (men: 74.2% (95%CI 69.5

78.4), women: 65.1% (95%CI 60.269.6), p 0.006). For
the early schizophrenia vignette, men were more likely to
be seen as dangerous (men: 64.1% (95%CI 59.168.7),
women: 56.8% (95%CI 51.861.6), p 0.038) and not to
be employed (men: 79.4% (95%CI 75.183.1), women:
72.5% (95%CI 67.876.7), p 0.024). For the social phobia vignette, men were less likely to be seen as being able
to snap out of the problem (men: 53.0% (95%CI 47.8
58.0), women: 60.2% (95%CI 55.265.1), p 0.046) and
more likely to be seen dangerous (men: 41.4% (95%CI
36.446.5), women: 29.0% (95%CI 24.633.9), p 0.001).
For the PTSD vignette, men were more likely to be seen
as dangerous (men: 44.0% (95%CI 39.149.0), women:
29.9% (95%CI 25.534.7), p 0.001), best avoided (men:
36.0% (95%CI 31.341.0), women: 29.3% (95%CI 25.0
34.0), p 0.048), unpredictable (men: 68.8% (95%CI
63.973.3), women: 56.1% (95%CI 51.160.9),
p 0.0003), not to be employed (men: 62.5% (95%CI
57.567.3), women: 53.8% (95%CI 48.858.7), p 0.015)
and not to be voted for as a politician (men: 66.0% (95%CI
61.070.6), women: 56.9% (95%CI 51.961.8),
p 0.0108).

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NATIONAL SURVEY OF MENTAL HEALTH LITERACY AND STIGMA

Table 3. Percentage (and 95%CI) of respondents who agree or strongly agree with statements about perceived
attitudes to mental disorders
Statement about
what most other
people believe
Person could
snap out of the
problem
Problem is a sign
of personal
weakness
Problem is not a
real medical
illness
People with this
problem are
dangerous
Avoid people with
this problem
People with this
problem are
unpredictable
If I had this
problem I
wouldnt tell
anyone
I would not
employ
someone with
this problem
I would not vote
for a politician
with this
problem

Depression

Depression
with suicidal
thoughts

Early
schizophrenia

Chronic
schizophrenia

53.8 (50.357.4)

54.8 (51.358.3)

48.7 (45.252.2)

47.5 (44.051.1)

56.6 (53.060.2) 49.0 (45.552.6)

53.0 (49.556.5) 52.6 (49.156.2)

47.7 (44.251.2)

48.4 (44.952.0)

55.2 (51.658.8)

49.5 (46.053.0) 49.0 (45.552.6)

45.0 (41.648.5)

46.1 (42.649.7)

58.7 (55.162.2) 48.9 (45.452.5)

39.1 (35.642.6) 49.6 (46.053.1)

60.4 (56.963.8)

73.0 (69.876.1)

35.1 (31.738.7) 36.8 (33.440.2)

36.6 (33.240.1) 40.2 (36.843.8)

40.1 (36.743.6)

48.6 (45.152.2)

35.5 (32.039.1) 32.6 (29.336.0)

69.2 (65.972.4) 74.1 (70.877.1)

80.4 (77.483.2)

86.9 (84.189.2)

62.3 (58.765.7) 62.3 (58.865.7)

70.2 (66.873.4) 72.2 (68.875.2)

72.4 (69.175.4)

75.8 (72.678.8)

73.6 (70.376.7) 63.9 (60.467.3)

70.5 (67.173.7)

70.3 (67.073.5)

75.9 (72.778.8)

84.7 (82.087.1)

65.1 (61.668.5) 58.1 (54.561.5)

66.0 (62.669.3) 69.6 (66.272.7)

72.7 (69.575.7)

83.1 (80.285.7)

67.4 (63.970.7)

Social distance
Table 4 shows the percentage of respondents who
were either probably unwilling or definitely unwilling to interact socially with the person described in
the vignette. For each vignette, respondents were most
unwilling to work closely with or marry into the family of someone with a mental disorder, while a desire
for social distance was least likely for making
friends.
When desire for social distance was analysed according to the gender of the person described in the vignette,
for the depression vignette, desire for men not to marry
into the family was higher than for women (men: 32.2%
(95%CI 27.737.1), women: 24.2% (95%CI 20.128.9),
p 0.032). For the depression with suicidal thoughts
vignette, unwillingness to spend the evening socializing
was higher for men (men: 11.4% (95%CI 8.515.0),
women: 7.0% (95%CI 4.810.1), p 0.003) as was desire
not to have the person marry into the family (men: 28.5%

Social phobia

PTSD

41.0 (37.644.6)

61.3 (57.864.7)

(95%CI 24.333.2), women: 17.8% (95%CI 14.422.0),

p 0.0002). For the early schizophrenia vignette, desire
for men not to marry into the family was higher (men:
38.1% (95%CI 33.443.0), women: 28.7% (95%CI 24.5
33.3), p 0.015). This was also the case for the chronic
schizophrenia vignette (men: 51.0% (95%CI 45.956.0),
women: 39.2% (95%CI 34.444.2), p 0.003) and the
social phobia vignette (men: 22.3% (95%CI 18.326.9),
women: 14.9% (95%CI 11.618.9), p 0.004). For the
PTSD vignette, the desire not to live next door to someone was higher for men (men: 10.2% (95%CI 7.513.6),
women: 5.2% (95%CI 3.47.9), p 0.023) as was desire
for the person not to marry into the family (men: 23.3%
(95%CI 19.327.8), women: 11.4% (95%CI 8.615.1),
p 0.0001).
Table 5 gives the mean social distance scores. Desire
for social distance was greatest for the chronic schizophrenia vignette and lowest for the social phobia and
PTSD vignettes. Scores across the following vignettes
were significantly greater for men: depression (men: 9.21

N. J. REAVLEY, A. F. JORM

1091

Table 4. Percentage (and 95%CI) of respondents probably unwilling or definitely unwilling to socially interact
with the person described in the vignette
Social
interactions

Depression

Live next door

8.8 (7.011.0)
Spend the evening 8.0 (6.410.0)
socializing
Make friends
5.7 (4.47.5)
Work closely
15.5 (13.218.2)
Marry into family
28.2 (25.131.6)

Depression with
suicidal thoughts

Early
schizophrenia

Chronic
schizophrenia

Social phobia

PTSD

11.6 (9.514.1)
9.2 (7.311.5)

15.2 (12.917.9)
12.7 (10.615.2)

29.9 (26.733.3)
24.4 (21.527.6)

6.3 (4.88.2)
6.9 (5.39.0)

7.6 (5.99.7)
6.5 (5.08.5)

5.9 (4.57.7)
15.8 (13.418.5)
23.1 (20.326.2)

11.0 (9.013.4)
18.5 (16.021.4)
33.3 (30.136.6)

19.5 (16.822.5)
30.0 (26.833.3)
45.1 (41.648.7)

5.5 (4.07.5)
13.2 (10.915.9)
18.5 (15.921.5)

5.2 (3.86.9)
10.4 (8.412.8)
17.2 (14.720.1)

(95%CI 8.929.51), women: 8.51 (95%CI 8.238.80),

p 0.001), depression with suicidal thoughts (men: 9.11
(95%CI 8.819.43), women: 8.44 (95%CI 8.158.72),
p 0.002), chronic schizophrenia (men: 10.88 (95%CI
10.5111.25), women: 10.27 (95%CI 9.9310.62)
p 0.019) and PTSD (men: 8.74 (95%CI 8.218.81),
women: 7.92 (95%CI 7.678.18) p 0.000).

Discussion
A 2011 survey of mental health literacy and stigma in
6019 Australians aged 15 showed that perceptions of
discrimination, social distance, dangerousness and unpredictability were generally highest for chronic schizophrenia, while beliefs in the problem as a sign of personal
weakness or not a real medical illness were generally
higher for social phobia than for other disorders. For both
personal and perceived stigma, across all vignettes, the
statements with which respondents were most likely to
agree or strongly agree involved beliefs about unpredictability, not telling anyone and not employing someone
with the problem. Current findings are also in keeping
with those of other studies that report higher levels of
stigmatizing attitudes towards schizophrenia than those
of other disorders [12,22,23].
Most previous studies of stigmatizing attitudes towards
mental illness have focused on depression or schizophre-

Table 5 Mean (95%CI) social distance scores in

relation to the person described in the vignette
Vignette

Mean (95%CI) score

Depression
Depression with suicidal thoughts
Early schizophrenia
Chronic schizophrenia
Social phobia
PTSD

8.87 (8.669.07)
8.77 (8.568.99)
9.40 (9.169.63)
10.58 (10.3310.83)
8.36 (8.158.56)
8.32 (8.138.52)

nia. The inclusion of anxiety disorder vignettes allowed

for an exploration of how different aspects of stigma
might vary according to disorder. Results of the current
study showed that patterns of agreement with different
statements varied according to disorder, highlighting the
multidimensional nature of stigma. Beliefs in the problem as a sign of personal weakness or not a real medical
illness were generally higher for social phobia than for
other disorders, while beliefs in dangerousness and
unpredictability were notably higher for the schizophrenia vignettes. This may partly reflect that fact that social
phobia is less often identified as a mental disorder and is
therefore less likely to be associated with some types of
stigmatizing attitudes [19,24]. Because it would be rare
for a respondent to have had personal experience of violence involving a person with schizophrenia, it is likely
that media reports associating violence with schizophrenia contribute to perceptions of dangerousness [25,26].
As far as the authors are aware, the current survey is
the first population-level survey to assess stigmatizing
attitudes towards PTSD. This is of significance as relatively few studies have assessed stigma in relation to
anxiety disorders [15,27,28]. Findings from the current
study indicating lower levels of stigmatizing attitudes
towards PTSD than to other mental disorders are consistent with those of other smaller studies, including a South
African study assessing community attitudes to a range
of mental disorders [28] and a study involving Croatian
adolescents [27]. It is possible that attributing a disorder
to an external cause, such as that described in the vignette,
makes it less likely that it be seen as a character problem
or source of shame.
As with previous studies of stigmatizing attitudes,
questionnaire items assessing perceived stigma received
much higher endorsement than those assessing personal
stigma [9,12]. A social desirability effect may have contributed to this finding, although it is unlikely that a
desire not be judged by an anonymous telephone interviewer fully explains the large differences. The discrepancy could be an example of what social psychologists

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have called pluralistic ignorance, where most people

erroneously perceive that they have different attitudes to
the majority. It is possible that increasing awareness of
the issue of stigma in the community has contributed to
the over-estimation of prevalence of stigmatizing beliefs.
This is supported by reports of an increase in the belief
that a person with depression would be discriminated
against, particularly in those Australian states with greatest exposure to campaigns run by beyondblue: the
national depression initiative [29]. These results suggest
that stigma reduction campaigns should focus on bringing beliefs about public perceptions in line with personal
beliefs. Such an approach has been used in other areas,
including the use of social norms interventions to curb
problem drinking [30].
When stigmatizing attitudes were compared according
to whether the person described in the vignette was male
or female, some significant differences emerged, with
men generally more likely to be seen as dangerous. Desire
for social distance was also generally significantly higher
for men, possibly due to perceptions of dangerousness.
This is consistent with other reported studies [31,32].
However, the differences in perceptions of dangerousness
were less likely to be significant for more severe disorders, perhaps indicating that views of dangerousness of
more severe disorders outweigh any perceptions of gender differences.
Limitations
Survey limitations include the self-report nature of the
data and the fact that responses may be affected by a social
desirability bias. In addition, the original items in the scales
were developed for use in evaluating depression stigma and
they may not be optimal for assessing stigmatizing attitudes
to other disorders. In this study, stigmatizing attitudes were
assessed in relation to an unknown person described in a
vignette. It is unclear how such beliefs might differ in cases
where the person with the disorder is known to the respondent. It is also not clear whether such attitudes translate into
behaviour and there is a need for further research into the
links between attitudes and behaviours towards people with
mental disorders.
Conclusions
Results of a national survey of stigmatizing attitudes
towards those with depression, schizophrenia and anxiety
disorders show that patterns of stigmatizing attitudes differ according to disorder, with differences between
schizophrenia and social phobia being particularly striking. This suggests that anti-stigma interventions are more

likely to be successful if they focus on individual disorders rather than on mental illness in general. Such interventions may need to focus on perceptions of social
phobia as being due to weakness and address perceptions
of dangerousness in those with more severe disorders.
Such interventions should also focus on bringing beliefs
about public perceptions in line with personal beliefs as
the latter are much less stigmatizing.
Declaration of interest: Funding for the study was provided by the Commonwealth Department of Health and
Ageing. The authors alone are responsible for the content
and writing of the paper.
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