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Research article
Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis
Ozlem Eylem
Vrije Universiteit Amsterdam
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5695-9523
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Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities compared to racial and/or ethnic majorities since the former often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities.
Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20 th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software.
Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures.
Conclusions Mental illness stigma is higher among ethnic minorities than majorities. An important clinical implication of these findings would be to tailor anti-stigma strategies related with mental illnesses according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach.
Keywords
stigma, mental illness stigma, common mental disorders, racial minorities
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Posted 28 May, 2020
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On 26 Mar, 2020
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On 16 Mar, 2020
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Editor invited
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Editorial decision: Minor revision
On 03 Mar, 2020
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Received 29 Feb, 2020
Reviewer #4 agreed
On 12 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #3 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 07 Feb, 2020
Review #1 received
Received 06 Feb, 2020
Reviewers invited
Invitations sent on 05 Feb, 2020
Reviewer #1 agreed
On 05 Feb, 2020
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On 31 Jan, 2020
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On 30 Jan, 2020
Editor invited
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis
Ozlem Eylem
Vrije Universiteit Amsterdam
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5695-9523
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 28 May, 2020
No community comments so far
Submission checks complete
On 20 May, 2020
No comments provided
Editorial decision: Minor revision
On 09 May, 2020
Review #1 received
Received 25 Apr, 2020
Reviewers invited
Invitations sent on 26 Mar, 2020
Reviewer #1 agreed
On 26 Mar, 2020
Editor assigned
On 16 Mar, 2020
Submission checks complete
On 15 Mar, 2020
Editor invited
On 15 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 03 Mar, 2020
Review #2 received
Received 29 Feb, 2020
Reviewer #4 agreed
On 12 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #3 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 07 Feb, 2020
Review #1 received
Received 06 Feb, 2020
Reviewers invited
Invitations sent on 05 Feb, 2020
Reviewer #1 agreed
On 05 Feb, 2020
Editor assigned
On 31 Jan, 2020
Submission checks complete
On 30 Jan, 2020
Editor invited
On 30 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities compared to racial and/or ethnic majorities since the former often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities.
Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20 th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software.
Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures.
Conclusions Mental illness stigma is higher among ethnic minorities than majorities. An important clinical implication of these findings would be to tailor anti-stigma strategies related with mental illnesses according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach.
Figure 1