Mentally Ill Youth Face Fear, Stigma From Adults

“Stigmatizing Attitudes and Beliefs About Treatment and Psychiatric Medications for Children With Mental Illness”

The goals of this study were to examine attitudes of two types of pediatric interventions—defined as “mental health treatment” and“ medication”—to treat mentally ill youth and to assess the impact of stigma on obtaining treatment and “willingness” to use psychotropic medications.

Investigators found that of a nationally representative target sample of 1,062 respondents (culled from the total 1,393 individuals surveyed), many perceived that children treated for mental illness are likely to be stigmatized. For example, 45 percent held the view that treatment for mental illness likely leads to rejection in school, and 43 percent believe that the stigma will follow a child into adulthood.

Most surveyed (68 percent) strongly agreed or somewhat agreed that psychiatric medications have a long-term, detrimental affect on a child's behavior; 52 percent believed such medications leave children with a f lat,“ zombie”-like affect; and 66 percent said that such medications simply delay the patient and the family from solving real, behavior-related problems.

The researchers concluded that the findings “revealed substantial stigma concerns, particularly surrounding medication options. These beliefs and attitudes cannot be easily inferred from adults' sociodemographic characteristics.”

“Perceived Dangerousness of Children With Mental Health Problems and Support for Coerced Treatment”

Using data from a target sample of 1,152 individuals (from the total 1,393 interviewed), investigators sought to discern respondents' opinions as to whether mentally ill children are prone to harm themselves or others and how amenable respondents are to accept or seek forced, coerced treatment (legally enforced, mental health intervention, even against a child's will), to help them obtain needed treatment.

Notable among the findings was that 33 percent of respondents perceived that a child with attention-deficit/hyperactivity disorder (ADHD) was somewhat likely or very likely to be dangerous to self, while 81 percent of respondents expressed the same thoughts about a child suffering from major depression.

In comparison, 15 percent of respondents expressed similar, dangerous-to-self thoughts related to the control vignette describing an asthmatic child, while 13 percent expressed similar, dangerous-to-self thoughts when weighing the second control vignette, which described a child who suffered from a condition vaguely described as “daily troubles.”

Although 35 percent viewed forced, legal coercion as a viable option to get treatment for a child with major depression, more than a third of those surveyed (42 percent) endorsed the same action as viable for a child suffering from asthma.

The researchers concluded that “large numbers of people in the United States link children's mental health problems, particularly depression, to a potential for violence and support legally mandated treatment.” This seems “to reflect the stigma associated with mental illness and the public's concern for parental responsibility.”

“Public Knowledge, Beliefs, and Treatment Preferences Concerning Attention-Deficit/Hyperactivity Disorder”

The target sample of 1,139 respondents surveyed (from 1,393 initially interviewed) received a battery of short tests to discern their knowledge and attitudes about ADHD. They were asked a series of ADHD-specific questions after responding to the vignette part of the survey.

Among the findings: Out of the 725 respondents who reported they had heard of ADHD (64 percent), 33 percent correctly described symptoms. Only 8 percent had knowledge of the primary medication (Ritalin) prescribed for ADHD, 5 percent viewed the cause of ADHD as being related to chemo-biological processes, and 16 percent knew someone who they believed had ADHD.

“Women and those with higher levels of [formal] education were more likely to have heard of ADHD; African Americans, members of other nonwhite racial and ethnic groups, and older respondents were less likely to have,” wrote the researchers.

Overall, 78 percent of people who had heard of ADHD viewed it as a“ real disease,” with most women, white people, and those with higher incomes concurring with that belief. And 65 percent supported counseling and medication as ways to treat it.

“The public is not well informed about ADHD,” the researchers concluded. Future media and educational efforts should make “a special effort to reach specific populations such as men, nonwhite minority groups, and older Americans.”

“Comparison of Public Attributions, Attitudes, and Stigma in Regard to Depression Among Children and Adults”

This study compared data from the 1996 and 2002 nationally representative General Social Survey modules on the public's attitudes about mental illness. Of those surveyed, a randomly selected subset of 193 responded to specific questions on a case-study vignette about an adult with major depression, while 312 responded to a case-study vignette of a child with major depression.

Investigators found that 83 percent of those who read the adult vignette viewed childhood depression as more serious than adult depression, while 53 percent of those who read the child vignette viewed childhood depression as more serious than adult depression. Many respondents (40 percent) believed that seriously depressed children have a higher risk for violence than adults who are depressed. And while those who found treatments of all types valuable,“ significantly fewer recommended talking to family and friends about a child's mental health problem.”

“Americans are more concerned about child depression than adult depression,” said the researchers, “and reveal more prejudice regarding perceptions of dangerousness. More respondents endorsed formal care versus informal care and advice. However, the heightened stigma surrounding childhood depression poses unique challenges for youth with depression and their families.”