A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States

Abstract

Among African Americans, the chronicity and severity of mental illness correlates with worse health outcomes and widens health disparities. Stigma related to mental illness compounds mental health disparities by creating barriers to help-seeking behavior. We examine the current tools designed to reduce mental illness stigma and promote improved mental health outcomes among African Americans. The authors reviewed the current evidence in the literature for such stigma reduction interventions. The review team developed a focused search across four databases: PubMed, Embase, Scopus, and APA PsycINFO. Initial searches identified 120 articles, from which six studies were included as reporting on mental illness stigma reduction interventions among African Americans. We describe these four quantitative and two qualitative studies. There have been various interventions used among African Americans to reduce mental illness stigma, and the level of efficacy and effectiveness is not well studied. Our review demonstrated a need for more robust studies to yield strong evidence on effectiveness among stigma reduction interventions in this target population. The evidence does support tailoring intervention studies to this population. Effectively engaging and partnering with key stakeholders, including schools, community organizations, and faith-based institutions enhances the acceptance and delivery of stigma reduction interventions.

A cross‐sectional study on social determinants of mental health during COVID‐19 among adults in California

“…Given that Black Americans experience several types of mental health stressors more than other racial and ethnic groups, this finding seems paradoxical. However, research has revealed that Black/African Americans are particularly susceptible to the prevalence and impacts of stigma related to mental illness, which frequently discourages them from getting care for their mental health (Rivera et al, 2021). While the study showed that Black/African Americans were less likely to experience mental health issues, we think this is due to the stigma associated with mental illness, thus, underreporting of experiences of such events.…”

Co-design and evaluation of a smartphone-based mental health promotion and anti-stigma embodied conversational agent for church-affiliated Black adults

“…Black and African-descended people of faith are a population that remains underrepresented in the design, development, and evaluation of both digital mental health and digital anti-stigma tools (Rivera et al, 2021). This work centers this priority population.…”

“…prioritizing religious communities with a high prevalence of mental health stigma should address cultural factors specific to Black and African Americans, such as the racialization of mental illness and dimensions of religious involvement (Rivera et al, 2021). In addition, church leadership should be approached directly to partner with researchers when developing mental health and care-seeking interventions (Berkley-Patton et al, 2021).…”

“…However, there is limited work in the mental health stigma reduction literature that centers this population. Rivera and colleagues conducted a narrative review of mental health anti-stigma interventions for African American and Black people in the United States, and they observed that only six studies met the inclusion criteria (Rivera et al, 2021). Such a paucity of research is problematic when empirical investigations have suggested that mental health stigma is prevalent in African American communities (Rao et al, 2007).…”

“…In summary, apart from studies that leveraged cultural-tailoring, most studies reviewed did not center African-descended populations explicitly. In a recent narrative review conducted by Rivera et al, only six mental health anti-stigma studies focused on Black and African-descended people, specifically (Rivera et al, 2021). Those six studies varied in the approaches utilized and their evaluation plans.…”