Mental Illness Stigma in Criminal Justice: An Examination of Stigma on Juror Decision-Making
IN THIS ARTICLE
Negative stereotypes associated with mental illnesses can lead to discrimination towards those with these illnesses through a process of stigmatization (Link & Phelan, 2001). This current study explored the stigmatization of offenders with mental illnesses through a mock-juror scenario. The influence of the media on this stigma was also examined. Undergraduate students (N = 266) were randomly assigned to one of three depictions of mental illnesses within the media (positive, negative, control) and one of three mental illness conditions for a defendant in a trial (schizophrenia, depression, no mental illness). After viewing media depictions of mental illness and reading a trial transcript, participants provided a verdict for the defendant and completed two scales (i.e., social distance, perceived dangerousness) to assess stigmatizing attitudes. The results suggest a potential role of perceptions of causal attribution and controllability of mental illnesses in forming verdict decisions. Such perceptions may relate to beliefs in criminal culpability. These findings have implications for anti-stigma education programs and reducing structural discrimination within the judicial system. Future research should explore areas such as applications of anti-stigma programs within this context.
Mental illness has increasingly become a focus of discussion within many spheres of life such as classrooms, workplaces, and the media. This is not surprising considering that worldwide lifetime prevalence rates for developing a mental illness range between 18.1-36.1% (Kessler et al., 2008). However, although attention to mental health issues is increasing (Bell Canada, 2015), mental illnesses are still often referred to negatively and lead to discrimination (e.g., Dewa, 2014). This may be due to the negative stereotypes associated with mental illnesses that shape what is referred to as stigma (Link & Phelan, 2001). According to Link and Phelan, such stigma encompasses several components: the use of a label, stereotypes, a separation of “us” and “them” groups, status loss and discrimination. Within the process of stigmatization, an individual or group with power recognizes traits in other individuals that are deemed to “matter socially” and subsequently assigns a label to those individuals, connecting them to certain stereotypes which form a rationale for justifying negative treatment (Link & Phelan, 2001, p. 367).
While research on the topics of mental illnesses and its stigma is growing, research targeting the experiences of specific groups, such as criminal offenders, is modest at best (Mossiere & Maeder, 2015). However, the need for such research is mounting due to the rising number of individuals with mental illnesses within the criminal justice system (Steadman, Osher, Robbins, Case, & Samuels, 2009). To address this gap, the primary objective of this study was to investigate the stigmatization of criminal offenders with mental illnesses within the context of a mock-juror scenario. In addition, this study explored the influence of the media on the formation of this stigma. Research has shown that the media greatly influences attitudes towards topics such as body image (e.g., Loeber et al., 2016), substance use (e.g., Chang et al., 2016), and mental health (e.g., Aguinia et al., 2016). Therefore, the potential influence of the media on attitudes of potential jurors was included in this study as well.
The Stigma of Mental Illnesses
Although many human differences are stigmatized according to the process described by Link and Phelan (2001), the current study focused on mental illness stigma specifically. Stereotypes that contribute to mental illness stigma include beliefs that those with mental illnesses are at fault for their illness, are unproductive or unpredictable, or are unable to recover (Angermeyer & Dietrich, 2006; Corrigan, Thompson, Lambert, Noel, & Campbell, 2003). One of the most prevailing stereotypes is the belief that those with mental illnesses (especially schizophrenia) are violent and dangerous (Pescosolido et al., 2010; Reavley & Jorm, 2011; Reavley, Jorm, & Morgan, 2016, Wood, Birtel, Alsawy, Pyle & Morrison, 2014). Although the co-occurrence of mental illness and substance use can lead to elevated incidences of violent behaviour, without substance use these incidences reflect rates within the public (Elbogen & Johnson, 2009; Fazel, Langstrom, Hjern, Grann & Lichtenstein, 2009; Canadian Mental Health Association, 2011).
Consequently, this process of stigmatization most commonly leads to discrimination which can take many forms (Link & Phelan, 2001). For example, through avoidance from neighbors and family members, feeling disrespected by healthcare professionals or reduced treatment adherence leading to adverse effects for recovery (Corrigan, Watson, & Barr, 2006; Corrigan, Druss, & Perlick, 2014; Knaak, Mantler, & Szeto, 2017; Ye et al., 2016). In addition, structural discrimination can occur and can be seen, for example, when resources and funding directed to research or caring for those with a stigmatized mental illness are scarce (Link & Phelan, 2001). In this example, an individual with a mental illness is not directly discriminated against but is a recipient of discrimination through existing societal structures.
Mental Illness and the Criminal Justice System
For years, mental illnesses have been overrepresented within the criminal justice system (CJS) compared to general population statistics (Steadman et al., 2009; Teplin, Abram & McClelland, 1996). In the United States, (a country with one of the largest prison populations), half of those incarcerated have a mental illness (James & Glaze, 2006; American Psychological Association, 2014). Research has found that the prevalence of schizophrenia in male and female inmates sits between 2% and 6.5% (Prins, 2014). For depression, the prevalence is as high as 10.2% for male inmates and 14.1% for female inmates (Fazel & Seewald, 2012). This compares to rates of 6.7% for depression and less than 1% for schizophrenia in the general population (Kessler, Chiu, Demler, & Walters, 2005; McGrath, Saha, Chant & Welham, 2008). Several reasons have been proposed to explain this overrepresentation, including the deinstitutionalization of psychiatric hospitals, a lack of mental health services within the community coupled with difficulty accessing treatment services, and mental illness stigma (Kuhlman, 1994; McVey, 2001; Simpson, McMaster & Cohen, 2013; Torrey, 1995). Therefore, although public perceptions may interpret this overrepresentation as an indication that these individuals may be more violent or dangerous, in reality there are multiple pathways that lead an individual with a mental illness to the CJS.
Irrespective of these reasons, imprisonment of offenders with mental illnesses has several adverse consequences. One consequence is a lack of access to treatment programs due to budget cuts and limited support from the public for such services (Ditton, 1999; Metzner & Fellner, 2010). When the needs of offenders with mental illnesses are not met, these individuals are more likely to exhibit behavioural problems leading to disciplinary action (Lamberti & Weisman, 2004; Metzner & Fellner, 2010). In addition, offenders with mental illnesses are at an increased risk for suicide and victimization (Fazel, Hayes, Bartellas, Clerici, & Trestman, 2016; Metzner & Fellner, 2010; Rivlin, Hawton, Marano & Fazel, 2010). This overrepresentation also has financial consequences. For example, mental health service costs within the CJS in one Canadian province was an estimated $160 million (13.5% of total costs) in 2013 (Jacobs et al., 2016).
Previous research has examined the interaction between stigma and offenders with a mental illness. When mental health training is directed towards those tasked with caring for offenders (e.g., police officers, attorneys), stigmatization is reduced. For example, police officers have more positive attitudes towards those with mental illnesses, are more supportive of mental illness treatment programs, and desire less social distance from individuals with mental illnesses (Compton, Esterberg, McGee, Kotwicki, & Oliva, 2006). Unfortunately, mental health training for these individuals is often very limited (Frierson, Boyd, & Harper, 2015). Within courtrooms, research has found that words such as “insane” and “lunatic” are still in use and that judges often describe offenders with mental illnesses based solely on their mental illness (e.g., schizophrenic) (Sisti, Caplan, & Rimon-Greenspan, 2013, p. 276). Although research on juries has examined various prejudices (e.g., race, age, and gender) towards a defendant (Breheney, Groscup, & Galietta, 2007; Pica, Pettalia, & Pozzulo, 2017; Pozzulo, Dempsey, Maeder, & Allen, 2010) a gap exists in current literature regarding how mental illnesses may be stigmatized in the context of a jury trial (Mossiere & Maeder, 2016).
Recently, research has begun to address this gap. Mossiere and Maeder (2015, 2016) conducted two studies examining the influence of a defendants’ mental illness on jury verdicts. Mossiere and Maeder (2015) examined how juror verdicts varied depending on the mental illness of a defendant. Participants were asked to indicate their attitude towards mental illnesses, read a trial transcript and then provide a verdict for a defendant with one of four mental illnesses or no mental illness at all. The results of this research did not indicate that participants’ attitudes or the mental illness of the defendant influenced verdict decisions. In the subsequent similar study, Mossier and Maeder (2016) again examined four mental illnesses but incorporated the use of a not criminally responsible on account of a mental disorder defense (NCRMD). This defense is used in instances in which an individual cannot understand the circumstances or gravity of the act they have committed and/or did not know it was wrong due to a mental illness (Mossiere & Maeder, 2016). Using similar methods, Mossier and Maeder (2016) found that participants were more likely to provide a guilty verdict to a defendant with substance abuse disorder and a verdict of NCRMD to the other three mental illnesses (schizophrenia, bipolar and depression). Due to the overrepresentation of individuals with mental illnesses in the criminal justice system and the potential for stigmatization of these individuals, more research of this nature is essential for fully understanding the role of mental illness stigma within the judicial process. The current study attempted to address this need by expanding on and replicating aspects of both studies previously conducted by Mossiere and Maeder.
Stigma and the Media
The media has a strong role in reflecting and shaping perspectives towards varying issues (Klin & Lemish, 2008). Mirroring the stereotypes previously mentioned, those with a mental illness are frequently represented in the media as violent and something to be feared (Aguinia, Madden, & Zellmann, 2016; Owen, 2012). For example, research suggests that stories in the news regarding mental illnesses tend to focus on an association with dangerousness and criminality (Coverdale, Nairn & Claasen, 2001). Research has also found that witnessing negative depictions of mental illness within the media over time can have consequences such as being more likely to believe that these depictions are accurate and endorse these stereotypes as suitable and desiring greater social distance from those with mental illnesses (Aguinia et al., 2016). Previous research has also found that even brief media exposure can influence individual participants attitudes and beliefs towards many other topics. For example, Burris, Brownlow and Linds (2016) found that participants perspectives on body image and fitness-related behaviors changed after reading about varying opinions regarding fitness in articles. Another study found that brief exposure to violence through video games increased hostile biases (Bushman & Anderson, 2002). Participants in this study played a violent or non-violent video game for 20 minutes and were then asked to read a story and state what the character in the story would do next. They found that exposure to violent video games resulted in participants expecting that situations with conflict would be dealt with aggressively by the character. Therefore, both short and long-term exposure to issues in the media can have a role in shaping attitudes towards varying issues.
The Current Study
The first research question addressed the influence of the mental illness of a defendant on juror decision-making and attitudes towards mental illness. Similar to Mossiere and Maeder’s first study, schizophrenia, depression and a control condition (i.e., no mental illness) were compared. However, a NCRMD defense was not included to reduce any confounding biases that are often associated with this defense (e.g., Skeem & Golding, 2001; Skeem, Louden, & Evans, 2004). Schizophrenia was examined in this study due to public perceptions that associate schizophrenia with violence (Angermeyer & Dietrich, 2006; Pescosolido, Monahan, Link, Steve, & Kikvzawa, 1999; Wood et al., 2014). Based on this association, it was predicted that participants would chose more guilty verdicts with greater confidence and be more stigmatizing towards a defendant with schizophrenia compared to depression or no mental illness. Conversely, depression was examined because it is not commonly associated with violent stereotypes in existing literature. Secondly, the effects of the media on participant’s attitudes towards mental illnesses and verdict decisions were explored. This area is important to examine as jurors are not blank slates and thus bring their own individual biases (informed by sources such as media) into courtrooms (e.g., Pica, Pettalia, & Pozzulo, 2017). Based on previous research (e.g., Aguinia et al., 2016), it was expected that those who viewed the negative mental illness portrayal would provide more guilty verdicts with greater confidence and be more stigmatizing then those who viewed positive or neutral depictions. Regarding both research questions, greater stigmatization would be indicated by higher scores on a social distance measure and a perceived dangerousness scale. Finally, this research examined the combined effect of the mental illness of a defendant and exposure to mental illnesses within the media on juror-decision making and stigmatizing attitudes. A significant interaction between the media and mental illness conditions on verdict and both stigma scale measures was predicted. Specifically, the greatest number of guilty verdicts (provided with greatest confidence) and most stigmatizing attitudes would be seen in conditions with both negative media depictions of mental illness and defendants with schizophrenia.
Participants were undergraduate students who were recruited using an online Research Participation System. These students were given 1% bonus course credit for their involvement. The responses from those who did not want their data kept, in addition to any response sets with missing data, were not included in the final sample (n = 248). Participants were predominantly female 84.2% (n = 224), Caucasian (53.6%, n = 134), with a mean age of 20.80 (SD = 3.70). The current study received ethics approval from the Conjoint Faculties Research Ethics Board (REB 16-1279).
Materials and Procedure
Video Clips. Participants watched five different video clips. Four clips were the same across all conditions and included a scene from the film Finding Dory (Collins & Stanton, 2016), scenes from the television shows The Big Bang Theory (Lorre & Cendrowski, 2008) and New Girl (Meriwether & Woliner, 2012), and an Old Spice (Old Spice, 2010) commercial. These clips were included for the purpose of concealing the true focus of the study, so participants were not aware that the study was examining mental illness. The fifth video clip, which represented the manipulated media condition, presented news broadcasts of differing content. In the positive media condition, an optimistic story of a woman with depression was presented (Goh, 2016). The negative media condition depicted a story of an individual with schizophrenia who had committed a violent crime (Romaniuk, 2014). In the control media condition, a weather story was shown (Nagai, 2015).
Media Questionnaire and Memory Test. The media questionnaire asked questions pertaining to participants’ engagement in various forms of media. A series of questions were also asked to test the participant’s memory on content from the video clips. The questionnaire and memory test were included to enhance the cover story that participants were told. The results of these measures were not examined or included in subsequent data analysis.
Trial Transcript. This transcript detailed a fictional homicide court case and was adapted from previous research (Webber, 2012). Evidence was presented by both the prosecution and defence, including cross-examinations of witnesses and a discussion of forensic evidence retrieved from the scene. At the beginning of each transcript it was stated that the accused had a history of either depression, schizophrenia, or no mental illness at all. Symptoms according to DSM-V (American Psychiatric Association, 2013) criteria for the respective mental illnesses was included to ensure saliency of the illness.
Juror Response Form. The juror response form in this study was adapted from previous research (Mossiere & Maeder, 2015). This form asked participants to provide a verdict (guilty or not guilty), sentence type (imprisonment or alternative punishment), sentence length (“no sentence” to “a life sentence”), a confidence rating (“not confident” to “very confident”) and an explanation for their sentencing decisions. Sentence length and confidence rating were indicated on a 5-point Likert scale. The dichotomous verdict and confidence rating variables were later combined into one single continuous variable. This variable was created by recoding a verdict choice of guilty into “+1” and not guilty into “–1,” and then multiplying these values by the continuous confidence rating variable ranging from not at all (1) to a great deal (5). The resulting variable, verdict decisions, ranged from -5 which indicated that the participant was very confident that the defendant was not guilty, to +5 which suggested that the participant was very confident that the defendant was guilty. However, as no zero value was included in the confidence rating scale, the verdict decisions variable did not have an absolute zero point. In addition to the juror response form, participants who provided a guilty verdict were asked follow-up questions regarding their belief that the defendant was a danger to the public, committed the act on his own free will, and would re-offend in the future. Participants were also given the option to provide an alternative punishment for the defendant.
Stigma Scales. Two scales that have been used in previous research were included in this study to assess participants’ stigma towards individuals with mental illnesses. The social distance scale assessed participants’ desired distance between themselves and the defendant in the trial (Link, Cullen, Frank, & Wozniak, 1987). This scale included seven items which were responded to on a 4-point Likert scale (1 = definitely willing to 4 = definitely unwilling). This scale had strong internal consistency with a Cronbach’s alpha of .93 in the current study. The second scale was an assessment of the participants’ perceived dangerousness of the individual within the trial transcript (Link, Cullen, Frank, & Wozniak, 1987). This scale included eight items which were responded to on a 7-point Likert scale (1 = strongly agree to 7 = strongly disagree). This scale also had good internal consistency (α = .85) in the present study. Higher scores on both scales indicated more stigmatizing attitudes towards the defendant in the trial.
Mental Health Experiences and Demographic Questions. Participants were asked questions pertaining to their experiences with mental health, including instances in which the participant had encountered an individual with a mental illness or experienced a mental illness personally. For each item, a value of zero was assigned if participants responded “no” and a value of one was assigned if participants responded with “yes.” Total scores for each participant were then summed out of five points, with higher scores indicating more experiences with mental health. This measure was adapted from the 2010 Canadian Community Health Survey (mental health experiences sub-block) (Statistics Canada, 2010). Participants also responded to a variety of demographic questions. These included questions pertaining to their ethnicity, age, gender, marital status, birthplace, and first and most fluent language. Finally, participants were asked whether they had previously taken any university courses regarding mental illness.
Manipulation Checks and Funnel Debrief. Manipulation checks were presented after the first and second sections of the study to assess the attention participants gave to the video clips and trial transcript. Due to the use of a cover story in this study, participants were asked three debrief questions to determine whether they had discovered what the study was truly examining (e.g., “What do you think the purpose of these studies was?”)
The current study was completed online using the Qualtrics platform (Qualtrics, 2017). To reduce socially desirable responding, participants were told that they would be participating in two independent studies, the first examining the effects of media on memory and the second examining juror decision-making. Participants began by first providing consent and then completing the media questionnaire. They were then randomly assigned to one of the three media conditions (i.e., positive, negative or neutral depictions of mental illnesses) in which they watched the video clips. The first manipulation check was introduced at this point. After viewing these videos, participants answered the memory test questions and were then randomly assigned to one of the three trial transcript conditions (a defendant with schizophrenia, depression or no mental illness). After reading the trial transcript they completed the juror response form and responded to the stigma scales. Finally, participants answered demographic, mental health experiences, and funnel debriefing questions. The second manipulation check was presented after the demographic questions. Following these questions participants were debriefed.
Correlations were conducted between the dependent measures, and between these measures and participants’ mental illness experiences to determine whether mental illness experiences were a possible covariate (see Table 1). As expected, the social distance scale was significantly positively correlated with the perceived dangerousness scale and the verdict decisions measure, p ≤ .001. The perceived dangerousness scale was also significantly positively correlated with the verdict decisions measure, p ≤ .001. Mental illness experience was significantly negatively correlated with the perceived dangerousness scale, p ≤ .001. This means that the more experience an individual had with mental illnesses, the less stigmatizing they were to individuals with mental illnesses regarding their belief that the individual is dangerous. Therefore, mental illness experience was controlled for in subsequent analysis using the perceived dangerousness scale as a dependent variable.
Stigma Scales. To examine the effect of media and mental illness type on a social distance scale, a 3 (mental illness type: schizophrenia, depression, control) x 3 (video condition: positive, negative, control) between-subject factorial analysis of variance (ANOVA) was conducted on the social distance scale. No significant effects were found for mental illness, F(2, 238) = 2.65, p = .07, or for media, F(2, 238) = .73, p = .48. In addition, no significant interaction was found between the mental illness and media conditions on social distance, F(4, 238) = 2.01, p = .09. A similar analysis was conducted for the perceived dangerousness scale with mental illness experiences as a covariate. This resulted in a 3 (mental illness type: schizophrenia, depression, control) x 3 (video condition: positive, negative, control) between-subject factorial analysis of covariance (ANCOVA). This analysis however, returned no significant main effects for mental illness, F(2, 236) = .56, p = .57, or for video condition, F(2, 236) = 1.63, p = .20. In addition, no significant interaction was found between the mental illness type and video condition, F(4, 236) = 1.11, p = .35.
Verdict Decisions. A 3 (mental illness type: schizophrenia, depression, control) x 3 (video condition: positive, negative, control) ANOVA was also conducted to examine the effect of media and defendant mental illness on participants’ verdict decisions. A significant main effect was found for mental illness type, F(2, 239) = 3.20, p = .04, ηp2= .03. Contrary to what was predicted, a Bonferroni post-hoc analysis revealed that those in the schizophrenia condition (M = -2.54, SE = .36) provided significantly more not guilty verdicts and were more confident in these verdicts than those in the depression condition (M = -1.39, SE = .35), p = .03. No other significant post-hocs were found across mental illness conditions. There was no statistically significant main effect of media on verdict decisions, F(2, 239) = .94, p = .39. However, the main effect of mental illness was subsumed by a significant interaction between the mental illness and media conditions on verdict decisions, F(4, 239) = 2.41, p = .05, ηp2= .04. The Bonferroni post-hoc analysis revealed that scores were significantly different between schizophrenia (M = -2.97, SE = .54) and depression (M = -.03, SE = .57) within the video control condition, p = .001. This significant interaction was unexpected as it suggests that participants provided more not guilty verdicts with greater confidence for schizophrenia compared to depression in the control media condition.
Participants were asked additional questions regarding their sentencing decisions that were not included in the primary analysis but still offer interesting information. A minority of participants (23.7%) believed the defendant was guilty and were moderately punitive in their sentencing decisions as represented by their decisions regarding sentence type (76.7% (n = 46) indicated that the defendant should be imprisoned) and length (40% (n = 24) stated a sentence of 10-15 years). Out of those participants who found the defendant guilty, 40% of participants believed that the defendant was likely to commit a criminal offence in the future, 53.3% indicated that they thought the defendant was a danger to the general public, and 85% believed that the defendant committed the offence by his own free will. Finally, out of those participants who believed that the defendant should receive an alternate form of punishment, 41.7% suggested some form of therapy, counselling or use of a mental hospital would be better suited in this case.
This current study concentrated on the stigmatization of mental illnesses within the context of a mock-juror trial while also examining the influence of media on that stigma. The following will explore the results revealed through this study and provide possible explanations for these findings. Interestingly, such findings were contrary to what was initially predicted based on existing research. Namely, participants were less inclined to find a defendant with schizophrenia guilty and therefore may have been basing their verdict decisions off factors other than perceptions of dangerousness. In addition, the implications of these findings will be discussed.
Mental Illness and Perceptions of a Defendant
It was hypothesized that a defendant with schizophrenia would be stigmatized the most and that such stigma would be expressed through more guilty verdicts provided with greater confidence, as well as greater stigma scale scores. However, the results of this study did not reveal a significant main effect for defendant mental illness on either stigma scale. Similar results were found in Mossiere and Maeder (2015) where they attributed such findings to a lack of saliency of the defendants mental illness or to the fact that their measure of attitudes did not specify which mental illness to refer to when responding. In this current study, measures were taken to reduce the likelihood of this occurring, however, the nonsignificant results may still have occurred if participants neglected specific details about the defendant (such as his mental illness) due to the length of time or number of additional stimuli they were exposed to between reading the transcript and answering subsequent questions on the stigma scales. Alternatively, it is possible that these results were seen because the sample used in this study was not as stigmatizing as the general population. For example, less stigmatizing attitudes have been found in those who are female, young, Caucasian, and educated (Chandra & Minkovitz, 2006; Cook & Wang, 2010; Link, Yang, Phelan, & Collins, 2004; Rao, Feinglass, & Corrigan, 2007).
A significant main effect was found for mental illnesses on verdict decisions. This effect, however, was not as predicted based upon previous mental illness stigma research (e.g., Wood et al., 2014). Instead, participants provided more not guilty verdicts and were more confident in these verdicts when the defendant had schizophrenia compared to the depression and control conditions. One explanation for this finding relates to the association between culpability for a criminal act and behaving in accordance with one’s free will. This explanation will be discussed further regarding the influence of media and mental illness on perceptions of a defendant, as similar findings were also revealed in this case.
The Role of Media in Shaping Perceptions of a Defendant
Although it was predicted that participants exposed to the negative media depiction would provide more guilty verdicts and exhibit more stigmatizing attitudes compared to other conditions, no significant main effect for media was found on any of these measures.As previous research has found that a significant effect of media may depend on the dose of the stimulus applied (Arendt, 2015), this finding may have occurred becausethe manipulated media clips were 32 to 149 seconds in length and therefore may not have been presented in a high enough dose. Alternatively, the expected effect of media may not have occurred due to the length of time elapsed or the additional stimuli (e.g., the trial transcript) introduced between exposure to the media stimulus and participant responding on subsequent variables. Additional research is needed to capture how the media influences stigma against mental illnesses.
The Combined Effect of Media and Mental Illness on Perceptions of a Defendant
Finally, it was predicted that the participants in both the negative media and schizophrenia mental illness conditions would provide the greatest number of guilty verdicts with the most confidence and have the most negative attitudes. The results returned no significant interaction between media and mental illnesses on either one of the stigma scales. However, a significant interaction was found between media and mental illnesses on verdict decisions. Additional Bonferroni post-hoc analysis revealed that when participants watched the control video depiction, there were significantly more not guilty verdicts provided with greater confidence when the defendant had schizophrenia compared to depression. In this case, the control video presumably had little effect on verdict decisions, meaning the defendants’ mental illness primarily influenced these results.
As alluded to previously, one possible explanation for this effect relates to beliefs in criminal culpability for a crime committed. Within the legal domain the concept of criminal culpability suggests that responsibility for a crime requires that an individual possesses a degree of rationality when committing criminal behaviors that allows him or her to act in accordance with his or her personal free will and understand the consequences of his or her actions (Morse, 2007). The application of this principle to mental illness is known as the NCRMD defense, which was mentioned previously. Research has explored the relationship between free will and mental illnesses by examining public perceptions about the causes of and control one has over various mental illnesses. As mentioned previously, Mossiere and Maeder (2016) found that participants were more likely to find a defendant with substance use disorder guilty compared to a defendant with depression, schizophrenia or bipolar disorder. They concluded that when participants believed a defendant has control over his behaviour (substances use disorder) he was guilty, whereas with less control (depression, schizophrenia, bipolar disorder) defendants were found NCRMD.
Such findings reflect what is referred to as Attribution Theory (Weiner, 1980), which has been used to provide a framework within which to understand the process of stigmatization. This theory suggests that atypical behaviors viewed as controllable are more likely to be regarded negatively and stigmatized than uncontrollable behaviours (Boysen & Vogel, 2008). Because of this, those who atypical exhibit behaviors caused by biological (i.e., uncontrollable) factors are seen more positively (Weiner, Perry, & Magnusson, 1988). Research suggests that public perceptions regarding attributional causes of mental illnesses tend to equate chemical or biological factors to schizophrenia and social factors (e.g., stress) to depression (Martin, Pescosolido, & Tuch, 2000). As a result, significantly less patient blame is often placed on schizophrenia compared to depression (Kvaale, Gottdiener & Haslam, 2013; Wood et al., 2014).
Thus, previous research has confirmed that beliefs related to the cause and controllability of a mental disorder have an influence on the attributions made regarding the individuals’ responsibility for their behavior. When applied to this current study, such research supports the notion that participants may have been less inclined to find a defendant with schizophrenia guilty out of the belief that he had less control over his mental illness and thus less responsibility for his alleged behaviour. Therefore, less blame and more confidence in a not guilty verdict was provided for a defendant with schizophrenia (compared to the defendant with depression). Previous research which reflects these results has found that when participants are informed that an individual with schizophrenia developed their mental illness due to uncontrollable causes, they are less likely to endorse punishing or segregating the individual away from society (Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003). Thus, both attributional theory and perceptions regarding criminal responsibility provide a preliminary framework within which to understand the findings within this present study.
It is imperative to know which defendant characteristics are salient to jurors and could influence the way evidence is perceived and verdicts are chosen. Therefore, the findings in this study are practically important to the judicial process as they suggest that mental illnesses do matter to juror-decision making. These findings suggest that jurors may factor beliefs of attributional causation and controllability into the decision-making process. Therefore, while this may lead to perceptions of individuals with certain mental illnesses (i.e., schizophrenia) that are more accurate, it may also suggest that there is an inflated public perception that individuals with mental illnesses such as depression or substance abuse have greater control over their actions then they may have. This notion is reflected in findings from Mossiere and Maeder (2016) that suggest that participants perceive a defendant with substance abuse as being more capable of reasoning logically, acting rational, and having control over his or her behavior. In addition, these findings have implications regarding possible shifting public perceptions of schizophrenia, as they are contrary to previous research that suggests that schizophrenia is most strongly associated with perceptions of violence and dangerousness. Understanding how the public views individuals with schizophrenia has an influence on future research or anti-stigma interventions that focus on perceptions of schizophrenia.
One context in which these interventions could be implemented is within the juror selection process. Measures have been put into place to reduce biases that may exist within juries. In the United States, this process is referred to as a void dire and involves a consideration of attitudes and beliefs that are relevant to the defendant and could subsequently muddle juror decision-making (Mahoney, 1982; Marder, 2015). However, problems with this process, such as an inability to accurately detect biases or discriminating attitudes, still exist and reduce the success of this process. Therefore, education programs implemented in the early stages of juror selection could be used to target potential jurors and focus on topics such as causal attributions, controllability, and the low risk of an individual with a mental illness engaging in violence. Providing education in these areas is one practical way to accurately inform potential jurors on mental illness issues and can lead to less stigmatizing attitudes and discrimination.
The findings in this study also provide insight into factors that influence structural discrimination towards those with mental illnesses within correctional institutions. For example, the results suggest that individuals with depression may be deemed as more in control of their illness or able to “get it over it” easier due to causal attributions such as stress or social situations. Drawing on these beliefs, it is possible that individuals involved in treatment planning and funding within these institutions may allot less treatment services towards offenders with depression. These research findings therefore have implications for the management of offenders with mental illnesses at an institutional level to reduce the structural discrimination.
Despite the fruitfulness of the current investigation, it is important to acknowledge some of its’ limitations. First, the sample was lacking in diversity and were undergraduate students enrolled in at least one psychology course. Previous research suggests that because of this, stigmatizing beliefs and attitudes towards mental illnesses would be lower within this sample then in the general population (Buizza, Ghilardi, & Ferrari, 2017). In the same vein, the current sample was also not representative of the composition of typical juries within North America (Bornstein et al., 2017), making it difficult to conclusively generalize these findings to a real juror scenario. Future research should aim to use a sample type with more diversity that is reflective of an actual jury. Finally, although the findings of this current study offer interesting insight into perceptions of mental illness in mock-juror scenarios, results that were significant are limited with small effect sizes and should be interpreted modestly. This research should therefore be used as a stepping stone to direct future research that can address some of the limitations previously discussed.
One objective of this study was to enhance understanding regarding how mental illness is perceived within the context of a jury trial. Although the general trend in the results of this study were unexpected, they do lend support for the fact that mental illnesses make a difference in this process. These findings have implications for policies that promote anti-stigma education programs directed towards both the public (i.e., potential future jury members) and those directly involved with offenders with mental illnesses at varying levels of the judicial system. These programs can act as a step towards improving the ability of the criminal justice system to manage offenders with mental illnesses in a manner that offers equality and justice for all.
Aguinia, D.M., Madden, E.E., & Zellmann, K.T. (2016). An exploratory analysis of students’ perceptions of mental health in the media. Social Work in Mental Health, 14(4), 428-444. DOI: 10.1080/15332985.2015.1118002
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders:DSM-5(5th ed.). Arlington, VA: American Psychiatric Association
American Psychological Association (2014). Incarceration nation The United States leads the world in incarceration. A new report explores why — and offers recommendations for fixing the system. American Psychological Association 45(9), 56. Retrieved from: http://www.apa.org/monitor/2014/10/incarceration.aspx
Angermeyer, M.C., & Dietrich, S. (2006). Public beliefs about attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113(3), 163-179. DOI: 10.1111/j.1600-0447.2005.00699.x
Arendt, F. (2015). Toward a dose-response account of media priming. Communication Research, 42(8), 1089-1115. DOI: 10.1177/0093650213482970
Bell Canada (2015). Bell Let’s Talk: The first 5 years (2010-2015). Retrieved from http://letstalk.bell.ca/letstalkprogressreport
Bornstein, B.H., Neuschatz, J., Magyarics, C., Golding, J.M., Kimbrough, C., Reed, K., & Leucht, K. (2017). Mock juror sampling issues in jury simulation research: A meta-analysis. Law and Human Behavior, 41(1), 13-28. DOI: 10.1037/Ihb0000223
Boysen, G.A., & Vogel, D.K. (2008). Education and mental health stigma: The effects of attribution, biased assimilation, and attitude polarization. Journal of Social and Clinical Psychology, 27(5), 447-470. DOI: 10.1521/jscp.2008.27.5.447
Breheney, C., Groscup, J., & Galietta, M. (2007). Gender matters in the insanity defense. Law and Psychology Review, 31, 93-180
Bushman, B.J., & Anderson, C.A. (2002). Violent video games and hostile expectations: A test of the general aggression model. Personality and Social Psychology Bulletin, 28, 1679-1686. DOI: 10.1177/014616702237649
Buizza, C., Ghilardi, A., & Ferrari, C. (2017). Beliefs and prejudices versus knowledge and awareness: How to cope with stigma against mental illness. Community Mental Health Journal, 53(5), 589-597. DOI: 10.1007/s10597-017-0116-9
Burris, KM., Brownlow, S., & Lins, K.C. (2016). Does fitness priming influence self- and other-judgments of personal and physical characteristics? Psi Chi Journal of Psychological Research, 21(4), 241-251
Canadian Mental Health Association. (2011). Violence and mental health: Unpacking a complex issue. Retrieved from http://ontario.cmha.ca/documents/violence-and-mental-health-unpacking-a-complex-issue/
Chandra, A & Minkovitz, C.S. (2006). Stigma starts early: Gender differences in teens willingness to use mental health services. Journal of Adolescent Health, 38(6), 754-761. DOI: 10.1016/j.jadohealth.2005.08.011
Chang, F.C., Miao, N., Lee, C., Chen, P., Chiu, C., & Lee, S. (2016). The association of media exposure and media literacy with adolescent alcohol and tobacco use. Journal of Health Psychology, 21(4), 513-525. DOI: 10.1177/1359105314530451
Collins, L. (Producer), & Stanton, A. (Director). (2016). Finding Dory [Motion picture]. United States: Pixar Animation Studios. Retrieved from https://www.youtube.com/watch?v=I3kIpCzLzEo
Compton, M.T., Esterberg, M.L., McGee, R., Kotwicki, R.J., & Oliva, J.R. (2006). Crisis intervention team training: Changes in knowledge, attitudes, and stigma related to schizophrenia. Psychiatric Services, 57(8), 1199-1202. DOI: 10.1176/ps.2006.57.8.1199
Cook, T. M. & Wang, J. (2010). Descriptive epidemiology of stigma against depression in a general population sample in Alberta. BCM Psychiatry, 10(29), 1-11. DOI: 10.1186/1471- 244X-10-29
Corrigan, P., Markowitz, F.E., Watson, A., Rowan, D., & Kubiak, M.A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162-179. DOI: http://www.jstor.org/stable/1519806
Corrigan, P.W., Thompson, V., Lambert, D., Noel, J., & Campbell, J. (2003). Perceptions of discrimination among persons with serious mental illness. Psychiatric Services, 54, 1105- 1110. DOI: 10.1176/appi.ps.54.8.1105
Corrigan, P.W., Watson, A.C., & Barr, L. (2006). The Self–Stigma of Mental Illness: Implications for Self–Esteem and Self–Efficacy. Journal of Social and Clinical Psychology, 25(8), 875-884. DOI: 10.1521/jscp.2006.25.8.875
Corrigan, P.W., Druss, B.G., & Perlick, D.A. (2014). The impact of mental illness stigma on seeking and participating in health care. Psychological Science in the Public Interest, 15, 37-70. DOI: 10.1177%2F1529100614531398
Coverdale, J., Nairn, R., & Claasen, D. (2001). Depictions of mental illness in print media: A prospective national sample. Australian and New Zealand Journal of Psychiatry, 36(5), 697-700. DOI: 10.1046/j.1440-1614.2002.00998.x
Dewa, C.S. (2014). Worker attitudes towards mental health problems and disclosure. International Journal of Occupational and Environmental Medicine, 5(4), 175-86
Ditton, P. (1999). Mental health and treatment of inmates and probationers. Bureau of Justice Statistics, U.S. Department of Justice. Retrieved from https://www.prisonlegalnews.org /media/publications/bojs_mental_health_and_treatment_of_inmates_and_probationers_1 999.pdf
Elbogen, E.B., & Johnson, S.C. (2009). The intricate link between violence and mental disorder. Archives of General Psychiatry, 66(2), 1520161. DOI: 10.1001/archgenpsychiatry.2008.537
Fazel, S., Langstrom, N., Hjern, A., Grann, M., & Lichtenstein, P. (2009). Schizophrenia, substance abuse, and violent crime. Journal of the American Medical Association, 301(19), 2016-2023. DOI: 10.1001/jama.2009.675
Fazel,S., & Seewald, K. (2012). Severe mental illness in 33 588 prisoners worldwide: systematic review and meta-regression analysis. The British Journal of Psychiatry, 200(5)364-373;DOI:10.1192/bjp.bp.111.096370
Fazel, S., Hayes, A.J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: Prevalence, adverse outcomes, and interventions. The Lancet Psychiatry, 3(9), 871-881. DOI: 10.1016/S2215-0366(16)30142-0
Fenwick, K. L. (2011). Educating the jury: Mental illness and criminal responsibility in the canadian courtroom (Doctoral dissertation, Carleton University Ottawa, Canada© 2014)
Frierson, R.L., Boyd, M.S., & Harper, A. (2015). Mental illness and mental health defenses: Perceptions of the criminal bar. The Journal of the American Academic of Psychiatry and the Law, 43(4), 483-491.
Goh, S. (Reporter). (2016, April 12: 10:16 MDT). Global news hour at 6:00 [Television newscast]. Edmonton, AB: Global News Edmonton. Retrieved from http://globalnews.ca/video/2634871/edmonton-photographer-turns-camera-to-depression-toexpose-its-impact
Hinshaw, S.P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychology, 4, 269-293. DOI: 10.1146/annurev.clinpsy.4.022007.141245
Jacobs, P., Moffatt, J., Dewa, C.S., Nguyen, T., Zhang, T., & Lesage, A. (2016). Mental health services costs within the Alberta criminal justice system. International Journal of Law and Psychiatry, 47, 102-108. DOI: 10.1016/j.ijlp.2016.04.008
James D.J., & Glaze L.E. (2006). Mental Health Problems of Prison and Jail Inmates.Washington, DC:Bureau of Justice Statistics, U.S.Department of Justice.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627. DOI:10.1001/archpsyc.62.6.617
Kessler, R.C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., Ustun, T.B., & Wang, P.S. (2008). The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys. Epidemiology and Psychiatric Sciences, 18(1), 23-33. DOI: 10.1017/S1121189X00001421
Klin, A., & Lemish, D. (2008). Mental disorder stigma in the media: Review of studies on production, content and influences. Journal of Health Communication, 13(5), 434-449. DOI: 10.1080/10810730802198813
Knaak, S., Mantler, E., & Szeto, A. C. H. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30, 111-116. DOI: 10.1177%2F0840470416679413
Kuhlman, T. (1994). Psychology on the streets: Mental health practices with homeless persons. New York: John Wiley.
Kvaale, E.P., Gottdiener, W.H., & Haslam, N. (2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science and Medicine, 96, 95-103. DOI: 10.1016/j.socsimed.2013.07.017
Lamberti, J.S., & Weisman, R.L. (2004). Persons with severe mental disorders in the criminal justice system: challenges and opportunities. Psychiatric Quarterly, 75(2), 151-164. DOI: 10.1023/B:PSAQ.0000019756.34713.c3
Link, B.G., Cullen, F.T., Frank, J., & Wozniak, J.F. (1987). The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92(6), 1461-1500. DOI: http://www.jstor.org/stable/2779844
Link, B.G., Cullen, F.T., Struening, E., Shrout, P.E., & Dohrenwend, B.P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400-423. DOI: 10.2307/2095612
Link, B.G., & Phelan, J.C. (2001). Conceptualizing Stigma. Annual Review of Sociology, 27, 363-385. DOI: http://www.jstor.org/stable/2678626?origin=JSTOR-pdf
Link, B.G., Yang, L.H., Phelan, J.C., & Collins, P.Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511-541. DOI: 10.1093.oxfordjournals.schbul.a007098
Loeber, S., Burgma, R., Wyssen, A., Leins, J., Rustemeier, M., Munsch, S., & Herpertz, S. (2016). Short term effects of media exposure to the thin ideal in female inpatients with an eating disorder compared to female inpatients with a mood or anxiety disorder or women with no psychiatric disorder. International Journal of Eating Disorders, 49(7), 708-715. DOI: 10.1002/eat.22524
Lorre, C. (Writer), & Cendrowski, M. (Director). (2008). The pancake batter anomaly [Television series episode]. In L. Aronsohn (Producer), The big bang theory. Burbank, CA: Warner Brothers Burbank Studios. Retrieved from https://www.youtube.com/watch?v=HU4xmWwYA2A
Mahoney, A. R. (1982). American jury voir dire and the ideal of equal justice. The Journal of Applied Behavioral Science, 18(4), 481-494. DOI: 10.1177%2F002188638201800410
Marder, Nancy S. (2015). Juror Bias, Voir Dire, and the Judge-Jury Relationship. Chicago-Kent Law Review, 90(3), 927-956. Retrieved from: http://scholarship.kentlaw.iit.edu/cklawreview/vol90/iss3/7
Martin, J.K., Pescosolido, B.A., & Tuch, S.A. (2000). Of fear and loathing: The role of ‘disturbing behavior,’ labels, and causal attributions in shaping public attitudes towards people with mental illness. Journal of Health and Social Behavior, 41(2), 208-223. DOI: 10.2307/2676306
McVey, C. (2001). Coordinating effective health and mental health continuity of care. Corrections Today, 63(5), 58-62.
Meriwether, E. (Writer), & Woliner, J. (Director). (2012). Menzies [Television series episode]. In B. Baer (Producer), New girl. Los Angeles, CA: 20th Century Fox Television. Retireved from https://www.youtube.com/watch?v=4cgVm7enQ14
Metzner, J.L., & Fellner, J. (2010). Solitary confinement and mental illness in U.S. prisons: A challenge for medical ethics. The Journal of the American Academy of Psychiatry and the Law, 38(1), 104-108.
Morse, S.J. (2007). The non-problem of free will in forensic psychiatry and psychology. Behavioral Sciences and the Law, 25, 203-220. DOI: 10/1002/bsl.744
Mossiere, A., & Maeder, E.M. (2015). Defendant mental illness and juror decision-making: A comparison of sample types. International Journal of Law and Psychiatry, 42-43, 58-66. DOI: 10.1016/j.ijlp.2015.08.008
Mossiere, A, & Maeder, E.M. (2016). Juror decision making in not criminally responsibly on account of mental disorder trials: Effects of defendant gender and mental illness type. International Journal of Law and Psychiatry, 49, 27-54. DOI: 10.1016/j.ijlp.2016.05.008
Nagai, T (Reporter). (2015, August 5: 1:49 MDT). Global news hour at 11:00 [Television newscast]. Calgary, AB: Global News Calgary. Retrieved from http://globalnews.ca/video/2148526/widespread-damage-across-calgary-after-hail-storm
McGrath, J., Saha, S., Chant, D., & Welham, J. (2008). Schizophrenia: A concise overview of incidence, prevalence, and mortality. Epidemiologic Reviews, 30, 67-76. DOI: 10.1093/epirev/mxn001.
Old Spice. (2010). The man your man could smell like [Television commercial]. Retrieved from https://www.youtube.com/watch?v=owGykVbfgUE
Owen, P.R. (2012). Portrayals of schizophrenia by entertainment media: A content analysis of contemporary movies. Psychiatric Services, 63(7), 655-659. DOI: 10.1176/appi.ps.201100371
Pescosolido, B.A., Monahan, J., Link, B.G., Stueve, A., & Kikvzawa, S. (1999). The public view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health, 89(9), 1339-1345
Pescosolido, B.A., Martin, J.K., Long, S., Medina, T.R., Phelan, J.C., & Link, B.G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry, 167(11), 1321-1330. DOI: 10.1176/appi.ajp.2010.09121743
Pica, E., Petalia, J., & Pozzulo, J. (2017). The influence of a defendant’s chronological age, developmental age, and race on mock juror decision making. Journal of Police and Criminal Psychology, 32(1), 66-76. DOI: 10.1007/s11896-016-9201-1
Pozzulo, J.D., Dempsey, J., Maeder, E., & Allen, L. (2010). The effects of victim gender, defendant gender, and defendant age on juror decision making. Criminal Justice and Behavior, 37(1), 46-63. DOI: 10.1177/0093854809344173
Prins, S.J. (2014). The prevalence of mental illnesses in U.S. state prisons: A systematic review. Psychiatric Services, 65(7), 862-872. DOI: 10.1176.appi.ps.201300166
Qualtrics [computer software]. (2017). Provo, UT. Retrieved from https://www.qualtrics.com
Rao, D., Feinglass, J., Corrigan, P. (2007). Racial and ethnic disparities in mental illness stigma. Journal of Nervous and Mental Disease, 195(12), 1020-1023. DOI: 10.1097/NMD.0b013e31815c046e
Reavley, N.J & Jorm, A.F. (2011). Stigmatizing attitudes towards people with mental disorders: Findings from an Australian National Survey of mental health literacy and stigma. Australian and New Zealand journal of Psychiatry, 45(12), 1086-1093. DOI: 10.3109/00048674.2011.621061
Reavley, N.K., Jorm, A.F., & Morgan, AJ. (2016). Beliefs about dangerousness of people with mental health problems: the role of media reports and personal exposure to threat or harm. Social Psychiatry and Psychiatric Epidemiology, 51(9), 1257-1264. DOI: 10.1007/s00127-016-1215-6
Rivlin, A., Hawton, K., Marzano, K., & Fazel, S. (2010). Psychiatric disorders in male prisoners who made near-lethal suicide attempts: Case-control study. The British Journal of Psychiatry, 197(4), 313-319. DOI: 10.1192/bjp.bp.110.077883
Romaniuk, R. (Reporter). (2014, February 28: 16:57 MDT). Winnipeg Sun [Television newscast]. Winnipeg, MB: Winnipeg Sun. Retrieved from http://www.winnipegsun.com/videos/search/Vince/selkirk-residents-react-to-vince-l unsupervisedpasses/3272612763001/page/3#89880668001
Simpson, A.F., McMaster, J.J., & Cohen, S.N. (2013). Challenges for Canada in meeting the needs of persons with serious mental illness in prison. Journal of the American Academy of Psychiatry and the Law, 41(1), 501-509.
Sisti, D.A., Caplan, A.L., & Rimon-Greenspan, H. (2013). Applied ethics in mental health care: An interdisciplinary reader. Cambridge, MA: MIT Press, 267-282.
Skeem, J.L, & Golding, S.L. (2001). Describing jurors’ personal conceptions of insanity and their relationship to case judgements. Psychology, Public Policy, and Law, 7(3), 561-621. DOI: 10.1037/1076-89126.96.36.1991
Skeem., J.L., Louden, J.E., & Evans, J. (2004). Venireperons’s attitudes towards the insanity defense: Developing, refining, and validating a scale. Law and Human Behavior, 28(6), 623-648. DOI: 10.1007/s10979-004-0487-7
Smetanin, P., Stiff, D., Briante, C., Adair, C.E., Ahmad, S., & Khan, M. (2011). The life and economic impact of major mental illnesses in Canada: 2011 to 2041. RiskAnalytica, on behalf of the Mental Health Commission of Canada, 2-199.
Statistics Canada. (2010). Annual Component 2010 Questionnaire in Canadian Community Health Survey. Ontario MOHLTC.
Steadman, H.J., Osher, F., Robbins, P.C., Case, B., & Samuels, S. (2009). Prevalence of Serious Mental Illness Among Jail Inmates. Psychiatric Services, 60(6), 761-765. DOI: 10.1176/appi.ps.60.6.761
Teplin, L.A., Abram, K.M., & McClelland, G.M. (1996). Prevalence of psychiatric disorders among incarcerated women: Pretrial jail detainees. Archives of General Psychiatry, 53(6), 505-512. DOI: 10.1001/archpsyc.1996.01830060047007
Thonon, B., Pletinx, A., Grandjean, A., Billieux, J., & Laroi, F. (2016). The effects of a documentary film about schizophrenia on cognitive, affective and behavioural aspects of stigmatisation. Journal of Behaviour Therapy and Experimental Psychiatry, 50, 196-200. DOI: 10.1016/j.jbtep.2015.08.001
Torrey, E.F. (1995). Jail and prisons – America’s new mental hospitals. American Journal of Public Health, 85(12), 1611-1613. DOI: 10.2105/AJPH.85.12.1611
Wahl, O.F. (1999). Mental health consumers’ experience of stigma. Schizophrenia Bulletin, 25, 467-478. DOI: 10.1093/oxfordjournals.schbul.a033394
Webber, A (2012).The influence of race on juror decision making.(Unpublished honours thesis), University of Calgary, Calgary, AB
Weiner, B. (1980). May I borrow your class notes? An attributional analysis of judgments of help giving in an achievement-related context. Journal of Educational Psychology, 72, 676-681. DOI: 10.1037/0022-06188.8.131.526
Weiner, B., Perry, R. P., & Magnusson, J. (1988). An attributional analysis of reactions to stigmas. Journal of Personality and Social Psychology, 55(5), 738–748. DOI: 10.1037/0022-35184.108.40.2068
Wood, L., Birtel, M., Alsawy, S., Pyle, M., & Morrison, A. (2014). Public perceptions of stigma towards people with schizophrenia, depression, and anxiety. Psychiatry Research, 220(1- 2), 504-608. DOI: 10.1016/j.psychres.2014.07.012
Ye, J., Chen, T.F., Paul, D., McCahon, R., Shankar, S., Rosen, A., & O’Reilly, C.L. (2016). Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings. International Journal of Social Psychiatry, 62(6), 532-541. DOI: 10.1177/0020764016651459