“are you insane

VARIABLES INFLUENCING ATTITUDES TOWARD THE MENTALLY ILL 1

“ARE YOU INSANE?”: VARIABLES INFLUENCING ATTITUDES

TOWARD THE MENTALLY ILL

Jen Kelly

Erin Pratt

Ty Lindsay

Winthrop University

SOCL 516


INTRODUCTION

According to the Centers for Disease Control and Prevention, “25% of all adults in the

United States, and nearly 50% of U.S. adults will develop at least one mental illness in their

lifetime” (CDC 2011). Due to the extremely high prevalence of mental illness diagnoses,

discussion of mental illness and attitudes toward them become even more important to

contemporary research. Individuals tend to stray away from the topic of and those suffering from

mental health issues due to the stigma and labeling that come into play with a mental illness

diagnosis. GOffman (1963) defines stigma as an “attribute or characteristic that is discrediting”

to the individual. In other words, it is any trait that makes an individual less accepted in one’s

society. Stigma becomes even more evident when incidents such as the Newton, Connecticut

shooting occur, and the shooter, Adam Lanza, is speculated to be suffering from mental health

issues (Walkup 2012; Rubin 2012). It provides support for the idea that mental illness could be

something to fear, or see as potentially dangerous simply based on one extreme case.

Prejudice toward individuals with mental illnesses appears to be a topic which is not

receiving significant research attention. Prior research has looked into the ways in which those

with mental illnesses are stigmatized, and how that affects their world and the way society treats

them. However, research has neglected to look deeper into correlations amongst individuals on

the side of mental illness and the variables behind their reactions toward someone who is

considered mentally ill. There is a myriad of research on the topics of stigmatization and labeling

theory, but less discussion of demographic variables that are involved with attitudes toward

people with mental illnesses. Furthermore, there is limited research available on the


stigmatization of the mentally ill in relation to the individual’s race, education level. and

socioeconomic status.

Our research uses data from the General Social SUrvey to examine the ways in which an

individual’s race, education level, and socioeconomic status affect his or her reactions and

behaviors toward those perceived as mentally ill. More specifically, we examine variables related

to avoiding individuals with mental health issues, feeling sympathy toward those individuals, and

one’s willingness to spend time with persons with mental illness. We considered the variable

responses related to sympathy and willingness to spend time with the mentally ill individuals

more positive views and behaviors whereas those pertaining to an unwillingness to spend time

with these individuals and avoidant behaviors were considered more negative. We hypothesized

that as an individual’s education level increases; there will be a decrease in prejudice towards

people with mental illness. We also predicted there will be less prejudice among the white

population than any other racial group. We predict that having received treatment for a mental

health issue will positively influence one’s willingness to spend time with an individual with

mental illness. We assumed knowing someone who has received treatment for mental health

issues would positively influence an individual’s willingness to spend time with mentally ill

individuals. Lastly, we hypothesized that the lower and higher class individuals will exhibit more

prejudiced attitudes toward the mentally ill than those in the middle class.

LITERATURE REVIEW

Researchers have previously discussed the severity of s tigma toward individuals with

mental illness (Perry 2011; CDC 2011). As defined by Corrigan et. al (2010), public stigma is

the creation of prejudicial attributes of the mentally ill by the general public (206). For instance,


Perry’s (2011) research focused on how the mentally ill feel they have been stigmatized, and

their opinions about others’ views toward them. He found that, “about seventeen percent report

that someone seemed unwilling to make friends [with them], and 20 percent indicated that

someone has broken off a friendship because of their mental illness; (Perry 2011:467). Perphas

these percentages are based solely on the individual’s perceptions, in which case they would not

seem as credible as the outsiders’ actual opinions toward the mentally ill. However, they are a

prime example of how stigma not only affects outsiders’ views, but also the individuals on the

inside as well; those with mental illness. Stigma has grave implications on how they see the

world, and how they believe the world sees them, and their perception usually pertains to

negative attitudes from outsiders. Perry (2011) concludes with a discussion of the need or

research that looks into the education level variable, which our present research focuses on.

Various researchers have looked into similar variables to our present research (Freeman,

1961, McLaughlin et. al, 2012, Papadopulos et. al, 2002). Freeman (1961; 60), focused on age,

class and education level as important indicators of feelings toward the mentally ill among

relatives of former patients. He found that “the younger and more educated persons in the

community have been found to be...more willing to associated with former patients…”

(Freeman, 1961; 60). Additionally, Freeman (1961; 60) found that family members in higher

social classes feel more positivity toward the former patients and the hospital experience as a

whole versus those of a lower social class. However, his article is relatively outdated,

considering it was written in the 1960s, and society has incurred changes over time.

Additionally, there could be differences between the individuals he looked at the relatives of

former patients and the rest of society in terms of views on mental illness. Popadopulos (2002;


431432) focused his research on two particular races to see how they viewed mental illness. He

looked at the whiteEnglish people and the GreekCypriot, which are the ethnic Greek population

of Cyprus. For both groups, Papadopulos examined sex, race, age, social class, education level,

knowledge about mental illness, and contact with mentally ill people. He found more

stigmatizing views among the GreekCypriot group, the lower social class individuals, and those

with low educational attainment levels. While Papadopulos looked at assorted variables

associated with views toward mental illness, his research was focused on Greece. It would be

interesting to see if racial or ethnic differences were also important in the United States context.

McLaughlin et. at (2012) looked at variables which influence the presence of mental

illness in individuals. which contrasts with our aim to look at similar variables in the context of

outsider opinions versus the actual cases of mental illness. For example, he looked at perceived

socioeconomic status among individuals with mental illness. and the correlations between the

status and the prevalence of mental illness cases. There were no conclusive finding from

McLaughlin’s (2012) research on socioeconomic status, which further implements our need to

not only look into the class variable, but to also do so from the outsider’s view of mental illness

because such has not yet been done in the United States since the 1960s.

In addition to the aforementioned articles, several researchers have discussed the concept

of social distance in its relation to interacting with those with mental illness (Lucas & Phelan,

2012, and Lauber, 2004). Lucas and Phelan (2012) define social distance as “deliberate effort to

avoid another or exclude another from social interaction” (1)/ Their research asked participants

to choose between keeping their fabricated mentally ill partner or antother individual, and their

results depicted mentally ill individuals as victims of social distancing eighty percent of the time


(Lucas & Phelan, 2012; 10). Lauber (2004; 268) researched social distance with mental illness in

different social contexts. He asked questions pertaining to activities with mentally ill individuals

such as, “would you be willing to start work with a person who has a mental illness, would you

make friends with a person with mental illness, and would you let your child marry a person with

a mental illness?” (Lauber 2004; 268). Results found that individuals were comfortable with

minimal contact with mentally ill individuals based on their negative perceptions of the mentally

ill (Lauber, 2004). Lauber (2004) failed to look into the variables associated with the individuals

who offered these opinions, which is what our present research aims to describe through similar

questions that involve the social distance concept.

Additionally, research exists about the added stigma of mental illness on racial minority

groups but little to no research can be found on the stigmatizing behaviors that the individuals

who belong to those groups impose on those with mental illness (Corrigan et. al 2010, and

Brown et. al 2010.) For instance, Corrigan et. al (2010 stated, “people who come out about their

mental illnesses may expose themselves to additional (emphasis is our own) discrimination and

social disapproval’ (260). Brown et. al (2010) mentions how this increase in stigma affects their

willingness to seek treatment, but does not state anything about racial minorities and mental

illness views in general (353). To the best of our knowledge, prior research has not investigated

the views of racial minority groups toward those with mental illness.

Prior research has focus on the stigmatization of mentally ill, variables associated with

the prevalence of mental illness, and how public stigma is influenced by race, sex, age, education

level, and perceived socioeconomic status. Our research takes a different approach in examining

variable influences of mental illness perceptions. In the next section we discuss the data we used


to study this phenomenon as well as our methods of analysis. That is followed by the findings

and finally, a discussion of the implications of this research.

METHODS

For data, we turned to the 2006 General Social Survey (GSS) carried out by the National

Opinion Research Center, which contains measures that are relevant for addressing prejudice

against people with mental health issues. The 2006 General Social Survey shows twentytwo

questions that mention mental health or mental illness. Of these, we carefully selected two

variables to represent two different dimensions of prejudice towards the mentally ill: mhsymp

and mhsocial. Degree of sympathy respondents reported feeling towards mentally ill individuals

was measured by the variable mhsymp. Respondents were able to choose from four different

responses ranging from no sympathy at all to quite a bit of sympathy. Willingness to spend time

with mentally ill individuals was measured by the variable mhsocial; their answer choices ranged

from definitely willing (4) to definitely unwilling (1).

Dependent Variables

We investigated respondents; attitudes toward the mentally ill in the form of two

dependent variables, how much sympathy the respondent felt for mentally ill individuals in

public places (mhsymp). The sample size for the sympathy question was 1,156 respondents, and

the frequencies are as follows: 1% reported feeling no sympathy, 25.5% reporting feeling a little

sympathy, 40.6% reported feeling quite a bit of sympathy, and 32.8% reported feeling a great

deal of sympathy. Whether or not the respondent would spend time socializing with mentally ill

individuals was classified in the variable mhsocial, with a sample size for the socializing

question was 1,398 respondents. 26.5% of respondents were definitely willing, 50.4% were


probably willing, 18.6% were probably unwilling, and 4.6% were definitely unwilling. We aim

to explain these attitudes through examining the influences of the independent variables race,

education level, income, whether the respondent has received treatment for mental health issues,

and if they know someone who has received treatment on each of the the two indicators of

prejudice toward the mentally ill.

Independent Variables

We dummy coded three independent variables (mhtrtslf, mhtrtot2, and race) for the

purposes of multivariate analysis. For the variable mhtrtslf, respondents were asked if they have

received mental health treatments. We recoded this variable into a new variable: hadtreatment. In

the new variable hadtreatment, a value of 1 was given to respondents who said they have

received mental health treatment, and a value of 0 was given to those who reported no prior

mental health treatment. 15.1% of respondents reported receiving prior treatment and 84.9%

reported receiving no treatment. The same recoding was done for the variable mhtrtot2, with the

creation of the new variable knowtreated. In this variable, a value of 1 was given to those who

responded with knowing someone who has had mental health treatment, and a value of 0 was

given to those who reported not knowing someone. 68.4% of respondents reported knowing

someone who received treatment and 31.6% reported not knowing someone who received

treatment. Lastly, we dummy coded the race variable as well. This variable was recoded into

three separate variables: white, black and other. For white, a value of 1 was given to all

respondents who reported being white, and all other responses were given a value of 0, For

black, a value of 1 was given to all respondents who reported being black, and all other


responses were given a value of 0. The same process was applied to the variable other. Of our

sample, 72.8% of respondents were white, 14.1% were black, and 13.1% were other races.

We recoded our last two independent variables by collapsing the data into fewer, less

precise categories. We recoded the variable education (educ) from twenty individual values

(ranking each grade level from never entering school, to completing a graduate degree or more)

to five values. We recoded the variable in this way to account for shortcomings in alternative

variables. The variable degree did not account for respondents who never entered high school,

but the variable educ did not group respondents. One represents never attending school; two

represents completing through middle school (previously one through eight); three represents

completing an education through high school (previously nine through twelve). The new value of

four represents completing through a bachelor’s degree (previously coded as thirteen through

sixteen). Finally, the value of five was given to anyone who responded as completing higher than

a bachelor’s degree. In our sample, 0.5% of respondents had received no formal education, 5.9%

completed middle school, 37.7% completed high school, 43.3% received a bachelor’s degree,

and 12.6% reported further education. Income (income06) was recoded from an original

twentyeight values (from $0 to $150,000) into five new values. One represents $0 to $24,999;

two represents $25,000 to $49,999 (previously fifteen through eighteen); and three represents

$50,000 to $74,999 (formerly nineteen and twenty). The created value of four represents $75,000

to $149,999 (previously representative of values twentyone through twentyfour). The final

value of five was given to incomes of $150,000 and above. In our sample, 29.7% of respondents

were in the first income bracket, 27.2% were in the second, 17.9% were in the third, 19.7% were

in the fourth, and 5.5% were in the fifth income bracket.


FINDINGS

We hypothesized that prior mental health treatment would influence one’s willingness to

spend time with mentally ill individuals. In support of this, a chisquare analysis showed that

there was a significant relationship (p=.009) between the aforementioned variables. 77.6% of

individuals who had received prior treatment reported that they were either definitely willing or

probably willing to spend time with a person with a mental illness as opposed to those who had

no prior treatment. Surprisingly, we did not find a significant relationship between knowing

someone who has received mental health treatment and the willingness to spend time with

mentally ill individuals.

Our analysis shows that there is a moderately significant difference between income and

willingness to spend time with mentally ill individuals with a significance level of p .032, and≤

between degree of sympathy and income level as well (p .015).≤

Additionally, there was a significant (p .008) relationship between degree of sympathy≤

and having received prior treatment. Individuals who have received prior treatment reported

more responses of quite a bit of or a great deal of sympathy for the mentally ill than those who

had not received prior treatment, which supports our hypothesis.

Lastly, there was a moderately significant (p .014) difference between one’s degree of≤

sympathy toward the mentally ill and level of income, but there was not a significant difference

between the level of income and willingness to spend time with mentally ill individuals.

Next, to be sure that the relationships we found were robust, we conducted a regression

that controlled for all variables in the analysis simultaneously. Although the relationships

between willingness to spend time and our other significant variables diminished somewhat,


income is still a significant predictor. Based on the standardized coefficients. the most important

predictor of willingness to spend time with the mentally ill appears to be level of income. Income

has a moderately significant positive net effect on willingness to spend time, which means that as

income level increases, the willingness to spend time increases.

We ran a regression test for the sympathy variable as well. Income and having received

prior treatment were significant predictors of the degree of sympathy an individual reported

feeling toward mentally ill individuals, with income as the most important predictor with a

significance level or p .10.≤

CONCLUSIONS

Our research shows that prejudice towards the mentally ill is a more random than

predicted behavior. We hypothesized that variables such as race, social class, education level,

income, having received prior mental health treatment or knowing someone who has received

prior mental health treatment would influence someone’s prejudice towards the mentally ill, but

what we found was much different. The only significant variables were having had prior

treatment and income. Both of these variables influenced the dependent variables willingness to

spend time with mentally ill individuals and degree of sympathy felt towards mentally ill

individuals. While we thought that the majority of people’s race, education, income level, having

received prior treatment and knowing someone who had received prior treatment would have a

significant impact on prejudice towards the mentally ill, only income and having received prior

treatment show significance with 95% confidence.

It is interesting that our research found income to be the main variable that seemed to

influence individuals’ prejudice toward the mentally ill. Future research could focus more on this


correlation to see if some causing factors could be discovered. Another interesting direction our

research could go in the future is the form of a longitudinal study. While several of our variables

did not result in statistically significant findings in a data set of one year, perhaps the variables

will show interesting significant changes over time. Finally, our research would benefit from

replication. It would be exceedingly interesting to see how our result compare to those who run

the same tests in the future.


Works Cited

Brown, Charlotte, Kyaien O. Conner, Valire Carr Copeland, Nancy Grote, Scott Beach, Deena Battista, and Charles F. Reynolds III. 2010. “Depression Stigma, Race, and Treatment Seeking Behavior and Attitudes.” Journal of Community Psychology 38(3) 350368.

Centers for Disease Control and Prevention 2011. “U.S. Adult Mental Illness Surveillance

Report.” Atlanta, Georgia: Centers for Disease Control and Prevention. Retrieved January 23, 2013 (http://www.cdc.gov/Features/MentalHealthSurveillance/).

Corrigan, Patrick W., Scott Morris, Jon Larson, Jennifer Fafacz, Abigail Wassel, Patrick

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Freeman, Howard. 1961. “Attitudes Toward Mental Illness Among Relatives of Former

Patients.” American Sociological Review. Retrieved January 21, 2013 (http://www.jstor.org/stable/2090513).

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