A Call to Action. A Critical Review of Mental Health Related Anti-stigma Campaigns

Abstract

Using a knowledge-attitudes-behavior practice (KABP) paradigm, professionals have focused on educating the public in biomedical explanations of mental illness. Especially in high-income countries, it is now common for education-based campaigns to also include some form of social contact and to be tailored to key groups. However, and despite over 20 years of high-profile national campaigns (e.g., Time to Change in England; Beyond Blue in Australia), examinations suggest that the public continue to Other those with experiences of mental ill-health. Furthermore, evaluations of anti-stigma programs are found to have weak- to no significant long-term effects, and serious concerns have been raised over their possible unintended consequences. Accordingly, this article critically re-engages with the literature. We evidence that there have been systematic issues in problem conceptualization. Namely, the KABP paradigm does not respond to the multiple forms of knowledge embodied in every life, often outside conscious awareness. Furthermore, we highlight how a singular focus on addressing the public's perceived deficits in professionalized forms of knowledge has sustained public practices which divide between “us” and “them.” In addition, we show that practitioners have not fully appreciated the social processes which Other individuals with experiences of mental illness, nor how these processes motivate the public to maintain distance from those perceived to embody this devalued form of social identity. Lastly, we suggest methodological tools which would allow public health professionals to fully explore these identity-related social processes. Whilst some readers may be frustrated by the lack of clear solutions provided in this paper, given the serious unintended consequences of anti-stigma campaigns, we caution against making simplified statements on how to correct public health campaigns. Instead, this review should be seen as a call to action. We hope that by fully exploring these processes, we can develop new interventions rooted in the ways the public make sense of mental health and illness.

Leveraging Neuroscience to Fight Stigma Around Mental Health

“…Ignorance of the biological basis of physical and (especially) mental health ailments is a major trigger of stigma. Ignorance reinforces and perpetuates beliefs and hearsay about the causes of illness, and therefore boosts stigmatization but surprisingly, informing the public about the biological correlates of mental disorders (Schomerus et al, 2012 ; Loughman and Haslam, 2018 ; Lebowitz, 2019 ; Walsh and Foster, 2021 ) does not seem to be an effective measure against stigma around mental health. As noted in the previous paragraph, stigma prevails even in societies with access to education and access to information about mental illness.…”

Psychometric properties of the Depression Stigma Scale in the Portuguese population and its association with gender and depressive symptomatology

“…3 Faculty of Psychology and Education Science, University of Porto, Porto, Portugal. 4 Center for Psychology at, University of Porto, Porto, Portugal. 5 Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.…”

“…The stigma associated with mental illnesses has been the subject of extensive study in recent years [1][2][3][4]. Two relevant concepts of stigma are social and self-stigma.…”

Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis

“…Most anti-stigma interventions and/or campaigns have been conceptualized using knowledge-attitude-behavior paradigm [6]. Knowledge is defined as information an individual perceives about mental health as a function of memory and stereotyping (related to, for e.g., treatment efficacy, symptom recognition, help-seeking, and employment), attitude is defined as perceptions or views towards people with mental disorders or about mental disorders (related to negative attitudes, for e.g., desiring social control and social distance), and behavior as intended or actual discriminatory actions towards people with mental health problems (related to, for e.g.…”