Depression prevention and mental health promotion interventions: is stigma taken into account? An overview of the Italian initiatives

Lanfredi, Mariangela; Rossi, Giuseppe; Rossi, Roberta; Bortel, Tine Van; Thornicroft, Graham; Quinn, Neil; Zoppei, Silvia; Lasalvia, Antonio

doi:10.1017/s2045796013000085

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…Europe is uniquely placed and may have a comparative advantage to research in comparison to other parts of the world as the heterogeneity in economic circumstances, population characteristics, and social-welfare/protection systems allows for interesting comparisons across countries. Incorporation of stigma measures in cohort or panel studies could help elucidate mechanisms and explore associations, while also facilitating natural experiments as a basis for evaluating policies or interventions which are introduced unevenly either over time [27] or across different cultural or other contexts. Proxy measures of social inclusion and exclusion are available in administrative databases, and measures to promote access and analyses of ''big data'' need to be fostered.…”

Section: Resultsmentioning

confidence: 99%

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

et al. 2014

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Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe-primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.

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Section: Resultsmentioning

confidence: 99%

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

et al. 2014

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“…Interventions targeted at fostering hope or dealing with depression should pay attention to the fact that self-stigma may account for a large part of the depressive symptoms and loss of hope found in service users. It has been suggested that significant gains in quality of life for people with schizophrenia spectrum disorders may result from education about self-stigma and the use of strategies to increase resilience against stigmatizing environments (Mittal et al 2012; Lanfredi et al 2013). Our results support this claim and argue for the use of strategies to conquer self-stigma both in everyday clinical practice as well as in specific interventions.…”

Section: Discussionmentioning

confidence: 99%

Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

Schrank

Amering

Hay

et al. 2013

Epidemiol Psychiatr Sci

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Aims. Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables. Methods. A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables. Results. Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight. Conclusions. This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.

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“…Stigma and discrimination associated with mental illness are common (Angermeyer & Dietrich, 2006;Rose et al 2011;Schomerus et al 2012b;Lasalvia et al 2013) and can act as barriers to helpseeking and prevention in different ways (Corrigan & Rüsch, 2002;Phelan et al 2006;Schomerus & Angermeyer, 2008;Clement et al 2012;Lanfredi et al 2013). People with mental illness may avoid helpseeking due to fear of being discriminated against by others (public stigma) or because they agree with negative stereotypes and turn them against themselves (self-stigma) (Vogel et al 2006;Rüsch et al 2009a;Evans-Lacko et al 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Three barriers to help-seeking have attracted increasing attention to explain low rates of service use: stigma of mental illness and shame as its emotional consequence; knowledge about mental health or mental health literacy; and satisfaction with one's mental health, a concept related to perceived need for treatment. Stigma and discrimination associated with mental illness are common (Angermeyer & Dietrich, 2006; Rose et al 2011; Schomerus et al 2012 b ; Lasalvia et al 2013) and can act as barriers to help-seeking and prevention in different ways (Corrigan & Rüsch, 2002; Phelan et al 2006; Schomerus & Angermeyer, 2008; Clement et al 2012; Lanfredi et al 2013). People with mental illness may avoid help-seeking due to fear of being discriminated against by others (public stigma) or because they agree with negative stereotypes and turn them against themselves (self-stigma) (Vogel et al 2006; Rüsch et al 2009 a ; Evans-Lacko et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking

Rüsch

Müller

Ajdacic-Gross

et al. 2013

Epidemiol Psychiatr Sci

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Aims.To examine stigma- and knowledge-related barriers to help-seeking among members of the general population.Methods.In a representative survey of young to middle-aged Swiss adults (n = 8875), shame about a potential own mental illness, perceived knowledge about and satisfaction with one's mental health, psychiatric symptoms and attitudes towards help-seeking were assessed.Results.A latent profile analysis of all participants yielded two groups with different attitudes towards help-seeking. Relative to the majority, a one-in-four subgroup endorsed more negative attitudes towards seeking professional help, including psychiatric medication, and was characterized by more shame, less perceived knowledge, higher satisfaction with their mental health, younger age, male gender and lower education. Among participants with high symptom levels (n = 855), a third subgroup was reluctant to seek help in their private environment and characterized by high symptoms as well as low satisfaction with their mental health.Conclusions.Shame as an emotional proxy of self-stigma as well as poor subjective mental health literacy may be independent barriers to help-seeking. Interventions to increase mental health service use could focus on both variables and on those individuals with more negative views about professional help, in the general public as well as among people with a current mental illness.

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Depression prevention and mental health promotion interventions: is stigma taken into account? An overview of the Italian initiatives

Cited by 9 publications

References 27 publications

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking

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