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Association between mental health-related stigma and active help-seeking: Systematic review and meta-analysis
Open accessAbstract
Background: Mental disorders create high individual and societal costs and burden, partly because help-seeking is often delayed or completely avoided. Stigma related to mental disorders or mental health services is regarded as a main reason for insufficient help-seeking. Aims: To estimate the impact of four stigma types (help-seeking attitudes and personal, self and perceived public stigma) on active help-seeking in the general population. Method: A systematic review of three electronic databases was followed by random effect meta-analyses according to the stigma types. Results: Twenty-seven studies fulfilled eligibility criteria. Participants' own negative attitudes towards mental health help-seeking (OR = 0.80, 95% CI 0.73–0.88) and their stigmatising attitudes towards people with a mental illness (OR = 0.82, 95% CI 0.69–0.98) were associated with less active help-seeking. Self-stigma showed insignificant association (OR = 0.88, 95% CI 0.76–1.03), whereas perceived public stigma was not associated. Conclusions: Personal attitudes towards mental illness or help-seeking are associated with active help-seeking for mental problems. Campaigns promoting help-seeking and fighting mental illness-related stigma should target these personal attitudes rather than broad public opinion.
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“Men in low-income and humanitarian contexts face considerable barriers to engagement with mental health services. A systematic review and meta-analysis of mental health-related stigma and help-seeking found that the interplay of societal norms and attitudes towards care were a driving force behind limited help-seeking behaviors for men [13].”
From Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation (2021) · cites this paper as [13]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A systematic review and meta-analysis of mental health-related stigma and help-seeking found that the interplay of societal norms and attitudes towards care were a driving force behind limited help-seeking behaviors for men [13].”
From Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation (2021) · cites this paper as [13]
Experimental — accuracy not yet measuredIn the citing paper
“These same brain areas show accelerated breakdown of monoamine neurotransmitters, 309 increased neuro-inflammation, 310 reduced grey matter, 311 and heightened reactivity to mood-relevant stimuli 312 in individuals with depression.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [309]
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“Previous results have revealed that stigma, including public stigma and self-stigma, are the main barriers to seeking professional help [39,40,41].”
From Mental health literacy intervention on help-seeking in athletes: a systematic review (2020) · cites this paper as [39]
In the citing paper
“There are many factors that influence help-seeking including stigma, attitudes, knowledge, financial resources, perceived need, and structural barriers/facilitators [12, 17–19].”
From Explaining adults’ mental health help-seeking through the lens of the theory of planned behavior: A scoping review (2022) · cites this paper as [17]
In the citing paper
“Regarding patients, it’s worth considering that recasting psychiatric conditions in terms of “misfiring circuits” rather than disorders of behavior might reduce stigma, a key barrier to seeking treatment [52].”
From Translational opportunities for circuit-based social neuroscience: advancing 21st century psychiatry (2021) · cites this paper as [52]
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Stevelink, S. A. M., Wu, I. C., Voorend, C. G. N., & van Brakel, W. H. (2012) · Stigma Research and Action · doi:10.5463/sra.v1i3.35 · Cited by 62
The Scientific Contributions of Paul D. MacLean (1913–2007)
Newman, J. D., & Harris, J. C. (2008) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31818ec5d9 · Cited by 60
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Thoits, P. A. (2005) · Journal of Health and Social Behavior · doi:10.1177/002214650504600108 · Cited by 59
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Kanehara, A., Umeda, M., Kawakami, N., & the World Mental Health Japan Survey Group (2014) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12267 · Cited by 56
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Evans-Lacko, S., Henderson, C., Thornicroft, G., & McCrone, P. (2013) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.113746 · Cited by 55
Sarıkaya, H., da Costa, B. R., Baumgartner, R. W., Duclos, K., Touzé, E., de Bray, J. M., Metso, A. J., Metso, T. M., Arnold, M., Araúz, A., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0072697 · Cited by 53
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Prevention of Anxiety Disorders
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Flagged first, then by citations
2 of the 119 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
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2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485
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2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
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Metadata
- Authors
- Schnyder, N., Panczak, R., Groth, N., & Schultze-Lutter, F.
- Affiliations
- University of Bern (CH)
- Corresponding author
- Schnyder, Nina
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2017-04
- Volume
- 210
- Issue
- 4
- Pages
- 261-268
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2585744943
- Cited by
- 716
- References
- 119
- Citations by year
- 2026: 78 · 2025: 127 · 2024: 103 · 2023: 96 · 2022: 101 · 2021: 82 · 2020: 67 · 2019: 26 · 2018: 27 · 2017: 6
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Funders
- University of Bern
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- mental health stigma, help-seeking, help-seeking attitudes, personal stigma, self-stigma, perceived public stigma, help-seeking delay, mental illness
- MeSH terms
- Humans, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Persons with Psychiatric Disorders, Social Stigma
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