Books, Articles and Research

Fear of stigma deters US soldiers from seeking help for mental health
Brief review of study conducted regarding military and stigma related behaviors.

Attitude of the university students and teachers towards mentally ill, in Lahore, Pakistan
This study was carried out to assess the attitude of university students and teachers in Lahore, Pakistan.

Stigma and psychiatric illness. A survey of attitude of medical students and doctors in Lahore, Pakistan.
This study was carried out to assess the attitude of medical students and doctors, attending medical colleges in Lahore, Pakistan.

Family heritage and depression guides: Family and peer views influence adolescent attitudes about depression
In this study, 15 adolescents were interviewed to examine how the views and behaviours of others influence teens' decisions about seeking care for depression.

Law & psychiatry: Slowing the revolving door: Community reentry of offenders with mental illness.
An article discussing the existing programs that help offenders with mental illnesses reenter the community and the importance of effective collaborations between criminal justice agencies and behavioral health providers.

Support workers' attitudes to mental illness: Implications for reducing stigma
An anonymous survey conducted of support workers to examine attitudes of people with different types of mental illnesses. Scores were based on a previously demonstrated stigmatization score.

Psychological distress among Latino family caregivers of adults with schizophrenia: The roles of burden and stigma
This study examined the relation between caregivers' mental health and perceived burden and stigma and characteristics of the patient and caregiver within the Latino community.

Americans attitudes toward mental health treatment seeking: 1990-2003
This study examined recent trends in Americans' attitudes toward mental health treatment seeking and beliefs about the effectiveness of such treatment.

The arts of healing
The relationship between artistic involvement and individual mental health is considered, and the concept of "healing" is differentiated from that of "therapy." Seven properties of art experience are identified which, when developed, have contributed to patients' recovery from mental illness. Implications of these properties for clinical programs, and the related value of art experience for non-patients, are discussed.

Art therapy: Using the creative process for healing and hope among African American older adults
This article provides an introduction to the field of art therapy and the potential it can offer to address the emotional needs of the frail elderly. Two case studies are discussed, and examples of artwork are provided.

Higher education and psychiatric disabilities: National survey of campus disability services
This article reports the results of a survey of disability services offices at colleges and universities in 10 States.

Mental health literacy in an educational elite: An online survey among university students
The aims of this paper are to determine whether a sample of university students recognise different symptoms of depression and schizophrenia and to reveal factors influencing correct recognition. 

Artistic expression in spontaneous paintings of depressed patients
This article explores creativity among people suffering from depression. A false belief exists that depressed patients are not creative. On the contrary, they have an urge to create--the creative spells are equivalent to the depression. They express themselves more easily through painting than through speech. They express their repressed feelings and ideas of sin and affect, suicidal tendency, etc., and in some cases, the spontaneous paintings have prophetic meaning. It is much easier for them to express their feelings through universal signs and symbols such as: face, posture; church, tower, bell, cross; coffin, tomb, cemetery, grave; skeleton, skull, bones; tree, mountain, boat, chair.

Family views of stigma
The views of 487 members of the National Alliance on Mental Illness (NAMI) concerning stigma were surveyed in 20 different States. Almost all identified stigma as a problem for their mentally ill relatives and for families in general.

University students' attitudes towards mental patients and psychiatric treatment
This study examined university students' attitudes towards different information regarding a person labeled as mentally ill.

Language and stigma
Editorial letter discussing the paper, "'Difficult Patients in Mental Health Care: A Review." The author points out that the term "difficult patient" can be stigmatizing.

Perceived and measured stigma among workers with serious mental illness
This research analyzed the extent to which self-reports of job-related discrimination by persons with serious mental illnesses are associated with econometric measures of discrimination.

What attitudes do psychiatrists hold towards people with mental illness?
To investigate the attitudes that psychiatrists hold towards people with mental illness. Each member of the Royal College of Psychiatrists in the UK was sent a questionnaire based on previous research in this area, supplemented with relevant questions on management.  

Power of art and music
An article discussing the work of the author in using art and music therapy as tools for promoting feelings of well-being in individuals with who have physical or psychological limitations.

The effect of healing gardens and art therapy on older adults with mild to moderate depression.
This study evaluated the effect of garden walks alone, garden walks with guided imagery, and art therapy on mild to moderate depression in older adults. Focus group interviews at the end of the 6-week intervention suggest that all 3 interventions were helpful to participants with mild to moderate depression.

Art therapy: A unique alternative for healing.
This article focuses on three aspects of art therapy. By defining the parameters of the field and outlining its possibilities in treatment, the author discusses the populations who can benefit from art therapy and why. The implications of introducing an art-therapy program to a health care facility are also discussed, as are ways of minimizing problems and promoting support among staff.

Art, dance, and music therapy.
Art, dance, and music therapy are a significant part of complementary medicine in the twenty-first century. These creative arts therapies contribute to all areas of health care and are present in treatments for most psychological and physiological illnesses. Although the current body of solid research is small compared with that of more traditional medical specialties, the arts therapies are now validating their research through more controlled experimental and descriptive studies. The arts therapies also contribute significantly to the humanization and comfort of modern health care institutions by relieving stress, anxiety, and pain of patients and caregivers. Arts therapies will greatly expand their role in the health care practices of this country in the twenty-first century.

The role of music therapy in psychiatry
Music has soothed the souls of human beings for ages. It also has helped people recover from ailments since ancient times. Today, there is a widespread interest in the use of music therapy in treating psychiatric disorders. This article describes the various types of music therapy in use today and also offers insight into how music therapy can be incorporated into the management of psychiatric disorders and as an element of psychotherapy.

Therapeutic music for patients with psychiatric disorders
Many patients with psychiatric disorders struggle with poor skills in coping, communication, socialization, and self-expression that may result in dysfunctional behavioral, cognitive, and emotional responses. Therapeutic music offers a noninvasive approach to strengthen these skills and effect behavior change. At a regional inpatient psychiatric hospital in Colorado, a program of therapeutic music was developed using Rogers' theory of unitary human beings as the theoretical framework. This article describes the approach used to strengthen coping skills in communication, socialization, and self-expression. Suggestions are made for developing a program of music with similar patient populations.

Art therapy for children: How it leads to change
The aim of art therapy is to facilitate positive change through engagement with the therapist and the art materials in a safe environment. This article will explore how art therapy is used to help children with emotional, developmental and behavioral problems. It will show how change occurs during the process of physical involvement with the materials; through the making of a significant art object; through sublimation of feelings into the images; and through communication with the therapist via the art object.

Pastors' perceptions of mental disorders
Letter to the editor in which a study is discussed where pastors were surveyed on their views of mental illness.

School-age children's perceptions of mental illness
The purpose of this study was to describe how school-age children perceive mental illness.

Gender specific correlates of stigma toward depression in a Canadian general population sample.
The objectives of this research were to identify gender specific demographic, clinical, knowledge and attitudinal factors associated with stigma related to depression.  

Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes
The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved.

Rurality, gender, and mental health treatment
The objective of this study was to identify the influence of gender and rurality on mental health services utilization by using more sensitive indices of rurality.

Sex differences in opinion towards mental illness of secondary school students in Hong Kong
This paper reports on the effect of sex differences in a study of secondary school students' opinions about mental illness in Hong Kong.

Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies
The portrayal of mentally ill persons in movies and television programs has an important and underestimated influence on public perceptions of their condition and care. The authors suggest that mental health professionals can fight this source of stigma by increasing their collaboration with patient advocacy groups in monitoring negative portrayals of mentally ill people,

Reducing stigma and discrimination against older people with mental disorders: A technical consensus statement
This technical consensus statement is jointly produced by the Old Age Psychiatry section of the World Psychiatric Association and the World Health Organization, and other non-governmental organizations. It is intended to be a tool for (i) promoting debate at all levels on the stigmatisation of older people with mental disorders; (ii) outlining the nature, causes and consequences of this stigmatisation; and (iii) promoting and suggesting policies, programmes and actions to combat this stigmatisation.

Growing older: The lived experience of older persons with serious mental illness
The purpose of this qualitative paper is to describe, from the consumers perspective, the complex factors involved as persons with serious mental illness grow older in the community.

Mental healthcare for rural seniors. An outreach program in Cedar Rapids, IA, uses an integrated approach to break down barriers to care
Article discussing the Abbe Center for Community Mental Health in the Cedar Rapids, IA, and the work that the Center does in breaking down some of the barriers to mental health services for older adults in rural communities.

Beliefs about mental illness and willingness to seek help: A cross-sectional study
Evidence indicates that older adults underutilize mental health services, but little is known empirically about the perceptions older adults have about mental illnesses and their attitudes about seeking professional help for psychological problems. The present study examined beliefs about mental illnesses and willingness to seek professional help among younger and older persons.

Stigma and ageism: Compounding influences in making an accurate mental health assessment
This paper defines stigma and ageism and their potential and actual influences on assessment and interventions for elderly persons with mental illnesses. Strategies for overcoming the impact of stigma and ageism are presented to assist healthcare providers to advocate for geropsychiatric clients.

Community integration for older adults with mental illnesses: Overcoming barriers and seizing opportunities
This report is the third in a series of reports prepared by the National and Statewide Coalitions to Promote Community-Based Care under Olmstead project. It is designed to help State and local Olmstead coalitions understand the barriers that older adults face and learn about the innovative solutions being adopted and adapted across the country.

Chapter 5 of "Mental health: A report of the Surgeon General": Older adults and mental health
This chapter of the Surgeon General's report on mental health addresses various areas of interest for the older adult population, specifically considering mental disorders in older people - their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment.

Rural and frontier mental and behavioral health care: Barriers, effective policy strategies, best practices
This report focuses on the following areas: barriers to mental and behavioral health service delivery in rural America, model programs and effective activities for rural America, model policy strategies for rural mental and behavioral health care delivery, the role telehealth should play in service delivery to rural America, and the role that State Offices of Rural Health and other State and local organizations should play in service delivery to rural America.

Stigma in psychiatry
The stigma and discrimination experienced by service users is something that impacts on everyone. One in four of us will personally experience mental illness. We are all likely to have to deal with mental illness at some time, whether in family members, work colleagues or ourselves. The difficulties of living with psychiatric distress are magnified by the experience of rejection which is the consequence of stigma. In this paper I discuss the nature and causes of stigma, the consequences of this discrimination and what we can do about it.

"Difficult patients" in mental health care: A review
This article provides an overview of what is known about "difficult patients" in mental health care. It aims to answer three main questions: What are the defining characteristics of difficult patients, how is the difficulty explained, and which treatment strategies are available?

Mentally ill are often victims of violent crime
A British study demonstrates that, contrary to media stereotypes and the rhetoric of forced treatment advocates, people with psychiatric disabilities are far more apt to be victims, not perpetrators of violent crime.

A survey of preferred terms for users of mental health services.
This survey was conducted to determine how users of mental health services would like to be addressed by professionals. Three hundred two persons participating in a variety of inpatient and outpatient psychiatric programs were surveyed.

Campus mental health services: Recommendations for change
College officials indicate that the number of students with serious mental illnesses has risen significantly. Media attention surrounding several high profile suicides has opened discussion of mental illness on campus. The authors summarize literature on college students and mental illness, including barriers to service receipt. Recommendations to improve campus-based responses for persons with a serious mental illness are presented on the basis of well-accepted service principles.

The journey of Native American people with serious mental illness: Executive summary
This report describes the first national conference on Native American people with serious mental illness. Describes meeting of State, tribal, and Federal mental health officials; providers; families; and consumers to tackle mental health delivery issues for Native Americans and to overcome barriers for developing coordinated, efficient, and culturally relevant systems of care.

Evaluating the effectiveness of a consumer-provided mental health recovery education presentation
The current study investigated the effectiveness of the In Our Own Voice (IOOV) mental health education program in improving knowledge and attitudes about mental illnesses.  

Solutions to discrimination in work and housing identified by people with mental illness
This study examines perceived solutions to discrimination in housing and employment situations.

Will filmed presentations of education and contact diminish mental illness stigma?
This study examines the impact of two versions of anti-stigma programs-education and contact-presented on videotape. 

Stigma and discrimination towards people with schizophrenia and their family members : A qualitative study with focus groups
There is a scarcity of data regarding the actual stigma and discrimination experienced by schizophrenic patients and their relatives. Those experiences can vary significantly depending on the specific social group involved. This study explored such phenomena in our culture with a qualitative technique.

Collaboration and referral practices of general practitioners and community mental health workers in rural and remote Australia
This article reports on a study that examines the collaboration and referral practices between general practitioners and community mental health workers in rural and remote areas of Australia. The researcher's findings indicate there are serious problems in Australia's rural and remote mental health care system due to the negative collaboration and referral practices between general practitioners and mental health workers.

Mental illness and employment discrimination
This article presents a review of recent research that seeks to determine employment-related stigma and discrimination experienced by people with mental disabilities. In this study, researchers take an extensive view of the stigmatization process to include cognitive, attitudinal, behavioral, and structural disadvantages.

Comparing life experiences of college students with differing courses of schizophrenia in Korea: Case studies
The objective of this study was to identify how daily experiences of college students with schizophrenia reflected the course of their disease.

Managing workplace depression: An untapped opportunity for occupational health professionals
An article discussing how occupational health professionals are the most qualified to design and deliver destigmatized, customer-friendly programs and services to help employees who are depressed. Integration of services like benefits, health promotion, EAP, and human resources across a company can lead to an effective, organization-wide depression initiative.

Workplace effects of the stigmatization of depression
Employers have previously been shown to hold negative attitudes toward mental illness. The purpose of this survey of human resource officers in UK companies was to ascertain whether these attitudes prejudice employment opportunities for subjects with mental illnesses--specifically, depression--and, if so, some of the beliefs upon which these attitudes are based.

Public awareness of the effectiveness of psychiatric treatment may reduce stigma
Stigmatization is of importance in mental disorders. It is widely believed that one of the most important factors in stigmatization is considering the patients as dangerous. This study aims at analyzing the impact of knowledge regarding the chances of treating mental illness.

The influence of information on social and occupational outcome in mental illness on the attitudes of students in Turkey
This article attempts to evaluate the influence of a series of determinants of stigmatization of mental illness.

Disclosure conundrum: How people with psychiatric disabilities navigate employment
This qualitative study of people with psychiatric disabilities explored the issues of self-disclosing their mental illness and the complex situations around employment and disclosure.

Effects of an antistigma program on medical students' attitudes toward people with schizophrenia
The purpose of this study was to examine whether an antistigma program which consists of education, contact, and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia.

Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members
Transcript of an Indian radio program that discusses the culture of mental illness within the setting of an Indian family, the stigma that surrounds mental illness, and the impact on the caregivers of individuals with mental illnesses.

Employment and mental health service utilization in washington state
This study examined employment among individuals utilizing publicly-funded mental health services in Washington State during a 2-year period through the analysis of archival administrative data.

Economic barriers to better mental health practice and policy
This paper discusses economic barriers to improving the availability, accessibility, efficiency and equity of mental health care in low- and middle-income countries.

What is in a name? Professionals and service users' opinions of the Hebrew terms used to name psychiatric disorders and disability
Stigma constitutes the hidden burden of mental disorders. Its ubiquitous presence may be reinforced by iatrogenic factors, such as the terms used to name mental disorders and disability. This preliminary study examines opinions with regard to the use of these terms in Hebrew.

Newspaper representations of mental illness and the impact of reporting of 'events; on social policy: The 'framing' of Isabel Schwarz and Jonathan Zito
This paper critically examines the potential significance of the way in which responsibility for events is constructed for social policy by means of a discourse analysis, inspired by the genealogical work of Michel Foucault. It uses the device of "frames" (originally developed by Goffman) to explore the nature of newspaper coverage of two deaths to which causal responsibility for changes in the nature of English social policy in mental health has been attributed.

Ethical considerations in rural health care: A pilot study of clinicians in Alaska and New Mexico
To investigate differences in the experiences of rural versus non-rural clinicians, we surveyed caregivers in New Mexico and Alaska regarding ethical aspects of care provision. Consistent with past literature, rural compared to non-rural clinicians perceived patients as having less access to health care resources.

The sympathetic discriminator: Mental illness, hedonic costs, and the ADA
Discrimination against people with mental illness occurs in part because of how those with mental illness can make other people feel.Thus, a central basis for discrimination in this context is what I call hedonic costs. Hedonic costs are affective or emotional costs: an influx of negative emotion or loss of positive emotion. In addition, the phenomenon of emotional contagion, which is one source of hedonic costs, makes discrimination against people with mental illness peculiarly intractable.

Stigmatization and access to health care in Latin America: Challenges and perspectives
This study attempts to analyze stigma and barriers to treatment on the basis of what is happening today in the countries of Latin America.

Focused expressive writing as self-help for stress and trauma
In the therapy process, the process of disclosing stressful or traumatic events is often considered essential. Focused expressive writing (FEW) is one method to help people express stressful or traumatic experiences. FEW is related to improvements in health and well-being across a wide array of outcomes and participant characteristics. Because FEW requires limited involvement of other individuals, is relatively low cost, and portable, it has tremendous potential as self-help. In particular, FEW may be an effective means to reach populations unwilling or unable to engage in psychotherapy. A case illustration of FEW is presented. Evidence and future directions for FEW as self-help are reviewed.

Is education of health professionals encouraging stigma towards the mentally ill?
A study in which students in a Boston area nursing school were offered the opportunity to take a battery of tests before and after receiving health education, training and experience regarding mental illness, in order to analyze their attitudes after being exposed to health education.

Mental health in rural America
This report addresses mental health services in the rural area, and provides recommendations for improvement of services.

Rural culture is a diversity issue
This article attempts to make the case that there are some significant differences in factors that affect rural people?s mental health, as well as in the manner in which we can most effectively provide mental health services to them.

Rural-urban differences in stigma and the use of care for depressive disorders
This article describes a study that examined rural-urban differences in the stigma associated with depressive symptoms and the stigma associated with seeking treatment for depressive disorders, as well as compared the impact of stigma associated with seeking treatment on the use of care in rural and urban residents with a history of depressive symptoms.

Examination of attitudes toward disabilities among college students: Rural and urban differences
The purpose of the study was to examine rural versus urban differences with respect to the Attitudes Toward Disabled Persons survey (ATDP), the Scale of Attitudes toward Disabled Persons (SADP), and the Rehabilitation Situations Inventory (RSI).

Talking about mental illness: An evaluation of an anti-stigma and educational program in Hamilton, Ontario
An evaluation of the "Talking About Mental Illness" program and its effectiveness in decreasing stigmatizing attitudes and increasing understanding of mental illness.

Stigma and the law
This paper is one of several delivered at an international conference, Stigma and Global Health: Developing a Research Agenda, sponsored by the National Institutes of Health's Fogarty International Center (FIC) in September 2001. The author discusses how enacted stigma law can influence the actions of persons diagnosed with stigmatized diseases and their community.

Stigma interventions and research for international health
This paper is one of several delivered at an international conference, Stigma and Global Health: Developing a Research Agenda, sponsored by the National Institutes of Health's Fogarty International Center (FIC) in September 2001. The paper includes a definition of health-related stigma and six research objectives, based on the stigma definition.

Conversation: Challenging the relevance and wisdom of separate mental health legislation.
This paper explores the dilemmas encountered by mental health nurses when working with mental health legislation.

"It's important to be proud of the place you live in": Housing problems and preferences of psychiatric survivors.
This paper reports findings from a series of focus group meetings held with survivors of mental illness to address issues concerning housing preferences and housing needs.

'She's manipulative and he's right off': A critical analysis of psychiatric nurses' oral and written language in the acute inpatient setting.
This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients.

The Carter Center Mental Health Program: Addressing the public health crisis in the field of mental health through policy change and stigma reduction.
This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program?s initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses.

Forensic mental health law reform in Japan: From criminal warehousing to broad-spectrum specialist services?
This article seeks to demonstrate that the new forensic law in Japan cannot achieve its own stated goals without seeking to put into place financial and administrative supports aimed to integrate the myriad of patient populations that inevitably will be affected by the new forensic system.

Mental health-related knowledge, attitudes and practices in two kibbutzim
This study explored mental health-related knowledge, attitudes and practices (KAP) in two kibbutzim (collective villages).

Beyond cultural and religious biases: Asian Indians and mental health issues
An article discussing the need for an understanding of the Asian Indian?s way of life as a means of providing appropriate and beneficial treatment for mental illness.

Psychological and mental illness among elder immigrants from the former Soviet Union
The study examined the cultural context of psychological illness among elder immigrants from the former Soviet Union (FSU).

Lived experiences of family caregivers of mentally ill relatives
The aim of this paper is to report a study conducted to explore the meanings of the lived experiences that Chinese family caregivers in Malaysia ascribed to the care they provided to relatives with severe and persistent mental illness.

Advocacy for mental health: Roles for consumers and family organizations and governments
The World Health Organization urges countries to become more active in advocacy efforts to put mental health on governments' agendas. Health policy makers, planners and managers, advocacy groups, consumer and family organizations, through their different roles and actions, can move the mental health agenda forward. This paper outlines the importance of the advocacy movement, describes some of the roles and functions of the different groups and identifies some specific actions that can be adopted by Ministries of Health.

Does stigma concerning mental disorders differ through medical education? A survey among medical students in Istanbul
The aim of this study is to determine the attitudes of medical students toward mentally disabled people and to understand the impact of schooling on attitude difference by evaluating second and sixth year medical students.

The Stigma Receptivity Scale and its association with mental health service use among bereaved older adults
The purpose of this article was to determine whether the Stigma Receptivity Scale (SRS) predicts use of mental health services among community-dwelling bereaved older adults.

Clinical utility and policy implications of a statewide mental health screening process for juvenile offenders
This study examined the utility of screening adjudicated juvenile offenders for mental health symptoms at intake to the State of Washington Juvenile Rehabilitation Administration. The authors assessed the ability of a screening measure, the Massachusetts Youth Screening Inventory, second edition (MAYSI-2), to identify youths with mental health problems and co-occurring substance use problems. This study also examined the relationship of these symptoms to treatment utilization both before and after intake to the juvenile justice system. Ethnic and gender differences in the screening results were studied.

Psychiatric illness and family stigma
This study examines the perceptions of and reactions to stigma among 156 parents and spouses of a population-based sample of first-admission psychiatric patients.

Association between community and client characteristics and subjective measures of the quality of housing
The objective of this study was to examine the relationship between subjective perceptions of the quality of housing among mental health consumers and both client characteristics and objective measures of the client's neighborhood.

Working with young people: The impact of mental health awareness programmes in schools in the UK and Canada
The persistent and disabling nature of psychiatric stigma has led to the establishment of global programmes to challenge the negative stereotypes and discriminatory responses that generate social disability, but these initiatives are rarely evaluated. This study compares the effectiveness of school-based interventions with young people aged 14-16 aimed at increasing mental health literacy and challenging negative stereotypes associated with severe mental illness in sites in Canada and the UK.

Clergy's role in reducing stigma: A bi-lingual study of elder patients' views
This study examined whether elderly psychiatric outpatients experience stigma in the context of interacting with their clergy and religious communities, and to identify possible interventions both to reduce such stigma and increase social support.

Stigmatization in Alzheimer's disease research on African American elders
Stigmatization in research sustains the spread of the silent epidemic of Alzheimer's disease (AD) in African American populations. Researchers use stereotypes and inappropriate assumptions to select a paradigm to examine the symptoms of AD. This paradigm fails to encompass the symptoms as manifested by African American elders. Yet, stigmatization can be minimized by recognizing the genetic heterogeneity of the symptoms within the general population, especially those manifested by African American elders. Thus, researchers can utilize pioneering genetic analyses to identify other paradigms critical in the assessment and proactive treatment of the symptoms of AD needed for this vulnerable population.

Words have power: (Re)-defining serious emotional disturbance for American Indian and Alaska Native children and their families
Circles of Care grantees were provided the opportunity to develop a locally relevant definition of serious emotional disturbance (SED) that would be used to define what type of emotional, behavioral, and mental disability would be required to receive services. The definitions for SED developed by rural grantees included American Indian and Alaska Native concepts specific to each tribal community?s culture.

Stigma as a barrier to employment: Mental disability and the Americans with Disabilities Act
This study examines the role played by stigma in employers' response to the 1990 Americans with Disability Act (ADA). The article describes employers' experiences with employees with mental disabilities and accommodations, specific employment practices, and attitudes towards those with mental disabilities.

When labels mask oppression: Implications for teaching psychiatric taxonomy to mental health counselors
Mental health counseling programs have an ethical responsibility to teach students to think about the sociopolitical context in which behaviors become understood as symptoms of mental disorders. Elaborating on this idea, the author discusses the importance of critical thinking and of adopting a reflective comportment when mental health counselors are engaged in the process of psychiatric diagnosis.

Forgotten policy: An examination of mental health in the U.S. [Brief]
This paper presents strategies and recommendations for improving the current mental health system so that it better addresses the mental health needs of Americans.

Appropriate language in discussing mental illness
A brief article discussing the use of appropriate language, when discussing mental illnesses. Following these suggestions can help to communicate acceptance and understanding.

Diminution of 'self'
This article is adapted from a speech the author gave at the Florida Self-Directed Care conference, in which he addressed how language affects the individual.

Effect of labeling on public attitudes toward people with schizophrenia: Are there cultural differences
A representative survey was recently conducted in Germany and concluded that labeling as mental illness has an impact on public attitudes towards people with schizophrenia, with negative effects clearly outweighing positive effects. In this study, we will examine whether this result can be replicated in other countries.

Stigma and mental disorder: Conceptions of illness, public attitudes, personal disclosure, and social policy
This article defines stigma and discusses empirical and narrative evidence for stigmatization, as well as historical trends regarding conceptualizations of mental illness.

Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care
This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.

Stigma impact on Moroccan families of patients with schizophrenia
The study was conducted among 100 family members accompanying patients with schizophrenia. Study used a heteroquestionnaire that inquired about family members' and patients' sociodemographic data, family members' knowledge of the patients' illness, their attitudes and behaviours toward the patient, and their perception of stigma

2004 APA Achievement Awards: silver and bronze achievement awards
This short article highlights the Senior Outreach Program of the New York Service Program for Older People, Inc. (SPOP), a program that improves quality of life and the delivery of comprehensive mental heath services and treatment to older adults. The article reviews the program's genesis, the model it follows, and the outcomes it has acheived to date. 

Design and initial results from a supported education initiative: The Kansas Consumer as Provider program
This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers.

Rural mental health: Neither romanticism nor despair
This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health.

Acquiring medical services for individuals with mental retardation in community-based housing facilities.
This study examined the understanding of issues involved in acquiring services and the clinical decision-making experiences of 13 service agency directors representing 1,400 individuals with MR were investigated.

Treatment delay in first-episode nonaffective psychosis: A pilot study with African American family members and the theory of planned behavior
This pilot study examined associations between three central constructs of the theory of planned behavior and the length of treatment delay among patients hospitalized for a first episode of nonaffective psychosis.

Medicaid managed care for mental health services in a rural state
State governments throughout the country increasingly have turned to managed care for their Medicaid programs, including mental health services. We used ethnographic methods and a review of legal documents and state monitoring data to examine the impact of Medicaid reform on mental health services in New Mexico, a rural state. New Mexico implemented Medicaid managed care for both physical and mental health services in 1997. The reform led to administrative burdens, payment problems, and stress and high turnover among providers. Restrictions on inpatient and residential treatment exacerbated access problems for Medicaid recipients. These facts indicate that in rural, medically underserved states, the advantages of managed care for cost control, access, and quality assurance may be diminished. Responding to the crisis in mental health services, the federal government terminated New Mexico's program but later reversed its decision after political changes at the national level. This contradictory response suggests that the federal government's oversight role warrants careful scrutiny by advocacy groups at the local and state levels.

Personal accounts: Help-seeking preferences of high school students: The impact of personal narratives.
Based on the author's personal experience with mental illness, she initiated a study to examine help-seeking behavior of adolescents and if an educational presentation aided in this behavior.

School based youth health nurses' role in assisting young people access health services in provincial, rural and remote areas of Queensland, Australia.
This study was undertaken to explore the referral role of the School Based Youth Health Nurse Program in provincial, rural and remote Queensland and to ascertain the availability of referral services.

Perception of stigma among family members of individuals with schizophrenia and major affective disorders in rural Ethiopia
This study aimed to estimate the extent and socio-demographic distribution of stigma as perceived by relatives of mentally ill individuals in rural Ethiopia.

A community needs assessment for rural mental health promotion
This paper describes the needs assessment phase of a mental health promotion programme for rural communities in Ireland.

How definition of mental health problems can influence help seeking in rural and remote communites
The present study sought to understand the rural and remote influences on people's identification of, and response to, mental health problems.

A primary mental health-care model for rural Australia: Outcomes for doctors and the community
To address the high rate of depression and suicide in rural Australia requires a multifaceted approach to educate the community, improve the skills of health workers and provide user-friendly patient counselling. This paper describes a model that covers each of these aspects and details the outcomes with respect to the doctors and the community.

Introducing a professional development programme to a rural area mental health service: The importance of context
This paper describes the introduction of an ongoing professional development programme for clinicians in a rural Australian, mental health service.

Adherence to antidepressant medications in Black and Latino elderly patients
The purpose of this pilot study was to identify ethnic group differences in nonadherence and to determine predictors of nonadherence to antidepressant medications in older minority-group members.

Chinese cultural dynamics of unemployability of male adults with psychiatric disabilities in Hong Kong
In this case history, instead of finding realistic employment, a male adult with psychiatric disability tried to indulge himself in what he felt was his ideal job to fulfill all requirements as an adult male in Chinese culture. The imaginative ideal job gave him excuses to discontinue open employment. Its implications to vocational rehabilitation with male adults with psychiatric disability are discussed.

Church-based support groups for African American families coping with mental illness: Outreach and outcomes
This study examined the outreach efforts used to provide information about support groups to congregants as well as the participation outcomes reported by families who attended support group meetings.

United States and Japanese college students' attitudes toward seeking professional psychological help
The purpose of the study was to find how nationality, sex, and past experience of seeking professional psychological services among Japanese students are related to attitudes toward seeking professional psychological help.

Religion and spirituality in the lives of people with serious mental illness
Although there is some literature that documents the relationship of religiousness and spirituality with health and well-being, far fewer studies have examined this phenomenon for people with serious mental illness. In this study, people with serious mental illness completed self-report measures of religiousness and spirituality.

Dynamics of inclusion and exclusion: Comparing mental illness narratives of Haredi male patients and their rabbis
By comparing versions of mental illness narratives - told by Haredi (Utraorthodox Jews) male patients of a mental health clinic in Israel and by their rabbis - this paper relates to two distinct, yet interrelated, theoretical questions: the place and agency of narrators, and the tension between experience and representation.

Beliefs about causation of schizophrenia: Do Indian families believe in supernatural causes?
Beliefs about the causation of schizophrenia could influence the attitudes patients' families adopt towards the patient and may also influence their help-seeking behaviour. Indian families have been typically described as often believing in causes like supernatural forces and therefore seeking help from magico-religious healers. In the changing mental health scenario in India, this impression needs verification.

Public attitudes to schizophrenia in rural Turkey
The aim of this study was to determine the public's attitudes towards patients with schizophrenia in rural areas.

Helping carers care: An education programme for rural carers of people with a mental illness
An article providing descriptive information about a short-term educational program for caregivers of people with a mental illness, living in rural Australia.

Shifting blame away from ill relatives: Latino families' reactions to schizophrenia
The present study examined attributions, emotions, and help-giving of 24 relatively unacculturated Latino-Americans toward a family member with schizophrenia.

Complementary spiritual beliefs in the Latino community: The interface with psychotherapy
This article is intended to help non-Latino mental health practitioners develop a level of understanding and respect for other spiritual traditions, as well as achieve the adjustment of clinical techniques necessary for better cultural responsiveness to patients who hold such beliefs.

"How much more can we lose?": Carer and family perspectives on living with a person with depression
This study was designed with the objective of exploring the experiences of careers and families of people with depression.

Stigma and the dynamics of social integration
A programming schedule for a conference held in August 2005, sponsored by the Advanced Study Institute in Cultural Psychiatry in Montreal, QC, Canada. The program also includes a series of abstracts for papers presented at the conference.

Stigma as a barrier to recovery: The extent to which caregivers believe most people devalue consumers and their families
This study was conducted to measure the extent to which 461 caregivers of persons with serious mental disorders believed that most people devalue consumers and their families was assessed, and the magnitude of the relationships between these beliefs and the diagnostic status of consumers was estimated.

Causes of schizophrenia reported by patients' family members in China
This study was conducted to develop a quantitative measure suitable for assessing the relationship of causal beliefs to expressed emotion, stigma, care-seeking and adherence.

Challenging stigma and discrimination in communities: A focus group study identifying UK mental health services users' main campaign priorities
This study was conducted to explore mental health service users' views on how campaigns to address stigma and discrimination should prioritise their actions

Employment of individuals with mental disabilities: Business response to the ADA's challenge
This research examines the response of the business community to the Americans with Disabilities Act (ADA) with specific focus on the employment of those with mental disabilities.

Perspectives of people with psychiatric disabilities on employment disclosure
A qualitative study, including a focus group and individual interviews, was conducted to gather data from people with psychiatric disabilities/labels regarding employment disclosure. Major findings include the significant impact of disability identity (does the participant think they have a disability?), and the importance of appropriate job matching as a disclosure strategy.

Role of stigma and attitudes toward help-seeking from a general practitioner for mental health problems in a rural town
This study was conducted to examine the role of perceived stigma and attitudes to seeking care in predicting help-seeking from a general practitioner (GP) for mental health problems in rural communities.

Sources of burdens on families of individuals with mental illness
This study set out to explore the relationship between stigma, accessibility of mental health facilities and family burden through individual interviews of patients' relatives in order to understand the burden on mentally ill patients' relatives from their perspectives.

Rural residence is not a risk factor for frequent mental distress: A behavioral risk factor surveillance survey
The purpose of this study was to examine the relationship between residing in a rural area and frequent mental distress, which is one indicator of poor mental health.

Reducing psychiatric stigma and discrimination: Evaluating an educational intervention with the police force in England
This paper evaluates the effectiveness of a mental health training intervention with the police force in England.

Structural stigma in state legislation
This article discusses examples of structural stigma that results from state governments' enactment of laws that diminish the opportunities of people with mental illness.

Spiritual psychotherapy a path around a stigma
An article discussing an increase in the involvement of ministries in addressing mental health with their congregations as a means of countering stigma.

Effects of an educational program on public attitudes towards mental illness
The World Psychiatric Association promotes global anti-stigma programs. However, evaluation research is crucial to developing effective programs. The present study examined the effects of a lecture on mental health on public attitudes towards mental illness. Subjects were recruited from individuals employed by private companies and the government. Attitudes towards mental illness were measured using the Mental Illness and Disorder Understanding Scale developed by the authors and the Scale of Negative Attitudes Towards the Independence of People with Mental Disorders. Test scores obtained before and after the lecture were compared. The results demonstrated that scores on both scales improved significantly. The present study suggests the effectiveness of this type of educational program in reducing stigma attached to mental illness and disorder.

Ethnocultural factors in the development of an Asian American psychiatrist
The authors discuss some of the difficulties for the Asian American psychiatric trainee, in relation to the stigma of mental illness and its impact on the trainee's decision to enter psychiatry, ethnic identity and stereotyping, psychotherapy supervision, and career opportunities.

The Treatment Initiation program: An intervention to improve depression outcomes in older adults
This pilot study tests the usefulness of the Treatment Initiation Program (TIP) to improve depression in older adults. The TIP is an individualized, early intervention to address older adults? attitudes (e.g., perceived need for care and stigma) about depression and treatment.

The role of stigma in the quality of life of older adults with severe mental illness
This study was conducted to investigate whether stigmatisation of older adults with mental disorders is associated with the type of residential institution they live in or the type of disorder they suffer. It also assesses the role of stigma experiences in their quality of life.

Diagnostic attributions versus labeling: Impact of Alzheimer's disease and major depression diagnoses on emotions, beliefs, and helping intentions of family members
Labeling theory suggests that applying disease labels to behavior may serve to medicalize deviance and produce stigma. Participants rated their emotional responses, attributions, and willingness to help.

Barriers to higher education for individuals with psychiatric disabilites
This qualitative study explored the college experiences of 35 people with psychiatric disabilities, in order to study barriers to higher education.

A family's painful journey
This article discusses the issues faced in Maryland in seeking assistance for children with severe mental illness. It focuses on State budget cuts for wraparound mental health coverage. 

Behavioral health care needs of rural women
This report attempts to direct attention to this underrepresented group and presents a review of the literature related to the behavioral health care needs of rural women. With this knowledge, psychologists and other health professionals will be able to more effectively plan and deliver services to this population.

Stigma, racism, or choice. Why do depressed ethnic elders avoid psychiatrists?
This study explored and compared the views of White British (WB) and Black African-Caribbean (BC) older people on depression as an illness, avenues of help and the place of mental health services.

At issue: Stop the stigma: Call mental illness a brain disease
Educating the public that mental illness is a brain disease is a popular strategy for combating mental illness stigma. Evidence suggests that while such an approach reduces blame for mental illness, it may unintentionally exacerbate other components of stigma, particularly the benevolence and dangerousness of stigmas. Researchers propose a balanced approach that combats the various myths about mental illness with factual information.

Structural levels of mental illness stigma and discrimination
In this article, using a sociological paradigm, we apply the concepts of structural discrimination to broaden our understanding of stigmatizing processes directed at people with mental illness.

From stigma to discrimination: An analysis of community efforts to reduce the negative consequences of having a psychiatric disorder and label
This study reports the results of a first step national survey of noteworthy on-the-ground efforts to reduce the negative consequences of having a psychiatric disorder and label. The sample consists of nontraditional, innovative local efforts along with wellknown programs.

Measuring mental illness stigma
This article is designed to assist researchers in selecting or creating measures that can address critical research questions regarding stigma.

Changing middle schoolers' attitudes about mental illness through education
An article discussing the effectiveness of a curriculum supplement for middle school assessing their knowledge and attitudes about mental illness.

Stigmatization, discrimination, and mental health: The impact of multiple identity status
The authors present the empirical characteristics of the Experience of Discrimination Scale (EDS) using baseline data from the Center for Mental Health Services-funded, multisite Consumer Operated Services Project. Specific hypotheses focused on the influence of multiple identity status on reports of discrimination. Data indicated that discrimination caused by mental disability was associated with level of psychiatric symptoms and perceived social rejection as a result of mental illness, whereas discrimination for other reasons was associated with broader quality of life and social interaction indicators. The clinical and policy implications of findings are discussed. 

Position statement on employment and rehabilitation for persons with severe psychiatric disabilities
The position statement, developed by NASMHPD, encouraged the integration of employment and recovery goals with service delivery to individuals with mental illnesses. The NASMHPD concluded that State mental health agencies should work to develop tools for appropriate evaluation of plan success in moving covered individuals into employment or partial employment settings.

A unitary theory of stigmatization: Pursuit of self-interest and routes to destigmatisation
This paper discusses the development of a theoretical foundation to help comprehend the core meaning of stigmatisation and to guide practical anti-stigmatisation measures.

Focus on women: Mothers with mental illness: I: The competing demands of parenting and living with mental illness
The purpose of this study is to understand the parenting experiences of women with mental illness from the perspectives of mothers and case managers employed by the state department of mental health.

Violence and schizophrenia: Examining the evidence
A selective review of the key literature on the epidemiology of violence and schizophrenia. Population-attributable risks for violence in schizophrenia are calculated from population-based studies.

Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods 
The public perception that mental disorder is strongly associated with violence drives both legal policy (eg, civil commitment) and social practice (eg, stigma) toward people with mental disorders. This study describes and characterizes the prevalence of community violence in a sample of people discharged from acute psychiatric facilities at 3 sites. At one site, a comparison group of other residents in the same neighborhoods also was assessed.  

Violence and psychiatric disorder in the community: Evidence from the epidemiologic catchment area surveys 
Data from the Epidemiologic Catchment Area survey were used to examine the relationship between violence and psychiatric disorders among adults living in the community. Psychiatric assessment of survey respondents was based on the Diagnostic Interview Schedule, which also provided self-report information about violent behavior. Those who reported violent behavior within the preceding year tended to be young, male, and of low socioeconomic status, and more than half met DSM-III criteria for one or more psychiatric disorders. Subjects with alcohol or drug use disorders were more than twice as likely as those with schizophrenia to report violent behavior. In a multivariate model of the predictors of violence, a significant interaction effect was found between major mental illness and substance abuse. The risk of violent behavior increased with the number of psychiatric diagnoses for which respondents met DSM-III criteria.  

Assessing the evidence of a link between mental illness and violence
The author formulates six statements on the associations that seem warranted by recent investigations and reviews the research evidence. Given the considerable limitations of current research, priorities for future research include attention to the strength of the association for individual subjects, inclusion of adequate comparison groups of non-mentally-ill persons and a broad range of variables, and intensive studies of repetitively violent individuals over time.

Use of schizophrenia as a metaphor in U.S. newspapers
Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused.

Association between cognitive functioning and employment status of persons with bipolar disorder
The purpose of this study was to identify variables associated with employment status among persons with bipolar disorder, including cognitive functioning, severity of symptoms, demographic variables, and variables related to course of illness.

Report of the Surgeon General's conference on children's mental health: A national action agenda
This report introduces a blueprint for addressing children's mental health needs in the United States.

American with Disabilities Act of 1990
The current text of the Americans with Disabilities Act of 1990 [?ADA?], as amended.

Research and training center in rehabilitation for persons with long-term mental illness: Summary of research accomplishments with training and dissemination highlights
A summary of the research accomplishments achieved by the Center for Psychiatric Rehabilitation of Boston University between 1994- 1999.

What factors explain how policy makers distribute resources to mental health services?
Advocates hope to influence the resource allocation decisions of legislators and other policy makers to capture more resources for mental health programs. Findings from social psychological research suggest factors that, if pursued, may improve advocacy efforts. In particular, allocation decisions are affected by policy makers' perceptions of the scarcity of resources, effectiveness of specific programs, needs of people who have problems that are served by these programs, and extent of personal responsibility for these problems. These perceptions are further affected by political accountability, that is, whether politicians perceive that their constituents will closely monitor their decisions. Just as the quality of clinical interventions improves when informed by basic research on human behavior, the efforts of mental health advocates will be advanced when they understand the psychological forces that affect policy makers' decisions about resources. 

Danforth residents cool to project group plans to build housing for people with mental illness
A brief article describing the life of an individual with mental illness and her struggles to find appropriate housing.

Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed With bipolar affective disorder
The purpose of this study was to evaluate the effect of concerns about stigma on social adaptation among persons with a diagnosis of bipolar affective disorder.

Child and adolescent mental health: Recommendations for improvement by state mental health commissions
Between June, 1997, and October, 2001, commissions in 13 states issued reports on the status of mental health in their state, and needed improvements. The National Association of State Mental Health Program Directors and Louis de la Parte Florida Mental Health Institute convened a meeting in 2002, to review the findings from these commission reports for the purpose of identifying their primary policy implications both at the federal and state level of government. This brief manuscript specifically focuses on the findings and recommendations with regard to children and adolescents, and their families.

Data trends, summaries of research on mental health services for children and adolescents and their families. No. 60
This article presents the results of a study of premature termination patterns among residents of the United States and Ontario using mental health services.

Establishing a comprehensive system of care for persons with mental illnesses
A proposed resolution submitted during the 66th Biennial Convention in which the Union of American Hebrew Congregations addresses various issues on mental illness in the Jewish community.

Churches must overcome fear, minister to mentally ill
This article highlights opinions of church leaders on the subject of mental illness.

Childhood revealed: Art expressing pain, discovery and hope
An overview of the book created by the New York University Child Study Center to help people overcome the stigmas attached to child psychiatric illness. The book contains over 100 pieces of art created by children from ages 4 through 18 who have a mental illness or have experienced a difficult life circumstance.

Children trapped by gaps in treatment of mental illness
A brief article in which the author addresses the need to close "the gap in mental health care," which "requires changes in attitudes and development of resources by all who care for children - families, schools, communities, health care agencies, the government, and children themselves."

New data on lesbian, gay, and bisexual mental health: New findings overturn previous beliefs
An article briefly discussing the results of several breakthrough studies which offer new insights on gay men, lesbians and bisexuals.

Employers, insurers integrate benefits
A brief article in which the writer discusses how psychologists are helping employers to integrate disability, health and employee-assistance program benefits into the workplace.