Stigma of mental illness in China: Exploring the intersectional effects of gender, ethnicity and disorder at the start of national mental health care reform.

Drawing on a large-scale survey in China, we examine how the unequal position of women, the political/cultural prejudice facing the Uyghur ethnic community, and the type of mental health problem simultaneously shaped public stigma from the majority Han Chinese population during the first quarter of this century. The Stigma in Global Context - Mental Health Study in China (N = 5610) deployed a survey experimental design, finding significant, unexpected and complex intersectional effects. For Uyghurs, being female and with schizophrenia (vs. depression) resulted in the highest levels of social distance. In comparison, for Han vignette characters, women surprisingly received greater social rejection from Han respondents when described with depression. For men, ethnicity had no effect, with both Han and Uyghur vignette characters facing similar higher levels of stigma for schizophrenia compared to depression. These findings provide quantitative evidence of the role of intersectionality in stigma research, and, in particular, the effect of holding multiple devalued statuses for women. Higher education's association with greater stigma highlights potential unintended consequences of early stage national social and programmatic change. Overall, mental illness stigma in China appears to operate through gendered mechanisms that create distinct patterns across ethnic lines and mental health issues, suggesting the need for deeper understandings of cultural meanings and expectations among in-groups as well as outgroups.