Analysis of interventions to reduce stigma related to mental disorder: A critical systematic review
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1493Keywords:
stigma, intervention, Mental Disorder, systematic review, psychoeducationAbstract
Objective: This review aimed to find and assess mental disorder stigma management solutions. Methods: The PROSPERO review ID is CRD42022369853 and followed the PRISMA protocol. This review recruited language-neutral publications from Scielo, Medline (via PubMed), and Google Scholar from 2019 to 2023. Three psychiatrists helped with selection, data collection and analysis, risk of bias assessment, and methodological quality rating. The ROBIS instrument assessed systematic review bias, while the Cochrane Handbook for Systematic Reviews of Interventions assessed CT bias. Use the Oxford Centre for Evidence-Based Medicine's 2011 Levels of Evidence to evaluate methodological quality. Following peer review. Results: Thirteen articles addressed stigma therapies for mental diseases like depression, anxiety, bipolar affective disorder, and schizophrenia. Audiovisual tools, theoretical and practical classes, and clinical case discussions reduced stigma, with evidence levels of 2–3. Studies found various drawbacks: a) some research did not focus on stigma reduction; b) data reporting was restricted. Conclusions: These findings show that stigma-reduction treatments must be continual and successful across varied intervention groups.
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1. Amaechi IA, Nwani PO, Akadieze AO. Stigmatizing attitudes towards mental illness, disabilities, emotional and behavioural disorders, among healthcare students in a Tropical University College of Health Sciences. J Educ Health Promot. 2023; 12(1):82. https://doi.org/10.4103/jehp.jehp_730_22 PMid:37288408 PMCid:PMC10243419
2. da Silva AG, Baldacara L, Cavalcante DA, Fasanella NA, Palha AP. The Impact of Mental Illness Stigma on Psychiatric Emergencies. Front Psychiatry. 2020; 11:573. https://doi.org/10.3389/fpsyt.2020.00573 PMid:32636773 PMCid:PMC7319091
3. Heinz I, Mergl R, Hegerl U, Rummel-Kluge C, Kohls E. Depression stigma and management of suicidal callers: a cross-sectional survey of crisis hotline counselors. BMC Psychiatry. 2019;19(1):342. https://doi.org/10.1186/s12888-019-2325-y PMid:31694588 PMCid:PMC6836490
4. Zolezzi M, Alamri M, Shaar S, Rainkie D. Stigma associated with mental illness and its treatment in the Arab culture: A systematic review. Int J Soc Psychiatry. 2018;64(6):597-609. https://doi.org/10.1177/0020764018789200 PMid:30019976
5. Oexle N, Rusch N. [Stigma - risk factor and consequence of suicidal behavior: Implications for suicide prevention]. Nervenarzt. 2018;89(7):779-83. https://doi.org/10.1007/s00115-017-0450-8 PMid:29147725
6. Link BG, Phelan JC. Conceptualizing Stigma. Annu Rev Sociol. 2001;27(1):363-85. https://doi.org/10.1146/annurev.soc.27.1.363
7. Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum. 2017;30(2):111-16. https://doi.org/10.1177/0840470416679413 PMid:28929889 PMCid:PMC5347358
8. Henderson C, Noblett J, Parke H, Clement S, Caffrey A, Gale-Grant O, Schulze B, Druss B, Thornicroft G. Mental health-related stigma in health care andmental health-care settings. Lancet Psychiatry. 2014;1(6):467-82. https://doi.org/10.1016/S2215-0366(14)00023-6 PMid:26361202
9. Feijó LP, Araújo RJD, Motta SG, Ramalho MHN Filho, Kubrusly M, Augusto KL. Tradução, adaptação e validação da escala MICA-4 no Brasil com aplicação para acadêmicos de Medicina. Rev bras educ med. 2023;47(4):e133. https://doi.org/10.1590/1981-5271v47.4-2022-0313
10. Torales J, Aveiro-Róbalo TR, Ríos-González C, Barrios I, Almirón-Santacruz J, González-Urbieta I, Caycho-Rodríguez T, Castaldelli-Maia JM, Ventriglio A. Discrimination, stigma and mental health: what's next? Int Rev Psychiatry. 2023;35(3-4):242-50. https://doi.org/10.1080/09540261.2023.2186218 PMid:37267024
11. Munawar K, Abdul Khaiyom JH, Bokharey IZ, Park MSA, Choudhry FR. A systematic review of mental health literacy in Pakistan. Asia Pac Psychiatry. 2020;12(4):e12408. https://doi.org/10.1111/appy.12408 PMid:32803860
12. Unger JB, Cabassa LJ, Molina GB, Contreras S, Baron M. Evaluation of a Fotonovela to Increase Depression Knowledge and Reduce Stigma Among Hispanic Adults. J Immigr Minor Health. 2013;15(2):398-406 https://doi.org/10.1007/s10903-012-9623-5 PMid:22485012 PMCid:PMC3602405
13. Pérez-Flores NJ, Cabassa LJ. Effectiveness of mental health literacy and stigma interventions for Latino/a adults in the United States: A systematic review. Stigma Health. 2021;6(4):430-39. https://doi.org/10.1037/sah0000343 PMid:35368243 PMCid:PMC8974450
14. Ma KKY, Anderson JK, Burn AM. Review: School‐based interventions to improve mental health literacy and reduce mental health stigma - a systematic review. Child Adolesc Ment Health. 2023;28(2):230-40. https://doi.org/10.1111/camh.12543 PMid:35005830
15. Chisholm KE, Patterson P, Torgerson C, Turner E, Birchwood M. A randomised controlled feasibility trial for an educational school-based mental health intervention: study protocol. BMC Psychiatry. 2012;12:1-7. https://doi.org/10.1186/1471-244X-12-23 PMid:22439814 PMCid:PMC3364875
16. Ojio Y, Yamaguchi S, Ohta K, Ando S, Koike S. Effects of biomedical messages and expert-recommended messages on reducing mental health-related stigma: a randomized controlled trial. Epidemiol Psychiatr Sci. 2019;29:e74 https://doi.org/10.1017/S2045796019000714 PMid:31753045 PMCid:PMC8061129
17. Li J, Li J, Thornicroft G, Yang H, Chen W, Huang Y. Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model. BMC Psychiatry. 2015;15:263. https://doi.org/10.1186/s12888-015-0660-1 PMid:26503370 PMCid:PMC4620640
18. Craig SL, Eaton AD, Leung VWY, Iacono G, Pang N, Dillon F, Austin A, Pascoe R, Dobinson C. Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada. BMC Psychol. 2021;9(1):94. https://doi.org/10.1186/s40359-021-00595-6 PMid:34099063 PMCid:PMC8183324
19. Liu Y, Wu YC, Fu H, Guo WY, Wang X. Digital intervention in improving the outcomes of mental health among LGBTQ+ youth: a systematic review. Front Psychol. 2023;14:1242928. https://doi.org/10.3389/fpsyg.2023.1242928 PMid:37809309 PMCid:PMC10556462
20. Tóth MD, Ihionvien S, Leduc C, Aust B, Amann BL, Cresswell-Smith J, Reich H, Cully G, Sanches S, Fanaj N, Qirjako G, Tsantila F, Ross V, Mathieu S, Pashoja AC, Arensman E, Purebl G. Evidence for the effectiveness of interventions to reduce mental health related stigma in the workplace: a systematic review. BMJ Open. 2023;13(2):e067126. https://doi.org/10.1136/bmjopen-2022-067126 PMid:36806140 PMCid:PMC9944311
21. Griffiths KM, Bennett K, Walker J, Goldsmid S, Bennett A. Effectiveness of MH-Guru, a brief online mental health program for the workplace: A randomised controlled trial. Internet Interv. 2016:6:29-39. https://doi.org/10.1016/j.invent.2016.09.004 PMid:30135812 PMCid:PMC6096203
22. Arthur YA, Boardman GH, Morgan AJ, McCann TV. Effectiveness of a Problem-Solving, Story-Bridge Mental Health Literacy Programme in Improving Ghanaian Community Leaders' Attitudes towards People with Mental Illness: A Cluster Randomised Controlled Trial. Issues Ment Health Nurs. 2021;42(4):332-45. https://doi.org/10.1080/01612840.2020.1799273 PMid:32877258
23. Heim E, Henderson C, Kohrt BA, Koschorke M, Milenova M, Thornicroft G. Reducing mental health-related stigma among medical and nursing students in low- and middleincome countries: a systematic review. Epidemiol Psychiatr Sci. 2019;29:e28. https://doi.org/10.1017/S2045796019000167 PMid:30929650 PMCid:PMC6848770
24. Üçok ALP, SoygÜR H, Ataklİ CEM, Kuşcu K, Sartorius N, Duman ZC, Polat A, Erkoç S. The impact of antistigma education on the attitudes of general practitioners regarding schizophrenia. Psychiatry Clin Neurosci. 2006;60(4):439-43. https://doi.org/10.1111/j.1440-1819.2006.01529.x PMid:16884445
25. Kaur A, Kallakuri S, Kohrt BA, Heim E, Gronholm PC, Thornicroft G, Maulik PK. Systematic review of interventions to reduce mental health stigma in India. Asian J Psychiatr. 2021;55:102466. https://doi.org/10.1016/j.ajp.2020.102466 PMid:33249319 PMCid:PMC7116814
26. Fujii T, Hanya M, Murotani K, Kamei H. Scale development and an educational program to reduce the stigma of schizophrenia among community pharmacists: a randomized controlled trial. BMC Psychiatry. 2021;21(1):211. https://doi.org/10.1186/s12888-021-03208-z PMid:33902519 PMCid:PMC8077925
27. Heim E, Kohrt BA, Koschorke M, Milenova M, Thornicroft G. Reducing mental healthrelated stigma in primary health care settings in low- and middle-income countries: a systematic review. Epidemiol Psychiatr Sci. 2018;29:e3. https://doi.org/10.1017/S2045796018000458 PMid:30176952 PMCid:PMC6399081
28. Ucok A, Gaebel W. Side effects of atypical antipsychotics: a brief overview. World Psychiatry. 2008;7(1):58-62. https://doi.org/10.1002/j.2051-5545.2008.tb00154.x PMid:18458771 PMCid:PMC2327229
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