GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 1

The Effects of Gender and Race on Stigma Surrounding Mental Illness

Megan Kilgore, Bonnie Schrag, and Alex Vrabely

University of Colorado Boulder

GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 2

Abstract

This study looks at gender and race on stigma surrounding mental illness, specifically how

stigma varies depending on an individual’s gender and race. Previous literature has looked

at gender and race and its effect on stigma, however separately, and has concluded that

men are more likely to feel stigma compared to women, and people of color are more likely

to feel stigma compared to white people. It was hypothesized that while every race and

gender is going to experience some degree of stigma, African American and Asian males

will experience more severe stigma than White males and African American and Asian

females will experience more severe stigma than White females. Additionally males of color

will report higher stigma than females of color. Data was collected using an anonymous

self-report survey distributed to residents of Colorado through social media and email.

Participants used a 5-point scale rating their answers to questions from “strongly agree” to

“strongly disagree”. We found that there was no difference between gender and race on

stigma surrounding mental illness. These results suggest that we need to conduct research

again, due to how varied the data is from previous research. A larger and more diverse

sample size is needed.

Keywords: mental health, stigma, race, gender.

GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 3

The Effect of Gender and Race on Stigma Surrounding Mental Illness

Mental Illness is very prevalent in the United States of America with 1 in 5 adults, or

48 million people, experiencing it in a given year (NAMI, 2015). While many Americans are

affected by mental illness, 60% of adults do not get treatment. There are many factors that

affect access to treatment including cost and insurance coverage, lack of mental health

professionals, lack of education surrounding mental illness, and racial barriers, however

stigma continues to be a major contributor to why people do not get treatment (Mental

Health Partners, 2013). While stigma has been studied in the past, it mostly has looked at

how it affects the larger institutions that prevent access to mental health, such as insurance

companies, policies, and availability of treatment centers. This study lays out new

groundwork on the importance of looking at race and gender and its effect on stigma

surrounding mental illness.

Mental illness is one of the most heavily stigmatized illnesses in western society.

Societies’ stereotyped views about mental illness and how it affects people result in

discrimination from peers, family members, employers, as well as how the institutions of

society are built (Mental Health Foundation, 2018). Stigma negatively affects mental illness,

and is a large deterrent to people seeking help.

There are two types of stigma that affect mental illness: public stigma and self-

stigma. Public stigma is common stereotypes and beliefs surrounding mental illness that

result in discrimination. Discrimination can be as simple as avoiding people with mental

illness all the way to segregating institutions (Corrigan & Watson, 2002). While the media

is a large perpetrator of spreading stigma, discrimination towards people with mental

GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 4

illness further keeps the stigma cycle going. Self-Stigma on the other hand results from

people with mental illness internalizing societies stigmatization. Self-stigma keeps many

individuals from seeking the help that they need, or it can go as far as denying the mental

illness (Corrigan & Watson, 1984).

While stigma surrounding mental illness is evident in most countries and cultures, it

is more severe in Western countries than in Asian and African countries (Corrigan &

Watson, 2002). In America however, African Americans and Asians are more likely to hold

severe views on stigma than Whites (Mental Health America, 2017). A large factor in the

variance in stigma between race, are historical inequalities and racism that have led to

socioeconomic and institutional disparities today. More African Americans are uninsured

compared to Whites, and people of color are overrepresented in jails and prisons.

Additionally less than 2 percent of American Psychological Association members are

Black/African American, thus there may be concerns about the cultural competence of

mental healthcare professionals (Mental Health America, 2017). While stigma itself is so

severe, people from different races experience it differently and to different degrees.

Stigma surrounding mental illness is associated with how laws, social services, and

the justice system are structured, as well as how resources are allocated (Corrigan &

Watson, 2002). This ultimately affects cost of treatment and insurance coverage, the

number of mental health professionals, especially in more rural low-income areas, and who

gets treatment. In a recent report by Substance Abuse And Mental Health Services

Administration, the adults most likely to receive treatment and prescription drugs for

mental illness were white adults (NIMH, 2015). Black, Hispanic, and Asian adults receive

treatment substantially less than white adults. Stigma effects gender differently as well as
GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 5

race. For example more women than men are likely to receive treatment from their general

practitioner, while men are more likely to use in-patient services (WHO, 2018).

While stigma has been studied in the past, it mostly has looked at how it affects the

larger institutions that prevent access to mental health, such as insurance companies,

policies, and availability of treatment centers. Race and Gender have been looked at

however rarely separately from the institutions. We want to look at how gender and race

together affect stigma surrounding mental illness. This is important because while the

effects of stigma are universal, the ways in which they appear, and the degree, are not. By

understanding what stigma people of different races and genders experience through a

survey, we can narrow down factors to address in order to make mental health care

accessible to all. We hypothesize that African American and Asian males will experience

more severe stigma than White males and African American and Asian females will

experience more severe stigma than White females. Additionally males of color will report

higher stigma than females of color.

Method

Participants

There were a total of 16 participants in the study with 6 males and 10 females. The

mean age of the participants was 20.69 years with a standard deviation of 2.28 years. The

participants were all individuals residing within the state of Colorado. Participants

received no incentive for taking the survey.

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Race White Asian Native Black or Total %

American/Pacific African
Islander American
Gender
Male 2 3 1 0 37%
Female 7 1 0 2 63%
Total % 56% 25% 6% 12%

Table 1: Table showing demographics of participants.

Design

The design of the study was correlational. Participants completed a self-report

survey in which they responded to questions regarding stigma surrounding mental illness

and mental health. The three variables observed in the study was gender, race, and

participants stigma towards mental illness. A selection of sample questions used in the

survey can be seen in Appendix A at the end of this report.

Measures

In order to measure for participants’ stigma towards mental illness we created a

stigma survey consisting of 17 items. Participants were asked to answer 17 questions using

a scale ranging from “strongly agree” to “strongly disagree”. Examples of questions asked

were “Mental health problems are not real illnesses in the way physical illnesses are” and

“Once you have a mental health problem, you have it for life”. The stigma survey was found

to have strong internal reliability α=.84.

Participants also recorded gender and race.

Procedure

Data was collected using an anonymous Qualtrics survey that was sent out through

email, text message, and social media accounts. All participants consented to the survey
 GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 7

and indicated that they were at least 18 years of age. Participants then recorded age,

gender, and race before completing questions regarding stigma.

Results

It was hypothesized that that while every race and gender would experience some

degree of stigma, African American and Asian males would experience more severe stigma

than White males. Additionally males will report higher stigma than females. The mean

score on the scale of stigma was 4.32 with a standard deviation of SD= .89. There was no

statistically significant relationship found between gender and stigma as r=(1.22), p>.001.

This means that we found no tendency for African American and Asian males to have more

of a stigma on mental health. In addition to race there was also no significant correlation

found between males and stigma on mental health shown by r=(3.25), p>.001. So, there

was no tendency found in our population of participants for males to be more stigmatized.

The following graphs show the total stigma, out of 100, for gender and race. The

lower the number, the higher the stigma.

Figure 1: Bar graph showing average mental illness

stigma for men compared to women. No significant Figure 2: Bar graph showing average mental illness
difference is shown. stigma depending on race. No significant difference is
shown.
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Discussion

It was hypothesized that that while every race and gender would experience some

degree of stigma, African American and Asian males would experience more severe stigma

than White males. Additionally males will report higher stigma than females. Our results

did not support this hypothesis. While our stigma scale had strong internal reliability,

displaying that our scale was testing what it needed to, there was no significant difference

between race and gender, or even between males and females. This differs from previous

research that suggests men are more stigmatized than women, and people of color are

more stigmatized than white people (Mental Health America, 2017). While our results

differ, they do not show change to the literature, due to limitations we faced from sample

size and diversity.

Limitations and Future Discretions

The biggest limitation that our study faced was the small sample size of 16. With

such a small number of participants, it is not possible to see trends, and generalizing to the

larger population not be tenable. In addition to the low number of respondents, the

homogeneity of our respondents proved to be another limiting factor; 37% of our

participants identified as male and 63% identified as female. Additionally 9 participants

identified as White, 4 as Asian, 1 as Native Hawaiian/Pacific Islander, and 2 as Black or

African American. This made it difficult to gauge an accurate representation of how race

and gender interact with stigma surrounding mental illness.

There are several possible factors that may have contributed to our results.

According to the US Census Bureau, 68.6% of the population in Colorado is White alone,
GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 9

21.3% is Hispanic or Latino, 4.5% is Black, and 3.3% is Asian (census.gov). This population

makeup may not be the most representative of the US population at large, and could

therefore skew any generalizations we may make. Another factor to consider is age. The

median age in the United States is 37.9 years old. An overwhelming majority of our sample

fell between the ages of 18 and 22, with few exceptions. Given that our hypothesis was

based on former research, evolving cultural attitudes and new social norms could play a

hand in younger members of the population responding differently than previous

generations.

Future studies could be improved by ensuring a sizeable pool of diverse

respondents. Given a larger, more diverse pool of participants, more definite conclusions or

implications could be drawn. Although our study was open to the entire state of Colorado,

our sample population reflected a lack of diversity. In the future, special attention should

be given to the makeup of the sample population to ensure that any results would be

statistically relevant.

Implications

With our sample population there is little that can be said about the implications to

society as a whole as it is not representative to the population of Colorado. However, the

lack of diverse responses speaks to the increasing demand for research on the topic at

hand. Previous research has shown us the extent of the racial and gender discrepancy of

mental health stigma but we need to know how and if these two factors influence each

other to affect the populations that are underrepresented in the field of mental health. If

these discrepancies are not addressed by researchers in psychology, then their need could

continue to be overlooked. If this pattern continues, the effects of these conditions could
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easily become one of the most prominent health issues concerning the populations of

Colorado and on a greater scale of the entire country. Once more statistically powerful

information can be collected on the relationship between gender and race then it can be

determined what steps need to be taken to correct these stigmatized views so that

healthcare professionals can better serve their diverse communities.

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References

Cornwell Health Schools (2018). The Stop Stigma Survey. Retrieved at

https://www.cornwallhealthyschools.org/mh-resources/ss-survey/

Corrigan, P., Watson, A. (1984). The Paradox of self-stigma and mental illness. Can J

Psychiatry, 57(8), 464-469.

Corrigan, P., Watson, A. (2002).Understanding the Stigma On People With Mental Illness.

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data

Mental Health Foundation (2018). Stigma and discrimination. Retrieved at

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Mental-Illness.aspx

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insel/blog/2015/mental-health-awareness-month-by-the-numbers.shtml#14.
GENDER AND RACE ON STIGMA SURROUNDING MENTAL ILLNESS 12

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Appendix A: Sample Questions

Question: On a scale from 1 “Strongly disagree” to 5 “Strongly Agree” please rate how you

feel about each question.

• I would be embarrassed to tell someone if I had a mental health problem.

• Only certain kinds of people have mental health problems

• If I thought someone had a mental health problem, I'd stay away from them.

• Mental health problems are not real illnesses in the way physical illnesses are.

• If I thought I had a mental health problem, I would talk to someone.