The study titled "Stigma toward mental illness in Latin America and the Caribbean: a systematic review" written by Franco Mascayano, Thamara Tapia, Sara Schilling, Rubén Alvarado, Eric Tapia, Walter Lips, Lawrence H. Yang provides an overview of how stigma has impacted mental health perception within Latin America and the Caribbean. Through their review of empirical articles from various databases like PubMed, MEDLINE, Bireme, and others, the authors were able to compose a review that highlighted many different aspects of how stigma plays an integral role in the discussion on mental health within Latin America and the Caribbean (LAC).
By Cassie Apuzzo
This article's goal was to focus on how stigma uniquely impacted mental health within Latin America and the Caribbean. By narrowing their focus to Latin American countries, the researchers are able to analyze how Latin America and the Caribbean's distinctive culture, impacted by their history, has been affected by stigma regarding mental health illness. Many studies have been done of the role of stigma in other regions, but because of the increase in mental health illness within Latin America, it is important to analyze what may contribute to this rise in mental health problems. The researchers were able to use 26 articles out of the 1,221 documents that they collected initially.
Forms of Stigma
The study identified four main forms of stigma that are prevalent within Latin American communities. Public stigma was a large influence on how mental illness is perceived within a community. The study noted that many people had negative attitudes towards people with mental illness (2016 Mascayano et al.). Studies found that stigma towards mental illness was apparent in a variety of forms, like negative attitudes towards healthcare professionals, and negative feelings towards those diagnosed with mental illness. Different forms of healthcare also had an impact on how mental health was perceived by the community. "In a qualitative study conducted in Jamaica, Hickling et al. identified that mental health consumers, family members, and community members had more positive attitudes toward mental illness when the community mental health services were integrated into the primary care network" (2016 Mascayano et al.).
"Regarding public stigma, the results of the Jamaican studies conducted by Hickling et al. and Gibson et al. indicated that, if mental health services are integrated into the primary care system, stigma in community members may decrease, while benevolence and compassion toward individuals with a mental illness could grow."
Consumer stigma was also apparent within Latin America and the Caribbean. People using mental health services reported stigma "as rejection, ignorance, and derogatory language, which led to low self-esteem, lack of autonomy and freedom, and feelings of social exclusion and “being different"" (2016 Mascayano et al.). Consumers of mental health services felt scared to disclose their use of mental health services for fear of being rejected or ostracized by their community.
Family stigma, both towards the family and from the family, impacted how mental illness was perceived within different communities. Families experience emotions of frustration and grief when confronted with mental illness upon learning of the diagnosis of their loved one. After diagnosis, family members were more likely to associate with mental healthcare consumers. Although families were more likely to associate with mental healthcare consumers, families often contributed to the stigma towards their loved one. "Family members’ agreement with the consumers’ ongoing hospitalization was a predictor of readmission. Readmitted persons were often classified as dangerous and unhealthy by their own families" (2016 Mascayano et al.).
Multiple stigmas were also noted in this study, with the main four being no stigma individuals, labelers, discriminators, and unobtrusive stigma individuals (2016 Mascayano et al.). Stigma towards mental health also intersected with other forms of discrimination, like on the basis of sex. " Many Latin American societies are traditional and influenced by the legacy of Colonialism and Christianity,which determined an active and authoritarian role for men (provider and protector of his family) and passive and secondary social roles for women, who must devote themselves to household chores and duties (i.e., cooking, cleaning), as reported by Wagner et al. Therefore, women may be more stigmatized if they lose their capacity to fulfill family roles, and men may hide their psychiatric diagnosis and refuse to attend mental health services to avoid losing status and the ability to work" (2016 Mascayano et al.). Both the history of Latin American colonialism and gender have played a role on how mental health is perceived within Latin America and the Caribbean.
It is clear through this analysis that stigma can present itself in a variety of forms. By reading this systematic review, the reader is able to analyze a broad overview of how stigma influences communities within Latin America and the Caribbean, where little research has been done. The study found "that stigma, in addition to having powerful forms that are shared across cultures, is expressed with important local differences that have meaning in particular Latin American contexts" (2016 Mascayano et al.). Overall, it is apparent through this systematic review that stigma has had a large impact on mental healthcare, mental health patients, and the medical policy system as a whole due to the fact that patients are scared to report and access services.
Written by Cassie Apuzzo
Relevant citations:
Mascayano, Franco, et al. “Stigma toward Mental Illness in Latin America and the Caribbean: a Systematic Review.” Brazilian Journal of Psychiatry, Associação Brasileira De Psiquiatria, Jan. 2016, www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462016000100073.