Reducing the Stigma of Mental Illness in Communities of Color

Photograph of a support group
Figure 1 Photograph by Tima-Miroshnichenko. Pexels. CCO.

Submitted by: Supriya Misra, Valerie W. Jackson, Jeanette Chong, Karen Choe, Charisse Tay, Jazmine Wong, Lawrence H. Yang

Highlights

We can take an action-oriented approach to identify how cultural aspects of mental illness stigma manifest for racial and ethnic minority groups in the United States.

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Culturally salient interventions can promote change and empowerment at systemic and individual levels.

Mental illness stigma can partially explain persistent mental illness disparities among racial and ethnic minority groups. There can be cultural aspects of how mental illness stigma manifests for different groups. Yet, the ways in which these cultural aspects of mental illness stigma operate for racial and ethnic minority groups in the United States have never been systematically documented and compared. Reviewing and synthesizing prior literature can inform interventions to reduce and resist cultural aspects of mental illness stigma for racial and ethnic minority groups in the future.

“These findings illuminate important cultural themes enabling understanding of, and intervention with, cultural aspects of mental illness stigma among Asian Americans, Black Americans, and LatinX Americans.”

Methods

We conducted a systematic review in three research databases (Medline, PsycInfo, Google Scholar) to identify empirical studies on cultural aspects of mental illness stigma (public, structural, affiliative, self) among the three largest racial and ethnic minority groups (Asian Americans, Black Americans, Latinx Americans) published from 1990 to 2019, yielding 97 articles. Studies were grouped into one of three study types: (i) Comparative studies including comparisons of stigma levels between at least two racial and ethnic groups; (ii) Descriptive studies of stigma restricted to a single racial or ethnic group, further subcategorized into a) Asian American studies; b) Black American studies; c) LatinX American studies; and (iii) Intervention studies that were specifically intended to reduce stigma among racial and ethnic minority groups and measured changes in stigma-related outcomes. For the three racial and ethnic minority group sections, culturally salient findings were narratively summarized by stigma type into the main cultural themes and subthemes.

How Did A Community Psychology Perspective Inform Your Work?

Community Psychology takes an ecological approach to understand individuals in their contexts including the multiple social marginalizations they may experience and the settings and locales that are culturally significant to them. Specifically, this perspective prompts community-based strategies to increase trust, provide education, and reduce stigma by building capacity and resources to address the social problems contributing to mental illness and stigma, creating a more supportive context to reduce stigma, and building agency to resist stigma.

Results

  • Mental illness stigma tended to be higher among racial and ethnic minority groups than white comparison groups.
  • Mental illness stigma has similar and unique cultural aspects across the three racial and ethnic minority groups.
  • Major cultural themes were 1) service barriers including access and quality, 2) family experiences including concealment for family’s sake, fear of being a burden, and stigma extending to family, 3) lack of knowledge about mental illness and specific cultural beliefs, and 4) negative emotional responses and coping.
  • Few studies tested culturally salient stigma reduction interventions.

What Does This Mean For?

Practice: Interventions can integrate cultural aspects to reduce service barriers and target stigma directly for individuals living with mental illness and their families.

Social Action: Cultural insights can inform contextual change at the health systems and community levels to reduce stigma, and empowerment at the interpersonal and individual levels to resist stigma.

Original Citation: Misra, S., Jackson, V. W., Chong, J., Choe, K., Tay, C., Wong, J., & Yang, L. H. (2021). Systematic Review of Cultural Aspects of Stigma and Mental Illness among Racial and Ethnic Minority Groups in the United States: Implications for Interventions. American Journal of Community Psychology.

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