Is there room for anti-stigma interventions in mental health preventive programmes?

Literature has provided evidence of effectiveness for a wide range of preventive interventions for mental disorders. However, these interventions are insufficiently implemented in routine public health or mental health service programmes. Among possible factors, stigma and discrimination associated with mental disorders do act as barriers. Stigma can express itself as public stigma (when members of the general public endorse prejudice and discrimination against people with mental disorders), self-stigma (when people with mental disorders agree with and internalise prejudice and negative stereotypes) and structural stigma (which refers to rules and regulations in society that intentionally or unintentionally disadvantage people with mental disorders). This chapter will discussed how these three forms of stigma may impair the three different types of preventive interventions - universal, selective and indicated - as outlined by the Institute of Medicine. Literature discussed here provide good evidence that the reducing of stigma associated with mental disorders represents a critical step for the successful implementation of prevention programmes both in public health and clinical settings. Stigma reduction initiatives should be therefore urgently undertaken at multiple levels and sustained over time.