Psychosocial outcomes of mental illness stigma in children and adolescents: a mixed-methods systematic review

Background: Mental illness stigma has serious psychological and social consequences for adults, and remains a significant barrier to help-seeking. The aim of this review was to synthesise findings from qualitative and quantitative studies investigating the psychosocial effects of mental illness stigma in youth with mental health problems who access services. Methods: Four databases were searched resulting in 3353 abstracts with 27 studies included for synthesis. Participants ranged from 8 to 19 years old across studies. Synthesis was conducted by consolidating qualitative data to be re-analysed in a meta-thematic analysis with qualitative data being additionally tabulated into qualitative codes to facilitate a narrative synthesis. Results: The review identified various deleterious stigma-related outcomes amongst youth such as: accepting or rejecting labels, experiencing poorer mental health, feeling socially rejected or fearful of the need to ‘fit in’, not seeking help, shame, and remaining secretive of their difficulties/medication use. Perceptions of mental illness were also influenced negatively by family and healthcare professionals. Finally, youth limited their interactions with young people experiencing mental health problems, enhancing their perceived sense of acceptance amongst social groups. Conclusions: Young people experience detrimental stigma-related outcomes which are linked to their need to preserve social identity and social capital. The need for models of mental illness stigma which are developmentally appropriate is essential for the effective development of effective intervention strategies.