Although “absence makes the heart grow fonder” may be true of most people, oddly enough when it comes to the mentally ill, the opposite may be true. A new survey of 731 mental health professionals finds that those with more seniority on the job — and presumably more time in the company of people struggling with mental illness — view those suffering from depression or schizophrenia in a more positive light than the general public. Considering the results of her research, published yesterday in Psychiatric Services, Jennifer Stuber, lead author and an assistant professor of social work at the University of Washington, observed, "…more experience may make mental health professionals more empathetic to their clients and aware of the possibility of recovery."

Measuring Stigma

Mental illness is common, but serious mental illness is not; those who live with a serious condition amount to about six percent, or one in 17 Americans. The researchers, a team from University of Washington, Washington Community Mental Health Council, and Columbia University, wished to explore people’s attitudes about the competence and perceived dangerousness of people with mental health problems, and also their desire for social distance from such people. To investigate these possibly complicated feelings, the researchers designed an online, 30-minute survey in which mental health professions — counselors, social workers, psychologists, case managers, and others — began by reading vignettes about people who had symptoms of either depression or schizophrenia. Next, the participants, who numbered more than 731 professionals, answered a series of questions that are often used in surveys assessing stigma: How likely is the person described in the vignette to be dangerous? How likely is the person to make responsible financial decisions? Would you want the person as your neighbor, housemate, coworker, or spouse?

The mental health workers who had a job position denoting greater seniority (for example, program manager) had more positive attitudes about people with mental health problems. “Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions,” wrote the authors in their study.

Less surprisingly, the researchers also discovered that those who had been diagnosed with a mental illness themselves also revealed more positive attitudes. "The finding that stands out the most is that almost a third of mental health professionals disclosed that they received a diagnosis of mental illness in the past," Stuber said in a press release. In fact, the National Institute of Mental Health reports that one in four adults, or approximately 57.7 million Americans, experience a mental health disorder in a given year. Stuber added that the effects of a mental health diagnosis on professionals' attitudes "… has implications for how we think of the relevance of that experience in recruiting for a mental health workforce."

Finally, the researchers compared the findings to the attitudes held by the general public, in this case, roughly 400 adults who had taken the national General Social Survey. Among these participants, about 70 percent stated they wouldn't want someone with schizophrenia as a coworker while the same percentage considered them to be dangerous. Among professionals, similarly negative responses amounted to 40 percent and 35 percent, respectively. “The study shows that even though mental health professionals have by and large more favorable views about mental health patients than the public, stigmatizing attitudes still exist," Stuber said. "We need to train mental health providers to reject inaccurate public perceptions about people with mental illnesses."

Specifically, she noted the persistent belief that individuals with schizophrenia are prone to violence. According to the National Alliance on Mental Illness, "... the overall contribution of schizophrenia to violence in a community is small." Recent research conducted by Dr. Jan Volavka, New York University School of Medicine, similarly concluded, "Most patients with schizophrenia and bipolar disorder are not violent." He notes, though, that substance abuse may increase the likelihood of violent behavior in those suffering from schizophrenia — which is also true for some with no mental illness.

Source: Stuber JP, Rocha A, Christian A, Link BG. Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public. Psychiatric Services. 2014.