Dataset Information

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations.

ABSTRACT:

Background

Globally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude and manifestations of public stigma, and synthesised evidence of recommendations to reduce mental-health-related stigma among young people in India.

Method

A systematic review and meta-analysis of observational studies was conducted. Nine electronic databases were searched and 30 studies (n =?6767) met inclusion criteria.

Results

Most studies (66%) focused on youth training to become health professionals. One-third of young people display poor knowledge of mental health problems and negative attitudes towards people with mental health problems and one in five had actual/intended stigmatizing behavior (I²>=95%). Young people are unable to recognize causes and symptoms of mental health problems and believe that recovery is unlikely. People with mental health problems are perceived as dangerous and irresponsible, likely due to misinformation and misunderstanding of mental health problems as being solely comprised of severe mental disorders (e.g. schizophrenia). However, psychiatric labels are not commonly used/understood.

Conclusion

Public education may use symptomatic vignettes (through relatable language and visuals) instead of psychiatric labels to improve young people's understanding of the range of mental health problems. Recommended strategies to reduce public stigma include awareness campaigns integrated with educational institutions and content relevant to culture and age-appropriate social roles.

SUBMITTER: Gaiha SM

PROVIDER: S-EPMC7667785 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations.

Gaiha Shivani Mathur SM Taylor Salisbury Tatiana T Koschorke Mirja M Raman Usha U Petticrew Mark M

BMC psychiatry 20201116 1

<h4>Background</h4>Globally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude a ...[more]

PMID: 33198678

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Project description:IntroductionThe stigma towards mental disorders can limit the use and effectiveness of available mental health interventions for young people. We aim to systematically review effectiveness of interventions to reduce stigma towards mental disorders in young people, as evidence has not been recently and systematically synthesised on this topic.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised or controlled clinical trials of interventions to reduce stigma towards mental disorders in people aged 10-24 years. Studies involving a comparison group, post intervention and/or follow-up assessments of knowledge, attitudes and/or behaviours towards mental disorders (including help-seeking behaviours), will be included. The Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PubMed and PsycINFO databases will be searched, without time limits, for eligible studies in English or Spanish, and with results available. Databases will be searched from July 2020 to April 2021. The study selection process, the data extraction and the critical evaluation-with the Cochrane risk-of-bias tool-of included studies will be performed independently and in duplicate by teams of reviewers, with the assistance of a third party, until reaching a high degree of agreement. In the presence of substantial heterogeneity (I2 >75%), a narrative synthesis of the study results will be used. If feasible, we will also conduct a quality effects model for the statistical synthesis of results. If sufficient data are available, subgroup analyses will be performed to assess potential sources of heterogeneity. Doi plots and the Luis Furuya-Kanamori index will be used to assess publication bias. The Grades of Recommendation, Assessment, Development and Evaluation approach will be used to assess the confidence in the evidence reviewed.Ethics and disseminationResults are expected to be published in a peer-reviewed journal in the field of adolescent and/or youth mental health.Prospero registration numberCRD42020210901.

Project description:BackgroundHIV-related stigma is associated with poor quality of life and poor healthcare-seeking behaviours in young people living with HIV (YPLHIV) and young people affected by HIV (YPAHIV). India has an estimated 120,000 YPLHIV and 4 million YPAHIV, but efforts to measure HIV-related stigma in them are sparse, impeded by the lack of measuring instruments. Here, we describe the development of the Pune HIV-Stigma Scale (PHSS) and modified-PHSS to measure HIV-related stigma among YPLHIV and YPAHIV, respectively, in India.MethodsWe used data from a mental health study for YPLHIV and YPAHIV aged 15-25 years, conducted at Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospitals, Pune, India, between August 2018 and June 2021. Findings from multiple confirmatory factor analyses and cognitive interviews guided the development of the 12-item PHSS. The modified-PHSS was developed by confirming the structure of the PHSS for YPAHIV. Convergent validity with Center for Epidemiological Studies Depression (CES-D) and UCLA Loneliness scales was assessed using Spearman's correlation coefficients.ResultsModel fit indices were good for both the PHSS (χ2 = 65.0, df = 48, p value: 0.052; root mean square error of approximation (RMSEA): 0.054; comparative fit index (CLI): 0.980; Tucker-Lewis index (TLI): 0.972; and standardized root mean square residual (SRMR): 0.067), and the modified-PHSS (χ2 = 56.9, df = 48, p value: 0.176; RMSEA: 0.045; CLI: 0.983; TFI: 0.976, and SRMR: 0.078). Spearman's correlation coefficients indicated low to moderate convergent validity (ρ: 0.03-0.52) across different subscales of the PHSS and modified-PHSS. Cronbach's alpha for the PHSS was 0.82 and for the modified-PHSS 0.81.ConclusionWe developed the first scales to measure HIV-related stigma among YPLHIV and YPAHIV in India. These concise scales can facilitate measurement of HIV-related stigma more frequently in research studies. We recommend that they be tested in different Indian languages.

Project description:BackgroundStigma towards people with mental health problems (PMHP) is known to have substantial negative impacts on their lives. More in-depth exploration of the stigma and discrimination experienced by PMHP in low- and middle-income countries is needed. Previous research suggests that negative attitudes towards PMHP are widespread among the Filipino general public. However, no study has investigated PMHP's own experiences of being stigmatised in the Philippines.MethodsA qualitative study was conducted on the stigma experienced by PMHP (including people with epilepsy) and its related factors in the Philippines, employing the constructivist grounded theory approach. We analysed data on 39 PMHP collected through interviews with PMHP, their carers, and community health volunteers who know them well.ResultsThe findings highlight the culturally and socio-economically specific contexts, consequences, and impact modifiers of experiences of stigma. Participants emphasised that PMHP face stigma because of the cultural traits such as the perception of mental health problem as a disease of the family and the tendency to be overly optimistic about the severity of the mental health problem and its impact on their life. Further, stigma was experienced under conditions where mental health care was not readily available and people in the local community could not resolve the PMHP's mental health crisis. Stigma experiences reduced social networks and opportunities for PMHP, threatened the economic survival of their entire family, and exacerbated their mental health problems. An individual's reaction to negative experiences can be fatalistic in nature (e.g. believing in it is God's will). This fatalism can help PMHP to remain hopeful. In addition, traditional communal unity alleviated some of the social exclusion associated with stigma.ConclusionsThe study indicates that existing stigma-reduction strategies might have limitations in their effectiveness across cultural settings. Therefore, we propose context-specific practical implications (e.g. emphasis on environmental factors as a cause of mental health problems, messages to increase understanding not only of the possibility of recovery but also of challenges PMHP face) for the Philippines.

Dataset Information

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations.

Background

Method

Results

Conclusion

Publications

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations.

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