Petra C Gronholm1, Elizabeth Nye2, Daniel Michelson3. 1. Personal Social Services Research Unit, London School of Economics and Political Science, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Electronic address: p.c.gronholm@lse.ac.uk. 2. Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK. 3. Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, UK.
Abstract
BACKGROUND: School-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact. METHODS: This review assessed findings from qualitative studies to identify potential stigmatising effects of participation in targeted school-based mental health interventions for students attending primary- or secondary-level education. Eight articles (reflecting seven studies) were identified through electronic database searches (PsycInfo, EMBASE, Medline, CINAHL, ERIC), supplemented by citation and reference searches and expert consultations. Data were synthesised according to established guidelines for thematic synthesis. RESULTS: Three overarching themes were identified: "anticipated and experienced stigma", "consequences of stigma" and "mitigating strategies". These findings illustrate how pervasively stigma can compromise efforts to increase access to mental health care through targeted school-based provision, while also outlining strategies endorsed by students for alleviating the risk and/or impact of stigma. LIMITATIONS: The findings need to be considered in view of the relative scarcity of surveyed evidence. Furthermore, as all evidence came from high-income and Western countries, the applicability to other contexts is unclear. CONCLUSIONS: This synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students' engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students' engagement in targeted mental health support, and serve to guide future research in this area.
BACKGROUND: School-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact. METHODS: This review assessed findings from qualitative studies to identify potential stigmatising effects of participation in targeted school-based mental health interventions for students attending primary- or secondary-level education. Eight articles (reflecting seven studies) were identified through electronic database searches (PsycInfo, EMBASE, Medline, CINAHL, ERIC), supplemented by citation and reference searches and expert consultations. Data were synthesised according to established guidelines for thematic synthesis. RESULTS: Three overarching themes were identified: "anticipated and experienced stigma", "consequences of stigma" and "mitigating strategies". These findings illustrate how pervasively stigma can compromise efforts to increase access to mental health care through targeted school-based provision, while also outlining strategies endorsed by students for alleviating the risk and/or impact of stigma. LIMITATIONS: The findings need to be considered in view of the relative scarcity of surveyed evidence. Furthermore, as all evidence came from high-income and Western countries, the applicability to other contexts is unclear. CONCLUSIONS: This synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students' engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students' engagement in targeted mental health support, and serve to guide future research in this area.
Keywords:
Barriers to care; Children and adolescents; Early intervention; Selective prevention; Stigma and discrimination; Targeted intervention; Young people
Authors: Lindy Beukema; Jacomijn Hofstra; Sijmen A Reijneveld; Andrea F de Winter; E L Korevaar Journal: Int J Environ Res Public Health Date: 2022-05-31 Impact factor: 4.614
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