Lecture 5: Mental Disorder and Crime Flashcards
Views of people with Mental Illness
Previous view: People with MI are dangerous. High stigma
New View: stigma around MI remains high. Effort to reduce stigma through stigma reduction programmes
Star (1955) study design (view the public had on MI)
- He wanted to assess the view the public had on MI
- Used vignettes to show people as having mental illnesses (SZ, alcoholism, phobia)
Star (1955) findings
found that very few identified the problems posed as being linked to MI. MI can dehumanise an individual and takes people away from what they really are
* this gives evidence of high stigma
Nunnally (1991) - stigma
Evidence that the stigma around MI remains high.
They found that MI individuals were classified as ‘dangerous, dirty’, ‘unpredictable’ and ‘worthless.
Phelan et al., (1991) findings
Found that stereotypes of mentally ill individuals are getting worse (particularly dangerousness)
A study that aimed to improve stigma around MI
Angermeyer and Matschinger (2005):
* they argued a need for increased public health literacy around MI
* Explained MI as a biological cause.
Repercussions of Angermeyer and Matschingers (2005) study
This produced an increase in stigma around MI. Encouraged increased distancing from MI individuals. Made public view MI as having a problem with their brain.
Why is stigmatisation of MI a major societal problem?
- 9/10 people with MI have suffered stigma and discrimination
- people with MI experience social drift - pushed out of society, making it harder to find work, maintain a relationship, have decent living circumstances. Leading to substance misuse and violence.
Examples of stigma reduction campaigns/resources
- Mind charity Stigma reduction campaigns
- The Guide
- The Guide Cymru
Thornicroft et al., (2016) design and findings:
Narrative review of published reports on Stigma reduction programmes.
Found modest change in short term attitudes but little change in knowledge.
- issues around the quality of studies used in the review as they did not assess long term changes or changes in stigma in people with mental disorders.
Milin et al., (2016) study design and findings
- RCT involving 534 Canadian students in year 11-12
- they tested the effectiveness of the curriculum guide that aimed to inform students on mental health content.
Findings: students who took the guide showed an increase in MH knowledge and a decrease in stigma
Limitations to Milin et al’s (2016) study
- effect is not strong
- control groups knowledge around MH gets worse
Why do we need to change stigma around MI at a young age?
MI can be detected as young as 14 (mean age of onset of MI = 14), so education need to be provided before this age to stop stigma.
Simkiss et al., (2020) study design
- RCT in all schools in Wales providing the Guide Cymru at age 11.
- They developed a new measure (KAMHs) to assess a range of impacts the guide will have in the individual:
1. knowledge
2. stigma to others
3. anticipated stigma
4. self-stigma
5. good mental health behaviours
6. help-seeking/disclosure
Simkiss et al., (2020) Findings
- Knowledge of MI increases
- Stigma towards other people with MI decreases
- Good mental health behaviour increases
How to investigate the relationship of MI and violence 1/3
Examine amount of patients with MI in a prison and compare to a control population.
Limitations: people with psychotic illness may be over-represented in the prison population
How to investigate the relationship of MI and violence 2/3
Examine records of patients with or without MI to see levels of past violence
Limitations: violence is used to define mental illness - hard to know the direction of the relationship
How to investigate the relationship of MI and violence 3/3
Examine patients discharged from hospital to see their rates of violent crime
Limitations:
* ethics
* different population comparison (people who have been hospitalised or imprisoned)
* effects of confounds (social drift is still a problem)
Swanson et al (2015) study design and findings
Assessed violence after 6-12 months in individuals released from prisons.
Found that involuntarily committed inpatients and first episode psychosis patients had a higher percent of violence within the time frame