Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany.

Background: In 1975, a special commission appointed by the German Parliament submitted its report on the desolate state of psychiatric care in the old Federal Republic of Germany including suggestions for much-needed reforms. Among them was a call for the reduction of existing prejudices against mentally ill people. This study addresses the question as to what attitude is commonly found among the general public towards the mentally ill nowadays, two decades after the first step towards reform in psychiatric care and focuses on social distance.

Methods: Between spring 1990 and the end of 1993, a total of 11 representative surveys were carried out in Germany, eight of them in the former Federal Republic, or the old Länder.

Results: Even today, mentally ill people are met with a great deal of rejection by the German public. Alcohol dependants are rejected most, even more so than those suffering from schizophrenia. Personal experience with mental illness is associated with a lower level of derived social distance, which may be attributed to an increase in positive emotional reactions and reduced feelings of anxiety. There is an association between a person's attitude towards the mentally ill and his/her overall value orientation.

Conclusions: Although, for methodological reasons, we are not able to show a significant change in attitude in the wake of the reform in psychiatric care, our results lend support to one of the basic assumptions of community psychiatry, namely the premise that personal contact with the mentally ill can help to reduce feelings of resentment towards the latter.