Mental illness stigma, secrecy and suicidal ideation

Oexle, Nathalie; Ajdacic-Gross, Vladeta; Kilian, Reinhold; Müller, Mario; Rodgers, Stephanie; Xu, Ziyan; Rössler, Wulf; Rüsch, Nicolas

doi:10.1017/s2045796015001018

Cited by 61 publications

(46 citation statements)

References 32 publications

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“…This is in line with previous observations that the sole awareness of stigma does not always lead to self-stigma, as perception alone is not necessarily self-relevant (Link et al 1989;Corrigan et al 2009). A recent investigation based on a different sample than the one included in the current study found perceived stigma to be associated with suicidal ideation only among persons labelled as mentally ill for whom stigma was self-relevant (Oexle et al 2016a). Although all included individuals in the current study identified themselves as having a mental illness, some participants might have judged perceived stigma as less self-relevant.…”

Section: Discussionsupporting

confidence: 92%

Mental illness stigma and suicidality: the role of public and individual stigma

Oexle

Waldmann

Staiger

et al. 2016

Epidemiol Psychiatr Sci

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In general, programmes addressing multiple stigma components seem to be most effective in improving suicide prevention. Besides interventions targeting negative attitudes and discriminating behaviours of the general public, programmes to support persons with mental illness in coping with perceived and experienced stigma could improve suicide prevention. Future studies should test the short- and long-term effects of such interventions on suicidality and further investigate the role of stigma coping (e.g. secrecy) and emotional consequences (e.g. hopelessness and loneliness) for the association between stigma components and suicidality.

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Section: Discussionsupporting

confidence: 92%

Mental illness stigma and suicidality: the role of public and individual stigma

Oexle

Waldmann

Staiger

et al. 2016

Epidemiol Psychiatr Sci

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“… 20 Second, those with mental disorders or symptoms may experience prejudice, discrimination, or stigma which can lead to downplaying of symptoms. 21 It may be that participants were, in an effort to prevent stigma, unwilling to report poor mental health ratings as compared to overall health ratings. Third, mental health symptoms, such as depression, could introduce non-response bias.…”

Section: Discussionmentioning

confidence: 99%

Older Adults Rate Their Mental Health Better than Their General Health

Magwene

Quiñones

Marshall

et al. 2017

Journal of Public Health Research

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Background.Self-rated health (SRH) shows strong associations with measures of health and well-being. Increasingly, studies have used self-rated mental health (SRMH) as a predictor of various outcomes, independently or together with SRH. Research has not firmly established if and how these two constructs differ. We sought to characterize the relationship between SRH and SRMH, and to determine how this relationship differed across subgroups defined by sociodemographic and health-related characteristics.Design and methods.We analyzed data from the 2012 CAHPS Medicare Advantage Survey. SRH and SRMH ratings were crosstabulated to determine the distribution of responses across response categories. The expected joint probability distribution was computed and compared to the observed distribution. A constructed variable indicated whether SRMH was better, the same, or worse than SRH. We analyzed the distribution of this variable across various subgroups defined by sociodemographic and health-related factors.Results.A total of 114,905 Medicare Advantage beneficiaries responded to both the SRH and SRMH questions. Both in general and within all subgroups, SRMH was usually rated as better than SRH, and rarely as worse.Conclusions.Within a large group of Medicare recipients, the overwhelming trend was for recipients to rate their mental health as at least as good as their overall health, regardless of any sociodemographic and health-related factors. This finding of a shifted distribution encourages caution in the analytic use of selfrated mental health, particularly the use of both SRH and SRMH for adjustment. Additional research is needed to help clarify the complex relationship between these variables.Significance for public healthSelf-rated health (SRH) has become established as a general measure of health status, but less is known about self-rated mental health (SRMH). Recent epidemiological studies have included self-rated mental health (SRMH) without scrutinizing its properties and in particular its relationship with SRH. In a large dataset of Medicare recipients, we found that self-rated mental health was consistently rated better than self-rated health, across all patient groups. None of the sociodemographic or health factors we examined accounted for this discrepancy. Self-rated mental health seemed to be more resistant to the effects of medical illnesses and functional impairments than was self-rated health. This points to a likely difference in how people formulate and differentiate between their mental and general health, with mental health being seen as more separate from other health factors. These findings encourage caution in the use of SRMH in analytic models, especially if included simultaneously with SRH.

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“…' We could hypothesize that a user activating this filter is preoccupied with how they are perceived, and is also considering death (whether their own or that of a loved one). This filter may indicate both a feeling of being observed, perhaps stigmatized, and an experience of suicidal ideation, as discussed by Oexle et al (2017).…”

Section: 'Leave None Out' Modelmentioning

confidence: 98%

“…Unfortunately, stigma surrounding poor mental health may prevent disclosure of suicidal ideation. For example, Oexle et al (2017) found that perceived stigma and the associated secrecy around mental illness were positively linked with feelings of hopelessness and suicidal ideation. McHugh et al (2019) found that the standard practice of clinicians asking people about suicidal thoughts fails in many cases, as 80% of patients who ultimately died of suicide reported no suicidal thoughts when prompted by their general practitioner.…”

Section: Introductionmentioning

confidence: 99%

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Allen¹,

Bagroy²,

Davis³

et al. 2019

Proceedings of the Sixth Workshop on Computational Linguistics and Clinical Psychology

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This work aims to infer mental health status from public text for early detection of suicide risk. It contributes to Shared Task A in the 2019 CLPsych workshop by predicting users' suicide risk given posts in the Reddit subforum r/SuicideWatch. We use a convolutional neural network architecture to incorporate LIWC information at the Reddit post level about topics discussed, first-person focus, emotional experience, grammatical choices, and thematic style. In sorting users into one of four risk categories, our best system's macro-averaged F1 score was 0.50 on the withheld test set. The work demonstrates the predictive power of the Linguistic Inquiry and Word Count dictionary, in conjunction with a convolutional network and holistic consideration of each post and user.

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Mental illness stigma, secrecy and suicidal ideation

Cited by 61 publications

References 32 publications

Mental illness stigma and suicidality: the role of public and individual stigma

Mental illness stigma and suicidality: the role of public and individual stigma

Older Adults Rate Their Mental Health Better than Their General Health

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