Exploring stigma associated with mental health conditions and alcohol and other drug use among people from migrant and ethnic minority backgrounds: a protocol for a systematic review of qualitative studies

Abstract

Background Stigma is a social process that impedes access to support for mental health conditions and alcohol and other drug (AOD) use, particularly for people from migrant and ethnic minority backgrounds. There is limited understanding, however, of people’s experiences of stigma, the underlying drivers, intersections with ethnicity, gender, and citizenship status, and how powerful discourses and social institutions create and perpetuate systems of stigma. This review aims to synthesise and critically analyse qualitative evidence to understand how stigma associated with mental health conditions and AOD use operates among people from migrant and ethnic minority groups. Methods Qualitative evidence will be identified using MEDLINE, Embase, PsycINFO, CINAHL, Applied Social Sciences Index and Sociological Abstracts. Two reviewers will screen the titles, abstracts and full-text articles. Eligible studies will include original, empirical, peer-reviewed qualitative evidence, published in English since 1990. Studies must examine stigma in relation to mental health conditions, illicit drug use or alcohol consumption among participants who are from migrant and ethnic minority backgrounds. Studies will be critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for qualitative studies and the level of confidence in the findings will be assessed using Confidence in the Evidence from Reviews of Qualitative research. Data will be analysed using the ‘best fit’ framework synthesis approach, drawing on the Health Stigma and Discrimination Framework. Discussion This review will provide an in-depth understanding of the stigma associated with mental health conditions and AOD use among people from migrant and ethnic minority backgrounds. The findings will inform culturally responsive interventions that aim to reduce the negative impact of stigma on individuals, families and communities. Systematic review registration PROSPERO CRD42021204057

Stigma Associated with Alcohol and Other Drug Use Among People from Migrant and Ethnic Minority Groups: Results from a Systematic Review of Qualitative Studies

“…Review methods are described in the protocol [31] in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and Enhancing transparency in reporting the synthesis of qualitative research checklist [34,35]. The broader review was designed to examine stigma associated with mental health and/or AOD use due to the high prevalence of mental health conditions among migrant populations and co-morbidity with AOD-related problems [36,37].…”

“…The theory underpinning this work is described in the protocol [31]. Our review draws on the concepts of habitus, symbolic power and stigma power.…”

Commentary on Saleh et al: The triple burden of stigma experienced by forcibly displaced people with substance use disorder ‐ considerations for research and practice

“…First, we must center the social and structural determinants as the principal drivers of substance use and SUD among displaced populations in research on substance use [15]. Secondly, we should prioritize the evaluation of interventions and policies that are designed to reduce stigma and related barriers to seeking and accessing SUD prevention and treatment services [1, 16, 17]. Promising strategies include implementing interventions and policies that explicitly address the social and structural drivers of substance‐related harm, such as providing stable housing, employment opportunities and supporting basic needs [18], as well as transdiagnostic and integrated interventions that address substance use within the context of other related public health conditions (e.g.…”

“…Secondly, we should prioritize the evaluation of interventions and policies that are designed to reduce stigma and related barriers to seeking and accessing SUD prevention and treatment services [1,16,17]. Promising strategies include implementing interventions and policies that explicitly address the social and structural drivers of substance-related harm, such as providing stable housing, employment opportunities and supporting basic needs [18], as well as…”