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Withdrawn/ passive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