Mental health stigma and discrimination in Ethiopia: evidence synthesis to inform stigma reduction interventions

Authors

Eshetu Girma, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia. yaneteshetu@gmail.com.
Bezawit Ketema, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Tesfahun Mulatu, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Brandon A. Kohrt, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA.
Syed Shabab Wahid, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA.
Eva Heim, Department of Psychology, University of Zurich, Zurich, Switzerland.
Petra C. Gronholm, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Charlotte Hanlon, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Graham Thornicroft, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Document Type

Journal Article

Publication Date

6-23-2022

Journal

International journal of mental health systems

Volume

16

Issue

1

DOI

10.1186/s13033-022-00540-z

Keywords

Discrimination; Ethiopia; Mental health; Stigma

Abstract

BACKGROUND: People with mental illnesses are at an increased risk of experiencing human rights violations, stigma and discrimination. Even though mental health stigma and discrimination are universal, there appears to be a higher burden in low- and middle-income countries. Anti-stigma interventions need to be grounded in local evidence. The aim of this paper was to synthesize evidence on mental health stigma and discrimination in Ethiopia to inform the development of anti-stigma interventions. METHODS: This evidence synthesis was conducted as a part of formative work for the International Study of Discrimination and Stigma Outcomes (INDIGO) Partnership research program. Electronic searches were conducted using PubMed for scientific articles, and Google Search and Google Scholar were used for grey literature. Records fulfilling eligibility criteria were selected for the evidence synthesis. The findings were synthesized using a framework designed to capture features of mental health stigma to inform cultural adaptation of anti-stigma interventions. RESULTS: A total of 37 records (2 grey literature and 35 scientific articles) were included in the evidence synthesis. Some of these records were described more than once depending on themes of the synthesis. The records were synthesized under the themes of explanatory models of stigma (3 records on labels and 4 records on symptoms and causes), perceived and experienced forms of stigma (7 records on public stigma, 6 records on structural stigma, 2 records on courtesy stigma and 4 records on self-stigma), impact of stigma on help-seeking (6 records) and interventions to reduce stigma (12 records). Only two intervention studies assessed stigma reduction- one study showed reduced discrimination due to improved access to effective mental health care, whereas the other study did not find evidence on reduction of discrimination following a community-based rehabilitation intervention in combination with facility-based care. CONCLUSION: There is widespread stigma and discrimination in Ethiopia which has contributed to under-utilization of available mental health services in the country. This should be addressed with contextually designed and effective stigma reduction interventions that engage stakeholders (service users, service providers, community representatives and service developers and policy makers) so that the United Nations universal health coverage goal for mental health can be achieved in Ethiopia.

APA Citation

Girma, Eshetu; Ketema, Bezawit; Mulatu, Tesfahun; Kohrt, Brandon A.; Wahid, Syed Shabab; Heim, Eva; Gronholm, Petra C.; Hanlon, Charlotte; and Thornicroft, Graham, "Mental health stigma and discrimination in Ethiopia: evidence synthesis to inform stigma reduction interventions" (2022). GW Authored Works. Paper 1078.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1078

Department

Psychiatry and Behavioral Sciences