Abstract: Counselling, Gossiping, or Silence – Interpersonal Communication about Mental Illnesses and its Role for Stigmatization

◆ Anna Freytag, Hanover University of Music, Drama, and Media
◆ Eva Baumann, Hanover University of Music, Drama, and Media
◆ Stefanie Hahm, University of Greifswald
◆ Matthias Angermeyer, University of Leipzig
◆ Georg Schomerus, University of Leipzig

Worldwide, every third person falls mentally ill during his or her life [1]. Although public attitudes towards the treatment of mental illnesses are improving, patients are still stigmatized in manifold ways [2]. Stigmatization, however, is an additional burden for those affected and their relatives, complicating as well as impeding early diagnosis and treatment [3].
When researching the stigmatization of people with mental disorders, exploring the role of interpersonal communication appears to be key: Interacting and communicating with people affected has not only been shown to be an effective anti-stigma-measure [4,5] and has successfully been used in anti-stigma-interventions [6], but feeling more or less comfortable in communicating with people with mental illnesses is also an important indicator for the attitude towards these patients [7]. As the role of interpersonal communication for mental health stigma is still understudied, we aim at a deeper understanding of the multi-faceted forms of interpersonal communication about mental illnesses and pose the explorative research question: How do people perceive and engage in interpersonal communication about mental illness?

We conducted 32 semi-structured face-to-face interviews in Germany. Respondents varied in gender, age (21-93 years), education, rural vs. urban residence, and mental health-related factors (healthy vs. directly vs. indirectly affected). The interview guide covered questions on perceptions of mental illness, with a special focus on communication. The interviews were transcribed verbatim and analyzed through a computer-assisted qualitative content analysis based on inductive and deductive coding strategies.

Our data provide comprehensive insights into communication patterns which can be described along the following dimensions:
(1) The social references of interpersonal communication are very broad. Respondents not only described their experiences in talking to mentally ill people, but elaborated also on conversations about single persons affected, about mentally ill people in general, about mental health in general, and about their mental health status. They further pointed to different social settings, in which conversations occur, e.g., at university, in clubs, in medical care institutions, and the private environment with friends and family. (2) The intensity of communication reached from strict restraint over a very selective communication behavior, to diverse and intense communication in manifold settings. (3) Regarding the content of the communication our respondents addressed multiple issues, e.g., specific problems from or with people affected, potential support measures, own experiences, politics or the public discourse. (4) Further, interpersonal conversations on mental illnesses appear to have different purposes: they fulfill both informational and emotional support needs, provide orientation and a sense of belonging, but can also be a subject of jokes, and thus be entertaining. (5) Finally, the interviews pointed to different communication styles, ranging from thoughtful to nasty.

Our data illustrate the very different facets of interpersonal communication about mental illnesses, in which stigma is formed, pronounced, spread, but also changed. We will reflect these findings regarding the driving forces of different types of communication, including the consequences for people affected and non-affected and on regard to shaping public opinion. Finally, we will discuss the implications of our study in light of stigma research and theory.