Affiliations 

  • 1 Pakistan Psychiatric Research Centre, Lahore, Pakistan; World Psychiatric Association (WPA), UK. Electronic address: afzalj@gmail.com
  • 2 Institute of Mental Health, Singapore
  • 3 Malaysian Psychiatric Association (MPA), Kuala Lumpur, Malaysia
  • 4 Department of Neurosciences, Manila Theological College - College of Medicine, Manila, Philippines
  • 5 Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
  • 6 Department of Psychiatry, Santo Amaro University, São Paulo, Brazil
  • 7 Asociación Psiquiátrica Mexicana, Mexico; University of California, San Diego, CA, USA
  • 8 NeuroPsychiatry Department, Ain Shams University, Cairo, Egypt; Egyptian Psychiatric Association (EPA), Cairo, Egypt; Egyptian Association of Cognitive Behavioral Therapy (EACBT), Cairo, Egypt
  • 9 Clinic Brain Neuropsychiatric Institute and Research Center, Kolkata, India; Indian Psychiatric Society, Kolkata, India
  • 10 Medical Affairs, Viatris, Dubai, UAE
  • 11 Research, Development & Medical, Upjohn - A Pfizer Division, Buenos Aires, Argentina
  • 12 Medical Affairs, Viatris, Singapore
  • 13 Department of Psychiatry, Sidra Medicine, Weill Cornell Medical College, Doha, Qatar
Asian J Psychiatr, 2021 Apr;58:102601.
PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601

Abstract

Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.