Interventions to Reduce Stigma Related to Mental Illnesses in Educational Institutes: a Systematic Review

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Abstract

This investigation reviews the effectiveness of anti-stigma interventions employed at educational institutes; to improve knowledge, attitude and beliefs regarding mental health disorders among students. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guidelines were followed and protocol was registered in PROSPERO (CRD42018114535). Forty four randomized controlled trials were considered eligible after screening of 104 full-text articles against inclusion and exclusion criteria.

Several interventions have been employed to tackle stigma toward psychiatric illnesses, including education through lectures and case scenarios, contact-based interventions, and role-plays as strategies to address stigma towards mental illnesses. A high proportion of trials noted that there was a significant improvement for stigma (19/25, 76%), attitude (8/11, 72%), helping-seeking (8/11, 72%), knowledge of mental health including recognition of depression (11/14, 78%), and social distance (4/7, 57%). These interventions also helped in reducing both public and self-stigma. Majority of the studies showed that the anti-stigma interventions were successful in improving mental health literacy, attitude and beliefs towards mental health illnesses.

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Most cited references 47

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Global Burden of Disease and the Impact of Mental and Addictive Disorders

Jürgen Rehm, Kevin Shield (2019)

This contribution reviews the newest empirical evidence regarding the burden of mental and addictive disorders and weighs their importance for global health in the first decades of the twenty-first century.

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Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness

Georg Schomerus, Susanne Stolzenburg, Simone Freitag … (2019)

It is unclear to what extent failure to recognize symptoms as potential sign of a mental illness is impeding service use, and how stigmatizing attitudes interfere with this process. In a prospective study, we followed a community sample of 188 currently untreated persons with mental illness (predominantly depression) over 6 months. We examined how lack of knowledge, prejudice and discrimination impacted on self-identification as having a mental illness, perceived need, intention to seek help, and help-seeking, both with respect to primary care (visiting a general practitioner, GP) and specialist care (seeing a mental health professional, MHP). 67% sought professional help within 6 months. Fully saturated path models accounting for baseline depressive symptoms, previous treatment experience, age and gender showed that self-identification predicted need (beta 0.32, p < 0.001), and need predicted intention (GP: beta 0.45, p < 0.001; MHP: beta 0.38, p < 0.001). Intention predicted service use with a MHP after 6 months (beta 0.31, p < 0.01; GP: beta 0.17, p = 0.093). More knowledge was associated with more self-identification (beta 0.21, p < 0.01), while support for discrimination was associated with lower self-identification (beta - 0.14, p < 0.05). Blaming persons with mental illness for their problem was associated with lower perceived need (beta - 0.16, p < 0.05). Our models explained 37% of the variance of seeking help with a MHP, and 33% of help-seeking with a GP. Recognizing one's own mental illness and perceiving a need for help are impaired by lack of knowledge, prejudice, and discrimination. Self-identification is a relevant first step when seeking help for mental disorders.

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Effects of a classroom-based educational resource on adolescent mental health literacy: a cluster randomized controlled trial.

Yael Perry, Katherine Petrie, Hannah Buckley … (2014)

Evidence suggests that poor mental health literacy is a key barrier to help-seeking for mental health difficulties in adolescence. Educational programs have shown positive effects on literacy, however, the evidence base remains limited and available studies have many methodological limitations. Using cluster Randomised Control Trial (RCT) methodology, the current study examines the impact of 'HeadStrong', a school-based educational intervention, on mental health literacy, stigma, help-seeking, psychological distress and suicidal ideation. A total of 380 students in 22 classes (clusters) from 10 non-government secondary schools was randomised to receive either HeadStrong or Personal Development, Health and Physical Education (PDHPE) classes. Participants were assessed pre- and post-intervention, and at 6-month follow-up. Literacy improved and stigma reduced in both groups at post-intervention and follow-up, relative to baseline. However, these effects were significantly greater in the HeadStrong condition. The study demonstrates the potential of HeadStrong to improve mental health literacy and reduce stigma.

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Author and article information

Contributors

Ahmed Waqas:

ORCID: http://orcid.org/0000-0002-3772-194X

ahmedwaqas1990@hotmail.com

Bio :

Ahmed Waqas

, MBBS, is a devoted clinical academic and researcher. He also works as a research fellow at the Human Development Research Foundation in Pakistan, which conducts cutting edge research in maternal and child mental health. He is also a doctoral fellow in psychiatry at the Institute of Life Science, University of Liverpool, UK. Waqas’ research in mental health, was inspired by his own struggle with depression during his second year of medical school. An avid researcher, Waqas’ research interests lie in public mental health with a primary focus on maternal and child mental health. In addition to evidence synthesis, Waqas is also involved in primary epidemiological and intervention research and applications of data science in psychiatry.

Salma Malik: salma.Malik@hhchealth.org

Bio :

Salma Malik

, M.D. is Board Certified in Adult Psychiatry as well as Child and Adolescent Psychiatry And currently serves as the Training Director at the Child and Adolescent fellowship program at Institute of Living/Hartford Hospital in Connecticut USA.

Ania Fida: an.fida@hotmail.com

Bio :

Ania Fida

, M.D. is an avid researcher in psychiatry with a focus in evidence synthesis. She is starting her clinical training in Psychiatry in the United States.

Noureen Abbas: noureenabbasmd@gmail.com

Nadeem Mian: nadeem@picacs.org

Bio :

Nadeem Mian

M.D. works as a research assistant in Psychiatry and frequently publishes systematic reviews in this field.

Sannihitha Miryala: smiryala@integrated-pc.com

Bio :

Sannihitha Miryala

M.D. works as a research assistant in Psychiatry and frequently publishes systematic reviews in this field. She graduated from Avalon University School of Medicine in 2017. She will be starting her internal medicine residency at Garden City Hospital this year in Michigan. She is currently working as a clinical associate with Integrative Psychiatric Consultants in Kansas City, KSAfshan Naz Amray M.D. works as a research assistant in Psychiatry and frequently publishes systematic reviews in this field.

Afshan Naz Amray: afshanamray@gmail.com

Zunairah Shah: zshah@weisshospital.com

Bio :

Zunairah Shah

M.D. is a Resident Psychiatrist at Louis A. Weiss Memorial Hospital, Chicago Illinois, USA.

Sadiq Naveed: snaveed@kumc.edu

Bio :

Sadiq Naveed

, M.D., is an assistant professor in the Department of Psychiatry and Behavioral Sciences at the University of Kansas Medical Center. He is board-certified in child and adolescent psychiatry, as well as adult psychiatry. He is currently pursuing a Master of Public Health degree from Benedictine University in Illinois. He earned his medical degree from Nishtar Medical College in Multan, Pakistan, and received his training in adult psychiatry at Griffin Memorial Hospital in Norman, Oklahoma. He also completed his training in child and adolescent psychiatry at the University of Kansas Medical Center.

Journal

Journal ID (nlm-ta): Psychiatr Q

Journal ID (iso-abbrev): Psychiatr Q

Title: The Psychiatric Quarterly

Publisher: Springer US (New York )

ISSN (Print): 0033-2720

ISSN (Electronic): 1573-6709

Publication date (Electronic): 5 May 2020

Publication date PMC-release: 5 May 2020

Publication date (Print): 2020

Volume: 91

Issue: 3

Pages: 887-903

Affiliations

[1 ]GRID grid.10025.36, ISNI 0000 0004 1936 8470, Institute of Population Health Sciences, , University of Liverpool, ; Liverpool, UK

[2 ]Program Director: Child and Adolescent Psychiatry Fellowship, Institute of Living/Hartford Healthcare, Hartford, CT USA

[3 ]GRID grid.412129.d, ISNI 0000 0004 0608 7688, King Edward Medical University, ; Lahore, Pakistan

[4 ]GRID grid.412956.d, FMH College of Medicine & Dentistry, ; Lahore, Pakistan

[5 ]Mental Health Counselor, PICACS, Washington, USA

[6 ]Integrated Psychiatric Consultants, Kansas, KS USA

[7 ]GRID grid.412080.f, ISNI 0000 0000 9363 9292, Dow University of Health Sciences, ; Karachi, Pakistan

[8 ]GRID grid.461516.1, ISNI 0000 0004 0452 2957, Weiss Memorial Hospital, ; Illinois, Chicago, USA

[9 ]GRID grid.412016.0, ISNI 0000 0001 2177 6375, Psychiatry and Behavioral Sciences, , University of Kansas Medical Center, ; Kansas, USA

Author information

Ahmed Waqas http://orcid.org/0000-0002-3772-194X

Article

Publisher ID: 9751

DOI: 10.1007/s11126-020-09751-4

PMC ID: 7395002

PubMed ID: 32372401

SO-VID: 31fa34cb-093e-402b-b764-91201c3117ef

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Funding

Funded by: University of Liverpool

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: stigma,institutions,mental health,depression,psychosis,anxiety,autism,interventions

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: stigma, institutions, mental health, depression, psychosis, anxiety, autism, interventions

Interventions to Reduce Stigma Related to Mental Illnesses in Educational Institutes: a Systematic Review

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Abstract

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Stigmatisation of mental illnesses

Most cited references 47

Global Burden of Disease and the Impact of Mental and Addictive Disorders

Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness

Effects of a classroom-based educational resource on adolescent mental health literacy: a cluster randomized controlled trial.

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