International Journal of Health Policy and Management

International Journal of Health Policy and Management

Political Ideology and Stigmatizing Attitudes Toward Depression: The Swedish Case

Document Type : Original Article

Authors
Jesper Löve 1
Monica Bertilsson 1
Johan Martinsson 2
Lena Wängnerud 2
Gunnel Hensing 1
1 Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
2 Department of Political Science, University of Gothenburg, Gothenburg, Sweden
10.15171/ijhpm.2019.15
Abstract
Background
Stigmatizing attitudes toward persons with mental disorders is a well-established and global phenomenon often leading to discrimination and social exclusion. Although previous research in the United States showed that conservative ideology has been related to stigmatizing attitudes toward mental disorders, there is reason to believe that this mechanism plays a different role in the context of a universal welfare state with a multi-party system such as Sweden. Furthermore, “mental disorders” may signify severe psychotic disorders, which may evoke more negative attitudes. This suggests the importance of specific studies focusing on the more common phenomenon of depression. This paper investigates the relationship between political ideology and stigmatizing attitudes toward depression in Sweden.
 
Methods
This study is part of the New Ways research program. Data were collected by the Laboratory of Opinion Research (LORE) at the University of Gothenburg in 2014 (N = 3246). Independent variables were political ideology and party affiliation. The dependent variable was the Depression Stigma Scale (DSS). Data were analyzed with linear regression analyses and analyses of variance.
 
Results
More conservative ideology (B = 0.68, standard error [SE] = 0.04, P < .001) and more conservative party affiliation (F(8 2920) = 38.45, P < .001) showed more stigmatizing attitudes toward depression. Item-level analyses revealed a difference where the supporters of the conservative party differed (P < .05) from supporters of the liberal party, with a higher proportion agreeing that “people could snap out of” depression if they wanted to; the populist right-wing party differed from the conservative party with a higher proportion agreeing on items displaying people with depression as “dangerous” and “unpredictable.” Even self-stigma was highest among the populist right-wing party with 22.3% agreeing that “if I had depression I wouldn’t tell….”
 
Conclusion
Political ideology was associated with stigmatizing attitudes toward depression in Sweden. The results also confirm the need to distinguish between different forms of conservatism by observing social distance as being a more important driver among voters for the populist right-wing party compared with personal agency and responsibility among voters for the more traditional conservative party.

Highlights

 

Watch the Video Summary here.

Keywords
Political Ideology
Depression
Stigmatizing Attitudes
Mental Health
Sweden
Subjects
  1. World Health Organization (WHO). Policies and practices for mental health in Europe: meeting the challenges. Geneva: WHO; 2008.
  2. Pescosolido BA, Martin JK, Lang A, Olafsdottir S. Rethinking theoretical approaches to stigma: a Framework Integrating Normative Influences on Stigma (FINIS). Soc Sci Med. 2008;67(3):431-440. doi:10.1016/j.socscimed.2008.03.018
  3. DeLuca JS, Yanos PT. Managing the terror of a dangerous world: Political attitudes as predictors of mental health stigma. Int J Soc Psychiatry. 2016;62(1):21-30. doi:10.1177/0020764015589131
  4. Thibodeau PH, Fein MJ, Goodbody ES, Flusberg SJ. The Depression Schema: How Labels, Features, and Causal Explanations Affect Lay Conceptions of Depression. Front Psychol. 2015;6:1728. doi:10.3389/fpsyg.2015.01728
  5. Link BG, Phelan JC. Conceptualizing Stigma. Annu Rev Sociol. 2001;27(1):363-385. doi:10.1146/annurev.soc.27.1.363
  6. Angermeyer MC, Schomerus G. State of the art of population-based attitude research on mental health: a systematic review. Epidemiol Psychiatr Sci. 2017;26(3):252-264. doi:10.1017/s2045796016000627
  7. Gagnon F, Bergeron P, Clavier C, Fafard P, Martin E, Blouin C. Why and How Political Science Can Contribute to Public Health? Proposals for Collaborative Research Avenues. Int J Health Policy Manag. 2017;6(9):495-499. doi:10.15171/ijhpm.2017.38
  8. Duckitt J, Bizumic B. Multidimensionality of right‐wing authoritarian attitudes: Authoritarianism‐conservatism‐traditionalism. Polit Psychol. 2013;34(6):841-862. doi:10.1111/pops.12022
  9. Feldman S, Johnston C. Understanding the determinants of political ideology: Implications of structural complexity. Polit Psychol. 2014;35(3):337-358. doi:10.1111/pops.12055
  10. DeLuca JS, Vaccaro J, Seda J, Yanos PT. Political attitudes as predictors of the multiple dimensions of mental health stigma. Int J Soc Psychiatry. 2018;64(5):459-469. doi:10.1177/0020764018776335
  11. World Health Organization (WHO). Depression and other common mental disorders: global health estimates. Geneva: WHO; 2017.
  12. Mattisson C, Bogren M, Nettelbladt P, Munk-Jorgensen P, Bhugra D. First incidence depression in the Lundby Study: a comparison of the two time periods 1947-1972 and 1972-1997. J Affect Disord. 2005;87(2-3):151-160. doi:10.1016/j.jad.2005.04.002
  13. Link BG, Phelan JC. Stigma and its public health implications. Lancet. 2006;367(9509):528-529. doi:10.1016/s0140-6736(06)68184-1
  14. Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med. 2012;42(8):1741-1752. doi:10.1017/s0033291711002558
  15. Clement S, Schauman O, Graham T, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11-27. doi:10.1017/s0033291714000129
  16. Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: An empirical assessment. Am Sociol Rev. 1989;54(3):400-423. doi:10.2307/2095613
  17. Butler JC. Personality and emotional correlates of right-wing authoritarianism. Soc Behav Pers. 2000;28(1):1-14. doi:10.2224/sbp.2000.28.1.1
  18. Xu X, Plaks JE, Peterson JB. From dispositions to goals to ideology: Toward a synthesis of personality and social psychological approaches to political orientation. Soc Personal Psychol Compass. 2016;10(5):267-280. doi:10.1111/spc3.12248
  19. Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K. Predictors of stigmatizing attitudes towards people with mental disorders in a general population in Finland. Nord J Psychiatry. 2011;65(2):125-132. doi:10.3109/08039488.2010.510206
  20. Oscarsson H, Holmberg S. Svenska Väljare. Wolters Kluwer; 2016.
  21. Oscarsson H, Solevid M. Sverige oroar sig. In: Bergstrom A, Johansson B, Oscarsson H, Oskarson M, eds. Fragment. Göteborgs Universitet: SOM-institutet; 2015:81-95.
  22. Griffiths KM, Christensen H, Jorm AF. Predictors of depression stigma. BMC Psychiatry. 2008;8:25. doi:10.1186/1471-244x-8-25
  23. Oscarsson H, Holmberg S. Issue voting structured by left–right ideology. In: Pierre J, ed. The Oxford Handbook Of Swedish Politics. Oxford: Oxford University Press; 2016:260-274.
  24. Newcombe RG, Altman DG. Proportions and their differences. In: Altman DG, Machin D, Bryant TN, Gardner MJ, eds. Statistics with confidence. London: BMJ Books; 2000:45-56.
  25. Olafsdottir S. Medicalizing mental health: a comparative view of the public, private, and professional construction of mental illness. Bloomington, IN: Indiana University; 2007.
  26. Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300-1307. doi:10.2105/ajph.2004.059402
  27. Larsen CA. The institutional logic of welfare attitudes: How welfare regimes influence public support. Comp Polit Stud. 2008;41(2):145-168. doi:10.1177/0010414006295234
  28. Schlenker BR, Chambers JR, Le BM. Conservatives are happier than liberals, but why? Political ideology, personality, and life satisfaction. J Res Pers. 2012;46(2):127-146. doi:10.1016/j.jrp.2011.12.009
  29. Bonanno GA, Jost JT. Conservative shift among high-exposure survivors of the September 11th terrorist attacks. Basic Appl Soc Psych. 2006;28(4):311-323. doi:10.1207/s15324834basp2804_4
  30. Kumlin S, Stadelmann-Steffen I. How welfare states shape the democratic public: Policy feedback, participation, voting, and attitudes. Cheltenham, UK: Edward Elgar Pub; 2014. doi:10.4337/9781782545491
  31. Angermeyer MC, Matschinger H, Link BG, Schomerus G. Public attitudes regarding individual and structural discrimination: two sides of the same coin? Soc Sci Med. 2014;103:60-66. doi:10.1016/j.socscimed.2013.11.014
  32. Barry CL, McGinty EE. Stigma and public support for parity and government spending on mental health: a 2013 national opinion survey. Psychiatr Serv. 2014;65(10):1265-1268. doi:10.1176/appi.ps.201300550
International Journal of Health Policy and Management
Volume 8, Issue 6
June 2019
Pages 365-374

  • Received Date 29 June 2018
  • Revised Date 28 February 2019
  • Accepted Date 02 March 2019
  • First Published Date 01 June 2019
  • Published Date 01 June 2019