A critical synthesis of interventions to reduce stigma attached to mental illness

Abstract

Several interventions have been developed and implemented to reduce the stigma attached to mental illness. However people who experience mental illness are still stigmatised in the communities in which they live, as well as in the healthcare centres where they receive treatment. The objective of this study was to critically synthesize the best available evidence regarding interventions to reduce stigma attached to mental illness. This study aimed to provide clinical practitioners with accessible information on interventions to reduce stigma attached to mental illness. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What best evidence is available regarding interventions to reduce the stigma attached to mental illness? A thorough search was done on selected electronic databases: EBSCOhost; Science Direct; Web of knowledge; Scopus; Sabinet; ProQuest; SA Nexus; Cochrane; Google Advance Scholar were searched for primary studies that were published from 2001-2011, including the available 2012 literature and reference lists. The following key words were used in the search: Intervention, stigma, program, mental illness, mental disorder, psychiatric patients. During the selection of studies pre-determined inclusion and exclusion criteria were applied. Seventeen studies (n=17) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP) the John Hopkins Nursing Evidence-Based Practice (JHNEBP) Research Evidence Appraisal Tool and Evidence Analysis Manual; Academy of Nutrition and Dietetics. All seventeen studies (n=17) were identified as evidence that answers the research question. Extraction of evidence, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in the Evidence Analysis Manual (EAM, 2012:70). Findings indicated some interventions that reduce the stigma attached to mental illness. Using Web-based approaches and reading printed educational materials, documentary films and anti-stigma films, live and video performances, and humanising and traditional, naturalistic educational methods are effective in reducing stigma attached to mental illness for health professionals because there were no stigmatising attitude and social distance towards individuals with mental disorders. The German WPA (World Psychiatric Association) “Program against stigma and discrimination because of Schizo-phrenia – Open the doors” is effective in reducing stigma attached to mental illness for the general population. Combining education and video-based contact, in vivo contact and videotaped education, Active Minds and documentary films are effective in reducing stigma of mental illness for students. The use of puppets, psycho-education and contact (via DVD) and public education programs are effective in reducing stigma attached to mental illness for adolescents. The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, nursing education and nursing research.