Interventions to reduce stigma towards people with severe mental disorders in Ibero-America: A systematic review

DOI:  https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.10054

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Published: Feb 24, 2021
Issue: Vol. 19 No. 1 (2021): Ciencias de la Salud
Section Clinical or Experimental Research


Keywords: Social stigma mental disorders evaluation of results of therapeutic interventions

Main Article Content

Authors

  Alexis Vielma-Aguilera
Universidad de Concepción
  Elvis Castro-Alzate
Universidad de Concepción
  Sandra Saldivia Bórquez
Universidad de Concepción
  Pamela Grandón-Fernández
Universidad de Concepción

Abstract

Introduction: The main goal of the present review was to systematically compile data on interventions to reduce stigma in Ibero-America. The aim is to describe the characteristics and determine the main results of interventions to reduce stigma towards people with severe mental disorders that have been developed in Latin America between the years 2007-2017. Materials and methods: A systematic review of articles from electronic databases such as MEDLINE, EBSCOHOST, EMBASE, LILACS and SCIELO, and grey literature obtained from Google Scholar, published in English, Spanish, and Portuguese covering the period between January 2007 and December 2017 was carried out. In order to evaluate the quality of the quantitative studies, ROBINS criteria were used for quasi-experimental and experimental studies, and CASPe criteria were used for qualitative studies. Results: A total of sixteen studies that met the inclusion criteria were selected; 75% were quantitative and out of these, one quarter did not meet the quality criteria. Conclusions: Currently, there are few interventions to reduce stigma in Ibero-America and they are mainly short term. Our evaluation of the available literature helps to identify aspects that should be included in future research in order to reduce possible biases that could arise when developing these types of studies.

How to Cite
Vielma-Aguilera, A., Castro-Alzate, E., Saldivia Bórquez, S., & Grandón-Fernández, P. (2021). Interventions to reduce stigma towards people with severe mental disorders in Ibero-America: A systematic review. Revista Ciencias De La Salud, 19(1), 1–27. https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.10054
References

Ross CA, Goldner EM. Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature. J Psychiatr Ment Health Nurs. 2009;16(6):558–67. https://doi.org/10.1111/j.1365-2850.2009.01399.x

Fox AB, Smith BN, Vogt D. How and when does mental illness stigma impact treatment seeking? Longitudinal examination of relationships between anticipated and internalized stigma, symptom severity, and mental health service use. Psychiatry Res. 2018;268:15–20. https://doi.org/10.1016/j.psychres.2018.06.036

Thornicroft G. Most people with mental illness are not treated. Lancet. 2007;370(9590):807– 08. https://doi.org/10.1016/S0140-6736(07)61392-0.

Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma, help seeking, and public health programs. Am J Public Health. 2013;103(5):777–80. https://doi.org/10.2105/ AJPH.2012.301056

Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2012;34(4):520–47. https://doi.org/10.1177/0193945911400638

Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V, van Ommeren M, et al. Evidence-based guidelines for mental, neurological, and substance use disorders in low- and middle-income countries: summary of WHO recommendations. PLoS Med. 2011;8(11):e1001122. https://doi.org/10.1371/journal.pmed.1001122

Stuart H, Arboleda-Flórez J, Sartorius N. Paradigms lost: fighting stigma and the lessons learned. Oxford, New York. 2012.

Mascayano F, Tapia T, Schilling S, Alvarado R, Tapia E, Lips W, et al. Stigma toward mental illness in Latin America and the Caribbean: a systematic review. Rev Bras psiquiatr. (9). 2016;38(1):73–85. https://doi.org/10.1590/1516-4446-2015-1652

Yang L, Kleinman A, Link B, Phelan J, Lee S, Good B. Cultura y estigma: la experiencia moral. Este País. 2007;195:4–15.

Mascayano-Tapia F, Lips-Castro W, Mena-Poblete C, Manchego-Soza C. Estigma hacia los trastornos mentales: características e intervenciones. Salud Ment. 2015;38:53–8.

Rao D, Elshafei A, Nguyen M, Hatzenbuehler ML, Frey S, Go VF. A systematic review of multi-level stigma interventions: state of the science and future directions. BMC Med. 2019(41);17(1):41. https://doi.org/10.1186/s12916-018-1244-y

Nguyen E, Chen TF, O’Reilly CL. Evaluating the impact of direct and indirect contact on the mental health stigma of pharmacy students. Soc Psychiatry Psychiatr Epidemiol. 2012;47(7):1087–1098. https://doi.org/10.1007/s00127-011-0413-5

Corrigan PW, O’Shaughnessy JR. Changing mental illness stigma as it exists in the real world. Aust Psychol. 2007;42(2):90–97. https://doi.org/10.1080/00050060701280573

Mascayano F, Schiling S, Escobar E, Abeldaño R, Gallo V. Programas para reducir estigma hacia la enfermedad mental: lecciones para Latinoamérica; 2015.

Allport G. Nature of prejudice. Oxford, England: Addison-Wesley; 1954.

Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA. An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav. 2003;44(2):162– 79. https://doi.org/10.2307/1519806

Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet. 2016;387(10023):1123–32. https://doi.org/10.1016/S0140-6736(15)00298-6

López M, Laviana M, Férnandez L, López A, Rodríguez AM, Aparicio A. La Lucha con- tra el estigma y la discriminación en salud mental. Una estrategia compleja basada en la información disponible. Rev Asoc Esp Neuropsiq. 2008;28(11):43–83. https://doi. org/10.4321/S0211-57352008000100004

Cazzaniga-Pesenti J, Suso-Araico A. Salud mental e inclusión social. Situación actual y recomendaciones contra el estigma. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2015.

Maiorano A, Lasalvia A, Sampogna G, Pocai B, Ruggeri M, Henderson C. Reducing stigma in media professional: is there room for improvement? Results from a systematic review. Can J Psychiatry. 2017;62(10):702–15. https://doi.org/10.1177/0706743717711172

Wood AL, Wahl OF. Evaluating the effectiveness of a consumer-provided mental health recovery education presentation. Psychiatr Rehabil J. 2006;30(1):46–53. https://doi. org/10.2975/30.2006.46.53

Yamaguchi S, Mino Y, Uddin S. Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry Clin Neurosci. 2011;65(5):405–15. https:// doi.org/10.1111/j.1440-1819.2011.02239.x

Yamaguchi S, Wu SI, Biswas M, Yate M, Aoki Y, Barley EA, et al. Effects of short-term interventions to reduce mental health related stigma in university or college students. A systematic review. J Nerv Ment Dis. 2013;201:490Y503;201(6):490–503. https://doi. org/10.1097/NMD.0b013e31829480df

Stuart H. Reducing the stigma of mental illness. Glob Ment Health. 2016;3:(e17):1–14. https://doi.org/10.1017/gmh.2016.11

Henderson C, Gronholm PC. Mental health-related stigma as a “wicked problem’: the need to address stigma and consider the consequences. Int J Environ Heal R. 2018;15(6). https://doi.org/10.3390/ijerph15061158

Michaels PJ, Corrigan PW, Buchholz B, Brown J, Arthur T, Netter C, et al. Changing stigma Through a consumer-based stigma reduction program. Commun Ment Health J. 2014;50(4):395–401. https://doi.org/10.1007/s10597-013-9628-0

Mak WWS, Cheung RYM. Affiliate stigma among caregivers of people with intellectual disability or mental illness. J Appl Res Intellect Disabil. 2008;21(6):532–45. https://doi. org/10.1111/j.1468-3148.2008.00426.x

Alcalá-Pompeo D, de Carvalho A, Morgado-Olive A, Graça Girade-Souza M, Frari-Galera S. Estrategias de enfrentamiento de familiares de pacientes con trastornos mentales. Rev Latino-Am Enfermagem. 2016;24:(e2799):1–8. https://doi.org/10.1590/1518- 8345.1311.2799

Mellor C. School-based interventions targeting stigma of mental illness: systematic review. Psychiatr Bull. 2014;38(4):164–71. https://doi.org/10.1192/pb.bp.112.041723

Saavedra-Macias F. Cómo encontrar un lugar en el mundo: explorando experiencias de recuperación de personas con trastornos mentales graves. Hist Cienc Saude Manguinhos. 2011;18(1):121–39. https://doi.org/10.1590/S0104-59702011000100008

Almeida-Filho A, da Silveira-Fortes F, Pina-Queirós P, de Almeida-Peres M, dos Santos Vidinha T, Alves-Rodrigues M. Trajetória histórica da reforma psiquiátrica em Portugal e no Brasil. Rev Enferm Ref. 2015;4(4);Série:117–25. https://doi.org/10.12707/RIV14074

Minoletti A, Sepúlveda R, Horvitz-Lennon M. Twenty years of Mental Health Policies in Chile: lessons and challenges. Int J Ment Health. 2012;41(1):21–37. https://doi.org/10.2753/ IMH0020-7411410102

Gaebel W, Zäske H, Baumann AE. The relationship between mental illness severity and stigma. Acta psychiatr Scand Suppl. 2006;(49)429(429):41–5. https://doi.org/10.1111/ j.1600-0447.2005.00716.x

National Collaborating Centre for Methods and Tools. Appraising the risk of bias in randomized trials using the Cochrane Risk of Bias Tool 2017. (Available from: http://www. nccmt.ca/resources/search/280

Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:(i4919):1-7. https://doi.org/10.1136/bmj.i4919

Cabello J. Plantilla para ayudarte a entender una Revisión Sistemática. En: CASPe. Guías CASPe de Lectura Crít de la Lit Med. Alicante: Caspe, Cuaderno. 2005;I.

Oliva P, Buhring K. Investigación cualitativa y evidencia en salud: respuestas fundamentales para su comprensión. Rev Chil Salud Publ. 2011;15(3):173–79. https://doi. org/10.5354/0717-3652.2011.17714

Andrés-Rodríguez L, Pérez-Aranda A, Feliu-Soler A, Rubio-Valera M, Aznar-Lou I, Serrano-Blanco A, et al. Effectiveness of the “what’s up!” intervention to reduce stigma and psychometric properties of the Youth Program Questionnaire (YPQ): results from a Cluster non-randomized controlled trial conducted in Catalan high schools. Front Psychol. 2017;8:1608. https://doi.org/10.3389/fpsyg.2017.01608

Ballesteros F, Bertina A. Efectividad de la intervención del Equipo de Apoyo Social Comunitario en el funcionamiento psicosocial de personas con trastorno mental grave. Rev Asoc Esp Neuropsiq. 2016;36(130):299–323. https://doi.org/10.4321/S0211- 57352016000200002

Rubio-Valera M, Fernández A, Evans-Lacko S, Luciano JV, Thornicroft G, Aznar-Lou I, et al. Impact of the mass media obertament campaign on the levels of stigma among the population of Catalonia, Spain. Eur Psychiatry. 2016;31:44–51. https://doi.org/10.1016/j. eurpsy.2015.10.005

Vila-Badia R, Martínez-Zambrano F, Arenas O, Casas-Anguera E, García-Morales E, Villellas R, et al. Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. World J Psychiatr. 2016;6(2):239–47. https://doi.org/10.5498/wjp.v6.i2.239

Martínez-Zambrano F, García-Morales E, García-Franco M, Miguel J, Villellas R, Pascual G, et al. Intervention for reducing stigma: assessing the influence of gender and knowledge. World J Psychiatr. 2013;3(2):18–24. https://doi.org/10.5498/wjp.v3.i2.18

De Simón Alonso L. Modificación del estigma asociado a la enfermedad mental: evaluación de una intervención en institutos de enseñanza secundaria obligatoria en Navarra. Madrid: Universidad Autónoma de Madrid; 2015.

Soto-Pérez F, Franco-Martín M. PsicoED: una alternativa online y comunitaria para la psicoeducación en esquizofrenia. Psicoperspectivas. 2014;13(3):118–29. https://doi. org/10.5027/psicoperspectivas-Vol13-Issue3-fulltext-416

Castillo Lasala M, Orna Díaz L, Pérez Rojo JA. Una visita contra el estigma y por la prevención en un centro de tratamiento para trastorno mental grave. Arteterapia. 2012;7:281–294. https://doi.org/10.5209/rev_ARTE.2012.v7.40775

Cangas A, López A, Orta A, Gallego J, Alias I, Soriano C, et al. Inclúyete: Programa Socioeducativo e Inclusivo para Personas con Trastorno Mental Grave y Estudiantes en la Universidad de Almería. Edupsykhé. 2017;16(1):86–97

Cangas AJ, Navarro N, Parra JMA, Ojeda JJ, Cangas D, Piedra JA, et al. Stigma-stop: A serious game against the stigma toward mental health in educational settings. Front Psychol. 2017;8:1385. https://doi.org/10.3389/fpsyg.2017.01385

Barrantes FR, Violante C, Graça L, Amorim I. Programa de Luta contra o estigma: resultados obtidos na formação nos pro!ssionais de saúde mental. Rev Port Enferm Saúde Ment. 2017;Spe;5(spe5):19–24. https://doi.org/10.19131/rpesm.0162

Oliveira S, Carolino L, Paiva A. Programa Saúde mental sem estigma: efeitos de estraté- gias diretas e indiretas nas atitudes estigmatizantes. RPESM. 2012;8(8):30-37. https://doi. org/10.19131/rpesm.0068

Campos L, Palha F, Dias P, Sousa-Lima V, Veiga E, Costa N, et al. Mental health awareness intervention in schools. J Hum Growth Dev. 2012;22(1):259–66

Oliveira AGB, Conciani ME, Marcon SR. A capacitação E a gestão de equipes do psf PARA a atenção psicossocial: um estudo de caso. Cienc Cuid Saude. 2008;7(3):376–84. https:// doi.org/10.4025/cienccuidsaude.v7i3.6511

Schilling S, Bustamante JA, Sala A, Acevedo C, Tapia E, Alvarado R, et al. Development of an intervention to reduce self-stigma in outpatient mental health service users in Chile. Rev Fac Cienc Med (Cordoba, Argentina). 2015;72(4):284–94.

Gutiérrez-Maldonado J, Caqueo-Urízar A, Ferrer-García M. Effects of a psychoeducational intervention program on the attitudes and health perceptions of relatives of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2009;44(5):343–48. https://doi. org/10.1007/s00127-008-0451-9

Gutiérrez-Maldonado J, Caqueo-Urízar A. Effectiveness of a psycho-educational intervention for reducing burden in Latin American families of patients with schizophrenia. Qual Life Res. 2007;16(5):739–47. https://doi.org/10.1007/s11136-007-9173-9

Cárdenas-Mancera K, De Santacruz C, Salamanca M. Aceptando mentes dementes. Grupo de opinión, información y apoyo sobre el estigma de las enfermedades mentales en Facebook. Rev Colomb Psiquiat. 2014;43(3):139–145. https://doi.org/10.1016/j. rcp.2014.02.007

Onwuegbuzie A, Leech N. Sampling designs in qualitative research: making the sampling process more public. Qual Rep. 2007;12(2):238–54.

Mehta N, Clement S, Marcus E, Stona AC, Bezborodovs N, Evans-Lacko S, et al. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. Br J Psychiatry. 2015;207(5):377–84. https://doi.org/10.1192/bjp.bp.114.151944

Bärnighausen T, Tugwell P, Røttingen J, Shemilt I, Rockers P, Geldsetzer P, et al. Quasi-experimental study designs series. Paper 4: uses and value. J Clin Epidemiol. 2017. https://doi.org/10.1016/j.jclinepi.2017.02.017

Henderson C, Noblett J, Parke H, Clement S, Caffrey A, Gale-Grant O, et al. Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry. 2014;1(6):467–82. https://doi.org/(14)10.1016/S2215-0366(14)00023-6

Manterola C, Otzen T. Estudios experimentales 2 parte: estudios cuasi-experimentales. Int J Morphol. 2015;33(1):382–87. https://doi.org/10.4067/S0717-95022015000100060

Gronholm PC, Henderson C, Deb T, Thornicroft G. Interventions to reduce discrimination and stigma: the state of the art. Soc Psychiatry Psychiatr Epidemiol. 2017;52(3):249–58. https://doi.org/10.1007/s00127-017-1341-9

Yanos PT, Lucksted A, Drapalski AL, Roe D, Lysaker P. Interventions targeting mental health self-stigma: a review and comparison. Psychiatr Rehabil J. 2015;38(2):171–78. https://doi.org/10.1037/prj0000100

Mascayano-Tapia F, Armijo J, Yang L. Addressing stigma relating to mental illness in low- and middle-income countries. Front Psychiatry. 2015;6(38):1–4. https://doi.org/10.3389/ fpsyt.2015.00038

Yepes-Delgado C, Ocampo-Montoya A. Comités de ética y salud mental. Rev Colomb Psiquiat. 2017:1–8. https://doi.org/10.1016/j.rcp.2017.05.011

Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatr Serv (Washington, DC). 2012;63(10):963–73. https://doi.org/10.1176/appi.ps.201100529

Gerlinger G, Hauser M, De Hert M, Lacluyse K, Wampers M, Correll CU. Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry. 2013;12(2):155–64. https://doi.org/10.1002/ wps.20040

Knaak S, Modgill G, Patten SB. Key ingredients of anti-stigma programs for health care providers: A data synthesis of evaluative studies. Can J Psychiatry. 2014;59(10)(11);Suppl 1:S19–S26. https://doi.org/10.1177/070674371405901s06

Ministerio de Salud (Minsal). Plan nacional de salud mental, 2017-2025. Santiago. 2017:1-234.

Geffner N, Salazar V, Mscayano F, Agrest M. Revisión de rogramas anti-estigma y a favor de la recuperación. Acta Psiquiátr Psicol Am Lat. 2017;63(3):189–202.

Dimenstein M. Psychiatric reform and the psychosocial care model in Brazil: in search of continuing integrated mental health care. RevCS. 2013;11:43–72. https://doi.org/10.18046/ recs.i11.1566

Molina-Bulla C. Participación, políticas públicas, discapacidad mental / psicosocial y estigma: barreras y retos. Perspectivas Pol Publ. 2018;11(21):173–200.

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