March 2008 Issue • Volume 36 • Issue 3

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An International Conference Examines Stigma Research

by Terry White, Indiana Consortium for Mental Health Services Research

As part of its commitment to promote dialogue on critical global issues affecting poor and excluded populations, the Rockefeller Foundation recently provided fiscal support to Indiana University sociologists to organize and host an international conference aimed at developing an understanding of the extent to which mental illness is understood and stigmatized internationally.

The conference, held October 15- 18, 2007, in Italy, was presided over by Indiana University sociologists Bernice Pescosolido, J. Scott Long, and Jack K. Martin who presented their preliminary data from the Stigma in Global Context- Mental Health Study (SGC-MHS). The SGC-MHS is the first theoretically based and methodologically coordinated attempt to understand the manner in which mental health problems are stigmatized across nations. This study is nearly complete with data collected from 14 of the 15 nations. The final 15-nation data file is expected within the year.

The SGC-MHS was designed to provide cross-national data for stigma researchers. A prior study by the World Health Organization’s landmark International Study of Schizophrenia (ISoS) concluded that less-developed countries appeared to have better clinical and social outcomes for persons with schizophrenia. The ISoS study investigators, after examining many other possible explanations, suggested that variation in stigma rates might explain why less developed countries had more positive outcomes for persons with schizophrenia than more developed countries. Absent data on stigma attitudes, however, suggestions for future research trajectories, policy efforts, and program development were not clear.

As discussed at the conference, the SGC-MHS data indicates that the outcome- stigma relationship is more complex than the ISoS investigators concluded. "There are many differences cross-nationally," said Pescosolido, the study’s principal investigator, "and differences in development are not directly linked to stigma attitudes as the ISoS investigators speculated. Availability of public health spending within a nation appears to be associated with attitudes about mental illness along with the historical background and cultural context found in any nation. The current study offers a real chance to better understand both stigma and other cultural differences that might be linked to social and clinical outcomes."

The SGC-MHS data were obtained from nationally representative cross-sections from each participating nation— with at least one country representing each of the inhabited continents—via face-to-face interviews. A total of 17,312 respondents are represented in the SGCMHS data. Countries examined included Argentina, Bangladesh, Brazil, Bulgaria, Cyprus, Germany, Hungary, Iceland, New Zealand, Philippines, South Africa, South Korea, Spain, and the United States. Still in the field is Great Britain. In addition to the 14 nations considered at the conference, other nations with unique and not-directly compatible protocols collaborating in the SGC-MHS include Nepal (with sociologists Mark Tausig, University of Akron, and Janardan Subedi, Miami University) and Japan (with sociologist Saeko Kikuzawa, Nara Women’s University). Those data were not considered at the conference but will be examined separately.

The conference brought together an international cadre of sociologists, social psychologists, psychiatrists, and survey methodologists. Attendees included Norman Sartorius, President of the Association for the Improvement of Mental Health Programmes and Professor of Psychiatry, University of Geneva; Howard Goldman, Professor of Psychiatry, University of Maryland School of Medicine and Director of Mental Health Policy Studies; and Tom W. Smith, co-principal investigator of the project and Director of the General Social Survey at the National Opinion Survey Center (NORC). The conference attendees reviewed the research team’s preliminary findings, discussed the theoretical and methodological implications of those findings, and suggested additional approaches to the analysis.

SGC-MHS is funded under a fiveyear, $3.4-million grant from the Fogarty International Center, the National Institute of Mental Health, and the Office of Behavioral and Social Science Research. Additional information on the project can be found at small_green


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