Table 4.
Characterizing mental-health-related public stigma: common conceptual gaps and perceptions among Indian youth
| Component of stigma | Themes and sub-themes | Frequency of the theme in study results (≤2 = Small (S), 3–5 = Medium, > 6 = High) | Number of studies reporting on the theme in results | Included in the discussion |
| Knowledge | Symptoms/ expected behaviour of a person with a mental illness | H | 8 [34, 42, 44, 45, 52, 54, 60, 62] | 2 [45, 52] |
| Low I.Q. | M | |||
| Difficult to identify | M | |||
| Likely to harm others/ violent | M | |||
| Unpredictable behaviour | S | |||
| Withdrawn/ passive | S | |||
| Unable to manage emotions | S | |||
| Life satisfaction | S | |||
| Speak differently | S | |||
| Differences in sleeping, eating and memory | S | |||
| Multiple personalities associated with depression | S | |||
| Treatment and recovery | H | 7 [34, 36, 37, 44, 45, 54, 57] | 4 [34, 36, 44, 57] | |
| Unlikely to be cured (recurrent, lifelong) | M | |||
| Marriage as a social intervention | M | |||
| Treatment by a spiritual healer | S | |||
| Heavy/ multiple medication/ hospitalisation needed | S | |||
| Causes of mental illness | H | 3 [34, 44, 57] | 5 [34, 42, 44, 57, 62] | |
| Genetic/ hereditary/ birth defect | M | |||
| Evil spirits and bad deeds | M | |||
| Brain damage | S | |||
| Stress | S | |||
| Social environment | S | |||
| Infectious transmission | S | |||
| Physical/ sexual abuse | S | |||
| Non-vegetarian diet | S | |||
| Alcohol and its effects | M | 4 [40, 49, 55, 56] | 3 [40, 49, 55] | |
| Associated with temporary harm | M | |||
| Locations to access | S | |||
| Prevalence of youth substance use | S | |||
| Treatment/ cessation services | S | |||
| Associated with suicide | S | |||
| Can happen to anyone | S | 2 [54, 60] | – | |
| Mental illness can happen to anyone | S | |||
| Suicide happens to few people | S | |||
| Suicide occurs more among women | S | |||
| Attitude | Cannot shoulder responsibility or take life decisions | H | 6 [34, 45, 50, 52, 57, 60] | 7 [34, 42, 45, 50, 52, 57, 60] |
| Should not marry or should be married | ||||
| Unlikely to be good parents | S | |||
| Unable/ incapable of having a job | S | |||
| Cannot take decisions in their own treatment | S | |||
| Voting | S | |||
| Poor interpersonal or social skills | – | |||
| Dangerous | M | 4 [44, 45, 52, 60] | 4 [41, 42, 45, 52] | |
| Likely to be violent | M | |||
| Likely to commit crimes (need punishment to prevent future attacks) | S | |||
| Intolerant of suicidal ideation | S | |||
| Avoid people with mental illness | M | 3 [42, 44, 60] | 1 [42] | |
| Desired physical separation (should be treated in different hospitals from people with physical illness, kept locked, in special schools) | M | |||
| Negative emotions | H | 8 [34, 41, 42, 44, 45, 48, 57, 60, 61] | 5 [34, 41, 42, 45, 52] | |
| Shame and blame (cowardly, inferior, lacking will power, should not | H | |||
| disclose illness, deliberately acting so) | ||||
| Fear | S | |||
| Pity/ sadness | S | |||
| Low status of psychiatry/ psychiatrists | S | |||
| Attention-seeking | S | |||
| Substance use | M | 3 [46, 49, 55] | 2 [49, 55] | |
| People who use are ‘bad’ | S | |||
| Improves sexual activity | S | |||
| Proximity to users increases risk of substance use | S | |||
| Alcohol as a status symbol/ celebratory product | – | |||
| Use is common in social scenarios | – | |||
| Behaviour | Treatment | M | 2 [44, 57] | 2 [44, 57] |
| Not taking a person with an epileptic seizure to the hospital, throwing | S | |||
| water on them or making them smell a shoe | ||||
| Treatment should be separate from physical problems or confinement | S | |||
| Personal interactions | S | 2 [34, 60] | 2 [34, 42] | |
| Not maintaining friendships | S | |||
| Laughing at persons with mental illness | S | |||
| Help-seeking for self | S | 1 [41] | 2 [52, 60] | |
| Commit suicide if diagnosed with a mental illness | S | |||
| Not disclose own mental illness | S |