Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Programs targeting mental illness stigma can improve knowledge and attitudes

Mehta N, Clement S, Marcus E, et al. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: Systematic review Br J Psychiatry. 2015;207(5):377-384.

Review question

What are some effective ways to reduce mental illness-based stigma? What is the impact of mental health anti-stigma programs in the long term? Are programs shown to be effective in reducing mental illness-based stigma in high-income countries also effective in low- and middle-income countries?


Mental illness-based stigma is described as negative attitudes and stereotypes against people with mental illnesses, and can act as a barrier for those with illnesses in having a satisfying life. Research focused on ways to reduce mental illness-based stigma has steadily grown in recent years. However, many of the approaches used to reduce mental illness-based stigma are based on findings from high-income countries. No review has explored the effectiveness of anti-stigma programs in low- and middle-income countries (although that is where 85% of the world’s population lives), nor have any measured the success of these programs in the long-term.

How the review was done

The researchers completed a systematic review of 80 studies published between 1983 and 2013. Half of the studies had a low risk for bias, and the remaining studies had unclear or high risk of bias.

A total of 422, 653 participants were included in the studies. Excluded from this review were studies focused on people with dementia, substance misuse, or developmental disorders.

Key features of the studies were:

  • Focused on measuring effectiveness of approaches to change mental health-related stigma (i.e prejudice, discrimination or public mental health awareness)
  • Measured impacts of approaches on at least one of:

i) knowledge - increasing study participant knowledge towards mental illnesses

ii) attitudes - reducing prejudice or negative self-stigma against mental illnesses

iii) behaviour - reducing discrimination against mental illnesses or increasing stigma-coping for those with mental illness

  • Minimum of 4 weeks of follow-up after completion of the anti-stigma intervention.

Examples of anti-stigma programs included motivational interviewing and mental health education workshops. Studies compared programs to control groups (i.e. people receiving usual treatment or best available treatment)

What the researchers found

Anti-stigma programs with at least 4 weeks of follow-up increased mental health knowledge by a moderate amount, and reduced stigma-related attitudes by a small amount. There was not enough data to determine whether anti-stigma interventions reduced negative behaviour against people with mental illness at 4 weeks or longer. None of the included studies measured the effects of anti-stigma programs in low-income countries, and only one study conducted in Chile (low-middle income country) found that programs reduced stigma-related attitudes. There is a need to study the impact of anti-stigma programs in low income countries.


Mental health anti-stigma programs show modest effectiveness in increasing mental illness knowledge and reducing mental illness-related stigmatization when follow up occurs 4 weeks or more after completion of the program.



Control group
A group that receives either no treatment or a standard treatment.
Risk of bias
Possibility of some systematic error in the studies.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Evidence Summaries

Related Web Resources

  • Depression

    Informed Health Online
    Depression is a common mood disorder that can make it hard to cope with everyday life. Causes and risk factors for depression include genes, difficult experiences and life circumstances, chronic anxiety disorders, biochemical changes, medical problems, and lack of light. Psychological therapies (e.g., cognitive behavioral therapy) and medication, alone or combination, are treatment options.
  • Medicines for Treating Depression: A Review of the Research for Adults

    This patient decision aid helps adults diagnosed as being depressed decide on the type of medicine by comparing the benefits, risks and side effects of each antidepressant.
  • Patient education: Delirium (Beyond the Basics)

    UpToDate - patient information
    Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use