Public attitudes and the challenge of stigma

2020 ◽  
pp. 6-11
Author(s):  
Nicole Votruba ◽  
Mirja Koschorke ◽  
Graham Thornicroft
Keyword(s):  
Mental Illness ◽  
Public Attitudes ◽  
Social Contact ◽  
Future Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
People With Mental Illness ◽  
Culturally Adapted ◽  
Low And Middle Income

People with mental illness frequently face challenges related to knowledge, attitudes, and behaviour. These challenges are more commonly known as stigma and discrimination, and appear universally with local and regional variations in their content and manifestations. They display in low levels of mental health literacy among the general population (ignorance/knowledge), negative affect towards people with experience of mental illness (prejudice/attitudes), and social exclusion and diminished citizenship for people with mental illness (discrimination/behaviour). This chapter looks at how people with mental illness are impacted by stigma and discrimination, considering the evidence of the implications of these knowledge, attitudes, and behaviour, and summarizes the literature on what can be done to effectively reduce stigma and discrimination. Increasingly strong evidence suggests that personal and social contact methods, including filmed/virtual contact, are the most strongly evidence-based method to reduce stigma and discrimination. Yet, most evidence is from high-income countries and tested for short- to mid-term efficacy. This evidence gap increases the need for more evidence from low- and middle-income countries and validation of sustainability in more long-term studies. In summary and for future research and interventions, service users will the key partners in anti-stigma programmes, and interventions specifically locally and culturally adapted for use in low- and middle-income countries are a pressing priority.

scholarly journals Stigma and discrimination related to mental illness in low- and middle-income countries

2015 ◽  
Vol 24 (5) ◽  
pp. 382-394 ◽  
Author(s):  
M. Semrau ◽  
S. Evans-Lacko ◽  
M. Koschorke ◽  
L. Ashenafi ◽  
G. Thornicroft
Keyword(s):  
Mental Illness ◽  
Large Scale ◽  
Grey Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stigma And Discrimination ◽  
Effective Interventions ◽  
Long Term Follow Up ◽  
Context Specific ◽  
Low And Middle Income

Aims.This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs.Methods.Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian.Results.Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs.Conclusion.Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.

scholarly journals Core components of mental health stigma reduction interventions in low- and middle-income countries: a systematic review

2020 ◽  
Vol 29 ◽  
Author(s):  
J. Clay ◽  
J. Eaton ◽  
P. C. Gronholm ◽  
M. Semrau ◽  
N. Votruba
Keyword(s):  
Mental Health ◽  
Medical Knowledge ◽  
Social Contact ◽  
Mental Health Stigma ◽  
Stigma Reduction ◽  
Middle Income ◽  
Middle Income Countries ◽  
People With Mental Illness ◽  
Core Components ◽  
Low And Middle Income

Abstract Aims To identify and categorise core components of effective stigma reduction interventions in the field of mental health in low- and middle-income countries (LMICs) and compare these components across cultural contexts and between intervention characteristics. Methods Seven databases were searched with a strategy including four categories of terms ('stigma’, ‘mental health’, ‘intervention’ and ‘low- and middle-income countries’). Additional methods included citation chaining of all papers identified for inclusion, consultation with experts and hand searching reference lists from other related reviews. Studies on interventions in LMICs aiming to reduce stigma related to mental health with a stigma-related outcome measure were included. All relevant intervention characteristics and components were extracted and a quality assessment was undertaken. A ‘best fit’ framework synthesis was used to organise data, followed by a narrative synthesis. Results Fifty-six studies were included in this review, of which four were ineffective and analysed separately. A framework was developed which presents a new categorisation of stigma intervention components based on the included studies. Most interventions utilised multiple methods and of the 52 effective studies educational methods were used most frequently (n = 83), and both social contact (n = 8) and therapeutic methods (n = 3) were used infrequently. Most interventions (n = 42) based their intervention on medical knowledge, but a variety of other themes were addressed. All regions with LMICs were represented, but every region was dominated by studies from one country. Components varied between regions for most categories indicating variation between cultures, but only a minority of studies were developed in the local setting or culturally adapted. Conclusions Our study suggests effective mental health stigma reduction interventions in LMICs have increased in quantity and quality over the past five years, and a wide variety of components have been utilised successfully – from creative methods to emphasis on recovery and strength of people with mental illness. Yet there is minimal mention of social contact, despite existing strong evidence for it. There is also a lack of robust research designs, a high number of short-term interventions and follow-up, nominal use of local expertise and the research is limited to a small number of LMICs. More research is needed to address these issues. Some congruity exists in components between cultures, but generally they vary widely. The review gives an in-depth overview of mental health stigma reduction core components, providing researchers in varied resource-poor settings additional knowledge to help with planning mental health stigma reduction interventions.

scholarly journals Early Mathematics Counts: Promising Instructional Strategies from Low- and Middle-Income Countries

2018 ◽  
Author(s):  
Yasmin Sitabkhan ◽  
Linda M. Platas
Keyword(s):  
Instructional Strategies ◽  
Future Research ◽  
Mathematics Interventions ◽  
Middle Income ◽  
Early Mathematics ◽  
Middle Income Countries ◽  
Informal Mathematics ◽  
Early Grade ◽  
Research And Policy ◽  
Low And Middle Income

This occasional paper examines common instructional strategies in early-grade mathematics interventions through a review of studies in classrooms in low- and middle-income countries. Twenty-four studies met the criteria for inclusion, and analyses reveal four sets of instructional strategies for which there is evidence from multiple contexts. Of the 24 studies, 16 involved the use of multiple representations, 10 involved the use of developmental progressions, 6 included supporting student use of explanation and justification, and 5 included integration of informal mathematics. Based on the review, we provide conclusions and recommendations for future research and policy.

scholarly journals Related Health Service Provider with Mental Health during Pregnancy

2020 ◽  
Vol 8 (T2) ◽  
pp. 188-191
Author(s):  
Nurul Husnul Lail ◽  
Rizanda Machmud ◽  
Adnil Edwin ◽  
Yusrawati Yusrawati ◽  
Anwar Mallongi
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Pregnant Women ◽  
Mental Health Problems ◽  
Health Problems ◽  
Political Support ◽  
Independent Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BACKGROUND: Mental illness or mental health problems during pregnancy in low- and middle-income countries are very high; the average prevalence reaches 15.6%. Subsequent research was conducted by Indian in the Jakarta and Bogor regions in the period January–June 2018 regarding the incidence of perinatal depression by 23.6% in the Bogor. AIM: This study aimed to evaluate the mental illness or mental health problems during pregnancy in low- and middle-income countries. METHODS: This research is qualitative research. This research was conducted in January–June 2019 in the Bogor independent practice midwife. Informants in the study came from the East Jakarta Health Office, Chair of the Indonesian Midwives Association, Head of the Health Center, Coordinating Midwives, Pregnant Women and husbands, and families of pregnant women. Data are analyzed by Regression Logistic. RESULTS: Construction model mental health of mothers during pregnancy in independent practice midwives is very important and needs attention. Pregnancy is still considered a physical change that needs to be intervened because it is easier to handle and easily detects it. Maternal examination during pregnancy is carried out by midwives, in the implementation of mental health checks during pregnancy for pregnant women, this role has not all been carried out optimally. CONCLUSION: This research suggests conducting socialization with midwives as well as across-related sectors to get political support in carrying out activities in health facilities and independent practice midwives.

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

scholarly journals Homelessness and severe mental illness in low- and middle-income countries: scoping review

BJPsych Open ◽  
2019 ◽  
Vol 5 (4) ◽  
Author(s):  
Caroline Smartt ◽  
Martin Prince ◽  
Souci Frissa ◽  
Julian Eaton ◽  
Abebaw Fekadu ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Scoping Review ◽  
Homeless People ◽  
Middle Income ◽  
Middle Income Countries ◽  
Manual Search ◽  
Cultural Responses ◽  
Key Aspects ◽  
Low And Middle Income

Background Despite being a global problem, little is known about the relationship between severe mental illness (SMI) and homelessness in low- and middle-income countries (LMICs). Homeless people with SMI are an especially vulnerable population and face myriad health and social problems. In LMICs, low rates of treatment for mental illness, as well as differing family support systems and cultural responses to mental illness, may affect the causes and consequences of homelessness in people with SMI. Aims To conduct a systematic, scoping review addressing the question: what is known about the co-occurrence of homelessness and SMI among adults living in LMICs? Method We conducted an electronic search, a manual search and we consulted with experts. Two reviewers screened titles and abstracts, assessed publications for eligibility and appraised study quality. Results Of the 49 included publications, quality was generally low: they were characterised by poor or unclear methodology and reporting of results. A total of 7 publications presented the prevalence of SMI among homeless people; 12 presented the prevalence of homelessness among those with SMI. Only five publications described interventions for this population; only one included an evaluation component. Conclusions Evidence shows an association between homelessness and SMI in LMICs, however there is little information on the complex relationship and direction of causality between the phenomena. Existing programmes should undergo rigorous evaluation to identify key aspects required for individuals to achieve sustainable recovery. Respect for human rights should be paramount when conducting research with this population. Declaration of interest None.

scholarly journals A systematic review of the association between perinatal depression and cognitive development in infancy in low and middle-income countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253790
Author(s):  
Matthew Bluett-Duncan ◽  
M. Thomas Kishore ◽  
Divya M. Patil ◽  
Veena A. Satyanarayana ◽  
Helen Sharp
Keyword(s):  
Cognitive Development ◽  
Perinatal Depression ◽  
Antenatal Depression ◽  
Current Theory ◽  
Future Research ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Infant Cognitive Development ◽  
Low And Middle Income

The association between perinatal depression and infant cognitive development has been well documented in research based in high-income contexts, but the literature regarding the same relationship in low and middle-income countries (LMICs) is less developed. The aim of this study is to systematically review what is known in this area in order to inform priorities for early intervention and future research in LMICs. The review protocol was pre-registered on Prospero (CRD42018108589) and relevant electronic databases were searched using a consistent set of keywords and 1473 articles were screened against the eligibility criteria. Sixteen articles were included in the review, seven focusing on the antenatal period, eight on the postnatal period, and one which included both. Five out of eight studies found a significant association between antenatal depression (d = .21-.93) and infant cognitive development, while four out of nine studies found a significant association with postnatal depression (d = .17-.47). Although the evidence suggests that LMICs should prioritise antenatal mental health care, many of the studies did not adequately isolate the effects of depression in each period. Furthermore, very few studies explored more complex interactions that may exist between perinatal depression and other relevant factors. More high-quality studies are needed in LMIC settings, driven by current theory, that test main effects and examine moderating or mediating pathways to cognitive development.

scholarly journals Measuring the Quality of Early Childhood Education in Low- and Middle-Income Countries

2021 ◽  
Vol 12 ◽  
Author(s):  
Si Chen ◽  
Sharon Wolf
Keyword(s):  
Early Childhood ◽  
Early Childhood Education ◽  
Child Outcomes ◽  
High Income ◽  
Future Research ◽  
Limited Evidence ◽  
Middle Income ◽  
Childhood Education ◽  
Middle Income Countries ◽  
Low And Middle Income

Young children’s access to early childhood education (ECE) is increasing in low- and middle-income countries (LMICs), though often without attention to service quality. Monitoring quality requires classroom observations, but most observation tools available were developed in high-income western countries. In this article, we examine key issues in measuring ECE quality in LMICs and consider challenges and opportunities in balancing theoretical grounding, cultural- and contextual-adaptation, and empirical rigor. We then review the literature on observed classroom quality in LMICs, focusing on process quality. We find limited evidence that the constructs identified in high-income countries replicate in LMICs. Further, the very limited evidence that ECE quality measures used in LMICs predict child outcomes is almost exclusively cross-sectional and associations are mixed. We conclude by discussing how future research can build a stronger knowledge base about ECE quality and child development globally.

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