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      A Call to Action. A Critical Review of Mental Health Related Anti-stigma Campaigns

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          Abstract

          Using a knowledge-attitudes-behavior practice (KABP) paradigm, professionals have focused on educating the public in biomedical explanations of mental illness. Especially in high-income countries, it is now common for education-based campaigns to also include some form of social contact and to be tailored to key groups. However, and despite over 20 years of high-profile national campaigns (e.g., Time to Change in England; Beyond Blue in Australia), examinations suggest that the public continue to Other those with experiences of mental ill-health. Furthermore, evaluations of anti-stigma programs are found to have weak- to no significant long-term effects, and serious concerns have been raised over their possible unintended consequences. Accordingly, this article critically re-engages with the literature. We evidence that there have been systematic issues in problem conceptualization. Namely, the KABP paradigm does not respond to the multiple forms of knowledge embodied in every life, often outside conscious awareness. Furthermore, we highlight how a singular focus on addressing the public's perceived deficits in professionalized forms of knowledge has sustained public practices which divide between “us” and “them.” In addition, we show that practitioners have not fully appreciated the social processes which Other individuals with experiences of mental illness, nor how these processes motivate the public to maintain distance from those perceived to embody this devalued form of social identity. Lastly, we suggest methodological tools which would allow public health professionals to fully explore these identity-related social processes. Whilst some readers may be frustrated by the lack of clear solutions provided in this paper, given the serious unintended consequences of anti-stigma campaigns, we caution against making simplified statements on how to correct public health campaigns. Instead, this review should be seen as a call to action. We hope that by fully exploring these processes, we can develop new interventions rooted in the ways the public make sense of mental health and illness.

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          Conceptualizing Stigma

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            An attributional analysis of reactions to stigmas.

            In two experiments, we examined the perceived controllability and stability of the causes of 10 stigmas. Guided by attribution theory, we also ascertained the affective reactions of pity and anger, helping judgments, and the efficacy of five intervention techniques. In the first study we found that physically based stigmas were perceived as onset-uncontrollable, and elicited pity, no anger, and judgments to help. On the other hand, mental-behavioral stigmas were perceived as onset-controllable, and elicited little pity, much anger, and judgments to neglect. In addition, physically based stigmas were perceived as stable, or irreversible, whereas mental-behavioral stigmas were generally considered unstable, or reversible. The perceived efficacy of disparate interventions was guided in part by beliefs about stigma stability. In the second study we manipulated perceptions of causal controllability. Attributional shifts resulted in changes in affective responses and behavioral judgments. However, attributional alteration was not equally possible for all the stigmas.
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              What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies

              Psychological Medicine, 45(1), 11-27
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                Author and article information

                Contributors
                URI : http://loop.frontiersin.org/people/929483/overview
                URI : http://loop.frontiersin.org/people/1096533/overview
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                08 January 2021
                2020
                : 8
                Affiliations
                King's College London , London, United Kingdom
                Author notes

                Edited by: Alexandre Andrade Loch, University of São Paulo, Brazil

                Reviewed by: Ziyan Xu, University of Ulm, Germany; Rasa Markšaitytė, Vytautas Magnus University, Lithuania; Joseph S. DeLuca, Icahn School of Medicine at Mount Sinai, United States

                *Correspondence: Daniel Alexander Benjamin Walsh daniel.walsh@ 123456kcl.ac.uk

                This article was submitted to Public Mental Health, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2020.569539
                7820374
                b7650ea5-dcd2-447b-a2d2-8cb37b10334a
                Copyright © 2021 Walsh and Foster.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 183, Pages: 15, Words: 14612
                Funding
                Funded by: King's College London 10.13039/501100000764
                Categories
                Public Health
                Review

                public health campaigns,implicit,emotion,mental illness,public health education and health promotion,contact theory,stigma,mental health

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