Challenging mental health related stigma in China: Systematic review and meta-analysis. II. Interventions among people with mental illness

Psychiatry Res. 2017 Sep:255:457-464. doi: 10.1016/j.psychres.2017.05.002.

Abstract

People with mental illness often face different types of mental illness stigma that may affect their lives, including perceived stigma, self-stigma, harmful coping strategies and poor quality of life. Although anti-stigma interventions for people with mental illness from Western countries have been identified by recent systematic reviews, their efficacy in China is unknown. This review evaluates the efficacy of anti-stigma interventions among people with mental illness in Mainland China, Hong Kong, Taiwan and Macau. A systematic search of 8 electronic databases in English and Chinese yielded 17 randomized and non-randomized controlled trials. Standardized mean differences (SMDs) were calculated wherever possible. Psychoeducation was the most commonly used intervention. SMDs were large and significant for perceived/experienced/anticipated stigma, self-prejudice and coping with stigma, as well as for depression and anxiety symptoms and quality of life. Both Cognitive Behavioral Therapy and psychoeducation had positive effects on perceived/experienced/anticipated stigma. The quality of studies was modest and heterogeneity across studies was high. Anti-stigma interventions demonstrated promise to reduce stigma's negative impact on people with mental illness in China, but more high-quality intervention research is needed.

Keywords: Chinese people; Interventions; Perceived stigma; Self-stigma; Systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adaptation, Psychological
  • Anxiety / psychology
  • China
  • Clinical Trials as Topic
  • Cognitive Behavioral Therapy / methods*
  • Depression / psychology
  • Female
  • Hong Kong
  • Humans
  • Macau
  • Mental Disorders / ethnology
  • Mental Disorders / psychology*
  • Mental Disorders / therapy*
  • Prejudice / psychology
  • Quality of Life
  • Social Stigma*
  • Taiwan
  • Treatment Outcome