Page 139 - GHES-3-1

Global Health Economics and
Sustainability
Reducing public stigma related to psychosis

1. Introduction notable in Europe. For example, in the UK, direct and
indirect costs per diagnosed individual reach up to $94,229
1.1. Psychosis and health economics annually (Kotzeva, 2023), while total societal costs in
Mental ill-health encompasses a range of cognitive, Norway are estimated to be $890 million/year (Evensen et
emotional, and behavioral difficulties that disrupt al., 2016). In China, the average annual cost per individual
individuals’ lives, productivity, and interpersonal with psychosis is $2586.21, with lost working days
relationships (Johnstone, 2001, p. 203). People with comprising the majority of indirect costs (Zhai, 2013).
mental ill-health (PMIH) not only face the distress of their Although clinical literature indicates that individuals
condition but also the stigma associated with it (Waqas with psychosis have the potential for functional
et al., 2020). This stigma leads to negative outcomes, psychosocial recovery (Mankiewicz, 2015), social isolation
including reduced help-seeking behavior, diminished and unemployment are commonly noted as factors
social integration, higher unemployment rates, and exacerbating the socioeconomic impact of the condition
increased psychological distress (Clement et al., 2015; (Evensen et al., 2016). In addition, the internalization of
Yang et al., 2008). widespread public stigma is believed to hinder individuals
Psychosis is a severe form of mental ill-health from seeking professional help, thereby delaying their
characterized by hallucinations, delusions, and overall recovery (Mankiewicz & Tan, 2024).
disorganized speech or behavior (Arciniegas, 2015). It is a 1.2. Understanding the public stigma of mental ill-
complex emotional and behavioral response to distressing health
interpretations of unusual experiences, such as hearing
voices or seeing things that are not there (Mankiewicz, Stigma can be categorized into three main types: public,
2013). Psychosis is not only worsened by public stigma structural, and self-stigma (Corrigan & Bink, 2016).
and discrimination (Vass et al., 2015) but is also often The present study focuses on public stigma, which was
cited in academic and clinical literature as one of the most conceptualized by Zvonkovic & Lucas-Thompson (2015).
misunderstood and stigmatized psychological conditions They labeled a person or group as different, assigning them
(Henderson et al., 2013; Morgan et al., 2018; Pingani et al., undesirable traits and subjecting them to discrimination,
2011; Wood et al., 2014). Recent studies have shown that leading to negative outcomes. According to this definition,
individuals with psychosis are often unfairly labeled as public stigma can be broken down into cognitive
dangerous and unpredictable (Crisp et al., 2000; Read et al., (stereotyping), affective (prejudice), and behavioral
2013; Stuart & Arboleda-Flórez, 2012), which traps them in (discrimination) components (Corrigan & Watson, 2002b;
a cycle of suffering and socioeconomic disadvantage (Vass Madianos et al., 2012).
et al., 2015). Misconceptions fueled by cultural stigma are Stereotyping involves holding beliefs about the
frequently internalized by those with psychosis, leading to characteristics, attributes, and behaviors of individuals
social isolation, long-term unemployment, and decreased categorized as members of a specific social group (Corrigan
economic productivity (Mankiewicz & Tan, 2024). Public & Shapiro, 2010, pp. 908-909). These beliefs are often
discrimination exacerbates these issues, causing delays in inaccurate, resulting in oversimplified or false labels that
seeking mental health services, which hinders recovery reinforce misperceptions about stigmatized groups and
and perpetuates the cycle of socioeconomic disadvantage foster prejudice (Bodenhausen & Richeson, 2010; Corrigan
(Clement et al., 2015; Schomerus et al., 2019). & Watson, 2002a; Cox et al., 2012). For example, people with
The impact of psychosis on health economics is well- psychosis are often labeled as unpredictable, dangerous,
documented in epidemiological literature. Psychosis is and violent (Angermeyer & Dietrich, 2006; Benbow, 2007;
identified as one of the top 25 global causes of disability, Zvonkovic & Lucas-Thompson, 2015). Prejudice involves
imposing a significant economic burden on gross domestic adopting these stereotypes (Corrigan et al., 2003; Rüsch
product (Chong et al., 2016). Several studies have et al., 2005) and having negative emotional responses
highlighted the significant health expenditures associated toward the affected group (Dovidio et al., 2010). Individuals
with psychosis worldwide. In the US, these costs have who hold such prejudices may agree with the stereotypes
been estimated to be $343.2 billion, including $259.1 that PMIH are unpredictable and violent, leading to fear
billion in indirect costs, $62.3 billion in direct health-care (Corrigan & Shapiro, 2010; Devine, 1989). Discrimination
costs, and $35.0 billion in direct non-health-care costs, is the behavioral manifestation of prejudice, resulting
with premature mortality and unemployment adding in differential treatment based on group membership
$77.9 billion and $54.2 billion, respectively (Kadakia et al., (Bodenhausen & Richeson, 2010; Corrigan & Shapiro,
2022). In addition, the economic burden of psychosis is 2010). Such behavior, driven by negative evaluations and

Volume 3 Issue 1 (2025) 131 https://doi.org/10.36922/ghes.3363