Public stigma of mental illness in Australia: shifts in attitudes across nationally representative surveys in 2011 and 2024

澳大利亚公众对精神疾病的污名化:2011 年和 2024 年全国代表性调查中态度的转变

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Abstract

AIMS: Reducing stigma and discrimination towards people with mental ill-health is a key priority in Australian mental health policy. Population-based surveys conducted in Australia between 2003 and 2011 showed some improvement in stigmatising attitudes, but also a deterioration in attitudes about dangerousness and unpredictability, particularly in relation to schizophrenia. This study aimed to investigate whether stigmatising attitudes have changed since the 2011 national survey. METHODS: Two large, nationally representative samples of Australian adults were surveyed in 2011 (n = 1967) and 2024 (n = 1984). At each time point, participants were presented with vignettes of a person in the early stages of depression or schizophrenia and completed questionnaires about stigmatising attitudes towards the person in the vignette (Personal Stigma Scale) and willingness to interact with them (Social Distance Scale). Using weighted data, logistic regressions assessed change from 2011 to 2024 while controlling for sociodemographic characteristics. Results were considered significant at p < .01. RESULTS: There were significant reductions in endorsement of stigmatising attitudes towards depression and early schizophrenia. Notably, there were large reductions in beliefs about dangerousness (depression 22.5-4.8% and schizophrenia 37.1-18.1%). Conversely, the willingness to interact with a person with depression remained unchanged and had worsened for schizophrenia, with the odds of being unwilling to interact approximately doubling (11.0-26.9% unwilling to make friends and 18.8-33.2% unwilling to work closely with them). CONCLUSIONS: The data show mixed findings regarding change in stigma in the Australian population. Despite negative beliefs diminishing over time, this has not translated into greater willingness to interact with people with depression or schizophrenia. Key action is needed on understanding the barriers to interacting with people with mental health conditions and reducing perceptions of unpredictability, particularly for schizophrenia, which remains more highly stigmatised.

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