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Meta-Analysis
. 2020 Jun 8;20(1):879.
doi: 10.1186/s12889-020-08964-3.

Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis

Ozlem Eylem  1   2 , Leonore de Wit  3 , Annemieke van Straten  3 , Lena Steubl  4 , Zaneta Melissourgaki  5 , Gözde Topgüloğlu Danışman  6 , Ralph de Vries  7 , Ad J F M Kerkhof  3 , Kamaldeep Bhui  8 , Pim Cuijpers  3
Affiliations
Meta-Analysis

Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis

Ozlem Eylem et al. BMC Public Health. .

Erratum in

Abstract

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 20th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software.

Results: After screening 2787 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: Common mental disorders; Mental illness stigma; Racial minorities; Stigma.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA flow chart of the study selection process
Fig. 2
Fig. 2
Stigma for CMDs between ethnic minorities and majorities: Forest plot for all studies. Not. The combined refers to the same outcomes which are automatically pooled together by the CMA software when the authors run the analyses. For instance, if different studies used CAMI questionnaire and measured stereotypes among Black racial group, they are pooled together by the CMA
Fig. 3
Fig. 3
Stigma for CMDs between ethnic minorities and majorities: Forest plot when low quality studies excluded
Fig. 4
Fig. 4
Stigma for CMDs between ethnic minorities and majorities: Forest plot when only studies with standardized outcome measures are included
Fig. 5
Fig. 5
Stigma for CMDs between ethnic minorities and majorities: Forest plot when outliers are excluded
Fig. 6
Fig. 6
Stigma for CMDs between ethnic minorities and majorities: Funnel Plot
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