The stigma of mental illness in children and adolescents: A systematic review

Abstract

IntroductionOne in ten children and adolescents experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes to longstanding individual difficulties, and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness in children and adolescents, identified as a key deterrent to treatment, have had limited success, and research is scarce.AimsTo gain a better understanding of the stigma experienced by children and adolescents with mental health difficulties.ObjectivesWe conducted a systematic review of the literature examining stigma and self-stigma towards children and adolescents with mental health difficulties, in order to better understand the extent and type of discrimination directed towards this particularly vulnerable group.MethodsFollowing PRISMA guidelines, the databases Pubmed, PsychINFO and Cochrane were searched for original research published between 1980 and 2014, assessing public stigma (i.e. the reaction of the general public) and self-stigma (i.e. internalized public stigma) towards children and adolescents with mental health difficulties.ResultsThirty-seven studies were identified, confirming that stigmatization towards children and young people suffering mental health difficulties is a universal and disabling problem. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and avoidance of interventions.ConclusionsThe findings confirm that stigmatization of mental illness is poorly understood due to a lack of evidence and methodological discrepancies. Implications of the findings are discussed, and suggestions made for future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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“…These findings may represent a common physiological mechanism associated with the vulnerability to psychosis in people with BD, and may suggest that the presence of psychosis in BD represents a unique subtype of the disorder . Also, the experience of being psychotic may have a significant impact on one's self‐concept (eg, poor self‐esteem, depression, anxiety), and lead to environmental stressors (eg, peer rejection) and PTSD‐like symptoms regarding the traumatic psychotic experience, which may last for months after the psychosis has resolved …”

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