PUBLIC ATTITUDES TOWARD MENTAL ILLNESS: AN EXPERIMENTAL DESIGN EXAMINING THE MEDIA‘S IMPACT OF CRIME ON STIGMA DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Christopher Ryan Locke, MSW, LISW-S, ACSW Graduate Program in Social Work The Ohio State University 2010 Dissertation Committee: Dr. Theresa J. Early, Advisor Dr. Tom Gregoire Dr. Susan Saltzburg Dr. Michael Vasey Copyright by Christopher Ryan Locke 2010 ABSTRACT Mental health consumers encounter numerous barriers that complicate their lives such as housing, employment, social support, and resulting low self-esteem. Stigma has been found to be a primary deterrent for individuals who need mental health services as well as impacting those already receiving services (Hinshaw, 2007). What has not been clear in the research is how stigma varies across psychiatric disorders. Also, the deinstitutionalization movement has led to increase in the number of consumers who live in the community so consequently, a better conceptualization of the attitudes held by the general public toward mental health consumers is critical in understanding how these consumers are ultimately treated by others. Studies have shown that the public learns about mental illness primarily through the media, particularly newspapers (Corrigan, 2005; Wahl, 1995). Negative stories far outnumber positive ones and the message being delivered to the public is that people with mental illness are dangerous and are to be feared. The current study used deception by not informing respondents as to the true purpose of the study until debriefing and measuring their impression management to control for self-selection and socially desirable responses. This study simulated a phenomenon popular in media today: a newspaper article featuring a man with mental illness who committed murder. Six vignettes were created and all featured a fictitious person who assaulted another man who later died from head trauma. The perpetrator had ii a wife, children and a part-time job and was being charged with murder. The only difference between vignettes was the diagnostic label (schizophrenia, bipolar disorder, panic disorder without agoraphobia, major depressive disorder, cancer, and control) of the perpetrator. The independent variable was vignette type, and dependent variables were the Social Distance Scale and the four subscales (authoritarianism, benevolence, social restrictiveness, community mental health ideology) of the Community Attitudes toward Mental Illness (CAMI). Labeling theory has been utilized as a framework to explain the impact of the label ―mental illness‖ through the works of Scheff and Goffman and more recently, Link. By varying only the diagnostic label in this study, it provided further evidence as to the power of a psychiatric label to affect attitudes which serve as a proxy for behavior. A convenience sample of adults (N=313) was obtained from a public science center in a large Midwestern city. Participants were randomly assigned to read one of six vignettes and were presented a packet with materials in the following order: vignette, CAMI, Social Distance Scale, Impression Management Scale, and a demographics questionnaire. MANCOVA analyses revealed no difference between vignette type on any of the four subscales of the CAMI. However, there was a statistically significant difference between groups on the Social Distance Scale, and post-hoc analyses found that panic disorder without agoraphobia and major depressive disorder were different. Major depressive disorder was associated with the highest social distance indicating least favorable attitudes whereas panic disorder without agoraphobia was associated with the iii most favorable attitudes. Results suggest that there may be different factors contributing to social distance other than fear. iv Dedicated to my parents, Barry and Pam Locke. v ACKNOWLEDGEMENTS I first began my collegiate journey as a computer science major at a small community college near my hometown. I soon realized that sitting behind a computer in a cubicle and typing code was not going to lead to a fulfilling career, nor was it going to fit well with my personality. Like most college students, I decided to switch my major and obtained a bachelor‘s degree in psychology at Wright State University. At the age of 21, a friend helped me to get a job at a local psychiatric hospital as a mental health technician. Although I had a genuine interest in the mental health field, I had no way of knowing that this experience would have such a lasting impact on me and ultimately shape my dissertation and trajectory of my research. I have found social work to be an ideal fit for me and my way of looking at the world. Because my practice experience in an inpatient hospital has been so influential in my career as a social worker thus far, I would like to thank my coworkers and colleagues, Nancy, Cheryl, and the distinguished Dr. Duncan for their continued support. In addition, Claudia and Connie have been very supportive as well as my ―old‖ coworkers from second shift: Rhoda, Sandy, and Dan. My friend and colleague Becky has also been helpful in providing a unique way to view this long, arduous process. vi My other colleagues and friends at another employer of mine have also been a source of strength. I give many thanks to Mr. Stop, Lisa, Zita, Rufus, Lucinda, Diane, and Bonnie for your support along the way. I would like to thank Theresa Early, my chair and advisor, for her numerous hours and emails throughout the doctoral program. I am grateful for the time you devoted to helping me succeed, and I appreciated our interactions discussing various mental health topics. Thank you so much for all of your assistance. I would like to acknowledge the support and encouragement of Susan Saltzburg which began during my days in the MSW program. She was an enormous strength as I embarked on the doctoral program journey. Also, I will be forever thankful for the research opportunity that she and Dr. Tamara Davis had presented to me. The chance to conduct research with these individuals, analyze the data, prepare manuscripts, and ultimately publish was so critical in formulating my identity as a researcher and scholar. Tom Gregoire has also been helpful in keeping me grounded during the dissertation process and providing guidance regarding research design and statistical analyses. His light-hearted humor has also been most welcomed. I would like to thank Mike Vasey for his expertise and experience regarding mental health consumers and for providing a unique lens in which to view the data. I am grateful that you agreed to be on my dissertation committee and follow my research project. My parents have been my biggest fans throughout my entire academic career and particularly the doctoral program. They have encouraged me and have been willing to vii provide any resources necessary in order for me to succeed. I am proud to be the first person in my family to go to college and to receive a doctorate from THE Ohio State University. My mother raised me to be a social worker and didn‘t even know it at the time. Her values and mindset are indicative of those set forth by our profession. My father worked hard his entire life to support my family so that I may have this chance. I would like to thank Karen, my colleague and best friend, for her guidance and support throughout the entire doctoral program. You have been an incredible source of strength in my life and helped tremendously during the difficult times. I am forever grateful. viii VITA October 1978 ..................................................Born – Springfield, Ohio 1999................................................................A.S. Clark State Community College 2001................................................................B.S. Psychology, Wright State University 2005 ...............................................................M.S.W. The Ohio State University 2005 - present .................................................Graduate Student Lecturer, College of Social Work, The Ohio State University PUBLICATIONS Davis, T.S., Saltzburg, S., & Locke, C. R. (in press). Assessing community needs of sexual minority youth: Modeling concept mapping for service planning. Journal of Gay and Lesbian Social Services 22(4). Davis, T.S., Saltzburg, S., & Locke, C. R. (2009). Supporting the emotional and psychological well being of sexual minority youth: Youth ideas for action. Children and Youth Services Review, 31(9), 1030-1041. FIELD OF STUDY Major Field: Social Work Minor Field: Research Methods in Human Resource Development ix TABLE OF CONTENTS Abstract……………………………………………………………………………………ii Dedication ........................................................................................................................... v Acknowledgements ............................................................................................................ vi Vita .................................................................................................................................... ix List of Tables ................................................................................................................... xiv List of Figures .................................................................................................................. xvi CHAPTER 1: INTRODUCTION…………………………………………………………1 Negative effects of stigma .................................................................................................