D’r‘u’WD s SOC" 'I ”61’ In. 0927 13 .3/ CD / 23:76:19 \_/ ABSTRACT ATTITUDES AND OPINIONS OF HIGH SCHOOL TEACHERS TOWARD MENTAL HEALTH BY Katherine Durham Mental health has become an area of increasing concern in our society today. The past few decades has seen an upsurge of research interest in the mental health area on the part of sociolo- gists. Much of the research has investigated the views held by the public toward selected aspects of mental illness. This research directs its attention toward the mental health attitudes and opinions of high school teachers. It is postulated that they play a key role in the socialization process of youth. They may be considered influential in the cognitive as well as emotional development of today's youth. There are three main groups under investigation in this study. They are: 161 high school teachers representing five Michigan high schools; 69 Future Teachers (Michigan State University secondary education students); 173 Summer Teachers (teachers attend- ing Michigan State University summer school). The Semantic Differ- ential technique (15 concepts and 12 scales) and 35 Mental Health Opinion Items (from Nunnally) were used to obtain data from these samples. Katherine Durham In the analysis of the semantic differential data, the con- cepts were categorized into five broader types. Four general hypothe- ses were established: Hypothesis 1: The concept "Ex-Mental Patient" will not be distinctive from the other "Normal" concepts (Me, Average Person, Most People), but will be distinctive from the Disorder concepts (Mental Patient, Neurotic Person), and the Severe Disorder concepts (Schizophrenic, Paranoid, Crazy, Insane). Hypothesis 2: The array of favorableness for the types of concepts will be in this order: Professionals (with Doctor rated highest), "Normal" (with Me rated highest), Physical Disease, Disorder, Severe Disorder. Hypothesis 2a: "Heart Disease" and "Cancer" will be more favorably perceived than the Severe Dis- order concepts by all three samples (High School Teachers, Future Teachers, Summer Teachers). Hypothesis 3: The Future Teachers will tend to view the Severe Disorder concepts less negatively than will the Summer Teachers and High School Teachers. Hypothesis 1, 2 and 2a were supported by the data and hypothe- sis 3 was not supported. Contrary to hypothesis 3, Future Teachers - were as negative in their responses as the High School Teachers and Summer Teachers. Twenty of the mental health opinion items provided the basis for the development of a "Knowledgeability Score" for each respondent. Knowledgeability was defined operationally in terms of similarity to the responses of mental health professionals to these items. Based on previous research investigations the following hypotheses were set forth concerning the relationship between knowledgeability and nine Katherine Durham social variables. (Summer Teachers were viewed as similar to High School Teachers for purposes of analysis.) High School Teachers Hypothesis 4: The older teachers will be more knowledgeable about mental health an the younger teachers. (Hypothesis 4 is not supported) Hypothesis 5: There will be no relationship between sex and knowledgeability. (Hypothesis 5 is not supported) Hypothesis 6: Respondents who grew up in an urban area (suburban or non-suburban) will be more know- ledgeable than those who grew up in the open country. (Hypothesis 6 is supported) Hypothesis 7: There will be no relationship between community size and knowledgeability. (Hypothesis 7 is supported) Hypothesis 8: Those teachers who teach social science sub- jects will be more knowledgeable than the others. (Hypothesis 8 is not supported) Hypothesis 9: Teachers who have more years of teaching exper- ience will be more knowledgeable. (Hypothesis 9 is not supported) Hypothesis 10: There will be no relationship between.type of institution (public vs. private) and know- ledgeability. (Hypothesis 10 is supported) Hypothesis ll: Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have none. (Hypothesis 11 is not supported) Future Teachers Hypothesis 12: There will be no relationship between age and knowledgeability. (Since this sample is com- posed of mostly Juniors and Seniors; there is a restricted age range.) (Hypothesis 12 is not supported) Katherine Durham Hypothesis 13: There will be no relationship between sex and knowledgeability. (Hypothesis 13 is supported) Hypothesis 14: Those "Future Teachers" who are social science majors will be more knowledgeable than the other majors. (Hypothesis 14 is not supported) Hypothesis 15: Respondents who grew up in an urban area (suburban or non-suburban) will be more know- ledgeable than those who have non. (Hypothesis 15 is supported) Hypothesis 16: There will be no relationship between community size and knowledgeability. (Hypothesis 16 is not supported) Hypothesis 17: Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have none. (Hypothesis 17 is not supported) The findings in this study revealed that teachers are reason- ably well informed with regard to mental illness, however, they tend to view mental disorders in a negative light. The study also indicates that the opinions and attitudes of teachers are not very different from those of the general public, although there is some indication that certain social structural variables have a relation- ship to knowledgeability. ATTITUDES AND OPINIONS OF HIGH SCHOOL TEACHERS TOWARD MENTAL HEALTH By Katherine Durham A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Sociology 1976 DEDICATION I wish to dedicate my dissertation to my parents, Mr. and Mrs. Henry L. Durham, and my sister, Helene. Without their inspiration and support, the realization of this goal would not have been possible. ii ACKNOWLEDGMENTS I am sincerely grateful to my chairman, Professor Donald W. Olmsted of the Department of Sociology for his time and guidance in helping me to prepare this dissertation. In addition, my appreication is also extended to the members of my committee: Professors Wilbur B. Brookover, James B. McKee, and Frederick B. Waisanen, all of the Department of Sociology, Michigan State University. I also wish to express my gratitude to Dr. Richard J. Morse, presently of the Department of Sociology, University of Alabama (Tuscaloosa, Alabama), for the encouragement he has given to me throughout my stay at Michigan State University. iii TABLE OF CONTENTS Page LIST OF TABLES. . . . . . . . . . . . . . . . . . . . . . . . . vi LIST OF FIGURES . . . . . . . . . . . . . . . . . . . . . . . . ix Chapter I. THE INTRODUCTION AND STATEMENT OF PROBLEM . . . . . . . . , 1 The Problem . . . . . . . . . . . . . . . . . Importance of the Problem . . . . Theoretical Perspectives. . \lO‘M II. REVIEW OF RELEVANT LITERATURE . . . . . . . . . . . . . . 10 III. THE SAMPLE AND THE RESEARCH INSTRUMENTS . . . . . . . . . 18 Description of Communities. . . . . . . . . . . . . 22 General Discussion of the Instruments . . . . . . . . . 25 The Semantic Differential . . . . . . . . . . . . . . 25 Mental Health Opinion Items . . . . . . . . . . . . . 27 IV. GENERAL HYPOTHESES. . . . . . . . . . . . . . . . . . . . 30 V 0 ANALYSIS OF DATA 0 O O O O O O O O O O O O O O O O O O O O 37 Analysis of Responses to Types of Concepts for High School Teachers. . . . . . . . . . 45 Analysis of Responses to Types of Concepts for Future Teachers . . . . . . . . . . 52 Analysis of Responses to Types of Concepts for Summer Teachers . . . . . . . . . . . 53 Analysis of Types of Concepts for All High School Teachers, Summer Teachers, and Future Teachers. . . . 57 Mental Health Opinion Items . . . . . . . . . . . . . . 69 I. Negative Stereotypes. . . . . . . . . . . . . . . 72 II. Will Power . . . . . . . . . . . . . . . . . . . 76 III. Sex Differences . . . . . . . . . . . . . . . . 78 IV. Environmental Forces . . . . . . . . . . . . . . 79 V. Role of Psychiatrist. . . . . . . . . . . . . . . 79 VI. Damage, Incurability, Seriousness. . . . . . . . 82 VII. Age and Childhood Experiences . . . . . . . . . 85 VIII. Physical Causes. . . . . . . . . . . . . . . . 85 IX. Miscellaneous. . . . . . . . . . . . . . . . . . 87 iv Chapter VI. SUMMARY AND CONCLUSIONS . conCIUSions O O O O O O O O I O 0 O O O O O 0 Suggestions for Future Research. . . . . . . . . . BIBLIOGRAPHY. . . . . . . . . . . . . . . . . . . . . . APPENDICES. . . . . . . . . . . . . . . . . . . . . . . Appendix A--Semantic Differential Means, High School Teachers, Future Teachers, Summer Teachers, Grand Rapids Citizens. . . . . . . . . . . . . . . . Appendix B--Demographic Data, High School Teachers, Future Teachers, Summer Teachers, Grand Rapids Citizens. . . . . . . . . . . . . . . Appendix C--Means of Mental Health Opinion Items, High School Teachers and Grand Rapids Citizens . . . . . . . Appendix D--A Study of Word Meanings and Opinions About Mental Health (Research Study Questionnaire). Page 90 97 100 101 105 106 115 130 132 Table 10. 11. 12. LIST OF TABLES Selected Demographic Characteristics of Five School Communities and Counties . . . . . . . . . Favorableness Index Toward Five Concept Types, Responses From Five High Schools (High Index Equals More "Favorableness"). . . . . . . . Favorableness Index Toward Five Concept Types, Responses of High School Teachers, Future Teachers, and Summer Teachers (Higher Index Equals More "Favorableness"). Relationship Between Knowledgeability Score and Age for High School Teachers . . . . . . . . . Relationship Between Knowledgeability Score and Sex for High School Teachers . Relationship Between Knowledgeability Score and Com- munity Type for High School Teachers . Relationship Between Knowledgeability Score and Com- munity Size for High School Teachers . Relationship Between Knowledgeability Score and Subjects Taught for High School Teachers. . . . . . . . . Relationship Between Knowledgeability Score and Teaching Experience for High School Teachers . Relationship Between Knowledgeability Score and Type of Institution Attended for High School Teachers . Relationship Between Knowledgeability Score and Mental Health Experience Indexes for High School Teachers . . . . . . . . . . . . . . . Relationship Between Knowledgeability Score and Age for Future Teachers. . . . . . . . . . . . . vi Page 23 39 40 59 6O 60 61 62 63 64 65 66 Table 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Relationship Between Knowledgeability Score and Sex for Future Teachers . Relationship Between Knowledgeability Score and Teaching Major for Future Teachers. Relationship Between Knowledgeability Score and Com- munity Type for Future Teachers . . . . . Relationship Between Knowledgeability Score and Com- munity Size for Future Teachers . Relationship Between Knowledgeability Score and Mental Health Experience Indexes for Future Teachers. Summary of the Relationship Between Social Variables and Knowledgeability. Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers, and Summer Teachers ("Negative Stereotypes"). . Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Will Power"). Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Sex Differences") Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Environ- mental Forces") . Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Role of Psychiatrist"). . . . . . . . . . . . Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Damage, Incurability, Seriousness") Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Age and Childhood Experiences") vii Page 67 67 68 69 70 71 75 77 8O 80 81 83 86 Table Page 26. Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Physical Causes") . . . . . . . . . . . . . . . . . . . 86 27. Opinion Statements, Responses of Teachers in Five High Schools, Future Teachers and Summer Teachers ("Miscellaneous") . . . . . . . . . . . . . . . . . . . . 88 A-l Semantic Differential Means, Fowler Teachers (N=14) . . . . 107 A-Z Semantic Differential Means, Ovid-Elsie Teachers N=23) . . . . . . . . . . . . . . . . . . . . . . . . . . 108 A-3 Semantic Differential Means, St. Johns Teachers (N=62). . . 109 A-4 Semantic Differential Means, Williamston Teachers (N=23). . . . . . . . . . . . . . . . . . . . . . . . . . 110 A-S Semantic Differential Means, Grand Rapids Teachers (N=39). . . . . . . . . . . . . . . . . . . . . . . . . . 111 A-6 Semantic Differential Means, "Future Teachers" (MSU Secondary Education Students) N=69. . . . . . . . . . . . 112 A-7 Semantic Differential Means, "Summer Teachers" (Teachers Attending MSU Summer School) N=173. . . . . . . . . . . . 113 A-8 Semantic Differential Means, Grand Rapids Citizens (Reservists) N=71 . . . . . . . . . . . . . . . . . . . . 114 8-1 Demographic Data, for High School Teachers. . . . . . . . . 116 B-2 Demographic Data, for "Future Teachers" (MSU Secondary Education Students. . . . . . . . . . . . . . . . . . . . 121 B-3 Demographic Data for Summer Teachers. . . . . . . . . . . . 124 8-4 Demographic Data for Grand Rapids Citizens (Reservists) . . 127 viii LIST OF FIGURES Figure l. Counties where "Summer Teachers" are employed . 2. "Favorableness Index" of Five Types of Concepts, Responses of Teachers in Five High Schools. 3. "Favorableness Index" of Five Types of Concepts, Responses of High School Teachers, Future Teachers Summer Teachers . 4. "Favorableness Index" of Five Types of Concepts, Responses of Future Teachers. 5. "Favorableness Index" of Five Types of Concepts, Responses of Summer Teachers. 6. Means of Mental Health Opinion Items, High School Teachers, Future Teachers, and Summer Teachers. 7. Means of Mental Health Opinion Items, High School Teachers and Grand Rapids Citizens. . . . ix Page 19 41 46 49 S4 73 . 131 CHAPTER I THE INTRODUCTION AND STATEMENT OF PROBLEM The past few decades have seen an increasing number of sociologists become interested in the area of mental health. Aside from other areas of interest in sociology, much research investiga- tion has focused its attention on mental health problems. The mental health movement, in the past two or three decades, has made a number and variety of attempts to "re-educate" the public regarding mental illness. With its major emphasis on publicizing the medical model of mental illness, the movement, for the most part, has been successful in acquainting the public with psychiatric symptomatology. Although opinions differ as to the increase in genuine popular understanding of psychological disorder as a conse- quence of these efforts, it seems reasonably clear that one result has been the maintenance of a predominantly mediCal definition and control of the mental health area. Past decades have also seen the advent of community mental health programs, with a new emphasis on community based treatment. Public understanding and favorable attitudes are essential for optimum utilization of these new types of mental health facilities and for acceptance of the greater number of mentally ill persons who can now be treated in the community. The Joint Commission on Mental Health, in 1961, suggested that: A national mental health program should avoid the risk of false promise in 'public education for better mental health' and focus on the modest goal of disseminating such informa- tion about mental illness as the public needs and wants in order to recognize psychological forms of sickness and to arrive at an informed opinion in its responsibility toward the mentally ill.1 It has been recognized that an important source for influ- encing the mental health levels of the nation and the attitudes of people is the formal education system. Because of the compulsory nature of the educational system in this society, very few persons escape attendance during the developing years of their lives. As a result of this, the American school seems to educators to be in the position to set the tone of mental health and to shape the attitudes of future generations. Few would deny that the family is the best of all possible settings for the promotion of mental health. Here are concen- trated the crucial influences and relationships that shape the development of the child and young adult, for better or for worse. Unfortunately, the family is a rather isolated unit of modern society; its members go forth from the home as individ- uals but may return to it as components of a different group. The family is not readily accessible to outside help, except as it seeks it, and society has no pervasive mental health resources that encompass the family within their structure. The school, however, comes remarkably close to achieving this relationship with the family. At least it is in a position to do so. In an era of universal, compulsory education, the school is the one institution of society through which each of 1Joint Commission on Mental Illness and Health, Action for Mental Health, (New York: Basic Books, Inc., 1961), p. xviii. us must pass. During our formative years we are influenced to a varying degree by this education experience, which takes place against the background of the family, yet apart from it. Rabkin and Suchoski has this to say about the role of schools in mental health education: If we [educators of teachers] are to succeed in bringing about any basic alteration in this state of affairs, it is clear that the schools are to play a prominent part in this campaign. The child not only learns from the direct tuition of the teachers but incorporates as well his attitudes and conceptualizations about the world. For the primary grade child and the college student alike, this is as true in the sphere of mental health as in that of primary didactic materials. 3 Shaped by varied and often competing, even conflicting, forces that are operative in a diverse and changing society, educa- tion in turn is viewed by educators as becoming a decisive and influential institutional complex for shaping the future of modern man and his society. The Problem Teachers, who are generally considered to be important with regard to the socialization of youth, are a vital cog in the educa- tional system. One good measure of the public's attitudes toward teaching as a profession can be found in whether parents would like to have their children become teachers. In a national study (by Gallup poll), parents were asked whether they would like to have a child of theirs take up teaching in the public schools as a career. Seventy-one percent of the parents of public school children said they would like their 2W. Allinsmith and George W. Goethal, The Role of Schools in Mental Health, (New York: Basic Books, Inc., 1962), p. 123. 3Leslie Y. Rabkin and Joseph F. Suchoski, Jr., "Teachers' Views of Mental Illness: A Study of Attitude and Information," Journal of Teacher Education, 18 (1967), p. 36. child to become a teacher, and less than twenty-one percent said no. Apparently then, teaching is held in relatively high esteem by a large segment of the public.4 One of the most important functions people everywhere assign to their education agencies is the transmission of the knowledge, attitudes and skills of their society--in short, their culture-- from the older to the younger generation. This is the process of socialization. Teachers, as agents of society, presumably plan an instru- mental role in the socialization of youth. They are widely believed to aid in the shaping and molding of personalities and in the nuturance of inquiring minds. Havighurst and Neugarten says this about the role of the teacher: The teacher's main role in relation to pupils, indeed the most significant of all his roles, is that of mediator of learning. In this role, he transmits knowledge and directs the learning process. In somewhat different terms, the main role of the teacher is to induce socially valued change in his pupils. This is at once the crux of the teaching profession and the most important criterion of the teacher's success.S According to Wilson, Robeck, and Michael,6 teachers for the most part accept the role assigned by their communities. In the view of parents, the function of the school is to teach certain’subject matter content and skills. The teachers, by and large, have accepted the role assigned to them by the 4Wilbur B. Brookover and Edsel L. Erikson, Sociologyof Education, (The Dorsey Press: Homewood, Illinois, 1975), pp. 227- 228. 5Robert J. Havighurst and Bernice L. Neugarten, Society and Education, (Boston: Allyn and Bacon, Inc., 1967), p. 445. 6J.A.R. Wilson, M.C. Robeck, and W.B. Michael, Psychological Foundations of Learningpand Teaching, (New York: McGraw-Hill, Inc., 1969), pp. 328-329. community. Although little or no time or thought was supposed to be given to teaching attitudes, the eventual emergence of young people with the "wrong" attitudes was and still is deplored. Teachers have been blamed for not having developed the "right" attitudes in their students, at the same time that any attention to the fostering of specific attitudes was being systematically attacked. Teachers are a part of culture, and when the community climate insist that cognitive content is the only phase of learning to which the school may properly address itself, most teachers quickly accept this limited definition of their role. The notion of considerable teacher influence on the beliefs and attitudes of their students seems to be based on both popular and professional beliefs. However, this is a very difficult proposi- tion to either confirm or refute in a convincing manner, and there does not appear to be compelling evidence either way. It seems best to make the assumption that teachers do have some influence on the cognitive development of their students. For the purpose of this study, we assume that this influence extends to knowledge of and development of attitudes about mental health. In this study we will be investigating the opinions and atti- tudes of high school teachers toward mental health. More specifically the study will center its attention around the following questions: 1. 'What are the attitudes of high school teachers toward mental illness? 2. What are the attitudes of future high school teachers (secondary education majors) toward mental illness? 3. Are there important differences between the attitudes of future-teachers and teachers on the job toward mental illness? If so, how can these differences be character- ized? 4. How similar are the responses of high school teachers and the general public toward mental health? 5. What are the differences, if any, between the responses of high school teachers and mental health experts, toward mental health? This study, as do several studies in the mental health area, has as its foundation research reported by Jum C. Nunnally, Jr. His book, Popular Conceptions of Mental Health, has been termed a "land- 7 mark in its field." This study, however, tends to follow previous research methodologically, but takes a new direction substantively. Importance of Problem High school teachers come in contact with students during a time when they are about to assume adult roles in our society and validate their stance on certain social issues. It is also during the high school years that students take courses as a part of their curriculum which center their attention on the social problems of our society. "Data on teachers' attitudes are important because we know that, in certain areas at least, teachers' attitudes are correlated with classroom behavior and both are related in some ways to students' develOpment."8 7Henry Wescheler, L. Solomon, and B.N. Kramer, (eds.), "Mental Health Attitudes," Social Psychology and Mental Health, (New York: Holt, Rhinehart, and Winston, Inc., 1970), p. 436. 8Barry Sugarman, The School and Moral Development, (New York: Barner and Noble, 1973), p. 141. I contend that the attitudes teachers hold toward certain subjects are bound to have some effect on the cognitive and affective development of youth. If one considers this to be a reasonably accurate view, then it becomes important to gain insight into the information and characteristic attitudes that teachers possess in the mental health area. Popular beliefs about mental health is not just a technical matter for psychiatrists and psychologists, but is a basic dimension of every person's everyday social psychology and is closely related the the definition of self that is taking place during the adolescent years. Theoretical Perspectives Although the last five decades have seen a vast number of studies of functional mental disorders, there is as yet no substantial, verified body of knowledge in this area. At this writing there is no rigorous knowledge of the cause, cure, or even the symptoms of functional mental disorder. Such know- ledge as there is, is clinical and intuitive, and thus not subject to verification by scientific methods.9 Thomas Scheff10 in what he calls a sociological theory of mental illness, sets forth two propositions concerning beliefs about mental disorder in the general public: 1. "Stereotyped imagery of mental disorder is learned in early childhood." Scheff feels that the literal meaning of "crazy," a term now used in a wide variety of contexts, is probably grasped by children during the first years of elementary school. Social 9Thomas Scheff, Being_Mentally 111: A Sociological Theory, (Chicago: Adine Publishing Company), 1968, p. 6. 10 Ibid., pp. 64-68. stereotypes are held by children and play an active part in their cognition and behavior. He admits, however, there are no substantiat- ing studies in this area, and that it is based on his scattered observations. 2. "The stereotypes of insanity are continually reaffirmed, inadvertently, in ordinary social interaction." Scheff feels that although adults become acquainted with medical concepts of mental illness, the traditional stereotypes are not discarded, but continue to exist alongside the medical conceptions, because the stereotypes receive almost continual support from the mass media and ordinary social discourse. A prominent controversy in the field of mental health, among its professionals, is centered around the claim by T.S. Szasz that mental illness is a "myth." Szasz has been the most outspoken critic of the use of the medical model when applied to mental illness. In the "Myth of Mental Illness,"11 Szasz proposes that mental disorder be viewed within the framework of "the game-playing model of human behavior." He then describes hysteria, schizophrenia, and other mental disorders as the "impersonation" of sick persons by those whose "real" problem concerns "problems in living." Although Szasz states that the role-playing by mental patients may be com- pletely or even mostly voluntary, the implication is that mental dis- order be viewed as a strategy chosen by the individual as a way of obtaining help from others. 11T.S. Szasz, "Myth of Mental Illness," American Psycholgggst, 15 (February 1960), pp. 113-118. Before we can determine that these theories are sound, more needs to be learned about the opinions and attitudes of the general public, which is what this study is about. The data in this study can be viewed in that light, as giving evidence to the content of popular views of mental disorder. In addition, it is also important to know if the views of high school teachers are highly similar to those of the general public as well as other significant adults with whom youth are in contact with. CHAPTER II REVIEW OF RELEVANT LITERATURE In the 20 or more years since the establishment of the National Institute of Mental Health, a number of surveys have been made to assess the American public's opinions and attitudes about mental illness. These surveys have been made at different times, by different investigators, with different research designs, and on different populations. /] There has emerged a body of literature in the mental health area, concerning the delineation of attitudes held by the general public, by mental health personnel, and by patients and their families; the susceptibility of such attitudes to modification through academic or practical experience; and the relationship between attitudes and behavior. Knowledge of such attitudes is not only germane to those con- cerned with the origins and maintenance of disturbed behavior, but critically important to workers involved in primary preven- tion programs, early intervention, and community treatment of psychiatric patients. Both administrators and clinicians bene- fit from acquaintance with public attitudes toward the presence of psychiatric facilities and patients in their neighborhoods. Psychiatric rehabilitation is facilitated when mental health professions recognize the social realities that their patients encounter in their daily living. In short, it is becoming generally recognized that mental patients, and those who deal with them exist in the larger framework of society and that it is imperative, in both planning and carrying out treatment 10 11 programs, to be aware of the attitudes toward mental illness and treatment that prevail in this larger framework.1 Elaine and John Cumming2 undertook an interesting project in Praire Province, Canada. Their study was designed to investigate to what extent and in what direction attitudes toward mental illness are changed by an intensive educational program. They were aware that ignorance and fear of mental illness are widespread but they were not aware of the feeling and functions underlying public atti- tudes toward mental illness. They point out that the ignorance and fear are not merely the result of the lack of information about mental illness, but are derived from and maintained by personal and community needs. The Cummings have characterized public response to mental illness as a pattern of "isolation and denial." That is, the public tends to wall off the mentally ill, both figuratively and literally, and would prefer to deny that they exist. The experiment in mental health education with Elaine and John Cumming here reported represented a concentrated effort to change attitudes toward mental illness and the mentally ill in a single community. Their goal was both concrete and practical. They had observed the coldness of many communities to patients returning from mental hospitals; patients, released as recovered or remarkably improved, are often unwelcome, feared, isolated. Changing such attitudes would favor complete rehabilitation of former patients.3 1J.G. Rabkin, "Public Attitudes Toward Mental Illness: A Review of the Literature," Schizophrenia Bulletin, 10 (Fall 1974), p. 9. 2Elaine Cumming and John Cumming, Closed Ranks (Cambridge, Massachusetts: Harvard University Press, 1957). 3 John Clausen, in Cumming and Cumming, op. cit., p. x. 12 The above is in sharp contrast to the finding in the follow- ing study. The results of a study on one Maryland community done by Jon K. Meyers which showed that, "the population sampled is rational and humane in its verbally expressed attitudes toward mental illness and is aware of the signs of some mental disorders."4 In a random sample of respondents in two predominantly rural North Carolina counties, the conclusions were that, "there appears to be very little difference between rural and urban pe0ple regarding the treatability of mental illness. Rural people tend to be more tolerant of the mentally ill (than are urban people). Both over- whelmingly accept the role of psychiatrist as unique for themselves and family and friends."5 More recently, Crocetti, Spiro and Siassi,6 conducted a field survey to test the hypothesis: The preponderance of the public has attitudes toward the mentally ill that are characterized by stereo- typing, stigmatization, rejection, and prejudice and regards them as incurable. _The hypothesis was rejected. The sample, which consisted of blue collar workers in the Baltimore area, unanimously considered mental illness to be an "illness" requiring the care of a physician 4Jon K. Meyer, "Attitudes Toward Mental Illness in a Maryland Community," Public Healtthgports, 79 (September 1964), pp. 769-772. 5W.J. Edgerton, and W.K. Bentz, "Attitudes and Opinions of Rural People About Mental Illness and Program Services," American Journal of Public Health, 59 (1969), pp. 470-477. 6Guido Crocetti, H. Spiro, and I. Siassi, "Are the Ranks Closed? Attitudinal Social Distance and Mental Illness," American Journal of Psychiatry, 127 (1971), pp. 1121-1127. 13 and one that could be cured with proper treatment. The respondents also showed a sign of greater acceptance than rejection of all those who were formerly mentally ill. Somewhat along the same line, Linsky7 conducted a study of the ratio of involuntary and voluntary commitments (by developing an "exclusion index") to three mental hospitals in Washington State, to discover the types of people who are likely to be excluded from a community for mental illness. The hypotheses tested are: 1. Communities have a greater propensity to exclude for "deviance" lower class persons and members of low status --ethnic groups. 2. Those who lack close social ties in the community are more likely to be excluded for deviance than those with such ties. 3. Communities have a greater propensity to exclude males for deviance than females. The findings indicated that community tendency to exclude persons for deviance is greater for those who are either culturally marginal or of low social class, and those more isolated from stable ties. In the last few years the concept of societal reaction has emerged as a critical independent variable in the study of deviance (Erickson, 1962, Kitsuse, 1962). In the ecology of mental illness, societal reaction is an issue on both method- ological and substantive grounds.8 7A. Linsky, "Who Shall Be Excluded: The Influence of Personal Attributes in Community Reaction to the Mentally 111," Social Psy- chiatry, 5 (1970), p. 166-171. 81bid., p. 171. 14 More knowledge about the views of various samples of the general public is needed if this societal reaction approach is to be adequately tested and its implications explored. There have been some studies in the mental health literature that have centered their attention on the investigation of the atti- tudes and opinions of ethnic minority groups toward mental illness. Ring and Schein,9 initiated a study to assess the attitudes toward mental illness of the Cobbs Creek neighborhood (an upwardly mobile lower-middle income Black community) in West Philadelphia, before the establishment of a mental health clinic. They were also interested in the nature and extent of psychiatric problems in the target population--type of caretakers currently utilized by the com- munity for help with mental or emOtional problems. The general trends in attitudinal responses was in the direction of acceptance and understanding. Respondents expressed or pronounced degrees of willingness to associate with ex-mental patients as fellow workers or club members; In“: they displayed some reluctance, however, to accepting an ex-patient as a roomer or having one marry a member of the family. In a survey interview conducted by Karno and Edgerton,10 on a Mexican American community in Los Angeles, the findings led to the conclusion that: they share a cultural tradition which causes them 9S. Ring and L. Schein, "Attitudes Toward Mental Illness and the Use of Caretakers in a Black Community," American Journal of Orthopsychiatsy, 40 (1970), pp. 710-716. 10M. Karno and R. Edgerton, "Perception of Mental Illness in a Mexican American Community," Archives of General Psychiatry, 20 (1969), pp. 233-238. \\ 15 to perceive and define mental illness in significantly different ways than Anglos. Because of their strong family ties they tend to turn to one another for emotional comfort. There seems to be some relationship between attitudes and where people are in the social structure--name1y class, ethnicity, etc.--but there has not been much research to come to definitive con- clusions. Very few studies in the mental health literature to date have centered their attention on the opinions and attitudes of teachers. The following several studies represent the more signifi- cant ones. Yamamoto and Dizney,11 concentrated their attention on atti- tudes toward the mentally ill as expressed by future teachers. The subjects were student teachers taking a course in educational psy- chology at the University of Iowa. They used a questionnaire which included a brief case description of a hypothetical fellow student, with Guttman scales of social tolerance and suggested help sources. The results showed that students tended to order the cases on the basis of social visibility (deviation from socially prescribed norms rather than severity of pathological conditions). It was also found that a larger number of help sources was suggested for men than women in each pathological category. In a study comparing the attitudes of teachers and the general public by Bentz et 31., it was found that: 11Karou Yamamoto and Henry F. Dizney, "Rejection of the Men- tally III: A Study of Attitude of Student Teacher," Journal of Counseling Psychology, 14 (1967), p. 264. 16 A comparison of the attitudes shows a positive consensus between the two groups regarding general perceptions of mental illness, and mental hospitals that is best described as 'enlightened.‘ An absence of consensus was found in their attitudes about the etiology and the treatment of mental illness. The general public expressed old stereotyped ideas about the causes of mental illness more frequently than the teachers. However, the public appears more positive about treatment than teachers, who seem to be uncertain about how mental illness should be treated.12 Rabkin and Suchoski also concentrated on the attitudes of teachers. Their sample was composed of 107 teachers taking summer courses at the University of Washington. They found that teachers are reasonably well informed in regard to mental illness. However, when it comes to the more affective components of their responses, teachers present a picture similar to that of the general population. Mental patients are viewed with distrust and generally devalued and are considered unsafe. But on a relative basis teachers have more positive attitudes toward the mentally ill. Rabkin and Suchoski concluded: If in the long, hard struggle to improve public attitudes on mental health problems we are to utilize the schoolroom effec- tively, we must first take a serious look at the feelings and understanding of teachers about these issues. An important emphasis in any program of primary prevention must be on the development of more positive attitudes in our educators.13 In general, there is a high degree of similarity between teachers and the general public. If there are relationships between social structural variables and attitudes operating in the general public, then it should also operate with teachers. 12W.K. Bentz, J.W. Edgerton and F.T. Miller, "Attitudes of Teachers and the Genral Public Toward Mental Illness," Mental Hygiene, 85 (1971), p. 329.‘ 13Leslie Y. Rabkin and Joseph F. Suchoski, Jr., 1967, p. 41. 17 Even though there has been an increase in the number of studies in the mental health area, research investigating the Opinions and attitudes of the general public are few. While the research studies here do not exhaust the literature available, they are representative and provide a background of the kind of studies that have been conducted in this sector of the mental health area. For the most part investigations of popular attitudes have been of particular kinds of people as reviewed by Judith Rabkin14-- relatives of patients who have been released, nurses, family members, professionals, hospital attendants. These studies tend to be more concerned with how these people respond and interact with the men- tally ill, rather than what their opinion and attitudes are; making the assumption that behavior is related to an underlying set of variables, which are hard to measure. There is an enormous amount of theoretical and empirical literature that has tried to make a distinction between opinions and attitudes. Without trying to resolve those issues, for Operational purposes within this study, I will view semantic differential responses as indicators of attitudes, and responses to the "mental health opinion statements" as indicators of opinions. This is not at variance with the way the terms are used in the literature, but it would take me too far afield to get into the issues. 14Judith G. Rabkin, op. cit., 1974. CHAPTER III THE SAMPLE AND THE RESEARCH INSTRUMENTS This study investigates the responses of three groups: MSU secondary education majors (the title "Future Teacher" will be used to identify this group) N = 69, teachers attending summer school at Michigan State University (the title "Summer Teachers" will be used to identify this group) N = 173, and ”High School Teachers" on the job in selected schools in the surrounding area, N = 161. The "Future Teachers" sample was taken from Secondary Teacher Methods classes, offered by the College of Education during the fall (1975) at Michigan State University. These are courses that all -secondary education majors are required to take as a part of their curriculum. Many teachers come to Michigan State during the summer from all over the state of Michigan (and outside the state) to earn graduate credits, complete graduate degrees, and/or update teaching certificates. The "Summer Teachers" sample was taken from several graduate courses offered by the College of Education during the Summer (1975) at Michigan State University. These teachers represent many different communities; they came from 30 counties in the state of Michigan (see Figure 1), four other states (California, Indiana, 18 19 Figure l.--Counties where "Summer Teachers" are employed. 20 Ohio and Oklahoma), and four other countries (Ethi0pia, Canada, Uganda and West Indies). The composition of this sample is as follows: Elementary Teachers 56 Junior High Teachers 42 Senior High Teachers 20 College Teachers 9 Administrators 14 Graduate Students 24 Foreign 4 Others (Unknown) __fl__ 173 For both this sample and the "Future Teachers" sample, Professors in the College of Education were consulted as to which courses would contain a large number of secondary education majors, and during the summer, which graduate courses would contain a large number of teachers who are on the job during the regular school year. Five high schools in the south central Michigan area comprise the sample of "High School Teachers" used in this study. The schools are: Fowler High School (N=14), Ovid-Elsie High School (N=23), St. Johns High School (N=62), Williamston High School (N=23), and Grand Rapids Christian High School (N=39). The following chart gives the total number of teachers in each school, the number in each sample, and the percentage: 21 Total No. of Name of High School Teachers in School Data From % of Total Fowler 17 14 82 Ovid—Elsie 34 23 68 St. Johns 66 62 94 Williamston 34 23 68 Grand Rapids Christian 53 39 74 TOTALS 204- 161. 79% We were interested in both rural and urban schools in this research study and we gained access to several "rural" schools (Fowler, Ovid-Elsie, St. Johns, Williamston) in the surrounding area, but lacked success with the urban schools. However we were able to get one high school in the Grand Rapids area, Grand Rapids Christian High School, which is unique in that it is parochial, middle class, and suburban. These five schools represent three counties in the state--Clinton, Ingham and Kent. Fowler, Ovid-Elsie, and St. Johns (Clinton county) are quite interesting school districts in terms of size, because out of 530 districts in the state they rank 414, 313 and 253 respectively. Previous research investigations have shown that the usual social variables that sociologists are concerned with when conducting research (such as social class, rural-urban, etc.) do not seem to have strong positive relationships in the mental health area. Never- theless, several attempts to gain access to more urban schools for data collection were made, but Without success. Even though in this research study, we are not concerned with assessing one's mental or 22 psychological state of mind, it seems that the term "mental health" raises much concern on the part of school administrators. Description of Communities Table 1 gives characteristic information about the communities from which the school samples were drawn. It shows that Grand Rapids is the largest by population (197,649) and Elsie is the smallest (988). Williamston's percent population increase between 1960-1970 (17.4%), more than doubled the increase of 1950-1960 (7. %). This table also shows that Fowler has the largest proportion of residents under 18 years (41.4%); and Grand Rapids has the largest proportion of residents 65 and over (12.2%). For the state of Michigan, most of the population is between 18-64 years of age. By county, one finds that out of 83 counties in the state of Michigan, Kent ranks 5th (411,044), Inghan ranks 6th (261,039) and Clinton ranks 28th (48,492). Clinton county had the largest percent population change during the last decade, 1960-1970 (27.7%). Ingham county has the largest percent under 18 years (41.6%), and Kent county has the largest percent 65 and over (9.3%). Clinton county has the largest percent of rural population both farm and non-farm (20.8% and 57. % respectively). There are more foreign born residents in Kent county (4.0%) which is closest to that of the state of Michigan (4.8%). In Clinton county almost all of the residents between 14 years and 17 years are in school (97.5%); which is greater than the state's percentage (94.2%). The largest percentage of residents working inside the county is in Kent county (92.2%). 23. .oumum ecu cw mowucsoo mm ohm epoch .:mmw:uwz mo oumum one now x»:506 wag» mo xcmu cnmm ecu mucmmoumoh Aucsoo :owo mo uzwwu on» o» momocucohma cw gonads och * A~.n m.ns m.m m.em 0.6m A.HH s.m~ ---- mmo.mnw.m swungofiz mm.m m.ms m.o s.Hm o.Hs s.o A.A~ N.HN Nav.ws flwmvsoscfifiu ofl.m m.mv w.o 6.06 o.~m v.8 m.mm N.NN mmo.~o~ flow esgmcH mm.m m.os m.m s.mm m.nm H.o N.mH o.cm eso.HHs mmvssox mowuczou .1 ---- ---- ---- ---- ---- --- m.m s.~ mwm ofimfim mm.m H.0s w.HH H.Hm S.Am m.o o.m “.0 omo.H eu>o om.m m.os H.HH m.ns s.Hs 0.0 s.mH m.om owe.“ smfisoa NH.m w.ms m.HH w.om m.Am ~.o s.AH 0.5 oos.m scomesuasfiz o~.m v.6s A.oH o.om A.mm m.o . m.m~ o.m~ «no.8 _ macaw .sm oo.m o.ms N.NH o.sm m.mm o.NH m.HH m.o mso.nms mewssm ensue vaocomso: Hod ho>o cam Ho>o cam .mhx vcuwa whom» ma oufl:3-:oz onuoo. oonom. :ofiumazaom xuwcseeou m:0mhom wH mam: mo unoohom ucoouod Hows: ucooyoa sewpmfismom ucoopom ucoohoa ca nomcmgu ucoonoa .moaucsou cam mowawcsaaou Hoonom o>fim mo moflumfluoHUMHmnu ofigmmhwosoa wouoofiomuu.n oHan 24 N.Nm o.mw h.mm m.mm m.~v m.wm H.NH N.NH v.NH H.NH oocovwmom molNucsoo nomsoz osmmv an cusps: on: muoxhoz mo accused mcmH cw ooconwmom .mh> Hoocom suave: .Hovflo paw .mhx mm N.vm m.om o.mm m.nm floccum :fl ucoohom ..mh> anvH m:0meom w.v v.9 o.v w.m H.m o.m N.H w.om :pom Ehmm :mwohom .Hmham ucoopog accuse; A.HN csmwcufiz o.sH “cox s.HH escucu m.mm cescufiu Ehmmlcoz mmmucsou Hmpsx _ ucoopo; .eossflpsou--.fi ofisse 25 General Discussion of the Instruments The instruments used to obtain data from these samples were the Semantic Differential Technique and Thirty-Five Mental Health Opinion Items (a copy of the instruments is found in the appendix). The Semantic Differential The "Semantic Differential" is a combination of word associ- ations and scaling techniques, that has found a variety of uses in recent years since its development by Osgood, Suci and Tannenbaum (1957);1 one of which is the structuring of an attitude domain. It is a limited association test measuring the meaning Of a concept on bipolar adjectival scales (usually seven—point scales). When a con- cept is decoded by a subject, a complex reactiOn is assumed to occur, consisting of a pattern of these alternative bipolar reactions elicited with varying intensities. When the subject encodes this semantic state against the differential, his selection of directions (i.e. good vs. bad; strong vs. weak, etc.) is assured to He co- ordinate within the intensity of these reactions.‘ . In an evaluation of this instrument, Osgood et al. found evidence to support the fact that it has objectivity, reliability and validity.2 1Charles E. Osgood; G.J. Suci; and P.H. Tannenbaum, The Measurement of Meaning_(Urbana, Illinois: University of Illinois Press, 1957). 2James Snider and Charles E. Osgood, (Eds.), Semantic Dif- ferential Technique, Chicago, Illinois: Aldine Publishing Company, 1969), p. 34. 26 A series of experiments performed to attempt to determine the generality of the affective semantic space revealed three dominate factors that appear to dominate the space. "The salient factors, Evaluation, Potency, Activity, have been found in many populations, samples with different linguistic and cultural backgrounds."3 Osgood suggests that the instrument measures connotative rather than denotative aspects of meaning. More precisely, he states: It is also apparent that, contrary to my early expectations, these factors are more reactive in nature than sensory, more broadly affective than discriminately cognitive and thus closer to connotative than to denotative aspects of meaning. Many semantic differential scales have been reported to have a strong evaluative factor, that is, one end which represents "favorableness” and the other end which represents "unfavorableness." Ten of the 12 scales used in this study have a strong evaluative component (possible exception of Simple-Complicated and Rugged- Delicate). The "Semantic Differential" has the advantage of being an easily administered instrument. There are three other important features of the semantic differential that are of particular impor- tance to this research investigation. They are: l. The semantic differential can be used as an attitudinal measure. 2. The responses of the semantic differential can easily be compared with other data (such as previous data of my own and of Nunnally). 31bid., p. 289. 4Snider and Osgood, op. cit., p. 305. 27 3. It's factor analytic approach. The following "dummy table" will be used to establish term- inology for the use of the semantic differential in this research: Scale I _g ‘ Means . I’ Scales "Doctor" Scale— "Relaxed- concept Tense" __mean Concept Overall Means *f’ g} Mean Mental Health Opinion Items Thirty-five of the original 60 items used by NunnallyS were selected to be used in this study. Responses to the items were made on a one to seven scale (one on the scale indicates "disagreement" with the statement, and seven indicates "agreement" with the state- ment). Nunnally's questionnaire items were derived from a broad spectrum of popular and professional conceptions and then subjected to a considerable array of validation procedures. Over three thousand statements concerning mental illness were gathered 5Jum C. Nunnally, Jr., Popular Conceptions of Mental Health (New YOrk: Holt, Rinehart and Winston, Inc., 1961). 28 from 22 public-information pamphlets, from professional publica- tions, and from over 200 personal interviews with the general public. The statements were then made randomly positive or negative and were pre-tested for clarity and for bias in phrasing. A final pre-test on 350 persons was conducted to further refine the instrument. It was decided to reduce the number of mental health opinion items from 60 to 35 because of a concern for length and the respond— ents' attentiveness to the instrument, which could have an affect on the responses. The selection of the particular 35 items was made on the basis of: (1) consensus among mental health experts7 and (2) previous research among college students.8 "Knowledgeability Score."--Twenty mental health opinion items provide the basis for the development of a "knowledgeability score" for each respondent in this study. They are 20 of the same items used to get responses from a sample of mental health experts by Nunnally. The selection of the particular 20 items is the result of close examination of the 35 items by three people who have several years of experience with mental health data--the author, Dorothy Smith,9 and Donald W. Olmsted10 (academic advisor for the author and 6J. Marshall Townsend, "Cultural Conceptions, Mental Dis- orders and Social Roles: A Comparison of Germany and America," American Sociolsgical Review, 40, 1975, p. 741. 7Nunnally, op. cit., 1961. 8Dorothy L. Smith, College Students' Knowledgeability and Opinions About Mentaerealth in 1962 and 1971, M.A. thesis, Michigan State University, 1972. 98mith, Ibid., 1972. 10Donald W. Olmsted and Robert K. Ordway, The Final Report of Concepts of Mental Health: A Pilot Analysis, (Report to NIMH, Grant m—5880(A), June 1963). 29 Smith). For example, an item was considered a candidate for rejec- tion if: (1) the statement contained ambiguity, and (2) the struc- ture of the statement represented a double negative. Consensus among the three of us determined whether an item was retained or deleted. The responses given by the mental health experts to these items was viewed as "correct," and was used as a response indicating knowledgeability about mental health by the respondent concerning the item. If the response given by a respondent was in one of the two "officially correct" categories, he received a score of five for that item; if his response was one category away, his score was four and so on to a score of zero. For example, if categories One and two are the "correct" answer to an item by professional consensus, then the score received by a respondent for his response on that item would be: Response Category Disagree Agree 1 2 3 4 5 6 7 Score on "Disagree" Item: 5 5 4- 3 2 1 0 Score on "Agree" Item: 0 l 2 3 4 5 5 The maximum score obtainable by a respondent for the 20 items is 100; the minimum score is zero. A low score indicates low accord with the experts' responses; a high score indicates high accord with the experts' responses. Accord with the experts' opinions is the Operational measure of knowledgeability about mental health. (In the analysis of data the means of the 35 items and the K - score will be used.) CHAPTER IV GENERAL HYPOTHESES There are 15 semantic differential concepts used in this study. They have been divided into five types for heuristic purposes. They are: Professionals--Doctor, Psychologist, Psychiatrist; "Normal"--Me, Average Person, Most People, Ex-Mental Patient; Disorder --Neurotic Person, Mental Patient; Severe Disorder--Schizophrenic Person, Paranoid Person, Crazy Person, Insane Person; Physical Disease--Person with Heart Disease, Person with Cancer. Concepts in a "concept type" would be viewed similarly. It is easier to discuss five types of concepts than it is to discuss 15 concepts. Each respondent responded to only ten of the 15 concepts. Five concepts were identical for all respondents (Doctor, Me, Ex- Mental Patient, Neurotic Person and Mental Patient). The remaining ten concepts were paired (Psychologist-Psychiatrist; Average Person- Most People; Schizophrenic Person-Paranoid Person; Crazy Person- Insane Person; Person with Heart Disease-Person with Cancer), and each respondent received a response form containing one of the other concepts of these five pairs. It was a matter of chance as to which one of the concepts in a pair, a given respondent received. 30 31 The following chart will show the "evolution" of the con- cepts used in this investigation. That is, the way in which new concepts were selected and the development of concept types for a more adequate analysis of the data. The 1976 study builds on previous research investigations. Results of 1971 Study Doctor Professionals Doctor Professional Doctor Psychiatrist Psychiatrist and Psychologist Professional Me "Normal" Psychiatrist Me Average Man Me Average Man "Normal" Most People "Normal” Average Person "Normal" Most People Ex-Mental Ex-Mental Patient Patient Ex-Mental 9 Mental Mental Patient Patient Disorder Patient Disorder Insane Neurotic People Person Schizophrenic Person Paranoid Severe Person Disorder Crazy Person Insane Person Person with Heart Disease Physical Pearson with Disorder Cancer ("Average Man” and "Insane People" were changed to "Average Person" and "Insane Person" for consistency.) An objective of the 1971 study (see Durham, 1972) was to see how the concept "Ex-Mental Patient" would be viewed. The results of the study showed that the respondents viewed "Ex-Mental Patient" 32 approximately as favorable as the ”Normal" concepts, and distinctly more favorable than the Disorder concepts (see Olmsted, Durham 1976). It is expected that this will be supported in the 1976 study. Our research studies prior to 1976 also investigated only the responses to the Disorder concepts, "Mental Patient" and "Insane People;" each time they were the lower rated concepts with "Insane People" lowest (similar results were also found by Nunnally). This prompted the decision to add more Disorder concepts. The concepts "Neurotic Person," "SchizoPhrenic Person," "Paranoid Person" (tech- nical terms), and "Crazy Person" (popular term) were added in the 1976 study. The 1971 study also revealed that the college students were less negative toward the Disorder concepts than the general public. It is expected that the Future Teachers will show similar results in this study. The concepts "Heart Disease" and "Cancer," which are two of the most dangerous physical diseases, were added to provide a con- trast to the mental disorders. This was done to gain insight into whether respondents tend to view all disease "negatively" or "unfavorably," or if they make this distinction only with mental disorders. The results of these research investigations is the rationale for setting forth the following general hypotheses: Hypothesis 1:_ The concept "Ex-Mental Patient" will not be distinctive from the other "Normal" concepts (Me, Average Person, Most People), but will be distinctive from the Disorder concepts (Neurotic Person, Mental Patient), and the Severe Disorder concepts (Schizophrenic, Paranoid, Crazy, Insane). 33 Hypothesis 2: The array of favorableness for the types of concepts will be in this order: Professionals (with Doctor rated highest), "Normal" (with Me rated highest), Physical Disease, Disorder, and Severe Disorder. Hypothesis 2a: "Heart Disease" and "Cancer" will be more favorably perceived than the Severe Disorder concepts by all three samples (High School Teachers, Future Teachers and Summer Teachers). Hypothesis 3: The Future Teachers will tend to view the Severe Disorder concepts less negatively than will the Summer Teachers and High School Teachers. "Knowledgeabilityfl This part of the chapter is concerned with the deve10pment of specific hypotheses dealing with the relationship between know- ledgeability and nine social variables which characterize the samples. These variables are: Age, Sex, Subjects Taught, Teaching Major, Type of Institution Attended (Public or Private), Years of Teaching Experience, Type of Hometown Community, Size of Hometown Community, and Reported Mental Health Experience. Jum C. Nunnally, who has done a considerable amount of work in the mental health area, has discovered that subgroups in the population have only slightly different attitudes toward the mentally ill. He sought to distinguish the differences between specific social variables in relation to mental health attitudes. Even though Nunnally found marked differences between the kind of information held by old as compared to young people, and by more educated as compared with less educated people, the differences in the attitudes of these and other subgroups are relatively small. 34 He found a small, but statistically significant tendency for more educated people to hold less derogatory attitudes toward the mentally ill. ‘ None of the other demographic variables showed more than minor differences. He found some significant differences (by t-test) between the mean responses of women and men. The differences, how- ever, formed no clearly interpretable pattern, and differences in one study sometimes were not supported in the other studies. Nunnally concluded that subgroups in the population do not differ substantially in their attitudes toward mental illness and the men- tally ill, (see Nunnally, 1961). ' The 1971 study on college students (see Smith, 1972) revealed that the older respondents (graduate students) were higher with regard to knowledgeability and only a weak relationship or none between sex and knowledgeability. With regard to type of hometown community and size of hometown community and knowledgeability the 1971 study indicated a weak or no relationship. It is expected that social science teachers and majors will be more knowledgeable because of the nature of the subject matter which centers its attention on social issues. It is not expected that type of institution attended will make a difference, because if we are participants in a "cultural belief system" than where we attend school will not effect responses in this area. The 1971 study also revealed that those who had mental health experience were more knowledgeable. It is expected that this will be supported in the 1976 study. 35 These research investigations provide the rationale for the following hypotheses concerning knowledgeability. (For the purpose of analysis, the Summer Teachers are viewed as similar to the High School Teachers.) Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 10: 11: 12: 13: High School Teachers The older teachers will be more knowledgeable about mental health than the younger teachers. There will be no relationship between sex and knowledgeability. Respondents who grew up in an urban area (suburban or non-suburban) will be more knowledgeable than those who grew up in the open country. There will be no relationship between community size and knowledgeability. Those teachers who teach social science sub- jects will be more knowledgeable than the others. Teachers who have more years of teaching experience will be more knowledgeable. There will be no relationship between type of institution attended (public vs. private) and knowledgeability. Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have had none. Future Teachers There will be no relationship between age and knowledgeability. (Since this sample is composed of mostly Juniors and Seniors there is a restricted age range.) There will be no relationship between sex and knowledgeability. Hypothesis Hypothesis Hypothesis Hypothesis 14: 15: l6: 17: 36 Those "Future Teachers" who are social science majors will be more knowledgeable than the other majors. Respondents who grew up in an urban area (suburban or non-suburban) will be more know- ‘ ledgeable than those who grew up in the Open country. There will be no relationship between community size and knowledgeability. Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have none. The following chart will summarize the hypotheses set forth concerning the relationship between knowledgeability and the social variables: Social Variables Age Sex Community Type Community Size Subjects Taught Teaching Major Type of Institution attended (Public vs. Private) Years of Teaching experience Reported Mental Health Experience (some vs. none) High School Teachers Future Teachers Older more knowledgeable None expected None expected Urban more knowledgeable None expected Social Science more knowledgeable Not applicable None expected Greater teaching experience, more ‘knowledgeable ‘Some reported experience, more knowledgeable None expected Urban more knowledgeable None expected Not applicable Social Science more knowledgeable Not applicable Not applicable Some reported experience, more knowledgeable CHAPTER V ANALYSIS OF DATA The results of the 1971 study showed high intercorrelations among ten of the 12 scales investigated (see M.A. thesis, 1972). These ten scales, because of their high intercorrelations and strong evaluative dimension, compose a "Favorableness Index" to be used in the analysis of the semantic differential data in this study. The scales are (with "favorable" end listed first and assigned a value of seven): Valuable-Worthless, Sincere-Insincere, Clean-Dirty, Safe-Dangerous, Warm-Cold, Wise-Foolish, Strong-Weak, Fast-Slow, and Predictable-Unpredictable. The scales not included are Simple- Complicated and Rugged-Delicate, because they have low correlations or are negatively correlated with the other scales. The "Favorableness Index" will be used in the evaluation of the concepts used in this study. A high mean score (4.00 and above) indicates "favorableness" toward a concept; a low mean score (below 4.00) indicates "unfavorableness" toward a concept. Hypothesis 1 states: The concept "Ex-Mental Patient" will not be distinctive from the "Normal" concepts (Me, Average Person, Most People), but will be distinctive from the Disorders concepts (Mental Patient, Neurotic Person), and the Severe Dis- order concepts (Schizophrenic, Paranoid, Crazy, Insane). 37 38 Results: The relevant data are in Tables 2 and 3 and Figure 2 which clearly show that "Ex-Mental Patient" is viewed favorably (mean score above 4.00) along with the other "Normal" concepts by the High School Teachers, (4.36), Future Teachers (4.52), and Summer Teachers (4.27). It is distinguished from the "Disorder" and "Severe Disorder" concepts which are viewed unfavorably (mean scores below 4.00) by all three samples. Hypothesis 1 is supported. Hypothesis 2 states: The array of favorableness for the types of concepts will be in this order: Professionals (with "Doctor" rated highest), "Normal" (with "Me" rated highest), Physical Disease, Disorder, and Severe Disorder. Results: Tables 2 and 3 and Figure 2 show that the array of types of concepts for the three samples, High School Teachers, Future Teachers, and Summer Teachers is: Professionals (5.15), "Normal" (4.72), Physical Disease (4.40), Disorder (3.47) and Severe Disorder (3.26). "Doctor" is the highest rated concept for the High School Teachers (5.54), and Future Teachers (5.37); it is the second highest for the Summer Teachers (5.71). "Me" is the highest rated concept for all the samples-~High School Teachers (5.48), Future Teachers (5.33), and Summer Teachers (5.75). Hypothesis 2 is supported. Hypothesis 2a states: "Heart Disease" and "Cancer" will be more favorably perceived than the Severe Disorder concepts by all three samples (High School Teachers, Future Teachers, and Summer Teachers). Results: The relevant data is in Figure 3 which shows that the High School Teachers, Future Teachers, and Summer Teachers make a distinction between the way they view the Physical Diseases and the Severe Disorder. 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Nu 3 U 9 I 3 B 3 3 B 8 8 8 B 9 9 9 B X 9 O 9 A 9 S S O 1 s 1 e 1 1_ 1 u. 1.u 1 n u 1 e 1 1 . o s 1 a ,A ,A 3 SB 82 SE St. 1.1. 5.1 OS 15 I.“ d1 51 O 3 1 o u 0.1 o u o z a e 0 0 a 0 1 0 a a I 0 e u. u. o u a u u o u o u I. u 1 1 u u u u a use I. o 1 t. d 1 I. G 1 1 e e I D. u. D M I.M E 1 O I I. S I. T. l 3 a 1 a 1 I. t. m. u. mu. . m s. povuomfio opo>om o housemwo ommomwo :HmEhoz: Hmc0wmeuo»a Assumsns .fi:mmo:ofinmuo>mm: one: mfimnwm xoecH Hoswflzv mHoosom swam o>flm Seam momcommom .memxb umoucou o>flm vaezoh xoccH mmocefineho>mmau.m oHneH 40 0N.m 0H.n vN.m hm.m HOOHOmHa ouo>ow vo.m mm.m hm.m mm.m wH.m Hm.n mm.~ mm.n v~.m om.m om.m ov.m d7... d3 dd an 31 98 l S I B I I SW 52 SW 0 OrA O u a U u 0 to p nonhomfia oue>om ne.m vm.m mm.m em.m Hmvhomma mv.m mm.m wm.m Hn.n m~.m mm.m me.m mm.m wv.m om.m wm.m an.m .anb .dnw .duN 93 89 99 1 U. 1.u I n S I. I.1 S I 02 99 00 u 0 u T. u 1 ya 1 I. U. 3 I a u T: 3 HovHOmwo ov.v am.v mm.v Hm.v ommomwo HmOmegm 2; mm; £1. em; $1. £4. 81. ms; nJ.d "H.d a m m m 3 S I S 8 0 1+ 0 l u u a M I.M to S to 1+ 9 .4 U. B u. S 9 ommomwo assesses wm.v nm.v mm.v om.v 1uetied {eiuew-xa Nh.v ow.v Ho.v wh.v :HNEOZ: _ov.v om.v mv.v mn.v HH.v ov.v m©.v ©v.v .an .dHV a o a A O S 1 9 Ta 1 S 1 T. o B a Una a :HmEhoz: mm.m mn.m mm.m mH.m Om.m Hm.v mm.m mamcoMmmomOAH m©.v mN.m Vm.m 00.? wh.m Hm.m N©.v mh.v nm.m ow.v OH.m vm.m d d O S S O .A .A o 3 D 1 u. u. o I. O I B T. 1 O 1 so TL. T... S S 1+ 1+ mHmCOHmmomOMm .M ewmpo>< muogumOb seesaw whosomob «sauna muesomeh Hoosum cm“: x owmhe>< mpecomoh hoEESm wheaomob eunuam who;umeh Hoocow cw“: .Azmmo:OHnmuo>mm: ones mfimswm xovcm nonwflzv whosoeeh possum wee .mnenoeob onzusm .muonomeh Hoonom swam mo momcommom .momxh pmoocoo O>Hm vhwzoh xovcH mmocemneno>emsu.m Oanmk 41 Figure 2.--"Favorab1eness Index" of Five Types of Concepts, Responses of Teachers in Five High Schools. F - Fowler G - Grand Rapids 0 - Ovid S - St. Johns W - Williamston 8- Average Mean for Concept 5.80 5.60 S.ho 5.20 5.00 b.80 b.60 h.ho h.20 h.OO DOCTOR PSYCHOw LOGIST go .9 o? PSYCHIA- TRISI a! .5 "NORM. [ II HE AVERAGE gnosr sxsnsner PERSON PEOPLE PATIENT ‘5 '6. “I 1? 5’ .9 a1 «a .5 ‘9 v 9 .o 0545 «i 3’91 :0 .9 1U 11020 h.OO 3.80 3.60 3.h0 1.20 3.()O 2.80 43 DISORDER 331333 DI§QBD§B , NEUROTIC MENTAL sedizo- PAHANOID caxzr INSANE PERSON PATIENT Pd“hNIC PLRSQN PERSON PERSON PERSON a? .9 0? ‘d .‘O as -s O 53.5 '9 ?' 6> .6 or W 6 9 a, 6 O a? ”a ed .0 ow 0 P .6 0° % 6 I? V 'F A: 44 HY I DIS E HEART CANCER DISEASE 5.20 ‘5 5.00 b.60 .9 b.60 .5 'YMO O h.hO '5 .PN‘.‘ P h.20 45 (with the exception of a 3.69 for the concept "Cancer" by the Summer Teachers), and the Severe Disorder have mean scores below 4.00. Hypothesis 2a is supported. Hypothesis 3 states: The Future Teachers will tend to view the Severe Disorder concepts less negatively than will the Summer Teachers and High School Teachers. Results: Figures 3 and 4 show that the Future Teachers are not distinctive in their views toward the Severe Disorder concepts. All three samples have highly similar views toward these concepts (the mean are very close). Table 3 shows that the average mean score of the Severe Disorders are as follows: High School Teachers (3.37), Future Teachers (3.24), and Summer Teachers (3.16). Hypothe- sis 3 is not supported. Anaiysis of Responses to Typss of Concspts for High School Teachers 1. Professionals: "Doctor" is rated highest in three of the five samples (Grand Rapids--5.61; Williamston—-S.6l, and St. Johns--5.49). "Psychologist" is rated highest in two of the samples (Fowler--5.33, and Ovid-Elsie--5.78). "Psychiatrist" is seen as the \ least favorable of the concepts by four of the five samples (Ovidgg Elsie--4.60, Williamston--4.97, St. Johns--4.67, and Fowler--4.79). 2. "Nsimsi": "Me" is the highest rated concept by all five samples (Ovid-Elsie--5.75, St. Johns--S.59, Grand Rapids--S.49, Fowler--5.29, andWilliamston--5.26). "Average Person" is the second highest rated by Ovid-Elsie (4.75) and Williamston (4.65). "Most People" is second highest concept by Fowler (5.09), Grand Rapids 46 Figure 3.-—"Favorab1eness Index" of Five Types of Concepts, Responses of High School Teachers, Future Teachers, Summer Teachers. HST - High School Teachers FT - Future Teachers ST - Summer Teachers 47 8:0. h. . c... .3 .E .5. 0 8A .. cu 0° 6} 8T x. a... 0 ha. a Qapa en. t . .e.‘ a. s. .1 X. . 803 e“. 3. .6. a... 8A. t. 3 a... . x. 3.. Va. 00mm . 923.21 zommmm 9232.1 585 zommmm SHE. $83 43.2%. 8.8552 iezmxuxm p.82 moém: m: 15:53.1 -2631 8989 $95me 3310:. J 1 fiaonmmEoE 48 00$ .t . vm 8% t v... . .. s. s wm . vs 3.“. e if“! e ‘6 a. w. 88 3.1. wm 1A...» k. -m _ as x v. e “s .688 -35- mméms zommmm 203E 16sz BEE H325 5:81 829$ .55 , 30251: 82:8 Jana 44% “gm 1 555a a 49 Figure 4.--"Favorableness Index" of Five Types of Concepts, Responses of Future Teachers. 50 00.3 ezmHe< m: aMdflder emHmB I< m: T .xuflufineowponosa use meaneflne> Hawoom coospom manmcoauwaom may we xnmaasmuu.wa ofinmh 72 during the 1950's. The following chart shows the factors and the number of items in each that corresponds to our research study: Mental Health Factors Number of Items 1. Negative Stereotypes 4 II. Will Power 6 III. Sex Differences 1 IV. Environmental Forces 3 V. Role of Psychiatrist 4 VI. Damage, Incurability, Seriousness 7 VII. Age and Childhood Experiences 3 VIII. Physical Causes 1 3 IX. Miscellaneous 4 Several tables and Figure 6 will be used as references in the analysis of opinion factor items. 1. Negative Stereotypes Item 7: "You can tell a person who is mentally ill from his appearances." There is strong disagreement with this item across all five high schools. The Future Teachers (2.17) and Summer Teachers (1.91) also disagree with this item (the Future Teachers somewhat more strongly), as shown in Table 19. Item 16: "The insane laugh more than normal peOple." Table 19 shows there is disagreement with this item, with Fowler (1.86) disagreeing the strongest. 'The High School Teachers (2.56), Future Teachers (2.49) and Summer Teachers (2.60) all have very similar opinions toward this item. 73 Figure 6.--Means of Mental Health Opinion Items for High School Teachers, Future Teachers and Summer Teachers. 74 muonoeoa won-5m I D «Hosanna. 0.335 I O 30:23.". Hoonum saw: I R o~.a oo.H o~.~ on.~ 0n.N o~.~ om.~ on.n on.n 0n.n co.n x u . xu . r 0 X0 . 0.x .x n k 0 OX . on X nflVN 0 X0 6 0X0 ox. X00 X60 . ox .Inu &‘ oo.¢ co.n :o.o . x 6 OX. V. Do U x a .9“ H0 0 ha \n X0. QUAD 0 UK ova nu 00X an.n ca.n o~.¢ on.c On.¢ oh.c ow.c o~.m on.n ow.m oh.n ca.n o«.c onoo oouw< «N .3 MN um um MN on «n ma an o." .3 0.— nu mu m.— ON ON .3 NH 0N mm on ma o.— w." .02 Evan 75 .muoocom cmuc e>um how mcmee .EOuueM>eu emmue>ea .O><¥ mccon .um meumoz vceuo coum -Eeumuuz eumam lum>o om.H VH.H heuzom .zmmeum eue ecmmcm ecu we meme och .vooumueucz on cue uwcu muuoz cw xeemm mneuflmmoc HmuceE cu eumoem ecu mo umoz .eumoen awake: :mcu egos cmnmm ecemcu ecb .euceumenmm muc Eoum uuu zuumucee nu cc: comuem e Hueu :eu 30> Homhouw v>Hum .nzmemxuoeueum e>uuemezzu muecoeek ueEESm use .muecoeeh eusuam .muoocom cwu: e>um cu muecueeh mo memcommem .muceEeuEum coucum01u.mu euceh- 76 Item 26: "Most of the people in mental hospitals speak in words that can be understood." Table 19 indicates agreement with this item across all five schools, with the Williamston Teachers (5.56) agreeing strongest. The average deviation is .12 which also indicates consensus among the teachers in their opinions. The Summer Teachers (5.06) agree somewhat more strongly than the High School Teachers (4.74) and the Future Teachers (4.39). Item 33: "The eyes of the insane are glassy." Table 19 shows that across the five schools, the Fowler teachers (1.79) dis- agree strongest. The High School Teachers (2.46), Future Teachers (2.58), and Summer Teachers (2.35) all disagree strongly with this item. II. Will Power Item 8: "People who become mentally ill have little will power." Table 20 shows that the average deviation is .14 for this item which indicates that the teachers' opinions are very similar. The Future Teachers (2.88) and Summer Teachers (2.67), along with the High School Teachers (2.55) disagree strongly with this item. Item 10: "People who keep themselves occupied with pleasant thoughts seldom become mentally ill." Table 20 shows there is less disagreement with this item among the Fowler teachers (3.36) and Grand Rapids Teachers (3.08). The High School Teachers, Future Teachers, and Summer Teachers have very similar opinions of strong disagreement with this item. Item 13: "Will power alone will not cure mental disorder." Table 20 shows very strong agreement with this item among fOur of 77 .muoocum cwuc e>um pow mcmes .cauumu>eu emeue>eo .e><- vv.v oo.m mscon .um wN.m mo.v om.N om.~ ov.~ Nm.N vu.m mm.m wo.m vn.N Hm.N vu.w mvumem coum vceuo uEeuHsz mo.v oo.m .Eecu uemuow cu vumc mcuxuu ac meuuoEeE ucemmeHmcs mo mzewemc vuu uo: :ee comuem < .mm mw.~ no.n .m:0quEe ecu Houucoo ou uuec mcuzuu mo ueuumE m xuewueu mu cuueec Heucez .mN ~m.— om.m .ucemeun ecu cm mucucu ucmmeeunca ac weuecuoc ec uo: uuuz ec mequEeE xammc co neumuuceecou :omuen m Mu .vm fie.m nm.m .ueuuemmv HmuceE eusu uo: Huuz ecocm uezon Hum: .mu mv.N om.m .Huu xuueuces esouec Eovuem mucwzocu ucmmeeun cuuz newmsuoo me>uemaecu neex oc: ounce; .ou mm.m v~.~ .uezom Huuz eHuumH e>ec Hum suceucea eEouec oc3 eunoem .m oumum souzoa sozos Huuz -vu>o Azuozoo 3?; 26:83. $53 one muecoeeh eunusm .muoocom cwuz e>um cu mueceeeh mo memcommem .muceEeueum :owcumo--.om eucek 78 the five schools. The St. Johns teachers (4.94) agree somewhat less strongly. Of the three groups the Future Teachers (4.94), like the St. Johns teachers, agree less strongly. Item 24: "If a person concentrated on happy memories he will not be bothered by unpleasant things in the present." Table 20 shows that the strongest disagreement with this item is among the Obid-Elsie teachers (1.91). The means of the Summer Teachers (2.38) and High School Teachers (2.43) are very Close, and the Future Teachers (2.15) are lower. Item 25: "Mental health is largely a matter of trying hard to control the emotions." The average deviation of .37 in Table 20 indicates much dispersion in the means across schools. Though they all tend to disagree with the item, Fowler (3.04) and St. Johns (3.50) disagree less. The Future Teachers (2.15) disagree with the item more than the other two groups. Item 35: "A person cannot rid himself of unpleasant memories by trying hard to forget them." Table 20 shows very strong agreement with the item among Fowler (5.00) and Grand Rapids (5.28) teachers; somewhat less in Ovid—Elsie (4.65), Williamston (4.65) and St. Johns (4.44). Of the three groups, the Summer Teachers have stronger agreement (4.92). 111. Sex Differences Item 14: "Women have no more emotional problems than men do." Table 21 shows that Ovid-Elsie (4.70) and Williamston (4.13) tend to agree with the item; Fowler (3.93), Grand Rapids (3.85) and St. 79 Johns (3.95) tend to disagree with the item. The Summer Teachers (4.42) tend to agree with the item more than the High School Teachers (4.06) and Future Teachers (4.06). IV. Environmental Forces Item 4: "Helping the mentally ill person with his financial and social problems often improve his condition." Table 22 shows that the strongest agreement with the item is in Fowler (5.50) and Williamston (5.22) samples. The Future Teachers (5.23) and Summer Teachers (5.10) have stronger opinions of agreement toward this item. Item 15: "Mental illness can usually be helped by a vacation or change of scene." Table 22 indicates disagreement across all five schools, but it's not very strong. The Future Teachers (3.68) disagree with the item much less than the other two groups. Item 12: "People cannot maintain good mental health without the support of strong persons in their environment." Table 22 shows that Fowler (3.43) and Williamston (3.96) tend to disagree with the item; Ovid-Elsie (4.52), Grand Rapids (4.39) and St. Johns (4.07) tend to agree with the item. There are very similar opinions of agreement among the High School Teachers, Future Teachers and Summer Teachers. V. Role of Psychiatrist Item 6: "The good psychiatrist acts like a father to his patients." Table 23 shows that all five schools disagree with the item; though somewhat less among the Williamston teachers (3.13). There are very similar Opinions of disagreement among the three groups. .mcoocum cmuc e>um new names .EOuueM>ev eweue>eo .e><« mccow .um ow.v moumoa vceuo COum tEEMHHmz emmmm nvm>o .uceecouu>:e Huecu :« mcemuem mcouum we uuonnam ecu unocuu: cuueec Hauces voom cumucuea ue: :eO ounce; .eceum mo emcecu he cemueuw> a xc venuec ec xuuesms :«u mmecuuu deuce: .ueuuom ER :Ouuuucoo muc e535 :euwo meeucoum ueuucecum mmc cuuz comuen Hum smuwunee ecu acumue: neuron meouom umuzeacouu>=m NH V 80 can muecuee .n:meouom Heucescouu>cmzv muecoeeb HesESm a eunusm .muoocom cmuz e>um cu muecomeh we memcommem .muceaeueum coucumol-.mm eucee we.” oo.v oo.v muecoeeh muecomeh muecomeh .ueEE:m euzusu coocum cmu: .>eo .0><«. mzcow .um neumoz vceuo :Oum uEMmaum: .ou ea cecu maemcoum "accuuoae egos e: e>ec :eao: meocehemeo xew .va .nsmeoceuemwua xemzu mHecoeeh Heassw wee muecoeeh eunuam .muoocom cwuz e>um cu muecoeeh mo memcommem .muceeeueuw coucflm0u-.um euceh 81 .mcoocum cmuc e>um uom mceee .c0uu6u>ev eueue>eo mccon memmmm coum eumum ueczou umuuumccoxmm mo ecom Hesasm eususu moocom cm“: " .e>o . . .nzumuuueucoxmm mo euomzu muecoeee Heaazm pee muecoeeh eunuSm .muoocom cmu: e>um cu muecoeee mo memcommez .muceaeueum :OMQMQOTu.mN euceb 82 Item 17: "Psychiatrists try to show the mental patient where his ideas are incorrect." Table 23 indicates varying opinions (Average Deviation .37) toward this item across schools. The Fowler teachers (4.29) tend to agree; St. Johns (3.47), Ovid-Elsie (3.30), Grand Rapids (3.13) and Williamston (2.83) all tend to disagree (with Williamston strongest). The Future Teachers (3.73) stand out from the other groups with less disagreement toward the item. Item 21: "The main job of the psychiatrist is to recommend hobbies and other ways for the mental patient to occupy his mind." Table 23 shows strong disagreement with this item across all five schools. All three groups tend to strongly disagree with the item and their mean scores are very close. Item 22: "Psychiatrists try to teach mental patients to hold in their strong emotions." Table 23 shows that all five schools strongly disagree with the item; with Grand Rapids (1.74) strongest in disagreement. There is a consensus of strong disagreement with this item among all three groups. VI. Damsge, Incurability, Serious- ness Item 1: "Mental disorder is one of the most damaging ill- nesses that a person can have." Table 24 shows that Williamston (3.96) disagrees somewhat with the item, and the other four schools agree with the item. The Future Teachers (4.87), High School Teachers (4.36) and Summer Teachers (4.76) all tend to agree with the item. 83 .mcoocom cwuc e>um mo mcmeE .couumu>ep owmuo><. _ mw.~ mw.H NN.H " NH. nw.a no.m mo.~ wn.~ HN.H .honuomwv amucoe m “ moce>ev oc: comuem 6 how ecop " on cue uecu cone uo: mu euech .nm . Hm.m mm.m vo.m " on. mm.m mm.m cm.m 5H.o vc.o .mEeccoua Hmcouue: ucmuuomeu " umoe ecu mo eco mu cuueec cause: .mc . . no.0 o~.o NN.O m mm. mH.o mv.o om.o v0.0 hm.c .COMumvcou mmecoaoc . m uo: mm ueeuOmup cause: .wc _ _ um.~ 66.5 6H.5 " 55. 56.5 N5.u 66.5 mu.~ m5.u .ossou soso mcsozsmog " causes ueuce cc: ecmoem zed .cc . . mm.v wm.m wc.v " 6H. oo.v Hm.v vo.v nw.m cm.v .pemmeueu eue xecu coca u xueMOOm ou usesumsmce poem 6 " ecee zuumsmz museuumm cmucez .m _ _ hN.N m~.N wv.N m av. en.m Nw.N on.~ om.N oo.N .Ueumhewmmxe seen we: . muucsoo ecu cu Eeccoum cuceoc m caucus ecu mo mmecmSOMuem ece .m 65.6 56.6 66.6 m om. 66.6 65.6 66.6 66.6 56.6 .oss; cso comsoo s . umcu memmecccu accumEew umoe m ecu mo eco 6c cenuOmmn cause: .u “ muecoeeh muecoeeh muecomeh m .>ec mccow enumem caum eumcm ueczou mmecmsouuem .hwucucmuzocc .emeEEL seesaw ousosu Hoocom cwu: " .o><. .om essso -esuuuuz -6uso .nzmmecmSOMHem .xuuuuceunocH .eweaeozv muecoeeh ueaesm use muecoeeb eunusm .muoocom cw“: e>um cu muecoeeb mo memcommem .muceEeueum coucum011.vm eccee 84 Item 3: "The seriousness of the mental health problem in this country has been exaggerated." Table 24 indicates strong dis- agreement with Williamston teachers (1.70) strongest. There is strong disagreement with this item among all three groups. Item 5: "Mental patients usually make a good adjustment to society when they are released." Table 24 shows that fOur of the schools tend to agree while Ovid-Elsie (3.87) disagrees somewhat. Of the three groups the Future Teachers (3.88) also disagree some- what with the item. Item 11: "Few people who enter mental hospitals ever leave." Table 24 shows that Fowler (1.79) and Grand Rapids (1.72) very strongly disagree with the item. While all three groups tend to dis- agree with the item, the Future Teachers disagree somewhat less. Item 18: "Mental Disorder is not a hopeless condition." Table 24 shows that all five schools very strongly agree with the item (mean score above 6.00). The Future Teachers (6.10) and Summer Teachers (6.07), along with the High School Teachers (6.27) all tend to agree very strongly with the item. Item 19: "Mental health is one of the most important national problems." Table 24 shows that while they all agree strongly, Fowler (6.57) and Ovid-Elsie (6.04) are the strongest. Of the three groups, the Summer Teachers (5.91) have the strongest agreement with the item. Item 27: "There is not very much that can be done for a person who develops a mental disorder." Table 24 shows very strong 85 disagreement across all five schools. The three groups very strongly disagree with the item and their means are very close. VII. Agssand Childhood Esperiences Item 31: "Disappointments do not affect children as much as they do adults." Table 25 shows that all five schools disagree strongly with this item. The three groups disagree strongly with the item, (Future Teachers somewhat less.) Item 32: "Most of the insanity cases are found in people over 50 years of age." Table 25 shows that all five schools have strong disagreement with the item. The Future Teachers (3.04) disagree with the item somewhat less than the other two groups. Item 9: "Most mental disturbances in adults can be traced to emotional experiences in childhood." Table 25 shows that there is agreement with the item across the five schools. Of the three groups, the High School Teachers (4.84) agree strongest with the item. VIII. Physical Causes Item 2: _"Nervous breakdowns seldom have a physical origin." Table 26 shows that while all five schools disagree with the item, Grand Rapids (2.44) is strongest. The strongest disagreement with the item is among the Future Teachers (2.77). Item 20: "Mental disorder is usually brought on by physical causes." Table 26 shows that the Fowler teachers (2.86) have the strongest disagreement with the item. The Future Teachers (3.73) disagree less with the item than the other two groups. 86 .mcoocem cmuc e>um new memes .=0uueu>ec emeue><. mn.N mv.N NN.N h”. NN.N mm.” mn.n mn.n mm.» ON. nn.m mm.m no.m nn.N wo.m mm. ov.m vv.N muecomeh mueceeek muecoeeh .>eo mccow meumem hesszm ensuam Hoocum cum: .e><1r .um venue vv.~ 5H.N om.~ .xuucmmcu co mcuuc cu xuexuu mu Eeumxm m=o>uec ecu mxumuum uecu emmewmv Ace umOEH< mm.m m~.n ow.~ .memaeu Heuumxcm Ac co ucmsouc squeam: mu heuHOmuu cause: oo.m oo.m c5.» .cumMuo Hmuwmxcm e e>ec soccem czouxeeuc wao>uez scum eumcm Heuzom memaeu cucum c6 neemauuz tvu>o ecu muecoeee eunuam .muoocom cmuz e>5m Cu .m:mem=eu Heoumxcmzv muecueeh Hesadm muecoeeh mo memcommem .muceEeueum cou=umotl.om euceh mv.v mm.v vw.v mm. Ho.v av.v mn.N vo.n mm.~ mm. mm.N Hv.N mv.N oo.m om.N mN. mm.N mv.N mueceeeh muecueeh muecumeh .>en macaw mmmmmm heasbm eunuau Hoocem cum: .e><« .um nceuo .voocucucu cu meecemuemxe uncouuose ou eeemuu ec :mo muczue :6 meucecusumuv Hmucee umo: oo.N m~.N ~5.~ .emm mo .mux om ue>o ecmoen :6 ucsom eue memeu xumcmmcm ecu we umoz 66.5 66.5 65.5 .mouses op xecu me cuss mm :eunuucu uuemmm uo: on muceEuccomaemua :Oum emmam heazom meuceuue xm uoocumucu can e < leewcumz nvw>o .n:meoceuuemxm voocvcucu use em<:u muecoeeh Heassw use muecoeeh eunusm .mcoocom cwuz e>um cu mueceeeh mo memnommem .muceaeumum caucumoun.mm euceb 87 Item 23: "Almost any disease that attacks the nervous system is likely to bring on insanity." Table 26 shows that Grand Rapids (1.95) has the strongest disagreement with the item. All three groups tend to disagree strongly with the item. IX. Miscellaneous Item 28: "Most people can recognize the type of person who is likely to have a nervous condition." Table 27 shows that Williamston (1.96) has very strong disagreement with the item. The Future Teachers, Summer Teachers, and High School Teachers disagree strongly with the item. Item 29: "Most suicides occur because of rejection in love." Table 27 shows that while all five schools disagree with the item, Williamston (2.74) is strongest. The Future Teachers (3.58) dis- agree with the item somewhat less than the other two groups. Item 30: "Many of the people who go to mental hospitals are able to return to work in our society." Table 27 shows that for the most part all five schools agree strongly with the item, but Fowler (6.07) is strongest. There is strong agreement with the item among the three groups. Item 34: "People who go from doctor to doctor with many com- plaints know that there is nothing really wrong with them." Table 27 shows that there is strong disagreement with this item across schools. There is strong disagreement with the item among the three groups. A comparison of the mean scores on the mental health opinion items for the High School Teachers and a sample of Grand Rapids 88 .muoocom cwuc e>um new names .ceuueu>ev eweue>oH cw :OquOnou we emceeec usooe nevueusm umoz. .mm Nv.~ 5m.m wm.m 6H. mm.m om.m em.u vv.m mv.N .ceuuuuceu mao>uec e e>ec ou zuecuu mu cc: coupon we emxu ecu enwcmeueu :eu ecmoea umoz .wm mueceeee muecomeh muecumeh .>eo mccew ecumem couw eumcm ueuzem mcoecenueomw: 566656 666666 uoocom :66: .o><. .66 66666 -ssuuuuz -65>6 .azmzoeeecueomuz:v muecoeeh ueEESm use muecoeeh eunusm .muoecom cwuz e>um :6 muecoeeh mo memeommem .mueeaeueum neucum011.5m eucee 89 citizens (which are viewed as a general public sample), revealed a very high correlation of .96 (see Appendix C). CHAPTER VI SUMMARY AND CONCLUSIONS We began this investigation with a general look at the prob- lem concerning mental illness in our society today. The fact that mental health educators seem to look to schools, rather than the family, to disseminate knowledge and attitudes about mental health, leads to the stressing importance of schools in transmitting know- ledge and values, and thus to the need to study the attitudes and opinions of teachers. Our purpose in this study has been just that, to investigate the attitudes and opinions of high school teachers toward mental health. I There were three main groups of teachers involved in this investigation. They are: 161 High School Teachers representing five high schools in Michigan (Fowler, Ovid-Elsie, St. Johns, Williamston, and Grand Rapids); 69 Future Teachers (MSU secondary education students); 173 Summer Teachers (teachers attending MSU summer school). The Semantic Differential technique and 35 Mental Health Opinion Items were used to obtain data from these samples. The semantic differential was selected as an instrument because (1) it probes the psychological meanings and aSSOciative connotations of the scales and concepts in the language repertory of the subjects, 90 91 thus avoiding, it is hoped, some of the "facade response" limitations of more direct questions; (2) it can be used as an attitudinal measure and provides the advantage of quantitative data; and (3) since the technique has been used very heavily in the investigation of a wide range of social psychological questions, the present results can be compared and contrasted to a vast amount of other research. The 35 opinion items were selected from 60 items used by Nunnally, on the basis of (1) consensus among mental health experts and (2) our previous research investigations. There were five types of concepts used in the semantic dif- ferential part of this study: Professionals--Doctor, Psychologist, Psychiatrist; "Normal"--Me, Average Person, Most People, Ex-Mental Patient; Physical Disease--Heart Disease and Cancer; Disorder--Mental Patient, Neurotic Person; Severe Disorder--Schizophrenic, Paranoid, Insane, Crazy. The following general hypotheses were set forth con- cerning these concepts. Hypothesis 1: Hypothesis 2: Hypothesis The concept "Ex-Mental Patient" will not be distinctive from the other "Normal" concepts (Me, Average Person, Most People), but will be distinctive from the Disorder concepts (Mental Patient, Neurotic Person), and the Severe Dis- order concepts (Schizophrenic, Paranoid, Crazy, Insane). The array of favorableness for the types of concepts will be in this order: Professionals, "Normal," Physical Disease, Disorder, Severe Disorder. 2a: "Heart Disease" and "Cancer" will be more favorably perceived than the Severe Dis- order concepts by all three samples (High School Teachers, Future Teachers, Summer Teachers). 92 Hypothesis 3: The Future Teachers will tend to view the - Severe Disorder concepts less negatively than will the Summer Teachers and High School Teachers. The data revealed support for hypotheses 1, 2 and 2a, but did not support hypothesis 3. The way in which the teachers arrayed the concepts gives us some information about how they view these concepts. Both the Future Teachers and High School Teachers (as well as Summer Teachers) tend to view mental illness in a negative light. The fact that the physical diseases are viewed more favorably tells us that it is not just any disease, but mainly mental disorders that tend to provoke negative responses. In this study, as in the 1971 study, the concept "Ex-Mental Patient" is viewed the same as essentially "normal" people. This leads to the possible conclusion of less stigmatization of people once diagnosed as mentally ill, at least as far as these respondents are concerned. It is of basic sociological importance to determine whether opinions about mental health are related to structural varialbes, if more adequate theoretical formulations are to be developed. The nine social variables used in the investigation of the respondents' knowledgeability about mental health are: Age Sex Community Type (one grew up in--open country, suburban, urban) Community Size Subjects Taught (High School Teachers) Teaching Major (Future Teachers) 93 Type of Institution Attended Years of Teaching Experience Reported Mental Health Experience These variables are examples of the kind of structural vari- ables that need to be examined in order to understand better the functioning of attitudes and opinions concerning mental health and mental disorder, including the critical dimension of "knowledgeabil- ity." From the theoretical standpoint, these variables have an "in-between" status--that is, they have some degree of likely rele- vance on the basis of previous research and widely held beliefs, but they have not been derived or deduced as important as part of a well- developed theory. Their in-between status underlines the exploratory nature of this research. The following hypotheses were developed concerning the relationship between knowledgeability and these nine social variables: High School Teachers Hypothesis 4: The older teachers will be more knowledgeable about mental health than the younger teachers. (Hypothesis 4 is not supported) Hypothesis 5: There will be no relationship between sex and knowledgeability. (Hypothesis 5 is not supported) Hypothesis 6: Respondents who grew up in an urban area (suburban or non-suburban) will be more know- ledgeable than those who grew up in the open ' country. (Hypothesis 6 is supported) Hypothesis 7: There will be no relationship between community size and knowledgeability. (Hypothesis 7 is supported) 94 Hypothesis 8: Those teachers who teach social science sub- jects will be more knowledgeable than the others. (Hypothesis 8 is not supported) Hypothesis 9: Teachers who have more years of teaching experience will be more knowledgeable. (Hypothesis 9 is not supported) Hypothesis 10: There will be no relationship between type of institution (public vs. private) and knowledge- ability. (Hypothesis 10 is supported) Hypothesis 11: Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have none. ‘ (Hypothesis 11 is not supported) Future Teachers Hypothesis 12: There will be no relationship between age and knowledgeability.(Since this sample is com- posed of mostly Juniors and Seniors; there is a restricted age range.) (Hypothesis 12 is not supported) Hypothesis 13: There will be no relationship between sex and knowledgeability. (Hypothesis 13 is supported) Hypothesis 14: Those "Future Teachers" who are social science majors will be more knowledgeable than the other majors. (Hypothesis 14 is not supported) Hypothesis 15: Respondents who grew up in an urban area (suburban or non-suburban) will be more know- ledgeable than those who have none. (Hypothesis 15 is supported) Hypothesis 16: There will be no relationship between community size and knowledgeability. (Hypothesis 16 is not supported) Hypothesis l7: Respondents who have mental health experience (family, friends, or visits to mental health facilities) will be more knowledgeable than those who have none. (Hypothesis 17 is not supported) 95 Given these assumptions (1) that teachers are important with respect to influence on the attitudes of young people, and hence on the future characteristics of popular beliefs, (2) that they differ with respect to knowledgeability about mental health, and (3) that we have a reasOnably adequate measure of knowledgeability, one can con- clude that (a) it is socially significant to learn more about factors related to this knowledgeability and (b) learning more about how such factors are related to attitudes and opinions is prerequisite to "improving" teacher's knowledgeability. The data revelaed that the teachers tend to differ in know- ledgeability with regard to age, sex (High School Teachers), type of community they grew up in and community size (Future Teachers). The relationship between age and knowledgeability (for both High School Teachers and Future Teachers) seem to indicate a curvilinear relationship, that is it increases up to a certain age group (26-33) and then begins to taper off. Among the high school teachers, females were clearly more knowledgeable, as indicated by their higher scores. Those teachers who grew up in urban areas were also found to be more knowledgeable. This seems to suggest the liklihood of more contact with mentally ill persons in urban areas. The teachers did not differ in knowledgeability with regard to subjects taught (High School Teachers), teaching major (Future Teachers), type of institution attended and whether they had mental health experience (as this was measured). The social science teachers and the secondary education students who are social science majors, were not significantly more knowledgeable than the others. 96 It seems that whether a teacher attended a public institution or a private institution doesn't make much difference in knowledgeability. The results, if confirmed by further research, would suggest that teachers are participants in what might be termed a "cultural belief system" which is not affected by what one teaches and where one attends school. These variables do not seem to have a differential effect. Contrary to what one might expect, having mental health experience did not indicate higher knowledgeability among these teachers. It is both a popular and professional belief, that greater mental health experience leads to greater knowledgeability and to favorableness or sympathy for people with psychological problems; but in this study, this notion was not supported. This whole notion about mental health experience is important because of the increased number of former patients being released from mental hospitals in our society today. The 35 mental health opinion items used in this study were analyzed in relation to the following nine factors which were derived by J.M. Townsend (see Townsend, 1975) through a factor analysis. These factors were used to group similar items together for convenience of analysis: I. Negative Stereotypes II. Will Power 111. Sex Differences IV. Environmental Forces V. Role of Psychiatrist 97 VI. Damage, Incurability, Seriousness VII. Age and Childhood Experiences VIII. Physical Causes IX. Miscellaneous These factors would seem to provide a way of conceptualizing some of the "key themes" that underly the views that teachers hold toward mental health. However, the differences in opinions were not concentrated in any one or few factors. For example, had the teachers differed on the Will Power or Environmental Forces factor, this would have pinpointed the dimensions of difference of opinion; but the data did not reveal support for such conclusions. Again these data would indicate that these factors probably summarize many of the issues that are controversial topics among professionals-~in some ways they are classic factors on which theorists have differed--but nevertheless these factors do not seem to be related to the differences in opinions found. Conclusions The future teachers (who will be on the job in a year or so) and the high school teachers were highly similar in their views in this study. This would seem to indicate that these attitudes are not acquired while on the job, but rather that one has them when he starts the job. The findings of this study tend to support the findings of studies in the literature on teacher attitudes toward mental health (Yamamoto and Dizney, Bentz et al., Rabkin and Suchoski). Teachers 98 are reasonably well informed with regard to mental illness, however they tend to view mental disorders in a negative light. Studies of teachers' attitudes have not been based on sociological theory as such, but rather on the common-sense notion that teachers influ- ence attitudes and "better" attitudes in teachers might lead to "better" attitudes on the part of the students. This research indicates that the opinions and attitudes of teachers are not very different from those of the general public, although there is some indication that certain social structural variables have a relationship to knowledgeability. However, finding that teachers' views are not very different from those of the general public, is not the same as finding teachers have no influence. If teacher attitudes are not different from those of the gen- eral public, it would be exceedingly difficult, if not theoretically impossible, to separate out the effects of teachers from those of other adults students are in contact with. This suggests that teachers are reflections of community attitudes rather than relatively autonomous shapers of students' attitudes. This tends to confirm the notion of Wilson, Robeck and Michael (see Chapter I) that teachers have accepted the role assigned to them by their communities. It may be that as a result it is a better expenditure of effort to determine the general conception of popular views. Since teachers tend to reflect and accept the role assigned to them by the communities they represent, an effort to improve popular view will have to be done in the total community as well as in the school. If the views of teachers were too different from 99 those of the surrounding community, one could not count on them being influential. In Chapter I Scheff's approach, which is often called the "societal reaction" approach, was outlined. An example of how research, as represented by this thesis, might contribute to theory in this area will be given: Following upon Scheff's theory, one aspect of stereo- typic notions, is it's implication of incurability or "permanent craziness." On the other hand, the "medical View" which (with its other shortcomings) implies cura- bility and no permanent stigma. Therefore if teachers accept this aspect of the medical view and really believe in curability (or no psychological "weakness" implied by having been ill), and if they could influence students' attitudes, they could help to squelch the stereotypic notions of incura- bility. The increased importance of this notion is associated with the growing trend to release patients from mental hospitals into communities. Apart from a contribution to theory, this study presents some hard empirical data which has not been here-to—fore available, that the author and others can use to build a better theoretical base. 100 Suggestions for Future Research As stated earlier, very little research in the mental health area thus far has concentrated on the views of high school teachers. If high school teachers do have an influence on the attitudinal development of students, more research is needed to investigate where this influence takes place. One possible way of tapping this notion would be to do a more intensive study within schools than we have done here, comparing the responses of teachers and the students they teach. Presumably any given teacher does not interact with the total student body as such, but he comes into certain degrees of association with certain students. The same is presumably true of any given student, that he also comes into certain degrees of association with certain teachers. If this could be determined through intensive research in a given school (using sociometric techniques, probing interviews, etc.), it could then become an empirical question as to whether the attitudes of particular teachers are related to those of particular students. In a general way the research question of whether teachers have some discernible influence on students could be determined. One could also see what other variables are related to this question, as well as look at certain details of the socialization process. The present data makes a contribution to this effort in that it provides leads as to how teacher influence in the mental health area could be investigated. BIBLIOGRAPHY 101 BIBLIOGRAPHY Allinsmith, Wesley and Goethal, George W. The Role of Schools in Mental Health. New York: Basic Books, Inc., 1962. Bentz, W.K., Edgerton, J.W., and Miller, F.T. "Perceptions of Mental Illness Among Public School Teachers." Sociology of Educa- tion. 42(1969), pp. 401-406. "Attitudes of Teachers and the Public Toward Mental Illness." Mental Hygiene. 55 (1971), pp. 324-330. Brookover, Wilbur B. and Erikson, Edel L. Sociology of Education. The Dorsey Press. Homewood, Illinois. 1975. Clarizio, Harvey, F. (Editor) Mental Health and the Educative Process. Rand McNally Company. 1969. Crocetti, Guido, Spiro, H., and Siassi, I. "Are the Ranks Closed?: Attitudinal Social Distance and Mental Illness." American Journal of Psychiatiy. 127 (1971), pp. 1121-1127. Cumming, Elaine and Cumming, John. Closed Ranks. Cambridge, Massachusetts: Howard University Press. 1957. Durham, Katherine. "Stability and Change in the Views of College Students Toward Mental Health Concepts: A Semantic Differen— tial Study." M.A. Thesis. Michigan State University. 1972. Edgerton, W.J. and Bentz, W.K. "Attitudes and Opinions of Rural People About Mental Illness and Program Services." American Journal of Public Health. 59 (1969), pp. 470-477. Havighurst, Robert J. and Neugarten, Bernice L. Sociesy and Educa- tion. Boston: Allyn and Bacon Inc. 1967. Joint Commission on Mental Health. Action for Mental Health. New York: Basic Books, Inc. 1961. Karno, M. and Edgerton, R. "Perceptions of Mental Illness in a Mexican American Community." Archives of General Psychiatry, 20 (1969), pp. 233-238. 102 103 Liberman, Lewis R. "Attitudes Toward the Mentally Ill, Knowledge of Mental Illness and Personal Adjustment." Psychological Reports. 26 (1960), pp. 47-52. Linsky, A. "Who Shall Be Excluded: The Influence of Personal .1 Attributes in Community Reaction to the Mentally 111." Social Psychiatiy, 5 (1970), pp. 166-171. Maguire, T.O. "Semantic Differential Methodology for the Structuring of Attitudes." American Education Journal. 10 (1973), pp. 295-306. Meyer, Jon K. "Attitudes Toward Mental Illness in a Maryland Com- munity." Public Health Reports. (September 1974), pp. 769- 772. Nunnally, Jum C. Sr. Pspular Conceptions of Mental Health. New York: Holt, Rinehart and Winston, Inc. 1961. Olmsted, Donald W. and Durham, Katherine. "Stability of Mental Health Attitudes: A Semantic Differential Study." Journal of Health and Social Behavior. 17, No. 1 (March 1976), pp. 35-44. Olmsted, Donald W. and Ordway, Robert K. The Final Report of Concepts of Mental Health: A Pilot Analysis. (Report to NIMH, Grant m-4880(A). June 1963). Osgood,Charles E., Suci, George J., and Tannerbaum, Percy H. The Measurement of Meaning: Urbana, Illinois: University of Illinois Press. 1957. Rabkin, J.G. "Opinions About Mental Illness: A Review of the Liter- ature." Psychological Bulletin. 1972. 153-171. "Public Attitude Toward Mental Illness: A Review of the Literature." Schizophrenia Bulletin. No. 10 (Fall 1974), pp. 9-33. . Rabkin, Leslie Y: and Suchoski, Joseph F. Jr. "Teachers' Views of Mental Illness: A Study of Attitudes and Information." Journal of Teacher Education. 18 (1967), pp. 37-41. Ring, S. and Schien, L. "Attitudes Toward Mental Illness and the Use of Caretakers in a Black Community." American Journal of Orthppsychiatiy. 40 (1970), pp. 710-716. Rokeach, Milton. Beliefs, Attitudes and Values. San Francisco: Jossey-Bass, Inc. 1969. Scheff, Thomas. Being Mentally 111: A Sociological Theory. Chicago: Aldine Publishing Company. 1968. 104 Smith, Dorothy L. "College Students' Knowledgeability and Opinions About Mental Health in 1962 and 1971." M.A. Thesis. Michigan State University. 1972. Snider, James G. and Osgood, Charles, Editors. Semantic Differential Technigue. Chicago: Aldine Publishing Company. 1969. Spitzer, Stephan P. and Denzin, Norman K. The Mental Patient: Studies in the Sociology of Deviance. New York: McGraw-Hill Book Company. 1968. Sugarman, Barry. The School and Moral Development. New York: Barnes and Noble. 1973. Szasz, T.S. "The Myth of Mental Illness." American Psychologist. 15 (1960), pp. 113-118. Townsend, Marshall J. "Cultural Conceptions, Mental Disorders and Social Roles: A Comparison to Germany and America." American Sociological Review. 40 (December 1975), pp. 739-752. . "Cultural Concepts and Mental Illness." Journal of Nervous and Mental Disease. 60, No. 6 (1975), pp. 409-421. Wechsler, H., Solomon, L., and Kramer, B.N. (Editors). "Mental Health Attitudes." Social Psychologysand Mental Health. New York: Holt, Rinehart, and Winston. 1961. Wilson, J.A.R., Robeck, M.C., and Michael, W.B. Psychological Founda- tions of Learning and Teaching, New York: McGraw-Hill Inc. 1969. Yamamoto, Karou and Dizney, Henry F. "Rejection of the Mentally 111: A Study of Attitudes of Student Teachers." Journal of Counseling Psychology, 14 (1967). APPENDICES 105 APPENDIX A SEMANTIC DIFFERENTIAL MEANS, HIGH SCHOOL TEACHERS, FUTURE TEACHERS, SUMMER TEACHERS, GRAND RAPIDS CITIZENS 106 107 Nm.v m~.v no.n mm.N mg.» cw.» mo.v ~v.v mn.v vn.v Nm.v Na.v mm.v D< mw.~ ao.n om.~ 5H.N on.» uos1ad auasul ov.n an.n mN.m aN.n m~.n nv.m ww.~ mN.n mu.n ww.~ no.n uos1od X2913 mv.n nv.n H~.N mm.N v~.~ nv.n no.m mn.m hm.» mv.m oo.v unaried [eiuaw :KOU—hm mmmcm MDNHO>mnT5 Nn.n Ho.n HB.N nm.~ mv.H nm.n mv.m vH.m e~.v mv.m ew.m uos1ed proua1ed hm.n mm.m HB.H ow.~ nv.N v~.m oo.v oo.v an.n oo.m mN.v uOS1ad or1ua1qdothes no.v mm.m oo.m om.~ om.N ow.» ~5.m mm.v no.v om.v no.v uos1ad otio1naN nm.v Nm.v mn.m oo.n mm.N om.m mm.v mu.v no.v oo.m mN.v mN.m oo.m om.m 1aoueg qirn uos1ad uueueuuumsouueumswm use eumOMHeoneewwsm uh.v am.v oo.m n~.n mm.~ mm.m nH.v om.v nm.v oo.m oo.m mm.m om.m om.m aseesrq 1183” qitn uos1ed wv.v mN.v mn.m ve.n v~.v Hm.v om.v vo.v om.v 1uariad [e1uew-xa mo.m mh.v mh.v oo.~ mn.n vH.v oo.m ow.v ow.v mv.m aN.m atdoed 150w 0H.v NH.v mm.m an.m no.m v~.v oo.v v~.v ow.m H5.v mv.v ah.v om.v wm.v mw.N ww.v mN.m mN.v m~.v nH.m om.v ww.v 1511191qusd nm.m mo.m oo.v oo.~ cv.v mn.v ov.m ov.v oo.m oo.m ow.m istflotoqoflsd 5N.m oa.v nm.v nm.m v~.v Hm.v om.m om.m vH.m vH.m mm.v meceum ecu usecuuz meme: mN.m wa.v mm.v ~5.N om.m vH.v HN.m Hm.m om.m om.m mv.m mm.m vo.m ow.m 9W @726 6526565 56366 .28: 2:686:66 6366666 .3 565 Ix _M euceuuueeuacbu.eeum eeueOMHOEOUTeHQEum emcehueexmuem eumouaeonvewmsm ceezuwcouuw 30cm-ummm cmuceomuemuz mseuewceouewem euoeusumz eueecumcuteueecum 5osu6-:6oue mmeucquZTeHcescm> meceom mueeucou 108 ~N.¢ oc.v ov.n mm.~ mN.n no.» om.m ao.v mN.v mN.v mn.v om.v oo.m ow.v I>< nm.~ mm.~ mm.~ mm.m mn.N ev.n ov.n mn.n mm.~ MN.N mm.» vm.n uosxad auesul an.n m~.m ou.~ ov.~ on.H oo.m co.» c~.v cw.~ OH.m on.» om.v uoszad K2213 n~.n mH.n um.a mm." mo.~ vo.n hh.~ ow.~ vH.m ow.N mm.n Nn.v Iain?” nuayzed .:xov:~ mmoconnano>wm: .nvoumUMHQEOUuuHmEfim cam oumofimwonvowwsm mofimom ozu psocuwz memo: . 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