Amanpreet Kaur1, Sudha Kallakuri2, Brandon A Kohrt3, Eva Heim4, Petra C Gronholm5, Graham Thornicroft6, Pallab K Maulik7. 1. George Institute for Global Health, India. Electronic address: akaur@georgeinstitute.org.in. 2. George Institute for Global Health, India. Electronic address: skallakuri1@georgeinstitute.org.in. 3. Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA. Electronic address: bkohrt@email.gwu.edu. 4. Department of Psychology, University of Zurich, Zurich, Switzerland. Electronic address: e.heim@psychologie.uzh.ch. 5. Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Centre for Global Mental Health and Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK. Electronic address: petra.gronholm@kcl.ac.uk. 6. Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Centre for Global Mental Health and Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK. Electronic address: graham.thornicroft@kcl.ac.uk. 7. George Institute for Global Health, India; University of New South Wales, Sydney; Prasanna School of Public Health, Manipal University. Electronic address: pmaulik@georgeinstitute.org.in.
Abstract
BACKGROUND: Stigma is a barrier for help-seeking, mental health service access, and contributes to the mental health treatment gap. Because the mental health treatment gap is greatest in low- and middle-income countries, it is vital to identify effective strategies to reduce stigma in these settings. To date, there has been a lack of synthesis of findings from interventions to reduce stigma related to mental disorders within India. METHOD: A systematic review was conducted to provide an overview of the characteristics and effectiveness of stigma reduction interventions studies in India. PubMed, Embase and PsycINFO databases were searched for literature published up to 30th June 2020. RESULTS: From a total of 1,984 articles identified, only 9 were eligible for final inclusion, published between 1990-2020. No study was found from North, North-East, Central or East India. Most stigma-reduction interventions were multi-level, that is, using a combination of intra-personal, inter-personal and community level strategies to target changes in outcomes of individuals, environments and community groups. Three studies focused on health and stigma-related changes at the organisational/institutional level. No interventions focused on the governmental/structural level. There were only two randomised controlled trials, and two studies focused on all three stigma components of knowledge, attitudes and behaviour. Most interventions were delivered to community members. None focused on mental health professionals as intervention delivery target. CONCLUSION: There is a need for the development of comprehensive, culturally acceptable evidence-based interventions that act at multiple levels, and involve a mixture of various stigma reducing strategies with multiple target groups.
BACKGROUND: Stigma is a barrier for help-seeking, mental health service access, and contributes to the mental health treatment gap. Because the mental health treatment gap is greatest in low- and middle-income countries, it is vital to identify effective strategies to reduce stigma in these settings. To date, there has been a lack of synthesis of findings from interventions to reduce stigma related to mental disorders within India. METHOD: A systematic review was conducted to provide an overview of the characteristics and effectiveness of stigma reduction interventions studies in India. PubMed, Embase and PsycINFO databases were searched for literature published up to 30th June 2020. RESULTS: From a total of 1,984 articles identified, only 9 were eligible for final inclusion, published between 1990-2020. No study was found from North, North-East, Central or East India. Most stigma-reduction interventions were multi-level, that is, using a combination of intra-personal, inter-personal and community level strategies to target changes in outcomes of individuals, environments and community groups. Three studies focused on health and stigma-related changes at the organisational/institutional level. No interventions focused on the governmental/structural level. There were only two randomised controlled trials, and two studies focused on all three stigma components of knowledge, attitudes and behaviour. Most interventions were delivered to community members. None focused on mental health professionals as intervention delivery target. CONCLUSION: There is a need for the development of comprehensive, culturally acceptable evidence-based interventions that act at multiple levels, and involve a mixture of various stigma reducing strategies with multiple target groups.
Authors: Graham Thornicroft; Somnath Chatterji; Sara Evans-Lacko; Michael Gruber; Nancy Sampson; Sergio Aguilar-Gaxiola; Ali Al-Hamzawi; Jordi Alonso; Laura Andrade; Guilherme Borges; Ronny Bruffaerts; Brendan Bunting; Jose Miguel Caldas de Almeida; Silvia Florescu; Giovanni de Girolamo; Oye Gureje; Josep Maria Haro; Yanling He; Hristo Hinkov; Elie Karam; Norito Kawakami; Sing Lee; Fernando Navarro-Mateu; Marina Piazza; Jose Posada-Villa; Yolanda Torres de Galvis; Ronald C Kessler Journal: Br J Psychiatry Date: 2016-12-01 Impact factor: 9.319
Authors: Rajesh Sagar; Raman Deep Pattanayak; R Chandrasekaran; Pranit K Chaudhury; Balbir S Deswal; R K Lenin Singh; Savita Malhotra; S Haque Nizamie; Bharat N Panchal; T P Sudhakar; J K Trivedi; Mathew Varghese; Jagdish Prasad; Somnath Chatterji Journal: Indian J Psychiatry Date: 2017 Jan-Mar Impact factor: 1.759