Professional Psychology Programs in Education, Krongold Clinic, Faculty of Education, Monash University, Melbourne, Victoria, Australia.
Centre for Critical Qualitative Health Research, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Int J Ment Health Nurs. 2021 Feb;30(1):6-26. doi: 10.1111/inm.12820. Epub 2020 Dec 6.
Stigma is a pervasive social mechanism with negative ramifications for people who experience mental illness. Less is known about the stigma experiences of families where a parent has a mental illness. This review aims to identify and synthesize evidence on the concept of stigma and stigma-related experiences and outcomes reported by parents and children living with parental mental illness. An integrative review method was employed, with PRISMA (Preferred Reporting Items of Systematic Review and Meta-Analyses) guidelines to search and select literature and extract and analyse data. This approach allows for inclusion of theoretical and empirical literature and for concept definition. Fifty-eight papers, mostly from the USA, Australia, and the UK, met the inclusion criteria. Stigma was primarily conceptualized in families as a marked difference that was negatively appraised, and which could be internalized. Some articles examined how underpinning assumptions could shape the behaviour of individuals and groups and be embedded within social institutions and structures. For parents, mental illness stigma was interconnected with stigma relating to perceived violations of social and cultural norms related to parenting. Children's experience of stigma resulted in bullying, embarrassment, guilt and social isolation, and efforts to conceal their parent's mental illness. One outcome was that stigma prevented children and parents from seeking much needed supports. Public health policies and campaigns that focus exclusively on promoting open disclosure of mental illness to foster community education outcomes are unlikely to be effective without additional strategies aimed at preventing and redressing the structural impacts of stigma for all family members.
污名是一种普遍存在的社会机制，会对经历精神疾病的人产生负面影响。对于父母一方患有精神疾病的家庭的污名经历，人们了解较少。本综述旨在确定并综合报告父母和子女共同生活在父母患有精神疾病的家庭中所经历的污名和与污名相关的体验和结果的证据。采用综合审查方法，遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行文献检索和选择，并提取和分析数据。这种方法允许包括理论和实证文献，并对概念进行定义。符合纳入标准的有 58 篇论文，主要来自美国、澳大利亚和英国。污名在家庭中主要被概念化为一种被负面评价的显著差异，并且可能被内化。一些文章研究了潜在假设如何塑造个人和群体的行为，并嵌入社会制度和结构中。对于父母来说，精神疾病污名与与育儿相关的社会和文化规范感知违反有关的污名相互关联。儿童经历污名会导致欺凌、尴尬、内疚和社会孤立，并努力隐瞒他们父母的精神疾病。一个结果是污名将儿童和父母拒之门外，无法获得他们迫切需要的支持。如果没有额外的策略来防止和纠正所有家庭成员的污名的结构性影响，仅专注于促进公开披露精神疾病以促进社区教育成果的公共卫生政策和运动不太可能有效。
