Stigma towards people with mental illness in the Nordic countries – a scoping review

Abstract

Introduction

Stigma affects people with mental illness globally, however, it is proposed that stigma is less prevalent in wealthier countries and that people hold more positive attitudes in Northern and Western Europe. Even so, accounts from surveys in Denmark and Sweden reveal that stigma is very much prevalent.

Aim

This scoping review aims to shed light on the body of literature regarding mental-health-related stigma in the Nordic Countries and identify knowledge gaps.

Methods

We searched four electronic databases in December 2017 and again in June 2020. All types of empirical studies (qualitative, quantitative, and mix-methods) examining the stigma of people with mental illness were included.

Results

In total, 61 studies were included. Overall, findings from the Nordic countries resemble global findings. Studies are primarily descriptive, and mostly survey studies of attitudes toward people with mental illness in the general population. Few studies focus on discrimination, and those who do, measure intended behavior in hypothetical situations rather than actual acts of discrimination in real-life situations. Studies were mostly conducted on a community or organizational level; no studies were identified on a system level. Experienced stigma and discrimination by patients, but also relatives, were a focus in one-third of the studies. Very few studies of interventions to reduce stigma and discrimination were identified.

Conclusion

More studies into stigma on a system or institutional level are needed. Ways to measure acts of discrimination should be invented. Furthermore, interventions to reduce stigma and discrimination should be developed, targeting all levels of society.

Keywords:

• Stigma
• discrimination
• mental illness
• Nordic countries

Acknowledgments

The authors thank librarian Charlotte Traberg-Andersen from the Institute of Human Rights (Denmark) for support in the development of the search strategy and assistance in mapping the literature; senior researcher Anette Faye Jacobsen, and senior researcher Hans-Otto Sano also from the Institute of Human Rights (Denmark) for valuable guidance in the planning of the review. Furthermore, the authors thank Marie Berg and Chalotte Heinsvig Poulsen for their valuable assistance in the selection of studies.

Disclosure statement

The authors declare that they have no conflicts of interest. The Institute of Human Rights (Denmark) and the research department CORE: Copenhagen Research Center for Mental health have covered the costs of this review.

Additional information

Notes on contributors

Lone Hellström

Lene Falgaard Eplov, MD, Ph.D. is Head of the research program for Recovery and Inclusion at the Copenhagen Research Center for Mental Health - CORE unit. LFE has many years of experience in being the prinicpal investigator of large research projects and in conducting systematic reviews.

Katrine Gren Voldby

Katrine Gren Voldby, MSc in Anthropology, is research assistant in CORE. KGV has a special interest and expertice within the field of stigma and mental illness. KGV has conducted a systematic scoping review on structural discrimination of people with mental illness.

Lene Falgaard Eplov

Lone Hellström, MSc in Health Science, Ph.D., is senior researcher in CORE and has solid experience in conducting systematic reviews.

Both LFE and LH co-authored the above mentioned review by KGV.