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BMC Psychiatry
Published in: BMC Psychiatry 1/2021

01-12-2021 | Research article

Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review

Authors: Mao-Sheng Ran, Brian J. Hall, Tin Tin Su, Benny Prawira, Matilde Breth-Petersen, Xu-Hong Li, Tian-Ming Zhang

Published in: BMC Psychiatry | Issue 1/2021

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Abstract

Background

Although cultural factors play a crucial role in experience of stigma, there is scant review on the impact and importance of culture on stigma of mental illness across Pacific Rim Region. This study aims to investigate: 1) the cultural factors related to stigmatizing beliefs about mental illness in Pacific Rim region, and 2) culture-specific measures and interventions on stigma of mental illness.

Methods

A systematic search of papers was conducted in the MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, Cochrane Library and Google scholar through January 2003 to April 2019.

Results

Forty-one studies in Pacific Rim region which met the inclusion criteria were included in the study. The rate of stigma of mental illness (e.g., public stigma: from 25.4 to 85.2%) was relatively high in Pacific Rim region. Culture factors (e.g., Collectivism, Confucianism, face concern and familism, religion and supernatural beliefs) contributed to people’s stigmatizing behaviors and attitudes toward persons with mental illness, their relatives and mental health professionals. Certain measurements were developed and employed to assess different type of cultural factors related to stigma of mental illness.

Conclusions

Cultural factors play an important role in influencing the rate and performance of stigma of mental illness. Further research on stigma of mental illness and culture-specific interventions to reduce the stigma should be conducted in the Pacific Rim region.
Literature
1.
Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16.PubMedPubMedCentral
2.
Ran MS, Zhang TM, Wong IYL, Yang X, Liu CC, Liu B, et al. Internalized stigma in people with severe mental illness in rural China. Int J Soc Psychiatry. 2018;64(1):9–16.PubMedCrossRef
3.
Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand. 2006;113(3):163–79.PubMedCrossRef
4.
5.
Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27.PubMedCrossRef
6.
Xu Z, Müller M, Heekeren K, Theodoridou A, Metzler S, Dvorsky D, et al. Pathways between stigma and suicidal ideation among people at risk of psychosis. Schizophr Res. 2016;172(1–3):184–8.PubMedCrossRef
7.
Oexle N, Waldmann T, Staiger T, Xu Z, Rüsch N. Mental illness stigma and suicidality: the role of public and individual stigma. Epidemiol Psychiatr Sci. 2016;27(2):169–75.PubMedPubMedCentralCrossRef
8.
Gerlinger G, Hauser M, De Hert M, Lacluyse K, Wampers M, Correll CU. Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry. 2013;12(2):155–64.PubMedPubMedCentralCrossRef
9.
Oexle N, Ajdacic-Gross V, Kilian R, Müller M, Rodgers S, Xu Z, et al. Mental illness stigma, secrecy and suicidal ideation. Epidemiol Psychiatr Sci. 2017;26(1):53–60.PubMedCrossRef
10.
Ng CH. The stigma of mental illness in Asian cultures. Aust NZ J Psychiatry. 1997;31(3):382–90.CrossRef
11.
Abdullah T, Brown TL. Mental illness stigma and ethnocultural beliefs, values, and norms: an integrative review. Clin Psychol Rev. 2011;31(6):934–48.PubMedCrossRef
12.
Mirza A, Birtel MD, Pyle M, Morrison AP. Cultural differences in psychosis: the role of causal beliefs and stigma in white British and south Asians. J Cross-Cult Psychol. 2019;50(3):441–59.CrossRef
13.
Tasman A, Sartorius N, Saraceno B. Addressing mental health resource deficiencies in Pacific rim countries. Asia Pac Psychiatry. 2009;1(1):3–8.CrossRef
14.
Berry JW. Intercultural relations and acculturation in the Pacific region. J Pac Rim Psychol. 2010;4(2):95–102.CrossRef
15.
Singh J, et al. Critical appraisal skills programme. J Pharmacol Pharmacother. 2013;4(1):76.CrossRef
16.
17.
Chiu MY, Yang X, Wong FHT, Li JH, Li J. Caregiving of children with intellectual disabilities in China–an examination of affiliate stigma and the cultural thesis. J Intellect Disabil Res. 2013;57(12):1117–29.PubMed
18.
Mak WW, Ho CY, Wong VU, Law RW, Chan RC. Cultural model of self-stigma among Chinese with substance use problems. Drug Alcohol Depend. 2015;155:83–9.PubMedCrossRef
19.
WonPat-Borja AJ, Yang LH, Link BG, Phelan JC. Eugenics, genetics, and mental illness stigma in Chinese Americans. Soc Psychiatry Psychiatr Epidemiol. 2012;47(1):145–56.PubMedCrossRef
20.
Mak WW, Cheung RY. Psychological distress and subjective burden of caregivers of people with mental illness: the role of affiliate stigma and face concern. Community Ment Health J. 2012;48(3):270–4.PubMedCrossRef
21.
Chiu MYL, Yang X, Wong HT, Li JH. The mediating effect of affective stigma between face concern and general mental health - the case of Chinese caregivers of children with intellectual disability. Res Dev Disabil. 2015;36C:437–46.PubMedCrossRef
22.
23.
Böge K, Zieger A, Mungee A, Tandon A, Fuchs LM, Schomerus G, et al. Perceived stigmatization and discrimination of people with mental illness: a survey-based study of the general population in five metropolitan cities in India. Indian J Psychiatry. 2018;60(1):24–31.PubMedPubMedCentralCrossRef
24.
Picco L, Pang S, Lau YW, Jeyagurunathan A, Satghare P, Abdin E, et al. Internalized stigma among psychiatric outpatients: associations with quality of life, functioning, hope and self-esteem. Psychiatry Res. 2016;246:500–6.PubMedCrossRef
25.
26.
Marquez JA, García RJI. Family caregivers’ narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness. J Fam Psychol. 2013;27(3):398.PubMedCrossRef
27.
Lin X, Rosenheck R, Sun B, Xie G, Zhong G, Tan C, et al. Associative stigma experienced by mental health professionals in China and the United States. Soc Psychiatry Psychiatr Epidemiol. 2018;54(6):745–53.PubMedCrossRef
28.
Pang S, Liu J, Mahesh M, Chua BY, Shahwan S, Lee SP, et al. Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population. BMJ Open. 2017;7(10):e016432.PubMedPubMedCentralCrossRef
29.
Haraguchi K, Maeda M, Mei YX, Uchimura N. Stigma associated with schizophrenia: cultural comparison of social distance in Japan and China. Psychiatry Clin Neurosci. 2009;63(2):153–60.PubMedCrossRef
30.
Caplan S, Paris M, Whittemore R, Desai M, Dixon J, Alvidrez J, et al. Correlates of religious, supernatural and psychosocial causal beliefs about depression among Latino immigrants in primary care. Ment Health Relig Cult. 2011;14(6):589–611.CrossRef
31.
Kurumatani T, Ukawa K, Kawaguchi Y, Miyata S, Suzuki M, Ide H, et al. Teachers’ knowledge, beliefs and attitudes concerning schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004;39.5:402–9.CrossRef
32.
Papadopoulos C, Foster J, Caldwell K. Individualism-collectivism’ as an explanatory device for mental illness stigma. Community Ment Health J. 2013;49(3):270–80.PubMedCrossRef
33.
Loya F, Reddy R, Hinshaw SP. Mental illness stigma as a mediator of differences in Caucasian and south Asian college students’ attitudes toward psychological counseling. J Couns Psychol. 2010;57(4):484.CrossRef
34.
Tsang HW, Angell B, Corrigan PW, Lee YT, Shi K, Lam CS, et al. A cross-cultural study of employers’ concerns about hiring people with psychotic disorder: implications for recovery. Soc Psychiatry Psychiatr Epidemiol. 2007;42(9):723–33.PubMedCrossRef
35.
Tanaka C, Tuliao MTR, Tanaka E, Yamashita T, Matsuo H. A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines. BMC Psychiatry. 2018;18(1):325.PubMedPubMedCentralCrossRef
36.
Fancher TL, Ton H, Le Meyer O, Ho T, Paterniti DA. Discussing depression with Vietnamese American patients. J Immigr Minor Health. 2010;12(2):263–6.PubMedCrossRef
37.
Luo A, He H, Mohamed S, Rosenheck R. Medical student attitudes towards people with mental illness in China: a qualitative study. Cult Med Psychiatry. 2018;42(3):535–51.PubMedCrossRef
38.
39.
Han M, Cha R, Lee HA, Lee SE. Mental-illness stigma among Korean immigrants: role of culture and destigmatization strategies. Asian Am J Psychol. 2017;8(2):134.CrossRef
40.
Ramli FZA, Tilse C, Wilson J. Qualitative interviewing of Malay caregivers: stigma and mental health problems of older adults. Int J Cult Ment Health. 2017;10:127–35.CrossRef
41.
Mascayano F, Toso-Salman J, Ruiz B, Warman K, Escalona JA, Muñoz AR, et al. What matters most’: stigma towards severe mental disorders in Chile, a theory-driven, qualitative approach. Rev Fac Cien Méd. 2015;72(4):250–60.
42.
Alvidrez J, Snowden LR, Kaiser DM. The experience of stigma among black mental health consumers. J Health Care Poor Underserved. 2008;19(3):874–93.PubMedCrossRef
43.
Interian A, Martinez IE, Guarnaccia PJ, Vega WA, Escobar JI. A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatr Serv. 2007;58(12):1591–4.PubMedPubMedCentralCrossRef
44.
Caplan S. Intersection of cultural and religious beliefs about mental health: Latinos in the faith-based setting. Hispanic Health Care Int. 2019;17(1):4–10.CrossRef
45.
Bui QN, Han M, Diwan S, Dao T. Vietnamese-American family caregivers of persons with mental illness: exploring caregiving experience in cultural context. Transcult Psychiatry. 2018;55(6):846–65.PubMedCrossRef
46.
Yang LH, Valencia E, Alvarado R, Link B, Huynh N, Nguyen K, et al. A theoretical and empirical framework for constructing culture-specific stigma instruments for Chile. Cadernos Saude Coletiva. 2013;21(1):71–9.PubMedPubMedCentralCrossRef
47.
48.
Yang X. No matter how I think, it already hurts: self-stigmatized feelings and face concern of Chinese caregivers of people with intellectual disabilities. J Intellect Disabil. 2015;19(4):367–80.PubMedCrossRef
49.
Yang LH, Lai GY, Tu M, Luo M, Wonpat-Borja A, Jackson VW, et al. A brief anti-stigma intervention for Chinese immigrant caregivers of individuals with psychosis: adaptation and initial findings. Transcult Psychiatry. 2014;51(2):139–57.PubMedCrossRef
50.
Lee S, Lee MT, Chiu MY, Kleinman A. Experience of social stigma by people with schizophrenia in Hong Kong. Br J Psychiatry. 2005;186(2):153–7.PubMedCrossRef
51.
Mascayano F, Tapia T, Schilling S, Alvarado R, Tapia E, Lips W, et al. Stigma toward mental illness in Latin America and the Caribbean: a systematic review. Braz J Psychiatry. 2016;38(1):73–85.PubMedPubMedCentralCrossRef
52.
53.
Yang LH, Kleinman A, Link BG, Phelan JC, Lee S, Good B. Culture and stigma: adding moral experience to stigma theory. Soc Sci Med. 2007;64(7):1524–35.PubMedCrossRef
54.
Hanzawa S. Toward an effective family support system in Japan: from research on family caregivers and schizophrenia patients in east Asian countries. Int J Ment Health. 2012;41(2):82–96.CrossRef
55.
Zane N, Yeh M. The use of culturally-based variables in assessment: studies on loss of face. In: Kurasaki K, Okazaki S, Sue S, editors. Asian American mental health: assessment theories and methods. Dordrecht: Kluwer academic; 2002. p. 123–40.CrossRef
56.
Kulhara P, Avasthi A, Sharma A. Magico-religious beliefs in schizophrenia: a study from North India. Psychopathol. 2000;33:62–8.CrossRef
57.
Kidd LI, Tusaie KR. Disconfirming beliefs: the use of poetry to know the lived experience of student nurses in mental health clinicals. Issues Ment Health Nurs. 2004;25(4):403–14.PubMedCrossRef
58.
Verhaeghe M, Bracke P. Associative stigma among mental health professionals: implications for professional and service user well-being. J Health Soc Behav. 2012;53(1):17–32.PubMedCrossRef
59.
60.
Yang LH. Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singap Med J. 2007;48(11):977–85.
Metadata
Title
Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review
Authors
Mao-Sheng Ran
Brian J. Hall
Tin Tin Su
Benny Prawira
Matilde Breth-Petersen
Xu-Hong Li
Tian-Ming Zhang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02991-5

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