Trends in Public Stigma of Mental Illness in the US, 1996-2018

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Abstract
Stigma, the prejudice and discrimination attached to devalued conditions, has been consistently cited as a major obstacle to recovery and quality of life among people with psychiatric disorders.1-3 Stigma has been implicated in worsening outcomes for people with serious mental illness,4,5 with nearly 40% of this population reporting unmet treatment needs despite available effective treatments.6,7 Although some psychiatrists claim that stigma has decreased8 or is irrelevant,9 stigma remains concerning to health care professionals, patients, advocacy groups, and policy makers. Research has not supported claims of a decrease in stigma.3 Moreover, national levels of public stigma have been associated with treatment-seeking intentions and experiences of discrimination reported by people with mental illness.10,11 Findings on antistigma interventions also reflect the persistence of stigma3,12,13; the unclear, limited, or short-term effectiveness of both large-scale messaging and small-scale interventions12-16; and the lack of scalability of many such programs. Herein, we examine US public stigma over a 22-year period to provide a detailed assessment of changes in the nature and magnitude of public stigma over 2 decades for major mental health disorders.

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