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

Author: Clement, S.; Schauman, O.; Graham, T.; Maggioni, F.; Evans-Lacko, S.; Bezborodovs, N.; Morgan, C.; Rusch, N.; Brown, J.S.L.; Thornicroft, G.

Description: BACKGROUND: Individuals 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?

METHOD: Five 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.

RESULTS: The 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.

CONCLUSIONS: Stigma 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.

Subject Headings: Attitude of Health Personnel; Female; Health Personnel/psychology; Humans; Male; Mental Disorders/psychology; Mental Health; Mental Health Services; Military Personnel/psychology; Patient Acceptance of Health Care/psychology; Primary Health Care; Qualitative Research; Social Stigma

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

Publication year: 2015

Journal or book title: Psychological Medicine

Volume: 45

Issue: 1

Pages: 11-27

Find the full text : https://www.cambridge.org/core/journals/psychological-medicine/article/what-is-the-impact-of-mental-healthrelated-stigma-on-helpseeking-a-systematic-review-of-quantitative-and-qualitative-studies/E3FD6B42EE9815C4E26A6B84ED7BD3AE

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Type: Journal Article

Serial number: 2794