Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Am J Public Health. 2013 May;103(5):781-5. doi: 10.2105/AJPH.2013.301224. Epub 2013 Mar 14.
Stigma against mental illness is a complex construct with affective, cognitive, and behavioral components. Beyond its symbolic value, federal law can only directly address one component of stigma: discrimination. This article reviews three landmark antidiscrimination laws that expanded protections over time for individuals with mental illness. Despite these legislative advances, protections are still not uniform for all subpopulations with mental illness. Furthermore, multiple components of stigma (e.g., prejudice) are beyond the reach of legislation, as demonstrated by the phenomenon of label avoidance; individuals may not seek protection from discrimination because of fear of the stigma that may ensue after disclosing their mental illness. To yield the greatest improvements, antidiscrimination laws must be coupled with antistigma programs that directly address other components of stigma.
对精神疾病的污名是一个具有情感、认知和行为成分的复杂结构。除了其象征价值外,联邦法律只能直接解决污名的一个组成部分:歧视。本文回顾了三项具有里程碑意义的反歧视法,这些法律随着时间的推移扩大了对精神疾病患者的保护。尽管取得了这些立法进展,但并非所有精神疾病亚群体都能得到一致的保护。此外,污名的多个组成部分(例如偏见)超出了立法的范围,正如标签回避现象所表明的那样;由于担心披露精神疾病后可能随之而来的污名,个人可能不会寻求免受歧视的保护。为了取得最大的改善,反歧视法律必须与直接解决污名其他组成部分的反污名计划相结合。