This study will examine stigmatizing attitudes and beliefs toward any mental illness among the general population. Similar to prior research, a focus on any mental illness, as opposed to serious mental illness or specific types of mental illness, will enhance the generalizability of the findings.

In collaboration with the Federal Office of Rural Health Policy, researchers will design and administer a survey to a nationally representative panel that includes a sufficient rural sample for analysis of rural/nonrural differences. Findings will generate a more nuanced, and current, description of mental illness stigma in rural and nonrural communities in the U.S. This understanding is a necessary step for mitigating negative consequences resulting from stigma and advancing the quality of health care, behavioral health, and quality of life of individuals experiencing mental illness.

Specifically, findings will inform strategies (e.g., education) to minimize stigmatizing attitudes and beliefs among rural residents, including potential targeting to rural subgroups where stigma may be greater.

Researchers propose to test the following hypotheses:

1. The prevalence of public stigma associated with mental illness will differ between rural and nonrural residents.
2. The prevalence of public stigma associated with mental illness varies by gender.
3. The prevalence of public stigma associated with mental illness will differ between residents who have and do not have experience with mental illness, with experience defined as either personally having mental illness or knowing someone with mental illness.

This project will employ a cross-sectional study design to document the burden of public stigma associated with mental illness, with a focus on identifying rural/nonrural differences. Researchers will administer a survey composed of 10 items to a sample drawn from a nationally representative panel (AmeriSpeak®) inclusive of rural and nonrural residents. Researchers identified an established, validated scale designed to examine public attitudes about mental illness. They modified it by removing two of the weakest items based on factor loadings and adding one item to assess personal experience with mental illness. From the AmeriSpeak® panel, researchers will also be able to include demographic information collected from survey respondents within the analyses.

Publications

• Examining the Burden of Public Stigma Associated With Mental Illness in the Rural United States
  Policy Brief
  Rural Health Equity Research Center
  Date: 09/2022
  Stigma is a widely recognized barrier to receipt of health and mental health services. This policy brief documents the burden of public stigma associated with any mental illness in rural versus non-rural communities in the United States. Differences in stigmatizing attitudes and beliefs by rurality, gender, race and ethnicity, and age are examined.