Pity versus Empathy: Emotional Responses to Mental Illness and Their Effects on Stigma

Abstract

Stigma surrounding mental illness is shaped by emotional reactions such as pity and empathy. While pity can involve condescension and reinforce hierarchies, empathy fosters understanding and connection. This study tested how different mental health conditions elicit these emotions and mediate stigmatizing attitudes. A nationally representative U.S. sample (N = 5,264) read vignettes describing a character with subclinical distress, major depression, alcohol use disorder, opioid use disorder, or schizophrenia. Vignettes varied by diagnosis and symptoms, causal explanation (none, trauma, genetics, both), and treatment recommendation (none, psychotherapy, medication). Structural equation modeling showed that empathy reduced social distance more consistently than pity. Schizophrenia and substance use disorders evoked less empathy and more pity, while environmental attributions to a traumatic event increased pity and empathy. Treatment recommendations enhanced empathy but not pity. Findings highlight that targeting empathy over pity may lead to stigma reduction, suggesting that interventions might benefit from emphasizing relatable experiences and trauma while balancing treatment messaging.