People living with schizophrenia in Ireland face significantly higher levels of public stigma than those with bipolar disorder, autism, or epilepsy, according to a large national survey. The findings, published in the Irish Journal of Psychological Medicine, raise fresh questions about whether broad mental health awareness campaigns are doing enough to shift attitudes towards some of the most misunderstood conditions.
The study, conducted across the Republic of Ireland between June and November 2022, surveyed more than 1,200 adults on their knowledge, attitudes, and intended behaviours towards four conditions. Schizophrenia consistently attracted the most negative responses, with participants both perceiving greater societal stigma around the condition and reporting that they would be less willing to live, work, or share schooling with someone diagnosed with it.
One of the most striking findings was the role of perceived danger. A substantial portion of the negative behaviour towards people with schizophrenia was explained by a belief that they pose a risk to others. This perception persists despite evidence that people with schizophrenia are far more likely to be victims of violence than perpetrators of it.
Familiarity with mental health conditions proved to be a meaningful factor. Participants who had personal experience of mental illness, either through their own diagnosis or through a close relationship with someone who had been diagnosed, reported more positive attitudes and behaviours across all four conditions. The effect was strongest for schizophrenia and bipolar disorder.
Importantly, general mental health knowledge did not have the same effect. Higher scores on a mental health knowledge questionnaire predicted more positive behaviour towards epilepsy, autism, and bipolar disorder, but showed no significant benefit when it came to schizophrenia stigma. This suggests that factual education alone may not be sufficient to reduce prejudice towards people with schizophrenia. Familiarity and direct social contact appear to matter more.
Bipolar disorder attracted the second highest level of stigma, followed by autism and then epilepsy. Autism, increasingly understood through the lens of neurodiversity as a natural variation in human brain function, fared considerably better than schizophrenia in public perception. Epilepsy, included as a neurological comparator rather than a psychiatric condition, attracted the lowest stigma of the four groups.
The researchers argue that these findings point to a gap in current anti-stigma policy. Most national campaigns, including Ireland’s See Change Green Ribbon initiative, address mental health stigma broadly. The results suggest that condition-specific messaging, particularly around schizophrenia, may be necessary to address the distinct fears and misconceptions that drive discrimination against this group.
These patterns are not unique to Ireland. Similar findings have emerged from France, Germany, the United Kingdom, and the United States, where stigma towards schizophrenia has remained persistently high or even worsened in recent decades, even as attitudes towards depression and anxiety have gradually improved.
The study adds to a growing body of evidence that social contact interventions, such as those involving personal stories and lived experience, are more effective for reducing schizophrenia stigma than education-based approaches alone.