公众精神疾病病耻感的影响因素与反歧视策略

Determinants of Public Stigma toward Mental Illness and Strategies for Anti-Discrimination

摘要: 目的：公众精神疾病病耻感是导致精神疾病患者遭受社会排斥、延迟就医与复发风险增加的重要社会心理因素。通过研究公众精神疾病病耻感的影响因素旨在为公众精神健康教育反污名化干预提供理论支持与实践指导，推动构建更包容、理性的社会心理环境。方法：文章通过中国知网和GOOGLE SCHOLAR检索了2000年~2025年与“公众精神疾病病耻感的影响因素”相关的文献28篇，叙述性地梳理了公众精神疾病病耻感的概念来源，重点分析了影响病耻感的多维因素，包括人口学变量(性别、年龄、学历、文化背景)、社会经历(与患者的接触程度、教育宣传、职业身份)，以及公众对精神疾病的认知因素(疾病类型、成因解释与可治愈性信息)。结果：对前人文献的总结发现，不同的疾病归因方式显著影响公众的排斥态度，生物遗传归因易引发本质主义偏见，而环境或多重归因有助于降低病耻感。同时，与精神疾病患者的正向接触经历、科学传播与积极治疗信息的传播也是减轻病耻感的重要路径。结论：基于这些发现，文章提出多元归因教育、可治愈性信息强化、促进公众实际接触、针对特定疾病类型的差异化宣传，以及媒体科学传播等五大反歧视策略。

Abstract: Purpose: Public stigma towards mental illness is a significant socio-psychological factor leading to social exclusion, delayed treatment, and an increased risk of relapse among individuals with mental health conditions. This study aims to explore the influencing factors of public stigma towards mental illness, providing theoretical support and practical guidance for public mental health education and anti-stigma interventions, thereby promoting the development of a more inclusive and rational social psychological environment. Method: A literature review was conducted by searching CNKI (China National Knowledge Infrastructure) and Google Scholar for studies published from 2000 to 2025 related to the “influencing factors of public stigma towards mental illness.” A total of 28 articles were reviewed. The concept of public stigma towards mental illness was summarized, with a focus on the multi-dimensional factors influencing stigma, including demographic variables (gender, age, education, cultural background), social experiences (contact with patients, educational campaigns, and occupational identity), and the public’s perceptions of mental illness (disease types, causal explanations, and information about treatability). Results: A summary of previous literature found that different attributions for mental illness significantly influence the public’s exclusionary attitudes. Biological or genetic attributions tend to trigger essentialist biases, whereas environmental or multi-causal attributions help reduce stigma. Positive contact with individuals with mental health conditions, the dissemination of scientific knowledge, and information about the treatability of mental illnesses are also key factors in reducing stigma. Conclusion: Based on these findings, the paper proposes five key anti-stigma strategies: multi-causal education, strengthening information on treatability, promoting real-life contact with people with mental health conditions, differentiated publicity targeting specific mental illnesses, and media-driven scientific communication.