Public Attitudes, Lay Theories and Mental Health Literacy: The Understanding of Mental Health

There is a large body of research into public conceptions of mental illnesses and disorders going back over 50 years (Star, 1955). This chapter seeks to review the complex literature on this topic scattered over a wide range of disciplines including anthropology, psychology, psychiatry and sociology. The aim is to provide the researcher in social psychiatry and allied disciplines the opportunity to have a comprehensive and critical review. Over the years there are three slightly different but overlapping research traditions with regard to this topic: public attitudes, lay theories and mental health literacy. The first concerns studies of attitudes towards people with mental disorders (Nunnally, 1961), that is, beliefs about what people with mental illness are like and also, how they should be treated. These studies may be about specific mental disorders, such as schizophrenia (Siegler & Osmond, 1966) and depression (Rippere, 1977, 1979) or more generally about mental illnesses. These are nearly always large survey based studies typical of market research or attitudinal studies. These studies are important as they can offer an explanation for negative and stigmatising attitudes towards mental disorder (e.g. Nunnally, 1961; Link, Phelan, Bresnahan, Stueve, & Pescosolido, 1999), and why so few of those diagnosed, seek help (Lin, Goering, Offord, Campbell & Boyle, 1996; Andrews, Hall, Teesson & Henderson, 1999). Secondly, studies relating to lay theories of mental illness have been conducted primarily by Furnham and colleagues (i.e. Furnham & Lowick, 1984; Furnham & Manning, 1997; Furnham & Haraldsen, 1998), focusing specifically on the nature, causes, and treatments of disorders, such as heroin addiction (Furnham & Thompson, 1996), and schizophrenia (Furnham & Rees, 1988). These studies are concerned with the structure of beliefs about aetiology and cure and the relationship between them. They originate in social attribution theory in psychology and are concerned with the extent to which lay people endorse biological, psychological or sociological theories for the causes of various illnesses. They are also concerned with the extent to which there is a clear logical correlation between perceived cause and recommended cure for specific individual illnesses. The third approach is the term ‘mental health literacy’ introduced by Jorm and colleagues (Jorm, Korten, Jacomb, Christensen, Rodgers, et al., 1997b) to refer to public knowledge and more specifically recognition of mental disorders. This encompasses theories of mental