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

Abstract

One in ten children and adolescents suffer with mental health difficulties at any given time, yet less than one third seek 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, identified as a key deterrent to treatment, have been disappointing. This indicates the need for a clearer understanding of the stigmatizing processes faced by young people, so that more effective interventions are employed. A systematic review of the literature, assessing public stigma and self-stigma (i.e. internalized public stigma) specifically in children and adolescents with mental health difficulties (YP-MHD), was conducted. Forty-two studies were identified, confirming that stigmatization of YP-MHD is a universal and disabling problem, present amongst both children and adults. 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 an avoidance of interventions. The findings confirm that stigmatization of mental illness is poorly understood due to a lack of research and methodological discrepancies between existing studies. Implications for the findings are discussed, and suggestions made for future research.

Intersections between polyvictimisation and mental health among adolescents in five urban disadvantaged settings: the role of gender

“…With a few exceptions, none of the affected adolescents, whether male or female, are currently receiving treatment. Even if services were available, stigma, especially prevalent among boys, would remain a major obstacle to treatment [31]. Stigma leads to secrecy and avoidance of treatment, and initiatives to counter stigma have met with little success to date [32].…”

Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS)

“…As self-stigmatization begins early in the journey of young people with mental health difficulties [8], the importance of developing valid measures for it cannot be underestimated. Considering the multifaceted nature of self-stigmatization, understanding its components is crucial in the accurate identification of areas for intervention aiming to reduce its impact.…”

“…Despite the limited evidence base, available data strongly support that children and adolescents with mental health difficulties are stigmatized against [8]. In fact, they are thought to be more stigmatized than their adult counterparts, with numerous pejorative labels used to describe them [9].…”

“…Developmentally, children are going through significant neurodevelopmental and psychological changes which would impact on their perceptions, maturity and insight into their difficulties and their understanding of stigma. Hence, findings in adults cannot be simply extrapolated to children, as the social and cognitive processes that are affecting these experiences may not mirror those of children [8].…”

Community-based rehabilitation programme for adolescents with mental health conditions in Israel: a qualitative study protocol

“…Public stigma refers to negative labelling (stereotype, prejudice and discrimination) of a group of people to distance them from society, whereas self-stigma (also termed internalised stigma) refers to the internalisation of those negative labels in a way that changes people’s self-perception 5. While there is ample evidence that adolescents with MHC experience public stigma,6 7 self-stigma is under-investigated and insufficiently understood for adolescents with MHC 8–10. In some studies adolescents' self-stigma has been associated with reduced self-esteem,11 limited social interactions, secrecy, shame12 and less adaptive coping strategies 13.…”