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Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences

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  • Claire Henderson

    (Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK)

  • Petra C. Gronholm

    (Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
    Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK)

Abstract

Recent reviews on the evidence base for mental health related stigma reduction show that under certain conditions interpersonal contact is effective in promoting more positive attitudes, reduced desire for social distance, and increased stigma related knowledge (knowledge which disconfirms beliefs based on stereotypes). Short-term interventions may have effects that are attenuated over time; longer term programmes may support sustained improvements, but research following up long-term interventions is scarce. However, the effectiveness of these interventions should not obscure the nature of stigma as a social problem. In this article we describe stigma as a ‘wicked problem’ to highlight some implications for intervening against stigma and evaluating these efforts. These include the risks of unintended consequences and the need to continually reformulate the concept of stigma, to ensure that tackling stigma at the structural, interpersonal, and intrapersonal levels become part of the core business of stakeholder organisations. We compare the main targets of anti-stigma programmes with what is known about the sources of stigma and discrimination and their impacts to identify targets for future intervention. In some cases, interventions have been directed at the interpersonal level when structural level intervention is also needed; in others, systematic reviews have not so far identified any interventions.

Suggested Citation

  • Claire Henderson & Petra C. Gronholm, 2018. "Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences," IJERPH, MDPI, vol. 15(6), pages 1-13, June.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:6:p:1158-:d:150275
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    References listed on IDEAS

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    1. Evans-Lacko, Sara & Knapp, Martin & McCrone, Paul & Thornicroft, Graham & Mojtabai, Ramin, 2013. "The mental health consequences of the recession: economic hardship and employment of people with mental health problems in 27 European countries," LSE Research Online Documents on Economics 51632, London School of Economics and Political Science, LSE Library.
    2. Cook, Jonathan E. & Purdie-Vaughns, Valerie & Meyer, Ilan H. & Busch, Justin T.A., 2014. "Intervening within and across levels: A multilevel approach to stigma and public health," Social Science & Medicine, Elsevier, vol. 103(C), pages 101-109.
    3. Melissa Pyle & Stephen Pilling & Karen Machin & Ginny Allende-Cullen & Anthony P. Morrison, 2018. "Peer support for internalised stigma experienced by people with psychosis: rationale and recommendations," Psychosis, Taylor & Francis Journals, vol. 10(2), pages 146-152, April.
    4. Sara Evans-Lacko & Martin Knapp & Paul McCrone & Graham Thornicroft & Ramin Mojtabai, 2013. "The Mental Health Consequences of the Recession: Economic Hardship and Employment of People with Mental Health Problems in 27 European Countries," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-7, July.
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    Cited by:

    1. Daniel Walsh & Juliet Foster, 2020. "A Contagious Other? Exploring the Public’s Appraisals of Contact with ‘Mental Illness’," IJERPH, MDPI, vol. 17(6), pages 1-18, March.

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