title: Addressing public stigma and disparities among persons with mental illness: the role of federal policy.
abstract: 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.
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. jrcummi@emory.edu
authors.forename: Janet R
authors.initials: JR
authors.lastname: Cummings
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Lucas
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
mesh_terms: D002961:Civil Rights / Q000331:legislation & jurisprudence*; D004519:Education, Special / Q000331:legislation & jurisprudence / Q000592:standards; D004651:Employment / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D054625:Healthcare Disparities / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000592:standards; D007348:Insurance, Health / Q000331:legislation & jurisprudence / Q000592:standards; D008605:Mental Health Services / Q000191:economics / Q000592:standards*; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000523:psychology / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011287:Prejudice / Q000331:legislation & jurisprudence / Q000517:prevention & control; D057545:Social Stigma; D014481:United States