Reducing mental health-related stigma in primary health care settings in low- and middle-income countries: a systematic review
Open accessAbstract
Aims: This systematic review compiled evidence on interventions to reduce mental health-related stigma in primary health care (PHC) in low- and middle-income countries (LMICs). Studies targeting PHC staff (including non-professionals) were included. Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods: Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, PHC staff and LMICs. A qualitative analysis of all included full-texts was done with software MAXQDA. Full-texts were analysed with regards to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a risk of bias assessment was undertaken. Results: A total of 18 studies were included. Risk of bias was rated as high in most included studies. Only six studies had tested their intervention against a control condition, two of which had used random allocation. Most frequently used interventions were lectures providing theoretical information. Many studies also used interactive methods ( N = 9), discussed case studies ( N = 8) or used role plays ( N = 5). Three studies reported that they had used clinical practice and supervision. Results of these studies were mixed. No or little effects were found for brief training interventions (e.g. 1 h to 1 day). Longer training interventions with more sophisticated didactic methods produced statistically significant changes in validated stigma questionnaires. These results have to be interpreted with caution due to risk of bias. Methods for cultural adaptation of interventions were rarely documented. Conclusions: More rigorous trials are needed in LMICs to test interventions that target discriminatory behaviours in relationship with patients. Cultural adaptation of stigma interventions and structural/institutional factors should be more explicitly addressed in such trials.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In many places, mental illness is stigmatized and stigma against transgender people is also highly prevalent, creating a 'double stigma' burden for this community.
“In many places, mental illness is stigmatized [129, 130] and stigma against transgender people is also highly prevalent [131, 132], creating a ‘double stigma’ burden for this community.”
From Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies (2020) · cites this paper as [129]
Recent studies have identified several putative treatment selection brain biotypes with potential utility for choosing between psychotherapy and medication and for stimulation-based treatments such as transcranial magnetic stimulation and deep brain stimulation.
“Recent studies implementing this general approach have identified several putative treatment selection brain biotypes with potential utility for choosing between psychotherapy and medication and for stimulation-based treatments such as transcranial magnetic stimulation and deep brain stimulation. 333,336”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [333]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(2007) · PubMed Central · Cited by 2,521 · see citing works
Resources for mental health: scarcity, inequity, and inefficiency
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61239-2 · Cited by 1,789 · see citing works
Self-citationCulture and stigma: Adding moral experience to stigma theory
Yang, L. H., Kleinman, A., Link, B. G., Phelan, J. C., Lee, S., & Good, B. J. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2006.11.013 · Cited by 1,382 · see citing works
Mental health-related stigma in health care and mental health-care settings
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., Schulze, B., Druss, B., & Thornicroft, G. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)00023-6 · Cited by 761 · see citing works
Self-citationTesting for multigroup equivalence of a measuring instrument: a walk through the process.
Byrne, B. M. (2008) · PubMed · Cited by 722 · see citing works
Thornicroft, G. (2003) · Oxford University Press eBooks · doi:10.1093/med/9780198570981.001.0001 · Cited by 656 · see citing works
Self-citationDevelopment and psychometric properties of the Mental Health Knowledge Schedule
Evans-Lacko, S., Little, K., Meltzer, H., Rose, D., Rhydderch, D., Henderson, C., & Thornicroft, G. (2010) · The Canadian Journal of Psychiatry · doi:10.1177/070674371005500707 · Cited by 402 · see citing works
Self-citationMehta, N., Clement, S., Marcus, E., Stona, A.-C., Bezborodovs, N., Evans-Lacko, S. E., Palacios, J. E., Docherty, M. J., Barley, E. A., Rose, D. S., et al. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.151944 · Cited by 371 · see citing works
Self-citationEvans-Lacko, S., Rose, D., Little, K., Flach, C., Rhydderch, D., Henderson, C., & Thornicroft, G. (2011) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796011000308 · Cited by 363 · see citing works
Self-citationChowdhary, N., Jotheeswaran, A. T., Nadkarni, A., Hollon, S. D., King, M., Jordans, M. J. D., Rahman, A., Verdeli, H., Araya, R., & Patel, V. (2014) · Psychological Medicine · doi:10.1017/s0033291713001785 · Cited by 349 · see citing works
Keynejad, R. C., Dua, T., Barbui, C., & Thornicroft, G. (2018) · Evidence Based Mental Health · doi:10.1136/eb-2017-102750 · Cited by 341 · see citing works
Self-citationde Santana, C. L. A. (2018) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000206 · Cited by 329 · see citing works
Shunned: Discrimination Against People Mental Illness
Nelson, S. H. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n1223b · Cited by 252 · see citing works
The future of psychiatry in low- and middle-income countries
Patel, V. (2009) · Psychological Medicine · doi:10.1017/s0033291709005224 · Cited by 223 · see citing works
Stigma and discrimination related to mental illness in low- and middle-income countries
Semrau, M., Evans-Lacko, S., Koschorke, M., Ashenafi, L., & Thornicroft, G. (2015) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796015000359 · Cited by 206 · see citing works
Self-citationKassam, A., Glozier, N., Leese, M., Henderson, C., & Thornicroft, G. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01562.x · Cited by 194 · see citing works
Self-citationYang, L. H., Thornicroft, G., Alvarado, R., Vega, E., & Link, B. G. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu039 · Cited by 191 · see citing works
Self-citationHarper Shehadeh, M., Heim, E., Chowdhary, N., Maercker, A., & Albanese, E. (2016) · JMIR Mental Health · doi:10.2196/mental.5776 · Cited by 188 · see citing works
Self-citationArmstrong, G., Kermode, M., Raja, S., Suja, S., Chandra, P. S., & Jorm, A. F. (2011) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-5-17 · Cited by 168 · see citing works
Kohrt, B. A., Jordans, M. J. D., Turner, E. L., Sikkema, K. J., Luitel, N. P., Rai, S., Singla, D. R., Lamichhane, J., Lund, C., & Patel, V. (2018) · Pilot and Feasibility Studies · doi:10.1186/s40814-018-0234-3 · Cited by 141 · see citing works
Self-citationSocial Distance Towards People with Mental Illness in Southwestern Nigeria
Adewuya, A. O., & Makanjuola, R. O. A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670801961115 · Cited by 138 · see citing works
Evans-Lacko, S. E., Courtin, É., Fiorillo, A., Knapp, M. R. J., Luciano, M., Park, A., Brunn, M., Byford, S., Chevreul, K., Forsman, A. K., et al. (2014) · European Psychiatry · doi:10.1016/j.eurpsy.2014.02.007 · Cited by 135 · see citing works
Self-citationStigmatization of severe mental illness in India: Against the simple industrialization hypothesis
Jadhav, S., Littlewood, R., Ryder, A. G., Chakraborty, A., Jain, S., & Barua, M. (2007) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.37320 · Cited by 113 · see citing works
Nursing personnel attitudes towards suicide: the development of a measure scale
Botega, N. J., Reginato, D. G., da Silva, S. V., Cais, C. F. D. S., Rapeli, C. B., Mauro, M. L. F., Cecconi, J. P., & Stefanello, S. (2005) · Brazilian Journal of Psychiatry · doi:10.1590/s1516-44462005000400011 · Cited by 111 · see citing works
General practitioners and depression—First use of the Depression Attitude Questionnaire.
Botega, N. J., MANN, A. H., Blizard, R., & Wilkinson, G. (1992) · International Journal of Methods in Psychiatric Research · Cited by 106 · see citing works
Levels of stigma among community mental health staff in Guangzhou, China
Li, J., Li, J., Thornicroft, G., & Huang, Y. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0231-x · Cited by 92 · see citing works
Self-citationIntegrating mental health into primary healthcare.
(2008) · PubMed Central · Cited by 77 · see citing works
Mental health training for health workers in Africa: a systematic review
Liu, G., Jack, H. E., Piette, A., Mangezi, W. O., Machando, D., Rwafa, C., Goldenberg, M., & Abas, M. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00379-x · Cited by 63 · see citing works
Integrating mental health into primary health care
sadeghi, M. (2010) · PsycEXTRA Dataset · doi:10.1037/e578342014-041 · Cited by 57 · see citing works
Li, J., Li, J., Huang, Y., & Thornicroft, G. (2014) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-8-49 · Cited by 53 · see citing works
Self-citationIntegrating mental health into primary health care in Iraq.
Sadik, S., Abdulrahman, S. A., Bradley, M., & Jenkins, R. (2011) · PubMed Central · Cited by 52 · see citing works
Üçok, A., Soygür, H., Ataklı, C., Kuşçu, K., Sartorius, N., Duman, Z. Ç., Polat, A., & Erkoç, Ş. (2006) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2006.01529.x · Cited by 50 · see citing works
Li, J., Li, J., Thornicroft, G., Yang, H., Chen, W., & Huang, Y. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0660-1 · Cited by 44 · see citing works
Self-citationMansouri, N., Gharraee, B., Shariat, S. V., Bolhari, J., Nooraie, R. Y., Rahimi‐Movaghar, A., & Alirezaie, N. (2009) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-3-15 · Cited by 34 · see citing works
Vesel, L., Waller, K., Dowden, J., & Fotso, J. C. (2015) · BMC Health Services Research · doi:10.1186/1472-6963-15-s1-s3 · Cited by 33 · see citing works
Hofmann-Broussard, C., Armstrong, G., Boschen, M. J., & Somasundaram, K. V. (2016) · International Journal of Culture and Mental Health · doi:10.1080/17542863.2016.1259340 · Cited by 31 · see citing works
Chinnayya, H. P., Chandrashekar, C. R., Moily, S., Puttamma, Raghuram, A., Subramanya, K. R., Shanmugham, V., & Udaykumar, G. S. (1990) · International Journal of Social Psychiatry · doi:10.1177/002076409003600408 · Cited by 28 · see citing works
Suicide Prevention Training for Professionals in the Public Health Network in a Large Brazilian City
Cais, C. F. D. S., da Silveira, I. U., Stefanello, S., & Botega, N. J. (2011) · Archives of Suicide Research · doi:10.1080/13811118.2011.616152 · Cited by 28 · see citing works
Shirazi, M., Parikh, S. V., Alaeddini, F., Lonka, K., Zeinaloo, A. A., Sadeghi, M., Arbabi, M., Nejatisafa, A., Shahrivar, Z., & Wahlström, R. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905401006 · Cited by 23 · see citing works
(2012) · Europe PMC (PubMed Central) · Cited by 22 · see citing works
Abayomi, O., Adelufosi, A., & Olajide, A. (2012) · International Journal of Social Psychiatry · doi:10.1177/0020764012448781 · Cited by 19 · see citing works
Alexander, C. L., Arnkoff, D. B., Glass, C. R., & Kaburu, A. W. (2013) · International Perspectives in Psychology · doi:10.1037/a0031360 · Cited by 10 · see citing works
Developing mental health education for health volunteers in a township in South Africa
Bradshaw, T., Mairs, H., & Richards, D. A. (2006) · Primary Health Care Research & Development · doi:10.1191/1463423606pc282oa · Cited by 9 · see citing works
Salcedo, V. V., Vargas-Terrez, B. E., & Díaz‐Anzaldúa, A. (2017) · Primary Health Care Research & Development · doi:10.1017/s1463423617000032 · Cited by 8 · see citing works
Wang, Y.-H., Huang, H., Liu, S., & Lu, R. (2012) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.43.4.a · Cited by 4 · see citing works
A mental health training programme for Chinese rural general practitioners
Cui, G., Li, H., & Yao, M. (2015) · Medical Education · doi:10.1111/medu.12692 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- WHO (2008) mhGAP: Mental Health Gap Action Programme: Scaling up Care for Mental, Neurological and Substance use Disorders. Geneva: WHO. 26290926
Cited by
Sorted by citations
Time for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104 · see citing works
Self-citationThe Lancet Commission on ending stigma and discrimination in mental health
Thornicroft, G., Sunkel, C., Alikhon Aliev, A., Baker, S., Brohan, E., el Chammay, R., Davies, K., Demissie, M., Duncan, J., Fekadu, W., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01470-2 · Cited by 748 · see citing works
Self-citationReducing the stigma of mental health disorders with a focus on low- and middle-income countries
Javed, A., Lee, C., Zakaria, H., Buenaventura, R. D., Cetkovich-Bakmas, M., Duailibi, K., Ng, B., Ramy, H., Saha, G., Arifeen, S., et al. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102601 · Cited by 317 · see citing works
Hartog, K., Hubbard, C. D., Krouwer, A. F., Thornicroft, G., Kohrt, B. A., & Jordans, M. J. D. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.112749 · Cited by 135 · see citing works
Self-citationA Call to Action. A Critical Review of Mental Health Related Anti-stigma Campaigns
Walsh, D., & Foster, J. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2020.569539 · Cited by 127 · see citing works
Heim, E., Henderson, C., Kohrt, B. A., Koschorke, M., Milenova, M., & Thornicroft, G. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796019000167 · Cited by 104 · see citing works
Self-citationClay, J., Eaton, J., Gronholm, P. C., Semrau, M., & Votruba, N. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020000797 · Cited by 103 · see citing works
Li, J., Fan, Y., Zhong, H.-Q., Duan, X.-L., Chen, W., Evans-Lacko, S., & Thornicroft, G. (2019) · International Journal of Mental Health Systems · doi:10.1186/s13033-018-0259-2 · Cited by 98 · see citing works
Self-citationKohrt, B. A., Jordans, M. J. D., Turner, E. L., Rai, S., Gurung, D., Dhakal, M., Bhardwaj, A., Lamichhane, J., Singla, D. R., Lund, C., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.31475 · Cited by 90 · see citing works
Self-citationGronholm, P. C., Nosè, M., van Brakel, W. H., Eaton, J., Ebenso, B., Fiekert, K., Milenova, M., Sunkel, C., Barbui, C., & Thornicroft, G. (2021) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796021000056 · Cited by 73 · see citing works
Self-citationAbayneh, S., Lempp, H. K., Alem, A., Kohrt, B. A., Fekadu, A., & Hanlon, C. (2020) · International Journal of Mental Health Systems · doi:10.1186/s13033-020-00383-6 · Cited by 71 · see citing works
Self-citationKoschorke, M., Oexle, N., Ouali, U., Cherian, A. V., Deepika, V., Mendon, G. B., Gurung, D., Kondrátová, L., Müller, M., Lanfredi, M., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0258729 · Cited by 72 · see citing works
Self-citationAbayneh, S., Lempp, H. K., & Hanlon, C. (2020) · Research Involvement and Engagement · doi:10.1186/s40900-019-0175-x · Cited by 59 · see citing works
Giebel, C. M., Gabbay, M., Shrestha, N., Ruíz, G. J. S., Reilly, S., White, R. G., Liu, G., Allen, D., & Zuluaga, M. I. (2024) · International Journal for Equity in Health · doi:10.1186/s12939-024-02106-6 · Cited by 60 · see citing works
Gronholm, P. C., Bakolis, I., Cherian, A. V., Davies, K., Evans-Lacko, S. E., Girma, E., Gurung, D., Hanlon, C., Hanna, F., Henderson, C., et al. (2023) · International Journal of Mental Health Systems · doi:10.1186/s13033-022-00564-5 · Cited by 61 · see citing works
Self-citationMakhmud, A., Thornicroft, G., & Gronholm, P. C. (2022) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796022000622 · Cited by 59 · see citing works
Self-citationRasmussen, J. D., Kakuhikire, B., Baguma, C., Ashaba, S., Cooper‐Vince, C. E., Perkins, J. M., Bangsberg, D. R., & Tsai, A. C. (2019) · PLoS Medicine · doi:10.1371/journal.pmed.1002908 · Cited by 48 · see citing works
Fischer, R. D., Bailey, Y., Shankar, M., Safaeinili, N., Karl, J. A., Daly, A., Johnson, F. N., Winter, T. J., Arahanga‐Doyle, H., Fox, R., et al. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102425 · Cited by 38 · see citing works
Eiroá‐Orosa, F. J., Lomascolo, M., & Tosas, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18031214 · Cited by 36 · see citing works
Happell, B., Waks, S., Horgan, A. M., Greaney, S., Manning, F., Goodwin, J., Bocking, J., Scholz, B., Hals, E., Granerud, A., et al. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12496 · Cited by 31 · see citing works
(2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374 · Cited by 28 · see citing works
Culture in Mind – An Enactivist Account
Hutto, D. D., Gallagher, S., Ilundáin‐Agurruza, J., & Hipólito, I. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.009 · Cited by 25 · see citing works
Mental health stigma at primary health care centres in Lebanon: qualitative study
Hana, R. A., Arnous, M., Heim, E., Aeschlimann, A., Koschorke, M., Hamadeh, R. S., Thornicroft, G., Kohrt, B. A., Sijbrandij, M., Cuijpers, P. J., et al. (2022) · International Journal of Mental Health Systems · doi:10.1186/s13033-022-00533-y · Cited by 30 · see citing works
Self-citationHenderson, C., Kotera, Y., Lloyd-Evans, B., Jordan, G., Gorner, M., Salla, A., Kalha, J., Coventry, P., Bojke, L., Hinde, S., et al. (2026) · World Psychiatry · doi:10.1002/wps.70031 · Cited by 19 · see citing works
Kohrt, B. A., Turner, E. L., Gurung, D., Wang, X., Neupane, M., Luitel, N. P., Kartha, M. R., Poudyal, A., Singh, R., Rai, S., et al. (2022) · Implementation Science · doi:10.1186/s13012-022-01202-x · Cited by 23 · see citing works
Self-citationKaiser, B. N., Gurung, D., Rai, S., Bhardwaj, A., Dhakal, M., Cafaro, C. L., Sikkema, K. J., Lund, C., Patel, V., Jordans, M. J. D., et al. (2022) · International Journal of Mental Health Systems · doi:10.1186/s13033-022-00546-7 · Cited by 23 · see citing works
Self-citationNaal, H., Whaibeh, E. R., & Mahmoud, H. (2020) · International Review of Psychiatry · doi:10.1080/09540261.2020.1766867 · Cited by 21 · see citing works
Pipe, A., Ravindran, N., Paric, A., Patterson, B. A., Ameringen, M. V., & Ravindran, A. V. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103232 · Cited by 23 · see citing works
Emergency department care experiences among people who use substances: a qualitative study
Rajab, D., Fujioka, J. K., Walker, M., Bartels, S. A., MacKenzie, M., & Purkey, E. (2023) · International Journal for Equity in Health · doi:10.1186/s12939-023-02050-x · Cited by 20 · see citing works
Gendron, M., Mesquita, B., & Barrett, L. F. (2020) · Culture, Mind, and Brain · doi:10.1017/9781108695374.010 · Cited by 20 · see citing works
Pokharel, A., Philip, S., Khound, M., Hayek, S. E., de Filippis, R., Ransing, R. S., Mokarrar, M. H., Orooji, M., & Shalbafan, M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1283715 · Cited by 15 · see citing works
Semrau, M., Gronholm, P. C., Eaton, J., Maulik, P. K., Ayele, B., Bakolis, I., Mendon, G. B., Bhattarai, K., Brohan, E., Cherian, A. V., et al. (2024) · International Journal of Mental Health Systems · doi:10.1186/s13033-024-00649-3 · Cited by 33 · see citing works
Self-citationEmbleton, L., Pooja, S., Allison, G., Kiptui, R., Ayuku, D., Juddy, W., Edith, A., & Braitstein, P. K. A. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06376-6 · Cited by 12 · see citing works
Semrau, M., Gronholm, P. C., Eaton, J., Maulik, P. K., Ayele, B., Bakolis, I., Mendon, G. B., Bhattarai, K., Brohan, E., Cherian, A. V., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3237562/v1 · Cited by 11 · see citing works
Self-citationDaniel, M., Kallakuri, S., Gronholm, P. C., Wahid, S. S., Kohrt, B. A., Thornicroft, G., & Maulik, P. K. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1337662 · Cited by 10 · see citing works
Self-citationNeuroanthropological Perspectives on Culture, Mind, and Brain
Lende, D. H., & Downey, G. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.014 · Cited by 10 · see citing works
İnan, F. Ş., Günüşen, N. P., İnce, S. Ç., & Duman, Z. Ç. (2021) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12748 · Cited by 8 · see citing works
An, S., & Sun, S. (2023) · BMC Public Health · doi:10.1186/s12889-023-17310-2 · Cited by 8 · see citing works
Mutual Constitution of Culture and the Mind
Kitayama, S., & Yu, Q. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.006 · Cited by 8 · see citing works
Kirmayer, L. J., Worthman, C. M., & Kitayama, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.028 · Cited by 9 · see citing works
Hook, K., Kozishkurt, J., Kovalchuk, O., Goncharenko, E., Kodovbetskyi, V., Opanasenko, M., Kopytko, A., Girnyk, A., Kliuzko, K., Drainoni, M., et al. (2021) · BMC Research Notes · doi:10.1186/s13104-021-05786-3 · Cited by 7 · see citing works
Neurodiversity as a Conceptual Lens and Topic of Cross-Cultural Study
Cascio, M. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.027 · Cited by 7 · see citing works
Liu, Q., Zhou, W., Niu, L., Yu, Y., Chen, L., Luo, B., & Xiao, S. (2019) · Patient Preference and Adherence · doi:10.2147/ppa.s224071 · Cited by 6 · see citing works
Kirmayer, L. J., Gómez-Carrillo, A., Langlois‐Thérien, T., Ramstead, M. J. D., & Gold, I. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.012 · Cited by 6 · see citing works
Community-based Psychosocial Intervention for Persons with Severe Mental Illness in Rural Kerala
Pallikkuth, R., Kumar, T. M., Manickam, L. S. S., Cherian, A. V., Bunders, J., & Regeer, B. J. (2021) · Indian Journal of Social Psychiatry · doi:10.4103/ijsp.ijsp_126_19 · Cited by 6 · see citing works
Cultural Priming Effects and the Human Brain
Han, S., & Northoff, G. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.011 · Cited by 5 · see citing works
Kirmayer, L. J., Worthman, C. M., & Kitayama, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.002 · Cited by 5 · see citing works
Goodwin, J., Cummins, J. S., & O’Malley, M. (2023) · International Journal of Mental Health Nursing · doi:10.1111/inm.13157 · Cited by 5 · see citing works
Ritual and Religion as Social Technologies of Cooperation
Kavanagh, C. M., Jong, J., & Whitehouse, H. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.016 · Cited by 5 · see citing works
The Cultural Brain as Historical Artifact
Boddice, R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.018 · Cited by 5 · see citing works
Heim, E., Kohrt, B. A., Koschorke, M., Milenova, M., & Thornicroft, G. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796019000349 · Cited by 5 · see citing works
Self-citationThe Reward of Musical Emotions and Expectations
Gold, B. P., & Zatorre, R. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.021 · Cited by 3 · see citing works
Bedi, R. P., & Bassi, M. (2020) · Ethical Human Psychology and Psychiatry · doi:10.1891/ehpp-d-20-00005 · Cited by 4 · see citing works
Kallakuri, S., Kaur, A., Hackett, M. L., & Maulik, P. K. (2021) · Journal of Public Health · doi:10.1093/pubmed/fdab314 · Cited by 4 · see citing works
Filiatreau, L. M., Ebasone, P. V., Dzudié, A., Wainberg, M. L., Yotebieng, M., Anastos, K., & Parcesepe, A. M. (2024) · AIDS and Behavior · doi:10.1007/s10461-024-04375-2 · Cited by 5 · see citing works
Booysen, D. D., & Haine, P. (2024) · South African Journal of Psychology · doi:10.1177/00812463241300824 · Cited by 3 · see citing works
Worthman, C. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.007 · Cited by 3 · see citing works
Bedaso, A., Workie, K., Gobena, M., & Kebede, E. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e09431 · Cited by 3 · see citing works
Yang, R., Long, A., McDaniel, B. M., Orr, M., Skoy, E. T., & Werremeyer, A. B. (2023) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.1913 · Cited by 3 · see citing works
Ferrín, M. (2020) · Mental health and illness worldwide · doi:10.1007/978-981-10-2348-4_41 · Cited by 3 · see citing works
Go beyond the individual: an intersectional perspective on mental illness stigma in ChinaPreprint
Lin, Z. (2023) · Research Square · doi:10.21203/rs.3.rs-2851490/v1 · Cited by 3 · see citing works
Ng, L. C., Bowers, G., Tesfaye, D., Serba, E. G., Fekadu, A., Hook, K., Ametaj, A., Henderson, D. C., Mueser, K. T., & Hanlon, C. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100502 · Cited by 2 · see citing works
Pigeon-Gagné, É., Hassan, G., Yaogo, M., & Saïas, T. (2024) · Culture Medicine and Psychiatry · doi:10.1007/s11013-024-09860-w · Cited by 4 · see citing works
Cratsley, K., & Radden, J. H. (2019) · Developments in neuroethics and bioethics · doi:10.1016/bs.dnb.2019.07.002 · Cited by 2 · see citing works
Capturing Context Is Not Enough
Lemelson, R., & Tucker, A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.023 · Cited by 2 · see citing works
Stendel, M. S., Ramstead, M. J. D., & Veissière, S. P. L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.026 · Cited by 2 · see citing works
Stein, D. J., Szatmari, P., Gaebel, W., Berk, M., Vieta, E., Maj, M., de Vries, Y. A., Roest, A. M., de Jonge, P., Maercker, A., et al. (2020) · BMC Medicine · doi:10.1186/s12916-020-1495-2 · Cited by 264 · see citing works
“In many places, mental illness is stigmatized [129, 130] and stigma against transgender people is also highly prevalent [131, 132], creating a ‘double stigma’ burden for this community.”
BackgroundThe Neural Mechanisms Underlying Social Norms
Mu, Y., & Gelfand, M. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.015 · Cited by 1 · see citing works
Braathu, N., Kabatooro, M. M., Babirye, J. N., Wentzel‐Larsen, T., Skar, A. S., & Engebretsen, I. M. S. (2025) · BMC Public Health · doi:10.1186/s12889-025-25059-z · Cited by 1 · see citing works
Almohammadi, A. A. (2025) · International Journal for Humanitarian Studies · doi:10.4103/jahs_20250604_25 · Cited by 4 · see citing works
Matsuzaka, Y., Matsushima, K., Hamada, H., Krishna, K. S., Ozono, E., Nagatani, A., Kinoshita, H., Imamura, A., & Ozawa, H. (2021) · Institutional Repositories DataBase (IRDB) · doi:10.11343/amn.64.111 · Cited by 1 · see citing works
Häger, M., Boman, E., & Forsman, A. K. (2023) · Gerontology and Geriatric Medicine · doi:10.1177/23337214231179819 · Cited by 1 · see citing works
Ferrín, M. (2020) · Mental health and illness worldwide · doi:10.1007/978-981-10-0753-8_41-1 · Cited by 1 · see citing works
Cities, Psychosis, and Social Defeat
Sayanvala, F., Bornstein, L., Choudhury, S., Shah, J. L., Weinstock, D., & Gold, I. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.025 · Cited by 1 · see citing works
Culture, Mind, and Brain in Human Evolution
Stout, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.005 · Cited by 1 · see citing works
Liminal Brains in Uncertain Futures
Choudhury, S., & Berson, J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.020 · Cited by 1 · see citing works
You shall never walk alone: burnout and depression amongst healthcare professionals
Ng, K. L. C., & Liu, C. (2021) · HepatoBiliary Surgery and Nutrition · doi:10.21037/hbsn-2021-21 · Cited by 1 · see citing works
Social Neuroscience in Global Mental Health
Kohrt, B. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.024
Self-citationLiterary Analysis and Weak Theories
Moses, O. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.022
Experience-Dependent Plasticity in the Hippocampus
West, G. L., & Bohbot, V. D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.019
Das Stigma der psychischen »Störungen«: Mehr als eine Wiederaufnahme der »labeling«-Debatte
Hrastnik, L. (2021) · psychosozial · doi:10.30820/0171-3434-2021-2-44
Wang, A., Qiu, S., Zhang, T., Deng, Y., Ran, M., & Wong, Y.-L. I. (2021) · Research Square · doi:10.21203/rs.3.rs-841056/v1
How Social Coordination and Cooperation are Achieved
Kirmayer, L. J., Worthman, C. M., Kitayama, S., Lemelson, R., & Cummings, C. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.013
Kirmayer, L. J., Worthman, C. M., Kitayama, S., Lemelson, R., & Cummings, C. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.001
The Co-emergence of Culture, Mind, and Brain
Kirmayer, L. J., Worthman, C. M., Kitayama, S., Lemelson, R., & Cummings, C. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.004
Kirmayer, L. J., Worthman, C. M., Kitayama, S., Lemelson, R., & Cummings, C. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.008
(2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.017
Kirmayer, L. J., Worthman, C. M., Kitayama, S., Lemelson, R., & Cummings, C. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108695374.029
Lovero, K. L., Yusuf, Y., Falcão, J., Zerbe, A., Gusmão, E. P. D., Ferreira, T., Mellins, C. A., & Abrams, E. J. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100447
Vielma-Aguilera, A., Grandón, P., Gutiérrez, D. A. V., Bustos, C., Contreras, Y., Castillo, G., Henríquez, P., Araya, C., & Flores, R. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116584
Yuan, Y., Hei, L., Zhao, M., Sun, S., & Yuan, B. (2025) · Schizophrenia Research · doi:10.1016/j.schres.2025.07.005
Factors Influencing Self-Stigma in Bipolar Disorder: A Survey of Japanese Outpatients
Shimizu, L., Nakagawa, A., Ando, K., & Kocha, H. (2025) · Journal of St Marianna University · doi:10.17264/stmarieng.16.23
Moro, L. M., Pontel, V. P., de Freitas, C. P. P., Arteche, A. X., & Rocha, K. B. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22121809
Kaiser, B. N., Gurung, D., Rai, S., Bhardwaj, A., Dhakal, M., Cafaro, C. L., Sikkema, K. J., Lund, C., Patel, V., Jordans, M. J. D., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20479833
Self-citationKarl, J. A., & Fischer, R. (2024) · OSF Preprints (OSF Preprints)
Jemli, H., Ayele, B., Bakolis, I., Bhattarai, K., Brohan, E., Cherian, A. V., Daniel, M., Girma, E., Gronholm, P. C., Gurung, D., et al. (2026) · SSM - Mental Health · doi:10.1016/j.ssmmh.2026.100609
Self-citationReisinger, B. A. A., Conboy, L., Bellchambers, M. S., & Gleaves, D. H. (2026) · Discover Psychology · doi:10.1007/s44202-026-00718-3
Cuijpers, P. J. (2026) · Behavior Therapy · doi:10.1016/j.beth.2026.10.003
- Authors
- Heim, E., Kohrt, B. A., Koschorke, M., Milenova, M., & Thornicroft, G.
- Affiliations
- University of Zurich (CH)
- George Washington University (US)
- King's College London (GB)
- Corresponding author
- Heim, E.
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-09-04
- Volume
- 29
- Pages
- e3-e3
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC6399081
- OpenAlex
- W2890726333
- Cited by
- 99
- References
- 46
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 9 · 2021: 16 · 2020: 38 · 2019: 7
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-10-17)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- SERVAL (Université de Lausanne) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- South London and Maudsley NHS Foundation Trust
- King's College Hospital NHS Foundation Trust
- National Institute for Health and Care Research (FP7/2007–2013, CL-2012-17-003)
- King's College London
- European Commission (2007–2013, FP7 2007-2013, FP7/2007)
- Medical Research Council (MR/R023697/1)
- National Institute of Mental Health (K01MH104310, K01MH104310 and R21MH111280, R21MH111280)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- mental health stigma, stigma reduction interventions, primary care, healthcare workers, discriminatory behavior, stigmatizing attitudes, low- and middle-income countries, employee training, role play, case-based training, cultural adaptation, risk of bias
- MeSH terms
- Attitude of Health Personnel, Mental Disorders, Humans, Primary Health Care, Stereotyping, Social Stigma, Social Discrimination
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
