Most California residents facing psychological distress do not perceive the public as being supportive, with a large proportion reporting discrimination both in personal relationships and in public realms such as the workplace, according to a new RAND Corporation study.

Just 41 percent of those surveyed believe that people are caring and sympathetic to those with mental illnesses, and 81 percent believe that people with mental illness experience high levels of prejudice and discrimination.

Consistent with their perceptions of public stigma, more than two-thirds of those polled said they definitely or probably would hide a mental health problem from co-workers or classmates, and more than one-third said they would do so from family or friends as well.

“These high levels of perceived stigma may discourage individuals facing a mental health challenge from getting needed support from friends and family, the workplace, school and mental health professionals,” said Eunice Wong, lead author of the report and a behavioral scientist at RAND, a nonprofit research organization.

The results come from the California Well-Being Survey, which assessed the impact of mental health prevention and early intervention programs on individuals who are experiencing psychological distress. The survey was conducted by RAND as part of efforts by the California Mental Health Services Administration (CalMHSA) to create prevention and early intervention programs designed to improve the mental health of California residents.

“This new report from RAND researchers highlights both the need to confront stigma, and the opportunity to promote mental health in our state with the statewide stigma reduction efforts offered by CalMHSA,” said Wayne Clark, executive director of CalMHSA. “This survey shows that CalMHSA’s partnership of California’s counties is successfully reaching the population most at risk for mental health challenges to increase support and encourage help-seeking.”

Researchers surveyed 1,066 people who had previously reported mild to serious psychological distress when they took part in the California Health Interview Survey, a statewide survey about a broad array of health issues.

The California Well-Being Survey is the first population-based survey of individuals who are at risk for or are experiencing mental health problems, but may or may not have obtained treatment. The group is a key target for prevention and early intervention efforts and largely has been unstudied.

Among survey participants who acknowledged experiencing a mental health problem, nearly 9 in 10 reported discrimination based on it. Most often discrimination occurred in the sphere of intimate social relationships, although they also reported high levels of discrimination at school, in the workplace, and from health care providers and law enforcement officials.

In spite of these adverse experiences, Californians who are experiencing psychological distress are showing signs of resiliency. More than 80 percent of those surveyed said they have a plan for how to stay or become well and believe they can meet their personal goals.

In addition, about 70 percent of those surveyed said that they are satisfied with life. The large majority of respondents believe that recovery from mental illness is possible and say they would seek treatment for a mental health problem if needed.

“While California residents facing mental health challenges are finding ways to cope and maintain important aspects of well-being, they are substantially burdened by self-stigma and discrimination, which may significantly undermine recovery,” Wong said. “Our overall findings show a clear need for stigma and discrimination reduction efforts in California.”

The survey also found that the mental health education campaign mounted by CalMHSA appears to be reaching individuals experiencing psychological distress. About one-third of the people surveyed had been reached during the prior 12 months by the early intervention efforts, such as viewing the campaign’s documentary on ending stigma about mental illness. In addition, other activities that could be related to the CalMHSA efforts reached nearly 90 percent of the group during the prior 12 months.

With funds generated by Proposition 63, which imposed a special state tax on people with incomes over $1 million, the efforts supported by CalMHSA are intended to reduce stigma and discrimination surrounding mental illness, prevent suicides, and improve the mental health of students in K-12 schools and colleges across the state. These statewide interventions are being evaluated by RAND, a nonprofit research organization.

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The study was sponsored by CalMHSA and conducted independently by RAND. The report, “Stigma, Discrimination, and Well-Being Among California Adults Experiencing Mental Health Challenges,” can be found at http://www.rand.org. Other RAND reports about the California mental health prevention and early intervention program are available at http://www.rand.org/health/projects/calmhsa.html.

Other authors of the report are Rebecca L. Collins, Jennifer L. Cerully, Elizabeth Roth and Joyce Marks.

RAND Health is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.

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Warren Robak
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RAND Corporation

Funder
  California Mental Health Services Administration