scholarly journals What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies

2014 ◽  
Vol 45 (1) ◽  
pp. 11-27 ◽  
Author(s):  
S. Clement ◽  
O. Schauman ◽  
T. Graham ◽  
F. Maggioni ◽  
S. Evans-Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Qualitative Studies ◽  
Deterrent Effect ◽  
Related Stigma ◽  
Health Related ◽  
The Impact

BackgroundIndividuals often avoid or delay seeking professional help for mental health problems. Stigma may be a key deterrent to help-seeking but this has not been reviewed systematically. Our systematic review addressed the overarching question: What is the impact of mental health-related stigma on help-seeking for mental health problems? Subquestions were: (a) What is the size and direction of any association between stigma and help-seeking? (b) To what extent is stigma identified as a barrier to help-seeking? (c) What processes underlie the relationship between stigma and help-seeking? (d) Are there population groups for which stigma disproportionately deters help-seeking?MethodFive electronic databases were searched from 1980 to 2011 and references of reviews checked. A meta-synthesis of quantitative and qualitative studies, comprising three parallel narrative syntheses and subgroup analyses, was conducted.ResultsThe review identified 144 studies with 90 189 participants meeting inclusion criteria. The median association between stigma and help-seeking was d = − 0.27, with internalized and treatment stigma being most often associated with reduced help-seeking. Stigma was the fourth highest ranked barrier to help-seeking, with disclosure concerns the most commonly reported stigma barrier. A detailed conceptual model was derived that describes the processes contributing to, and counteracting, the deterrent effect of stigma on help-seeking. Ethnic minorities, youth, men and those in military and health professions were disproportionately deterred by stigma.ConclusionsStigma has a small- to moderate-sized negative effect on help-seeking. Review findings can be used to help inform the design of interventions to increase help-seeking.

scholarly journals Impact of economic crises on mental health care: a systematic review

2018 ◽  
Vol 29 ◽  
Author(s):  
M. Silva ◽  
D. M. Resurrección ◽  
A. Antunes ◽  
D. Frasquilho ◽  
G. Cardoso
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Economic Crisis ◽  
Mental Health Problems ◽  
Hospital Admissions ◽  
Health Problems ◽  
Economic Crises ◽  
The Impact

Abstract Aims Unmet needs for mental health treatment are large and widespread, and periods of economic crisis may increase the need for care and the treatment gap, with serious consequences for individuals and society. The aim of this systematic review was to summarise the empirical evidence on the association between periods of economic crisis and the use of mental health care. Methods Following the PRISMA statement, MEDLINE, Embase, Scopus, Open Grey and Cochrane Database were searched for relevant publications, published between 1990 and 2018, from inception to June 2018. Search terms included (1) economic crisis, (2) use of mental health services and (3) mental health problems. Study selection, data extraction and the assessment of study quality were performed in duplicate. Results Seventeen studies from different countries met the inclusion criteria. The results from the included articles suggest that periods of economic crisis might be linked to an increase of general help sought for mental health problems, with conflicting results regarding the changes in the use of specialised psychiatric care. The evidence on the use of mental health care specifically due to suicide behaviour is mixed. The results also suggest that economic crises might be associated with a higher use of prescription drugs and an increase in hospital admissions for mental disorders. Conclusions Research on the impact of economic crises on the use of mental health care is scarce, and methodologies of the included papers are prone to substantial bias. More empirical and long-term studies on this topic are needed, in order to adapt mental health care systems to the specific needs of the population in times of economic crisis.

scholarly journals Association between mental health-related stigma and active help-seeking: Systematic review and meta-analysis

2017 ◽  
Vol 210 (4) ◽  
pp. 261-268 ◽  
Author(s):  
Nina Schnyder ◽  
Radoslaw Panczak ◽  
Nicola Groth ◽  
Frauke Schultze-Lutter
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Random Effect ◽  
Public Stigma ◽  
Related Stigma ◽  
Personal Attitudes ◽  
The Impact

BackgroundMental disorders create high individual and societal costs and burden, partly because help-seeking is often delayed or completely avoided. Stigma related to mental disorders or mental health services is regarded as a main reason for insufficient help-seeking.AimsTo estimate the impact of four stigma types (help-seeking attitudes and personal, self and perceived public stigma) on active help-seeking in the general population.MethodA systematic review of three electronic databases was followed by random effect meta-analyses according to the stigma types.ResultsTwenty-seven studies fulfilled eligibility criteria. Participants' own negative attitudes towards mental health help-seeking (OR = 0.80, 95% CI 0.73–0.88) and their stigmatising attitudes towards people with a mental illness (OR = 0.82, 95% CI 0.69–0.98) were associated with less active help-seeking. Self-stigma showed insignificant association (OR = 0.88, 95% CI 0.76–1.03), whereas perceived public stigma was not associated.ConclusionsPersonal attitudes towards mental illness or help-seeking are associated with active help-seeking for mental problems. Campaigns promoting help-seeking and fighting mental illness-related stigma should target these personal attitudes rather than broad public opinion.

scholarly journals A mixed-methods investigation of mental health stigma, absenteeism and presenteeism among UK postgraduate researchers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Clio Berry ◽  
Jeremy E. Niven ◽  
Laura A. Chapman ◽  
Sophie Valeix ◽  
Paul E. Roberts ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Problems ◽  
Health Problems ◽  
Workplace Culture ◽  
Mental Health Stigma ◽  
Content Type ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Health Related

Purpose Postgraduate researchers (PGRs) appear to be particularly vulnerable to mental health problems. Mental health-related stigma and discrimination may be endemic within universities, creating a threatening environment that undermines PGRs’ health and well-being. These environmental characteristics may increase PGRs’ absenteeism and presenteeism, attendance behaviours that have great personal and institutional consequences. The study of this issue, however, has been limited to date. Design/methodology/approach This was a mixed methods psychological study using cross-sectional data provided by 3,352 UK-based PGRs. Data were collected in a new national survey (U-DOC) led by a British University in 2018–2019. We used structural equation modelling techniques to test associations between workplace mental health-related stigma and discrimination, presenteeism, absenteeism and demographic characteristics. The authors analysed qualitative survey data with framework analysis to deductively and inductively explore associations between workplace culture, stigma and discrimination, and attendance behaviours. Findings The authors found that some PGRs report positive perceptions and experiences of the academic mental health-related workplace culture. However, experiences of mental health stigma and discrimination appear widespread. Both quantitative and qualitative results show that experiences of mental health-related stigma are associated with greater absenteeism and presenteeism. People with mental health problems appear especially vulnerable to experiencing stigma and its impacts. Practical implications Key implications include recommendations for universities to improve support for PGR mental health, and to encourage taking annual leave and necessary sickness absences, by providing a more inclusive environment with enhanced mental health service provision and training for faculty and administrative staff. Originality/value This study presents the first large-scale survey of PGR experiences of mental health-related stigma and discrimination, and their associations with absenteeism and presenteeism.

scholarly journals Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shivani Mathur Gaiha ◽  
Tatiana Taylor Salisbury ◽  
Mirja Koschorke ◽  
Usha Raman ◽  
Mark Petticrew
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young People ◽  
Mental Disorders ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Public Stigma ◽  
Targeted Interventions ◽  
Awareness Campaigns

Abstract Background Globally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude and manifestations of public stigma, and synthesised evidence of recommendations to reduce mental-health-related stigma among young people in India. Method A systematic review and meta-analysis of observational studies was conducted. Nine electronic databases were searched and 30 studies (n = 6767) met inclusion criteria. Results Most studies (66%) focused on youth training to become health professionals. One-third of young people display poor knowledge of mental health problems and negative attitudes towards people with mental health problems and one in five had actual/intended stigmatizing behavior (I2>=95%). Young people are unable to recognize causes and symptoms of mental health problems and believe that recovery is unlikely. People with mental health problems are perceived as dangerous and irresponsible, likely due to misinformation and misunderstanding of mental health problems as being solely comprised of severe mental disorders (e.g. schizophrenia). However, psychiatric labels are not commonly used/understood. Conclusion Public education may use symptomatic vignettes (through relatable language and visuals) instead of psychiatric labels to improve young people’s understanding of the range of mental health problems. Recommended strategies to reduce public stigma include awareness campaigns integrated with educational institutions and content relevant to culture and age-appropriate social roles.

scholarly journals Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shivani Mathur Gaiha ◽  
Tatiana Taylor Salisbury ◽  
Shamaila Usmani ◽  
Mirja Koschorke ◽  
Usha Raman ◽  
...  
Keyword(s):  
Mental Health ◽  
Performing Arts ◽  
Mental Health Problems ◽  
Assessment Tool ◽  
Role Play ◽  
Educational Interventions ◽  
Health Problems ◽  
Art Forms ◽  
Related Stigma ◽  
Health Related

Abstract Background Educational interventions engage youth using visual, literary and performing arts to combat stigma associated with mental health problems. However, it remains unknown whether arts interventions are effective in reducing mental-health-related stigma among youth and if so, then which specific art forms, duration and stigma-related components in content are successful. Methods We searched 13 databases, including PubMed, Medline, Global Health, EMBASE, ADOLEC, Social Policy and Practice, Database of Promoting Health Effectiveness Reviews (DoPHER), Trials Register of Promoting Health Interventions (TRoPHI), EPPI-Centre database of health promotion research (Bibliomap), Web of Science, PsycINFO, Cochrane and Scopus for studies involving arts interventions aimed at reducing any or all components of mental-health-related stigma among youth (10–24-year-olds). Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Data were extracted into tables and analysed using RevMan 5.3.5. Results Fifty-seven studies met our inclusion criteria (n = 41,621). Interventions using multiple art forms are effective in improving behaviour towards people with mental health problems to a small effect (effect size = 0.28, 95%CI 0.08–0.48; p = 0.007) No studies reported negative outcomes or unintended harms. Among studies using specific art forms, we observed high heterogeneity among intervention studies using theatre, multiple art forms, film and role play. Data in this review are inconclusive about the use of single versus multiple sessions and whether including all stigma components of knowledge, attitude and behaviour as intervention content are more effective relative to studies focused on these stigma components, individually. Common challenges faced by school-based arts interventions included lack of buy-in from school administrators and low engagement. No studies were reported from low- and middle-income countries. Conclusion Arts interventions are effective in reducing mental-health-related stigma to a small effect. Interventions that employ multiple art forms together compared to studies employing film, theatre or role play are likely more effective in reducing mental-health-related stigma.

scholarly journals Falling through the cracks’ – the role of assertive alcohol outreach teams in treating comorbid mental health problems in people with addictions

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S277-S277
Author(s):  
E. Naomi Smith ◽  
Emily Finch ◽  
Colin Drummond
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Admissions ◽  
Health Problems ◽  
Mental Health Needs ◽  
Health Related ◽  
History Of ◽  
The Impact ◽  
Drug And Alcohol

AimsInput from Assertive Alcohol Outreach Teams (AAOTs) reduces the ‘burden’ on already overstretched community mental health teams (CMHTs).AAOTs are specialist addictions services. This project focuses on an AAOT based in the London, which engages with people with severe alcohol and illicit substance misuse problems.Previous research has shown that input from AAOTs reduces hospital admissions. This project examined the impact of AAOT input on reducing the ‘burden’ on CMHTs.MethodThe full caseload of the Southwark-based AAOT was reviewed, including mental health records, general practitioner notes, hospital notes and discharge summaries. We collected data on diagnoses and previous hospital admissions. Patients were assessed to determine whether they met criteria to be open to a CMHT (the presence of complex or serious mental health problems, in addition to addictions).ResultThe caseload was made up of 39 patients, 85% of patients were deemed to meet criteria for being under the care of a CMHT. Only 15% of patients are currently under the care of a CMHT. 87% of patients had at least one comorbid psychiatric diagnosis. 72% of patients had had at least one emergency department or medical hospital admission due to mental health-related problems. 39% had previous admissions to mental health wards. 21% of patients has been admitted under Section of Mental Health Act.ConclusionThe majority of AAOT patients have severe mental health problems in addition to addictions. The patients are complex and often have a history of disengagement from standard mental health services. Formal diagnosis and treatment of comorbid mental health problems is challenging in the presence of protracted drug and alcohol misuse. AAOT input appears to address a serious ‘gap’ in supporting patients with complex mental health needs who are often ineligible for CMHT input or disengage from CMHT support.

scholarly journals Mental health implications of detaining asylum seekers: systematic review

2009 ◽  
Vol 194 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Katy Robjant ◽  
Rita Hassan ◽  
Cornelius Katona
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Negative Impact ◽  
Adult Child ◽  
Health Problems ◽  
Internally Displaced ◽  
Manual Search ◽  
The Impact

BackgroundThe number of asylum seekers, refugees and internally displaced people worldwide is rising. Western countries are using increasingly restrictive policies, including the detention of asylum seekers, and there is concern that this is harmful.AimsTo investigate mental health outcomes among adult, child and adolescent immigration detainees.MethodA systematic review was conducted of studies investigating the impact of immigration detention on the mental health of children, adolescents and adults, identified by a systematic search of databases and a supplementary manual search of references.ResultsTen studies were identified. All reported high levels of mental health problems in detainees. Anxiety, depression and posttraumatic stress disorder were commonly reported, as were self-harm and suicidal ideation. Time in detention was positively associated with severity of distress. There is evidence for an initial improvement in mental health occurring subsequent to release, although longitudinal results have shown that the negative impact of detention persists.ConclusionsThis area of research is in its infancy and studies are limited by methodological constraints. Findings consistently report high levels of mental health problems among detainees. There is some evidence to suggest an independent adverse effect of detention on mental health.

scholarly journals Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

2020 ◽  
Vol 55 (11) ◽  
pp. 1397-1413 ◽  
Author(s):  
Andrea B. Martinez ◽  
Melissa Co ◽  
Jennifer Lau ◽  
June S. L. Brown
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Systematic Review ◽  
Help Seeking ◽  
Mental Health Problems ◽  
The Philippines ◽  
Qualitative Studies ◽  
Mental Health Stigma ◽  
Self Reliance ◽  
Seeking Help

Abstract Purpose This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking. Methods Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis. Results Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help. Conclusion We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

A qualitative study exploring experiences of discrimination associated with mental-health problems in Ireland

2012 ◽  
Vol 21 (3) ◽  
pp. 271-279 ◽  
Author(s):  
R. Lakeman ◽  
P. McGowan ◽  
L. MacGabhann ◽  
M. Parkinson ◽  
M. Redmond ◽  
...  
Keyword(s):  
Mental Health ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Structured Interviews ◽  
Health Practitioners ◽  
Help Seeking Behaviour ◽  
The Republic ◽  
The Impact

Aims.Stigma and discrimination related to mental-health problems impacts negatively on people's quality of life, help seeking behaviour and recovery trajectories. To date, the experience of discrimination by people with mental-health problems has not been systematically explored in the Republic of Ireland. This study aimed to explore the experience impact of discrimination as a consequence of being identified with a mental-health problem.Methods.Transcripts of semi-structured interviews with 30 people about their experience of discrimination were subject to thematic analysis and presented in summary form.Results.People volunteered accounts of discrimination which clustered around employment, personal relationships, business and finance, and health care. Common experiences included being discounted or discredited, being mocked or shunned and being inhibited or constrained by oneself and others.Conclusions.Qualitative research of this type may serve to illustrate the complexity of discrimination and the processes whereby stigma is internalised and may shape behaviour. Such an understanding may assist health practitioners reduce stigma, and identify and remediate the impact of discrimination.

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