This chapter provides a frame for examining extant issues and evidence concerning labeling and stigma as it pertains to mental illnesses. The issues addressed are: (1) the conceptualization of labeling and stigma, (2) evidence about trends in stigma-relevant public attitudes and beliefs, and (3) how labeling and stigma affect individuals who develop mental illnesses. Both modified labeling theory and the conceptualization of stigma developed by Link and Phelan point to the importance of attitudes and beliefs, leading to questions about how such attitudes and beliefs are faring in trends over time. The research reviewed in this chapter shows that the public recognizes mental illnesses as illnesses with genetic and biological bases; however, the core stereotypes of dangerousness and incompetence have either changed little or actually become stronger. No change in social distancing responses has accompanied the increasingly medical conception of mental illnesses. Discrimination against people with mental illnesses occurs through multiple mechanisms, including direct person-to-person discrimination, discrimination operating through the stigmatized person, discrimination that emerges silently but perniciously through social interaction, and structural stigma. What are the policy implications of this chapter?
When we ask who is labeled mentally ill and what the consequences of such labeling are, we ask questions that are central to the sociological understanding of mental disorder. Such questions are relevant to those who are concerned that so many people with serious mental illnesses go unlabeled and untreated (Regier et al., 1993; Wang et al., 2005). Such questions are also relevant to people attempting to recover from mental illnesses who often feel that they suffer as much from being labeled mentally ill as they do from mental illness itself (Deegan, 1993).
As a society, we have created specific professions (including psychiatry, clinical psychology, psychiatric social work, and psychiatric nursing) upon whose members we confer the authority to define, label, and treat mental illnesses. Social processes determine who encounters these professionals and many of the important consequences that might follow from such an encounter. The treatment they receive may ameliorate their symptoms, improve their well-being, and enhance their social and occupational functioning. At the same time, along with treatment comes the possibility of pejorative labeling and stigma. Social science research on labeling and stigma can help us understand the processes involved, and, by bringing those processes to light, open the possibility of addressing some of their negative consequences.