Predictors of experiences of discrimination and positive treatment in people with mental health problems: findings from an Australian national survey
The aim of the study was to assess the factors predicting experiences of avoidance, discrimination and positive treatment in people with mental health problems.
In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered experiences of avoidance, discrimination and positive treatment by friends, spouse, other family, workplace, educational institution and others in the community; as well as disclosure of mental health problems. Avoidance, discrimination and positive treatment scores were calculated by counting the number of domains in which each occurred. Predictors of avoidance, discrimination and positive treatment were modelled with negative binomial regression analyses.
After adjusting for the effects of other predictors in multivariate analyses, symptom severity and a diagnosis of ‘any other disorder’ (most commonly psychotic disorders or eating disorders) predicted experiences of both avoidance and discrimination but not positive treatment. Disclosing a mental health problem in more settings was also associated with higher rates of avoidance and discrimination, but also with positive treatment.
Disclosure of mental health problems to others may increases experiences of discrimination, but may also increase experiences of positive treatment. These findings can help to inform decision making by people with mental health problems about disclosure, particularly in the case of more severe or low-prevalence disorders.
KeywordsMental disorders Discrimination Stigma Positive treatment Disclosure
Compliance with ethical standards
The study was funded by the National Health and Medical Research Council.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 4.World Health Organisation (2001) The World Health Report: mental health: new understanding, new hope. World Health Organisation, GenevaGoogle Scholar
- 11.Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, Van Audenhove C, van Weeghel J, Reneses B, Germanavicius A, Economou M, Lanfredi M, Ando S, Sartorius N, Lopez-Ibor JJ, Thornicroft G (2013) Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381(9860):55–62. doi: 10.1016/S0140-6736(12)61379-8 CrossRefPubMedGoogle Scholar
- 14.Alonso J, Buron A, Bruffaerts R, He Y, Posada-Villa J, Lepine JP, Angermeyer MC, Levinson D, de Girolamo G, Tachimori H, Mneimneh ZN, Medina-Mora ME, Ormel J, Scott KM, Gureje O, Haro JM, Gluzman S, Lee S, Vilagut G, Kessler RC, Von Korff M, World Mental Health C (2008) Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatr Scand 118(4):305–314. doi: 10.1111/j.1600-0447.2008.01241.x CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Farrelly S, Clement S, Gabbidon J, Jeffery D, Dockery L, Lassman F, Brohan E, Henderson RC, Williams P, Howard LM, Thornicroft G, group Ms (2014) Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study. BMC Psychiatry 14:157. doi: 10.1186/1471-244X-14-157 CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Corker EA, Beldie A, Brain C, Jakovljevic M, Jarema M, Karamustafalioglu O, Marksteiner J, Mohr P, Prelipceanu D, Vasilache A, Waern M, Sartorius N, Thornicroft G, Group FS (2015) Experience of stigma and discrimination reported by people experiencing the first episode of schizophrenia and those with a first episode of depression: The FEDORA project. Int J Soc Psychiatry 61(5):438–445. doi: 10.1177/0020764014551941 CrossRefPubMedGoogle Scholar
- 26.Kessler RC, Green JG, Gruber MJ, Sampson NA, Bromet E, Cuitan M, Furukawa TA, Gureje O, Hinkov H, Hu CY, Lara C, Lee S, Mneimneh Z, Myer L, Oakley-Browne M, Posada-Villa J, Sagar R, Viana MC, Zaslavsky AM (2010) Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. Int J Methods Psychiatr Res 19(Suppl 1):4–22. doi: 10.1002/mpr.310 CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Reavley NJ, Morgan AJ, Jorm AF (2016) Discrimination and positive treatment towards people with mental health problems in workplace and education settings: Findings from an Australian national survey. Stigma and Health (in press) Google Scholar
- 29.Brohan E, Henderson C, Wheat K, Malcolm E, Clement S, Barley EA, Slade M, Thornicroft G (2012) Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace. BMC Psychiatry 12:11. doi: 10.1186/1471-244X-12-11 CrossRefPubMedPubMedCentralGoogle Scholar