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Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis

Eylem, Ozlem, de Wit, Leonore, van Straten, Annemieke, Steubl, Lena, Melissourgaki, Zaneta, Danışman, Gözde Topgüloğlu, de Vries, Ralph, Kerkhof, Ad J. F. M., Bhui, Kamaldeep, Cuijpers, Pim·2020·BMC Public Health
DOI 10.1186/s12889-020-08964-3PMC PMC7278062

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Abstract

Background: There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities compared to racial and/or ethnic majorities since the former often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities. Methods: This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software. Results: After screening 2787 abstracts, 29 studies with 193,418 participants ( N = 35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g = 0.20 (95% CI: 0.12 ~ 0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures. Conclusions: Mental illness stigma is higher among ethnic minorities than majorities. An important clinical implication of these findings would be to tailor anti-stigma strategies related with mental illnesses according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach.

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Fig. 1 PRISMA flow chart of the study selection process
Fig. 1 PRISMA flow chart of the study selection processCC BY · PubMed Central
Fig. 2 Stigma for CMDs between ethnic minorities and majorities: Forest plot for all studies. Not. The combined refers to the same outcomes which are automatically pooled together by the CMA software when the authors run the analyses. For instance, if different studies used CAMI questionnaire and measured stereotypes among Black racial group, they are pooled together by the CMA
Fig. 2 Stigma for CMDs between ethnic minorities and majorities: Forest plot for all studies. Not. The combined refers to the same outcomes which are automatically pooled together by the CMA software when the authors run the analyses. For instance, if different studies used CAMI questionnaire and measured stereotypes among Black racial group, they are pooled together by the CMACC BY · PubMed Central
Fig. 3 Stigma for CMDs between ethnic minorities and majorities: Forest plot when low quality studies excluded
Fig. 3 Stigma for CMDs between ethnic minorities and majorities: Forest plot when low quality studies excludedCC BY · PubMed Central
Fig. 4 Stigma for CMDs between ethnic minorities and majorities: Forest plot when only studies with standardized outcome measures are included
Fig. 4 Stigma for CMDs between ethnic minorities and majorities: Forest plot when only studies with standardized outcome measures are includedCC BY · PubMed Central
Fig. 5 Stigma for CMDs between ethnic minorities and majorities: Forest plot when outliers are excluded
Fig. 5 Stigma for CMDs between ethnic minorities and majorities: Forest plot when outliers are excludedCC BY · PubMed Central
Fig. 6 Stigma for CMDs between ethnic minorities and majorities: Funnel Plot
Fig. 6 Stigma for CMDs between ethnic minorities and majorities: Funnel PlotCC BY · PubMed Central

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Authors
Eylem, O., de Wit, L., van Straten, A., Steubl, L., Melissourgaki, Z., Danışman, G. T., de Vries, R., Kerkhof, A. J. F. M., Bhui, K., & Cuijpers, P.
ORCID
Eylem, Ozlem
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2020-06-08
Volume
20
Issue
1
ISSN
1471-2458
DOI
10.1186/s12889-020-08964-3
PMC
PMC7278062
Cited by
196
References
9
Language
en
Update notices
correction (2020-09-01)
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CoChat. (2026). Citation check: Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. https://app.cochat.ai/papers/10.1186/s12889-020-08964-3
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Eylem, O., de Wit, L., van Straten, A., Steubl, L., Melissourgaki, Z., Danışman, G. T., de Vries, R., Kerkhof, A. J. F. M., Bhui, K., & Cuijpers, P. (2020). Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. BMC Public Health. https://doi.org/10.1186/s12889-020-08964-3