[The stigma of mental illness: Α historical overview and conceptual approaches]

Abstract

The present article explores the concept of stigma from a historical and theoretical perspective. At first, the conceptual origin of the term "stigma" is presented as well as its subsequent course and incorporation in the scientific field. The term stigma originates from ancient Greek language and in particular from the verb «στίζω», which means "to carve, to mark as a sign of shame, punishment or disgrace". In contemporary thinking about stigma, the work of Erving Goffman is seminal. According to him, stigmatization is elicited by the presence of a socially undesirable characteristic, which signals otherness. When this characteristic becomes conspicuous during a social interaction, it may act in a disqualifying manner for the identity of the person who bears it. One of the first theories on social stigma which attracted increased scientific attention is labeling theory by Thomas Scheff. Later on, the conceptual model of Corrigan and Watson underscored the main constituents of stigma, namely stereotypes, prejudices and discrimination; whereas the theoretical framework of Link and Phelan stressed labeling, stereotyping, separation, status loss and discrimination as interconnected components in a power situation. During the last half of the previous century, the concept of stigma came to the fore and gained growing research attention, especially due to shedding light on the ways whereby people with mental disorders were treated socially. Most of the literature has focused on recording the general population's level of knowledge and lay beliefs about mental illness as well as on exploring social attitudes and desired social distance from people with mental disorders. Converging evidence indicates that stereotypical beliefs and discriminatory attitudes against people with mental illness prevail worldwide; while illness severity, poor therapeutic outcome, disturbances in patients' emotional expression during a social interaction, incidents of violent or dangerous behaviours and labeling have all been shown to influence public stigma. Regarding lay respondents' correlates of public stigma; male gender, older age, lower socio-economic status, lower educational attainment and residence in semi-urban or rural areas have been linked to unfavourable attitudes towards people with mental disorders; while of outmost importance is personal experience/ familiarity with mental illness.