Mental health stigma is a process that involves stereotyping, prejudice, or discrimination against the people who are affected by mental illnesses, and it greatly hinders the youths from seeking help. This stigma affects every culture and impacts the lives of individuals and communities as well as personal, social, and economic problems. It is important to eliminate because there are lasting negative consequences when mental health problems are not treated.
Two interventional strategies that have been examined to reduce stigma include educational programs and social interactions with those with mental illnesses. Though educational interventions are most suited for school-going age kids social contact interventions are more effective for higher learning individuals.
The current systematic literature review and meta-analysis were conducted based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. This study was also preregistered on the International Prospective Register of Systematic Reviews (PROSPERO) to maintain the transparency of the study process.
The relevant studies were selected using CENTRAL, CINAHL, Embase, PubMed, and PsycINFO databases up to February 27, 2024. This study focuses on young people aged around 10-24 years (n = 43,852; 59.2% female, mean age = 18.7 years, college students = 46.4%). The meta-analysis used a 3-level multivariate approach that took into consideration outcome dependencies to increase efficiency. Publication bias and moderation tests were conducted through meta-regression and funnel plots.
A total of 97 studies were included in the review process and 74 studies for meta-analysis. Approximately 63.9% of randomized controlled trials (RCTs) were conducted with 30.9% of these taking place in the U.S. The interventions ranged from single (16.5%) to mixed (28.9%) among included studies.
Short-term interventions led to moderate improvements in knowledge (Standardized mean difference (SMD) = 0.66, 95% confidence interval (CI): 0.43-0.89) and smaller effects on attitude (SMD = 0.38, 95% CI: 0.20-0.56), behavior (SMD = 0.29, 95% CI: 0.13-0.45), and general stigma (SMD = 0.20, 95% CI: 0.06-0.34). Social contact interventions were more effective than educational ones with respect to behavior (β = 0.15, P = 0.045). The metanalysis between active and control interventions, showed short-term effects on help-seeking attitudes (SMD = 0.18, 95% CI: 0.09-0.28) and intentions (SMD = 0.14, 95% CI: 0.07-0.21) whereas significant long-term effects on help-seeking attitudes (SMD = 0.15, 95% CI: 0.04-0.27).
No further changes were observed in secondary outcomes, but promotional behavior remained significantly different in the long-term follow-up (OR = 1.43, 95% CI: 1.01–2.02). These meta-analysis interventions are useful to lessen mental health stigma in youth reported by improving stigma-related cognition and practices slightly with little sustainability. The results also showed that social contact type of interventions particularly those that include direct contact with severe mental illness are more effective than the educational type of interventions or the videos that are typically used.
This review also pointed out numerous drawbacks of the evidence, such as masking was not conducted adequately, and the outcome assessment was often subjective and may have contained measures of clinician bias. Over half of them failed to clarify the risks of allocation concealment by pointing toward selection biases. In conclusion, the review establishes the importance of future extended longitudinal research to improve mental health stigma for youths.
References: Crockett MA, Núñez D, MartĂnez P, et al. Interventions to reduce mental health stigma in young people: A systematic review and meta-analysis. JAMA Netw Open. 2025;8(1):e2454730. doi:10.1001/jamanetworkopen.2024.54730
