Abstract
Introduction: Consideration of cultural issues is gaining prominence in the arena of mental health, and yet discrepancies in the experiences of different ethnic groups in mental health services remain. Notably, persistently higher rates of schizophrenia diagnosis are found among the Afro-Caribbean population compared to the White European population in the UK. Some authors have considered whether stigmatising attitudes to mental illness are more prominent in the Afro-Caribbean community, leading individuals to avoid treatment-seeking and thus explaining the increased incidence of schizophrenia (Jarvis, 1998; Littlewood, 2001). Using Angel & Thoits’ (1987) theory of symptom interpretation, this study aimed to investigate recognition and evaluation of schizophrenia, with a focus on stigma and treatment-seeking. Method: Participants were 128 adult students from colleges predominantly from multicultural London boroughs. A questionnaire was constructed to assess stigma beliefs, evaluation of symptoms as mental illness and help-seeking beliefs, in response to symptom vignettes. The questionnaire was developed on the basis of vignettes previously used to assess mental illness beliefs (Pote & Orrell, 2002) and items from Link’s (1987) stigma scale. Participants were divided into Afro-Caribbean (n = 76) and White-European (n = 50) groups. Results & Discussion: Analyses showed that the Afro-Caribbean participants indicated less stigmatising beliefs towards both the symptoms and diagnostic label of schizophrenia compared to the White-European participants. Further, White European participants were more likely to label vignettes as implying ‘mental illness’ and also more likely to recommend professional health treatment compared to Afro Caribbean participants. Thus this study’s results are inconsistent with the hypothesis that Afro-Caribbean people stigmatise schizophrenia more than White-European people. In line with Angel & Thoits’ model, the two groups have different ways of understanding schizophrenia symptoms. Whilst White-European participants’ beliefs appeared relatively consistent with a Western model of mental illness, Afro Caribbean participants had alternative beliefs. The influence of racial discrimination, mental illness knowledge and societal structures on such understandings are discussed.