The Lancet Commission on ending stigma and discrimination in mental health

In the paper

“stigma and discrimination negatively affect most PWLE”

In the paper

“Our umbrella review of 216 systematic reviews shows that interventions based on the principle of social contact (whether in person, virtual, or indirect) that have been appropriately adapted to different contexts and cultures are the most effective ways to reduce stigmatisation worldwide”

• Also stated in: § Abstract · boosted

  “The clearly emerging core finding is that forms of social contact (direct or indirect) between people who do and do not have lived experience of mental health conditions is the most effective evidence-based way to reduce stigmatisation.”

In the paper

“the media could play a crucial part in reducing stigma and discrimination”

In the paper

“when target groups are consulted on programme content and delivery”

In the paper

“stigma and discrimination can be worse than the impact of the mental health condition itself”

In the paper

“the media are an important factor in worsening stigma and discrimination”

In the paper

“Most (≥70%) participants agreed that PWLE should be treated as equal to people with physical health conditions”

In the paper

“Indeed, many people describe stigma as being worse than the condition itself.”

• Also stated in: § Aims and scope of the Commission · boosted

  “Indeed, as this report will demonstrate, many people with such conditions describe stigma as being worse than the condition itself.”

In the paper

“Our evaluation of ten large-scale anti-stigma programmes around the world found that they are most effective when they involve people with lived experience of mental health conditions (PWLE) as co-producers in all aspects of development, when target groups are consulted on programme content and delivery, and when programmes are sustained over the long term”

In the paper

“when programmes are sustained over the long term”

In the paper

“People who responded to our lived experience survey reported experiences of discrimination in all aspects of their lives, from blatant discrimination in social interactions and at work, to social isolation and loneliness, shame and secrecy, and damaged marital prospects.”

In the paper

“Stigma stress has been associated with increased suicidality.55”

What the sources say

• Not checked yetcites [55] Xu, 2018, Involuntary hospitalization, stigma stress and suicidality: a longitudinal study, Soc Psychiatry Psychiatr Epidemiol source

In the paper

“Three studies, two from Africa and one from Europe, reported participants' beliefs that public stigma led to inadequate funding and provision of health care.”

In the paper

“Some of these effects were mediated by self-stigma and lack of social support.”

In the paper

“Several qualitative studies from different parts of the world described discriminatory laws or judicial practices arising from public stigma, for instance, using an unsubstantiated allegation of dangerousness against a PWLE in a court ruling.”

In the paper

“Two studies from African countries described public stigma as a barrier for PWLE to be involved in policy making.”

In the paper

“In more collectivistic cultures, there was a stronger link between self-stigma and experienced discrimination.51”

What the sources say

• Not checked yetcites [51] Yu, 2021, Internalization process of stigma of people with mental illness across cultures: a meta-analytic structural equation modeling approach, Clin Psychol Rev source

In the paper

“One English study described respondents' experience of going through the process of welfare benefit applications as stigmatising.59”

What the sources say

• Not checked yetcites [59] Hamilton, 2016, Qualitative analysis of mental health service users' reported experiences of discrimination, Acta Psychiatr Scand source

In the paper

“Among young people at risk of psychosis, high stigma stress raises the rate of transition to schizophrenia after 1 year.56”

What the sources say

• Not checked yetcites [56] Rüsch, 2015, Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis, Schizophr Res source

In the paper

“Higher levels of stigma reduce help-seeking and healthservice use in several ways.49”

What the sources say

• Not checked yetcites [49] Gabbidon, 2014, Discrimination attributed to mental illness or race-ethnicity by users of community psychiatric services, Psychiatr Serv source

In the paper

“Psychosocial interventions, even in HICs and many with proven effectiveness, are often not implemented, for example those offering help with employment, housing, or family interventions. 1”

What the sources say

• Not checked yetcites [1] Rüsch, 2022

In the paper

“Our review identified only qualitative and no quantitative papers on structural discrimination as a consequence of public stigma.49”

What the sources say

• Not checked yetcites [49] Gabbidon, 2014, Discrimination attributed to mental illness or race-ethnicity by users of community psychiatric services, Psychiatr Serv source

In the paper

“Many cross-sectional and longitudinal studies identified in our review reported the impacts of stigma and discrimination on health-related outcomes, such as symptoms of depression, anxiety, post-traumatic stress disorder, psychosis, substance use conditions, suicidality, physical symptoms, disability, and recovery.49,65,66”

What the sources say

• Not checked yetcites [49] Gabbidon, 2014, Discrimination attributed to mental illness or race-ethnicity by users of community psychiatric services, Psychiatr Serv source
• Not checked yetcites [65] Pyle, 2014, “It's just a very taboo and secretive kind of thing”: making sense of living with stigma and discrimination from accounts of people with psychosis, Psychosis source
• Not checked yetcites [66] Burke, 2016, Experiences of stigma in psychosis: a qualitative analysis of service users' perspectives, Psychosis source

In the paper

“These studies showed that such forms of stigma negatively affected clinical and personal recovery outcomes.67”

What the sources say

• Not checked yetcites [67] Mak, 2017, A cross-diagnostic investigation of the differential impact of discrimination on clinical and personal recovery, Psychiatr Serv source

In the paper

“The link between selfstigma and self-harm or suicidality was particularly strong among young people.52”

What the sources say

• Not checked yetcites [52] Eliasson, 2021, Unpacking stigma: meta-analyses of correlates and moderators of personal stigma in psychosis, Clin Psychol Rev source

In the paper

“over 90% agreed that PWLE should be treated as well as people with physical health conditions”

In the paper

“People with mental health conditions who perceived greater public stigma found their own condition more threatening than other respondents.”

What the sources say

• Not checked yetcites [17] Sheehan, 2016, Stigma by any other name, Psychiatr Serv source
• Not checked yetcites [50] Mak, 2007, Meta-analysis of stigma and mental health, Soc Sci Med source

In the paper

“The key lessons that emerge include involving PWLE in all aspects of co-producing antistigma programmes”

In the paper

“Nevertheless, most evidence on these effects are from North America, Europe, and east Asia.”

In the paper

“Self-stigma is positively associated with a why try effect, which leads people not even to attempt important activities (eg, applying for a job) because of the expectation of failure.”

In the paper

“Prejudice by healthcare staff has been linked with worsened health outcomes and physical health care because of diagnostic overshadowing, in which physical symptoms are misattributed to mental health conditions.74,75”

What the sources say

• Not checked yetcites [74] Knaak, 2017, Mental illness-related stigma in healthcare: barriers to access and care and evidence-based solutions, Healthc Manage Forum source
• Not checked yetcites [75] Jones, 2008, ‘Diagnostic overshadowing’: worse physical health care for people with mental illness, Acta Psychiatr Scand source

In the paper

“Stigma is also associated with low investment in mental health care.70”

What the sources say

• Not checked yetcites [70] DeLuca, 2017, Does individual stigma predict mental health funding attitudes? Toward an understanding of resource allocation and social Climate, Isr J Psychiatry Relat Sci

In the paper

“Although policies aimed to establish respect towards people with mental health conditions and to stipulate their rights, they fell short in effectively reducing discrimination.”

In the paper

“In line with the concept of what matters most, stigma and discrimination drastically limit a person's active participation in society with respect to education, employment, establishing healthy and safe social interactions, and starting a family.1,46,49,79”

What the sources say

• Not checked yetcites [1] Rüsch, 2022
• Not checked yetcites [46] Yang, 2014, “What matters most:” a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma, Soc Sci Med source
• Not checked yetcites [49] Gabbidon, 2014, Discrimination attributed to mental illness or race-ethnicity by users of community psychiatric services, Psychiatr Serv source

In the paper

“Additionally, housing conditions might be poor due to stigmatising attitudes of landlords who may refuse to have a tenant with a mental health condition.”

In the paper

“In some east Asian countries, changing the name of schizophrenia was used as a strategy to reduce public stigma.”

In the paper

“More inclusive policies, legislation, and plans that were more effective in reducing stigma were generally linked with community-based treatment, programmes of public education, and media activities, including participation of champions who had lived experience of mental health conditions.”

In the paper

“Stigma and discrimination not only affect the labelled individual but also, by association, family members and carers, for example by damaging the marital prospects of siblings, or when parents are blamed for their child's condition.80”

What the sources say

• Not checked yetcites [80] Moses, 2014, Stigma and family

In the paper

“In employment settings, many people with mental health conditions decide not to disclose their condition due to fear of discrimination (figure 5).”

In the paper

“One of the most salient stigma experiences in adolescents is the fear of social rejection.”

In the paper

“Detrimental stigma outcomes in young people were mostly related to their need to preserve social identity and social capital.87,88”

What the sources say

• Not checked yetcites [87] Moses, 2010, Being treated differently: stigma experiences with family, peers, and school staff among adolescents with mental health disorders, Soc Sci Med source
• Not checked yetcites [88] Gronholm, 2017, Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review, Psychol Med source

In the paper

“Evidence for stigmatisation of young people with mental health conditions has been found worldwide.84”

What the sources say

• Not checked yetcites [84] Ferrie, 2020, Psychosocial outcomes of mental illness stigma in children and adolescents: a mixed-methods systematic review, Child Youth Serv Rev source

In the paper

“Young people in that survey also reported stigma perpetrated by school staff, who expressed fear, dislike, avoidance, and underestimation of their abilities.”

In the paper

“We found very few articles that review policies targeting mental health conditions.”

In the paper

“These forms of health discrimination contribute to reduced life expectancy among people with mental health conditions.43,[76][77][78]”

What the sources say

• Not checked yetcites [43] Thornicroft, 2011, Physical health disparities and mental illness: the scandal of premature mortality, Br J Psychiatry source
• Not checked yetcites [76] Henderson, 2014, Mental health-related stigma in health care and mental health-care settings, Lancet Psychiatry source
• Not checked yetcites [77] Gissler, 2013, Patterns in mortality among people with severe mental disorders across birth cohorts: a register-based study of Denmark and Finland in 1982–2006, BMC Public Health source

In the paper

“The views of young people about mental health can differ from those of their parents, revealing important intergenerational perspectives.”

In the paper

“People also often report losing friends after disclosing a mental health condition.82”

What the sources say

• Not checked yetcites [82] Lasalvia, 2015, Cross-national variations in reported discrimination among people treated for major depression worldwide: the ASPEN/INDIGO international study, Br J Psychiatry source

In the paper

“Lack of employ ment and income due to stigma are important contributors to poverty among people with mental health conditions.90”

What the sources say

• Not checked yetcites [90] Trani, 2015, Mental illness, poverty and stigma in India: a case-control study, BMJ Open source

In the paper

“The State of the World's Children survey in 13 countries showed that families can also create substantial barriers to help seeking among adolescents.”

What the sources say

• Not checked yetcites [86] 2021

In the paper

“Effective efforts to address structural stigma at the policy level have included interventions through national mental health plans and policies and anti-discrimination laws for people with mental health conditions in care, at work, and in wider society.”

In the paper

“The anticipation of discrimination, such as the fear of being discredited by police, having to withdraw from educational activities, or being avoided by family, friends, neighbours, also accounts for substantial negative effects.42,79”

What the sources say

• Not checked yetcites [42] Moitra, 2022, The global gap in treatment coverage for major depressive disorder in 84 countries from 2000–2019: a systematic review and Bayesian meta-regression analysis, PLoS Med source
• Not checked yetcites [79] Lasalvia, 2013, Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey, Lancet source

In the paper

“Interventions included empowerment by involving the service users in decision making about their mental health condition and about appointments and follow-up schedules, and by identifying treatment goals.The effect size for these programmes increased progressively with rising number of specific treatment targets.”

What the sources say

• Not checked yetcites [104] Greene, 2016, Interventions to increase retention in mental health services: a systematic review, Psychiatr Serv source

In the paper

“In a meta-analysis, they found significant improvements in attitudes or beliefs about seeking care could be seen in four of six studies (effect size -0•02 to 2•56).”

What the sources say

• Not checked yetcites [103] Werlen, 2020, Interventions to improve children's access to mental health care: a systematic review and meta-analysis, Epidemiol Psychiatr Sci source

In the paper

“Reviews of studies on interventions to support people into gaining work have also been published, covering intellectual disability, 110 autism, 111 severe mental health conditions, 112 and other mental health conditions.113”

What the sources say

• Not checked yetcites [110] Nevala, 2019, The effectiveness of rehabilitation interventions on the employment and functioning of people with intellectual disabilities: a systematic review, J Occup Rehabil source
• Not checked yetcites [111] Khalifa, 2020, Workplace accommodations for adults with autism spectrum disorder: a scoping review, Disabil Rehabil source
• Not checked yetcites [112] Kinoshita, 2013, Supported employment for adults with severe mental illness, Cochrane Database Syst Rev

In the paper

“Eight (80%) of ten studies on treatment engagement for individuals at risk (eg, a family-based session to increase motivation during an emergency room visit) showed improved access to care with interventions.”

What the sources say

• Not checked yetcites [103] Werlen, 2020, Interventions to improve children's access to mental health care: a systematic review and meta-analysis, Epidemiol Psychiatr Sci source

In the paper

“The most frequently used strategies were improving mental health knowledge, addressing stigmatising attitudes, and reducing behavioural barriers through psychoeducational approaches.”

What the sources say

• Not checked yetcites [104] Greene, 2016, Interventions to increase retention in mental health services: a systematic review, Psychiatr Serv source

In the paper

“Coalitions of stakeholders, often led by non-governmental organisations, mental health associations, and mental health professionals, with the participation of empowered PWLE, have been instrumental in advocating these changes.”

In the paper

“Interventions that aim to reduce interpersonal stigma in the workplace have been evaluated, such as the Mental Health First Aid (MHFA) programme.108”

What the sources say

• Not checked yetcites [108] Hanisch, 2016, The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review, BMC Psychiatry source

In the paper

“44 reviews covered children, adolescents, teachers, parents, and university students (excluding health professions).”

In the paper

“A review of the cost-effectiveness of initiatives to reduce stigma in the workplace found no eligible studies.109”

What the sources say

• Not checked yetcites [109] Nogues, 2018, Economic evaluations of workplace mental health interventions: a critical review, Can J Adm Sci source

In the paper

“Training managers to understand and support the mental health needs of employees was effective in improving mental-health-related knowledge, non-stigmatising attitudes, and self-reported supportive behaviour.”

What the sources say

• Not checked yetcites [106] Gayed, 2018, Effectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis, Occup Environ Med source

In the paper

“There is a knowledge gap for interventions addressing structural stigma experienced by people within mental health conditions in LMICs, where formal employment may be an exception.”

In the paper

“However, the effect of such policies on people's lives, knowledge, attitudes and behaviours have not been assessed.”

In the paper

“The authors also examined collaborative care training for primary care or community care staff, and they found long-term effects on mental health service use among individuals in primary care settings, including people with depression.”

What the sources say

• Not checked yetcites [105] Xu, 2018, Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis, Psychol Med source

In the paper

“Stigma and discrimination were addressed as primary outcomes in 19 (43%) of the included reviews.”

In the paper

“Joshi and colleages 99 found that training health-care providers to share non-stigmatising messages with pregnant women who used opioids helped increase acceptability of services and access to care.”

What the sources say

• Not checked yetcites [99] Joshi, 2021, Women-centered drug treatment models for pregnant women with opioid use disorder: a scoping review, Drug Alcohol Depend source

In the paper

“four of seven that measured social distance also reported improvements.”

What the sources say

• Not checked yetcites [116] Waqas, 2020, Interventions to reduce stigma related to mental illnesses in educational institutes: a systematic review, Psychiatric Quarterly source

In the paper

“Stigma was included as a secondary outcome in 25 studies that primarily focused on universal, selective, or indicated interventions to prevent mental health problems (appendix 3 pp 94-96).”

In the paper

“One qualitative study included in the review by Morris and colleagues 118 found that a theme of difference (us and them) emerged after an intervention, which requires further investigation.”

What the sources say

• Not checked yetcites [118] Morris, 2021, Classroom-based peer interventions targeting autism ignorance, prejudice and/or discrimination: a systematic PRISMA review, Int J Incl Educ

In the paper

“Several reviews indicate that structured direct social contact involving children with disabilities and giving them equal status to children without disabilities can lead to improved attitudes among peers.[119][120][121]”

What the sources say

• Not checked yetcites [119] Sentenac, 2012, Peer victimization among school-aged children with chronic conditions, Epidemiol Rev source
• Not checked yetcites [120] McManus, 2021, A meta-analytic review of interventions to improve children's attitudes toward their peers with intellectual disabilities, Contemp Educ Psychol source
• Not checked yetcites [121] Louw, 2020, Enhancing social inclusion of young adults with intellectual disabilities: a systematic review of original empirical studies, J Appl Res Intellect Disabil source

In the paper

“Sentenac and colleagues 119 showed that peer victimisation was reduced after an average of 25 weeks of involvement in a programme using social contact to bring peers with and without disabilities together for shared activities in school and community settings.”

What the sources say

• Not checked yetcites [119] Sentenac, 2012, Peer victimization among school-aged children with chronic conditions, Epidemiol Rev source

In the paper

“Regarding prevention of poor mental health and mental health literacy programmes, results are more mixed.”

In the paper

“intervention 125 resulted in significant and sustained improvements in participants' attitudes towards suicide.”

What the sources say

• Not checked yetcites [125] Shannonhouse L, Lin YD, Shaw K, Wanna R, Porter M. Suicide intervention training for college staff: program evaluation and intervention skill measurement. J Am Coll Health 65: 450–56. source

In the paper

“Four reviews concluded that the combination of multiple strategies was more effective than using any single strategy.[118][119][120]”

What the sources say

• Not checked yetcites [118] Morris, 2021, Classroom-based peer interventions targeting autism ignorance, prejudice and/or discrimination: a systematic PRISMA review, Int J Incl Educ
• Not checked yetcites [119] Sentenac, 2012, Peer victimization among school-aged children with chronic conditions, Epidemiol Rev source
• Not checked yetcites [120] McManus, 2021, A meta-analytic review of interventions to improve children's attitudes toward their peers with intellectual disabilities, Contemp Educ Psychol source

In the paper

“In a meta-analysis, Salazar de Pablo and colleagues 85 found a small effect for changes in attitudes towards people with mental health conditions across 16 studies involving youth of various ages (effect size Hedges g=0•18).”

What the sources say

• Not checked yetcites [85] Salazar de Pablo, 2020, Universal and selective interventions to promote good mental health in young people: systematic review and meta-analysis, Eur Neuropsychopharmacol source

In the paper

“most studies which assessed attitudes showed positive changes (eight of 11)”

What the sources say

• Not checked yetcites [116] Waqas, 2020, Interventions to reduce stigma related to mental illnesses in educational institutes: a systematic review, Psychiatric Quarterly source

In the paper

“These strategies all had positive outcomes on stigma reduction.”

What the sources say

• Not checked yetcites [133] Hartog, 2020, Stigma reduction interventions for children and adolescents in low- and middle-income countries: systematic review of intervention strategies, Soc Sci Med source

In the paper

“Liang and colleagues 127 did a meta-analysis of MHFA among college students (aged 19-27 years) but found no significant effect on stigma-related attitudes across four studies.”

What the sources say

• Not checked yetcites [127] Liang, 2021, Mental health first aid improves mental health literacy among college students: a meta-analysis, J Am Coll Health

In the paper

“Stigma was widely measured in terms of social distance.142,143”

What the sources say

• Not checked yetcites [142] Stubbs, 2014, Reducing mental illness stigma in health care students and professionals: a review of the literature, Australas Psychiatry source
• Not checked yetcites [143] van Brakel, 2019, Out of the silos: identifying cross-cutting features of health-related stigma to advance measurement and intervention, BMC Med source

In the paper

“It is notable that studies reporting multiple kinds of contact (eg, live or filmed) were more often associated with better outcomes for knowledge and attitudes related to mental health than educational interventions alone.145”

What the sources say

• Not checked yetcites [145] Lien, 2021, Challenging mental illness stigma in healthcare professionals and students: a systematic review and network meta-analysis, Psychol Health source

In the paper

“A randomised controlled trial in rural China showed that an enhanced social contact model is a promising method for reducing stigma among family members.141”

What the sources say

• Not checked yetcites [141] Ran, 2022, Effectiveness of enhancing contact model on reducing stigma of mental illness among family caregivers of persons with schizophrenia in rural China: a cluster randomized controlled trial, Lancet Reg Health West Pac

In the paper

“Six reviews showed that disclosure of mental health conditions and discussion within families reduced mental health stigma.140”

What the sources say

• Not checked yetcites [140] Adu, 2021, Policies and interventions to reduce familial mental illness stigma: a scoping review of empirical literature, Issues Mental Health Nurs source

In the paper

“One review identified two original studies that showed reduced stigma within families after psychoeducation in China and Korea.137”

What the sources say

• Not checked yetcites [137] Armijo, 2013, Efficacy of community treatments for schizophrenia and other psychotic disorders: a literature review, Front Psychiatry source

In the paper

“Davies and colleagues 135 found that information about the levels of hereditary risks of mental health conditions was considered important so that young people do not feel conditions experienced by their parents will be inevitable for them.”

What the sources say

• Not checked yetcites [135] Davies, 2022, Barriers, facilitators and interventions to support help-seeking amongst young people living in families impacted by parental mental illness: a systematized review, Early Interv Psychiatry source

In the paper

“However, in two of the three studies assessed, digital video interventions and direct contact did not differ for attitudes toward people with mental health conditions.”

What the sources say

• Not checked yetcites [131] Ito-Jaeger, 2021, Digital video interventions and mental health literacy among young people: a scoping review, J Ment Health

In the paper

“56 reviews were published between 1994 and 2021 and focused on prequalifying stigma reduction programmes for trainees (eg, nursing and medical students) and in-service programmes for qualified staff.29”

What the sources say

• Not checked yetcites [29] Barber, 2019, Microaggressions towards people affected by mental health problems: a scoping review, Epidemiol Psychiatr Sci source

In the paper

“Internet-based anti-stigma campaigns have also had positive effects on stigmatising attitudes among health-care staff.156”

What the sources say

• Not checked yetcites [156] Zubala, 2019, Large-scale online education programmes and their potential to effect change in behaviour and practice of health and social care professionals: a rapid systematic review, Interact Learn Environ source

In the paper

“Only five studies met their minimum quality standards.”

What the sources say

• Not checked yetcites [129] Reis, 2022, The impact of mental health literacy training programs on the mental health literacy of university students: a systematic review, Prev Sci source

In the paper

“LMICs are under-represented in the literature.”

In the paper

“A review of digital video interventions that were tested among youth aged 15-25 years found that videos produced better outcomes than lectures or no intervention.131”

What the sources say

• Not checked yetcites [131] Ito-Jaeger, 2021, Digital video interventions and mental health literacy among young people: a scoping review, J Ment Health

In the paper

“At the same time, effects were higher for education-only interventions if they were delivered in internet and community settings.”

What the sources say

• Not checked yetcites [130] Patafio, 2021, A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes, and behaviours, Early Interv Psychiatry source

In the paper

“Fully online multicomponent interventions, such as educational tutorials, case-based instruction, and practice-based learning, showed efficacy in stigma reduction. 155”

What the sources say

• Not checked yetcites [155] Muirhead, 2021, Establishing the effectiveness of technology-enabled dementia education for health and social care practitioners: a systematic review, Syst Rev source

In the paper

“They found positive changes in attitudes (effect size d=0•36-1•18) after intervention and at follow-up (0•68-1•0).”

What the sources say

• Not checked yetcites [132] Anderson, 2019, Mental health training programs for secondary school teachers: a systematic review, School Mental Health source

In the paper

“One of the areas that has received increasing attention for health-care students and professionals is the use of simulations (eg, standardised role-plays with actors), which have consistently been associated with stigma reductions.147,153,157”

What the sources say

• Not checked yetcites [147] Piot, 2020, Simulation in psychiatry for medical doctors: a systematic review and meta-analysis, Med Educ source
• Not checked yetcites [153] Carrara, 2021, Health care providers and people with mental illness: an integrative review on anti-stigma interventions, Int J Soc Psychiatry source
• Not checked yetcites [157] Goh, 2021, Effects of online stigma-reduction programme for people experiencing mental health conditions: a systematic review and meta-analysis, Int J Ment Health Nurs source

In the paper

“a comprehensive systematic mapping review of interventions used with adolescents aged 12-18 years found that a combination of education and social contact led to better outcomes than education alone.130”

What the sources say

• Not checked yetcites [130] Patafio, 2021, A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes, and behaviours, Early Interv Psychiatry source

In the paper

“In addition, interventions with two or more components had greater effects than those with one only.”

What the sources say

• Not checked yetcites [171] Clement, 2013, Mass media interventions for reducing mental health-related stigma, Cochrane Database Syst Rev

In the paper

“In this review, effect sizes were significantly greater after in-person contact than after video contact.”

What the sources say

• Not checked yetcites [168] Corrigan, 2012, Challenging the public stigma of mental illness: a meta-analysis of outcome studies, Psychiatr Serv source

In the paper

“In other reviews, the authors found that the concurrent use of several strategies, such as distribution of educational material, a media campaign, and training of gatekeepers and health-care professionals, appeared to be more effective than education alone.”

In the paper

“A meta-analysis showed small to medium size reductions in prejudice, with standardised mean differences of -0•38, -0•38, and -0•49 immediately, 1-8 weeks, and 6-9 months after the intervention, respectively.”

What the sources say

• Not checked yetcites [171] Clement, 2013, Mass media interventions for reducing mental health-related stigma, Cochrane Database Syst Rev

In the paper

“As in other reviews, there were methodological limitations, such as small unrepresentative samples and cross-sectional designs.”

What the sources say

• Not checked yetcites [173] Scior, 2011, Public awareness, attitudes and beliefs regarding intellectual disability: a systematic review, Res Dev Disabil source

In the paper

“A further key challenge is that few studies have used well adapted and validated outcome measures for stigma and discrimination, particularly in LMIC settings.26,[162][163][164][165][166]”

What the sources say

• Not checked yetcites [26] Brohan, 2013, Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC), Psychiatry Res source
• Not checked yetcites [162][163][164][165][166]

In the paper

“In contrast, among children and adolescents, education yielded a larger effect than contact.”

What the sources say

• Not checked yetcites [168] Corrigan, 2012, Challenging the public stigma of mental illness: a meta-analysis of outcome studies, Psychiatr Serv source

In the paper

“Across 16 studies, five assessed discrimination.”

What the sources say

• Not checked yetcites [171] Clement, 2013, Mass media interventions for reducing mental health-related stigma, Cochrane Database Syst Rev

In the paper

“Interventions were more likely to have a positive impact if the practice-based experience was preceded by an element of preparatory educational training.”

In the paper

“Another recommendation was that the evidence for improving attitudes was greater among students treating patients with less severe conditions, from which recovery could be seen.160”

What the sources say

• Not checked yetcites [160] Heim, 2020, Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: a systematic review, Epidemiol Psychiatr Sci source

In the paper

“20 reviews assessed creation of mental health awareness, mental health education, and training the general population and other specific population groups.”

In the paper

“Hung and colleagues 174 found that the active involvement of PWLE in the design of such support provided a sense of value and autonomy.”

What the sources say

• Not checked yetcites [174] Hung, 2021, Creating dementia-friendly communities for social inclusion: a scoping review, Gerontol Geriatr Med source

In the paper

“Direct contact without preparation led to feelings of intimidation and inhibition when interacting with people with dementia.”

In the paper

“A qualitative study focusing on intergenerational activities (eg, a choir) found that young adults' involvement resulted in reduced stigma towards people with dementia.”

In the paper

“As noted previously, most of these were based on studies from HICs and upper MICs.”

In the paper

“Among students, all interventions targeting dementia led to improved comfort for patients.159”

What the sources say

• Not checked yetcites [159] Alushi, 2015, Evaluation of dementia education programs for pre-registration healthcare students—a review of the literature, Nurse Educ Today source

In the paper

“The effect of awareness on help-seeking attitudes and behaviours is inconsistent.184,185”

What the sources say

• Not checked yetcites [184] Bu, 2020, Mental health literacy intervention on help-seeking in athletes: a systematic review, Int J Environ Res Public Health source
• Not checked yetcites [185] Castaldelli-Maia, 2019, Mental health symptoms and disorders in elite athletes: a systematic review on cultural influencers and barriers to athletes seeking treatment, Br J Sports Med source

In the paper

“Interventions that directly involved PWLE were more effective in reducing stigma than those that did not.[200][201][202][203]”

What the sources say

• Not checked yetcites [200][201][202][203]

In the paper