Stigma and Intellectual Disability: Potential Application of Mental Illness Research

nicole_ditchman1-001Dr. Nicole Ditchman is Assistant Professor in the Department of Psychology at Illinois Institute of Technology. In addition to conducting research, Dr. Ditchman teaches graduate courses in Rehabilitation and Mental Health Counseling. She received her doctorate in Rehabilitation Psychology from the University of Wisconsin-Madison and is a Certified Rehabilitation Counselor and a Licensed Clinical Professional Counselor. Her recent paper, titled “Stigma and intellectual disability: potential application of mental illness research” was published in the journal Rehabilitation Psychology.

Research interests

I was drawn to the field of rehabilitation psychology because of its emphasis on a strengths-based approach to working with diverse clients and families facing disability or chronic illness. In my clinical work with high school students with intellectual and developmental disabilities, I recognized that all too often after school ended these young adults were at considerable risk of facing social isolation, poor health outcomes, and unemployment. I became aware of the critical need for continued research looking at how to best serve this population and help them successfully transition into adult lives where they are afforded the same opportunities and expectations to engage fully in their communities.

To this end, my research efforts aim to better understand the myriad factors affecting quality of life, employment outcomes, and community engagement for people with disabilities. One facet of this line of research hinges on more clearly understanding the impact social attitudes and stigma has on community integration, sense of belonging, and social justice for people with disabilities, and ultimately, identifying strategies that are effective for making social change.

Background of the study

The impetus for this paper came from a working collaboration with Dr. Patrick Corrigan, a prominent researcher in the field of psychiatric rehabilitation and a colleague at Illinois Institute of Technology; Dr. Shirli Werner from Hebrew University of Jerusalem; and several graduate students. We all recognized that individuals with intellectual disabilities and individuals with mental illness were consistently found to be among the most socially excluded groups and face substantial disparities related to housing, health, and employment.

Understanding stigma is important for both these groups. However, we noticed that while in the mental illness literature a sizeable amount of research attention has focused on developing and testing conceptual models of stigma and the stigma process, this was not happening in the intellectual disability literature. We used this paper to highlight this disparity by reviewing the existing research on attitudes and stigma related to intellectual disability in parallel with the stigma models that have been developed for mental illness stigma.

We were interested in why stigma had not received as much attention in the intellectual disability literature and how further research on stigma toward intellectual disability could be informed by the existing work done with mental illness stigma. Moreover, we hoped to call attention to stigma as an issue of social justice and the need to develop effective intervention strategies.

Findings

It is apparent that stigma indeed affects many key areas of life for both people with mental illness and people with intellectual disability, including social equity and inclusion, autonomy and choice making, physical health, and mental health. While these groups are indeed very different, they continue to face substantial disparities related to employment, housing, and health outcomes.

The stigma process established in the mental illness research has been conceptualized in terms of stereotypes (beliefs), prejudice (affective attitudes), and discrimination (behavior). Furthermore, stigma operates at multiple interconnected levels. Public stigma is the process by which the general public endorses prejudice and engages in discriminatory actions. Structural stigma is a type of stigma that includes purposeful or unintentional discriminatory policies and laws that lead to exclusion over equality. Self-stigma occurs when members of the stigmatized group internalize and direct negative attitudes toward themselves or their own group.

Based on our review of the existing research on public attitudes and stigma toward intellectual disability, we found that it makes sense to draw from the stigma models developed for mental illness to inform an understanding and approach to investigating the stigma of intellectual disability.

Next steps

The ultimate goal of research looking at intellectual disability stigma is to generate effective and practical stigma change strategies. We believe that a first step is focusing on the stereotypes associated with intellectual disability. In addition, the development of more sophisticated and psychometrically sound scales to measure stigma is essential. Finally, it is imperative that individuals with intellectual disability be encouraged to take an active role in these research efforts and be involved throughout the research process.

What are the practice and policy implications?

Recognizing the presence of stigma faced by people with intellectual disability has important implications for practice and policy. The United Nations Convention on the Rights of Persons with Disabilities explicitly calls for increasing awareness as a means of combatting stereotypes and prejudice towards people with disabilities to prevent discrimination.

Research also suggests that enhancing interactions between stigmatized individuals and the public is an effective stigma change strategy. It is also important that clinical practitioners working with people with intellectual disability are familiar with this population, and at the same time, recognize each person’s unique experience of social stigma and the extent to which a label of “intellectual disability” is associated with pride, shame, or indifference. We believe that the models developed for mental illness stigma can guide the study of intellectual disability stigma and inform targeted stigma change efforts.

About the department

The faculty and staff of the Department of Psychology at Illinois Institute of Technology represent a broad range of dedicated professionals whose work serves to support our academic mission for excellence in teaching, training, and education. Our faculty have broad interests and conduct research that touches on the lives of people of all ages and sectors. Our Counseling and Rehabilitation Sciences Division within the department has a CORE-accredited M.S. program in Rehabilitation and Mental Health Counseling. Ranked 9th in nation by U.S. News & Work Report, this program prepares students for a career providing counseling and rehabilitation services to clients with physical, mental, and emotional disabilities.

More information about the Department of Psychology can be found at: http://www.iit.edu/psych/psy/

More information about my ongoing research can be found here: www.ditchmanresearchteam.com

See also:

Illinois Institute of Technology Health Insurance