The Conception Of Mental Illness In Chinese Public: Content, Structure And Measure

The high prevalence of mental illness within the scope of the world appears to be an important global public health problem. Lack knowledge of mental illness, misunderstanding and stigma to mental illness of the public, greatly hampered the patients seeking professional help, damaged to their living atmosphere and rehabilitation, even hindered the development of mental health services in the nation and social. Therefore, it has become an important research topic in the field of mental health services to do more research on public conceptions of mental illness and to reduce the stigma to mental illness and patients of the public.At present many researches on the public conception of mental illness are rooted in western cultural background. Firstly, research topics are scattered, not involving the structural relationship between the conception of mental illness and attitude toward patients. Secondly, views of public are inevitably influenced by social culture, which leads to the findings under the western culture characterized by individualism are possibly not fitted in Chinese culture characterized by collectivism. Based on the above two points, this study puts forward the assumption that public conception of mental illness is a hierarchy system composed of three components:knowledge, evaluation of mental illness, and the attitudes towards patients. Based on this assumption, six researches in this study were used to describe the contents of and the relationship among the three components, explore and validate the core dimensions of the conception of mental illness in Chinese public.In study 1, we used qualitative method to explore contents of the three components by research interview and open-ended questionnaire. A total of 183 participants above 18 years from different areas, professions and ages participated. Results showed, in the eyes of public:problems of psychological was different from physical illness which existed organic damage, and it could be self-healed; problems of mental and psychiatric are essentially different; the representation of mental illness were based on originally prototypes of psychosis; sometimes, mental illness was more terrible than physical illness due to the uncontrollable extremely abnormality; public attitudes towards patients coexisted negative social refuse and positive social accept.In study 2, we used questionnaire survey to explore dimensions of the three components by EFA and CFA. A total of 1375 participants from 27 provinces, with different professions, social status and ages, joined the research. The results indicated:(1)About the knowledge content, opinions of patients manifestations including seven dimensions:social vandalism, abnormal verbal expression, abnormal interpersonal relationship, abnormal appearance and expression, abnormal thoughts, abnormal feelings, and abnormal thinking characteristics; The causes of mental illness containing six dimensions:social climate and environment, frustration and life pressure, emotional factors, family environment, interpersonal relationship, brain and body defect; The consequences of mental illness containing seven dimensions:burden and affect to family, social isolation, self-injury, career and life setbacks, emotional pain, loss of life safety and meaning, harm the social security; The handle methods of mental illness including eight dimensions:help from friends and family, medical treatment, psychotherapy, social support, self-adjustment by activity, adjustment thought by self, adjustment emotion by self and social control. (2)The evaluation of mental illness included eight dimensions:bad on the overall, serious harm to social,behaviors’ unpredictable reasons hard to understand, difficult to treat, serious impact on individual, complex reasons and individually controllable reasons; (3)The public feeling to patients with mental illness included four dimensions:embarrassing and helpless, depressed and annoyed, sympathy and pity, tension and fear; behavior disposition towards patients included three dimensions:avoidance, discrimination, understanding and helping.In study 3, we examined relationship of the three components by regression analysis. Self-made Chinese public view of Mental Illness Questionnaire was used in a sample of 695 above 18 years from 27 provinces from the country. The mean age was 37.44 (SD= 13.86). We found that there were correlations in different degree among those dimensions of three components. Among contents of knowledge component, opinions on consequences and handle methods of mental illness affected evaluation component more than opinions on causes of mental illness. Bad on the overall evaluation to mental illness focused on impact on patients themselves, and social harmful evaluation focused to some extremely abnormal psychosis. Public opinions of negative effect of mental illness could predict negative attitude to patients, and understanding could predict positive attitude to patients.Based on the nine indexes of evaluation component obtained from study 2, in study 4, we used multidimensional scaling analysis method to explore the core dimensions of evaluation on mental illness. We showed 20 vignettes of different mental illness patients, participants should evaluate vignettes by the nine indexes according to understanding by themselves.156 participants from 18 provinces completed the investigation. The mean age was 35.14 (SD=12.78). The results showed that the core dimensions were consequences severity and causes-controllable by themselves, with severity including patient behaviors’unpredictable, serious harm to social, serious impact on individual, difficult to treat and bad on the whole.In study 5, we used the implicit association test and behavioral experiment to investigate the impact of core dimensions of evaluation on implicit attitude to mental illness and helping behavior to patients. A total of 195 adults participated the research, with mean age of 28.92(SD=11.67). Results showed that the worse evaluation on the disease, the more negative public implicit attitude to patients; the more controllable to illness causes, the more positive public attitude to patients; the more severity of impact on individual, the more negative attitude to patients. The overall bad evaluation to mental illness would improve the willingness of giving help to patients face-to-face, but reduce the time length of giving help. Public opinions of patients’ behaviors hard to predict would reduce their willingness of giving help to patients face-to-face.Based on the above five studies, the sixth study developed a simplified version of Chinese Public conception of Mental Illness Questionnaire in a sample of 2222 from all over the country to investigate Chinese public view of mental illness, and explore the knowledge contents component. Results showed that in the eye of Chinese public, the mental illness is weird,patient behaviors’ unpredictable, bad on the whole, causes complex, impact on individual severely, difficult to handle and harmful to social. The most prominent feeling to patients is sympathy and pity. There were also other feelings such as discrimination, understanding, and refusal. In the eye of public, mental illness was caused by several reasons, and the main consequences were pain to patient individual, burden to family, and fail in career and life. Psychological treatment was considered to be the most effective method, and medical treatment and social control as useless.Research conclusion:(1)The conceptions of mental illness in Chinese public composes three components:knowledge, evaluation of mental illness, and the attitudes towards patients. The knowledge content involve opinions of patients manifestations, the causes, consequences and handle methods of mental illness. The representations of mental illness were based on originally prototypes of psychosis, and the problems of psychological were distinguished from physical illness by public. The Chines public evaluate mental illness by eight indicate with bad on the overall, serious harm to social, serious impact on individual, behaviors’ unpredictable, reasons hard to understand, difficult to treat, complex reasons and individually controllable reasons. The evaluation of mental illness was negative. (2) There were correlations in different degree among those dimensions of three components. Opinions on consequences were the main basis for evaluation of mental disorder and attitudes toward the patient. (3)The core dimensions of conception of mental illness in Chinese public were consequences severity and causes-controllable by themselves, and the consequences severity was basis on evaluation of benefit damage on the patient and the society. There were correlations between the core dimension of conception and implicit attitude about mental illness, the help behavior toward patients affected by the core dimension of conception of mental illness.