Research Paper on Mental Disorders and Illnesses

Abstract

Mental disorders and illnesses are serious problems as they make their patients undergo stigma and discrimination. Several governments have adopted different ways of fighting discrimination and stigmatization against those suffering from mental illness. This paper conducted a meta-analysis of the existing literature concerning the effectiveness of public awareness education on reducing stigma and discrimination of young adults living with mental illness. The initial step was to conduct the literature review of the several studies conducted in the past. Search engines were utilized in obtaining the articles to be utilized. Mainly PubMed, PsycINFO, Cochrane library and the APA were the search engines used in obtaining the articles.

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The paper utilized the Centre for Reviews and Dissemination's guidelines in determining the articles to be utilized. The search engines resulted in 320 peer-reviewed articles and journals, which were further narrowed down to seventy eligible articles. The seventy articles were then narrowed down to four final articles, which were chosen based on the CASP technique for inclusion in the study.

The results from the four articles proved that education and contact were the main intervention methods against stigma and discrimination. This article, therefore, concluded that education alone is not effective in the fight against stigma and discrimination in the UK and therefore should be incorporated by other interventions such as contact and social marketing.

Introduction

By 1990, five of the top ten leading causes of disability globally were as a result of mental illnesses, which accounted to a near quarter of the total years a person lives with a disability (Murray & Lopez, 1996). By 2010, the disability levels arising due to mental illnesses globally had increased from the 1990s 5.4 percent to 7.4 percent (Whiteford et al. 2014). The term "stigma' in psychiatry, can be defined as the negative attitudes, thoughts, beliefs, and behaviors that people have towards those suffering from mental illness, thereby making them develop fear, rejection, and marginalization of those diagnosed of mental disorders (Baldwin & Marcus, 2006). In this case, the quality of life of the people who suffer from mental disorder does not depend only on the severity of the disease, but also on the stigma and discrimination that they are exposed to. Consequently, several governments have developed different programs to create awareness among their citizens in an effort of fighting stigma against those suffering from mental diseases. This study will, therefore, carry out a critical review of the existing literature on the effectiveness of public awareness education in the reduction of stigma in young adults living with the mental illness in the UK.

Literature Review

In several countries, especially in the middle and low-income countries, mental health research is faced with minimum to zero funding programs (Stuart, 2016). As such, these countries have the lowest level of stigma reduction programs that are exposed to independent evaluations and reviews (Stuart 2016). In this case, it becomes difficult to ascertain the success of stigma-reduction programs in such countries. Several types of research have been conducted in developed countries, with the majority of the research showing that ill-conceived anti-stigma programming tends to have more detrimental impacts on society (Arboleda-Florez & Stuart 2012). For instance, several anti-stigma campaigns that have been popularly conducted in the high-income countries have borne negative results as it has made people to adopt the mental illness as a "disease like any other" instead of letting them understand the extent of its detrimental effects and the urgent need of addressing it. Consequently, the neurobiological messages have failed to reduce stigma and instead have, in other instances, made stigma to be deeper as Pescosolido et al. (2010) pointed out in their study. As a result, their study showed that good intention alone is not sufficient in reducing stigma against mental illness.

One of the main methods that have been utilized in fighting discrimination and stigma is the use of public awareness education. Stuart et al (2014) conducted a study, whereby they pointed out that several community-based awareness programs run in high-income countries like the UK and US are initiated with good intentions to fight stigma against mental illness, but due to their lack of sufficient evidence in supporting their activities, such programs tend to fail. Stuart et al (2014) further suggest that one of the main reason for the failed success of such programs is the difference in the culture of the knowledge between anti-stigma advocacy community and the research community. This difference stems in that the advocacy groups have little to no opportunity, they lack the funds, the time and the expertise required for in-depth participation, monitoring, reflection, and learning. As such, the advocacy groups do not commit to formal research. Consequently, the advocacy group tends to accept a broader range of evidence and, in turn, tend to share the evidence in more informal ways. On the contrary, scientific knowledge tends to be more formal and objective, in turn, becoming too lengthy and irrelevant to the advocacy groups. When these two sides come together, it becomes difficult to agree on the extent of compromise from each side in terms of the acceptance of evidence and the process of gathering evidence.

According to Overton and Medina (2008), stigma is a process, which begins from the recognition of the cues that a person is suffering from mental illness (disorders). The process then continues to the next step, which is the step that the stereotypes are activated. Once stereotypes have been activated, the next step is the prejudice step, which results from the cognitive and effective response to stereotypes. With the activation of the prejudice, stigma reaches its final stage, which is discrimination. Overton and medina (2008) found that stigma created several barriers to those who had a mental illness. Particularly, the researchers pointed out that stigma and discrimination were more prevalent when the victims were applying for jobs, looking for houses to rent, as well as trying to access mental health services. In the same way, Mellor (2014) conducted a systematic analysis of the existing literature review to determine the effectiveness of classroom-based interventions in tackling the stigma of mental illness in young people, as well as identifying the existing consistent elements within successful programs. Mellor's research showed that a small percentage of the studies reviewed resulted in a positive impact on stigma following the several interventions.

However, the methodologies of the several reviewed articles had methodological shortcomings, making it difficult for the researcher to reach a final conclusion on the best approach of creating a sustainable awareness campaign. In turn, the author concluded that it is important for the future anti-stigma interventions to be designed in a way that the methodology is associated with significant evidence as proof for their effectiveness, with the audience and the settings for such programs being the most appropriate.

Casale et al, (2013) also carried research with the aim of evaluating the efficiency of an educational project which was carried out among teenagers who attend high school. The project's main aim was to increase the mental health knowledge and to go against the negative stereotypes of those suffering from mental illness. The results of the research by Casale et al showed that student's recorded a significant reduction in the stigma levels against those suffering from a mental disorder after getting educated on the subject. In this case, the researchers concluded that several people in the community tend to stigmatize those suffering from mental disorders due to lack of sufficient knowledge on the matter. However, conducting training and imparting knowledge in the society is an important factor which would result in the people changing their attitudes towards those suffering from mental illness. In the same way, Henderson, Corker, Lewis-Holmes, Hamilton et al (2012) carried out an evaluation of the progress at one year of the UK's time to change (TTC) program. The results showed that the program had, with a year, made positive steps towards meeting its intended goals of reducing the stigma by 5%.

The rate of discrimination and stigma faced by several individuals have made several individuals to choose not to seek medical healthcare services (Mann & Himelein 2008). In this case, Rusch et al., (2011) conducted a study to determine the effect of more knowledge and more positive attitude towards mental illness on the rate of seeking help from medical officers. Their research showed that the initiatives put in place to fight stigma, especially through public awareness education tend to make the general public to change their attitude towards mental illness. In turn, the authors concluded that public awareness campaigns are more significant in fights against discrimination and stigma against those living with mental illness, in turn making it more effective as it reaches a wider majority of the audience.

It should be noted that the caregivers for mentally challenged individuals include the relatives who play important roles in ensuring that those affected by the disorders get through the healing process (Sadow & Ryder 2008). In this case, Harvey et al, (2002) conducted research to determine the effect of intensive case management on the relatives of patients with severe mental illness. The authors argued that even though these relatives are critical for the recovery of patients, they tend to get limited knowledge concerning how to effectively handle such patients. In turn, the authors suggest that the most appropriate ways of ensuring that the general public help in reducing the level of discrimination and stigma faced by those suffering from mental health would be to increase the level of knowledge that relatives have towards handling such cases. In this case, the authors challenge medical staff to develop initiatives that will ensure the support given to relatives of those suffering from mental illness in terms of knowledge and public awareness is improved.

The UK's anti-stigma campaign known as the Time to Change is an initiative aimed at improving the amount of knowledge that the public has concerning the mental illness and the attitude that the public adopts towards those suffering from the disorder. In this case, several pieces of research from the literature review have addressed the importance of public awareness towards fighting discrimination, the need to avoid stigma and the need to encourage those suffering from such illnesses to gain the courage of facing stigma and open up about their conditions. However, there is still a gap in the effectiveness of the public awareness campaign's success in fighting stigma. In this case, the main review question in this paper is "how effective is the public awareness education in fighting stigma and discrimination among young adults living with mental illness in the UK?"

Methodology

The search methodology was guided by the Centre for Reviews and Dissemination's guidelines for systematic reviews in health care which helped in conducting the meta-analysis of the studies. The scholarly articles were searched with the help of search engines. In this case, the search engines utilized wer...