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DuPont-Reyes MJ, Villatoro AP, Tang L. Mechanisms of mental illness anti-stigma messaging matter: Leveraging mental health communication inequities among Latinx populations to understand what works and what we can do better. Soc Sci Med 2024; 349:116865. [PMID: 38643699 DOI: 10.1016/j.socscimed.2024.116865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Since 1950, public communication about the neurobiological-psychosocial basis of mental illness from the diathesis-stress model has promoted reception to treatment yet violent/dangerous stereotypes have increased during this period. Moreover, public mental health communication efforts have predominantly diffused in English-language media, excluding Spanish/Latinx media and its consumers from these efforts. To inform future mental health communication strategies, this study leverages high versus low diffusion of public mental health communication across English and Spanish/Latinx media to examine public mental health communication effects on stigma and treatment beliefs via neurobiological-psychosocial beliefs. METHODS A quota sample of 2058 U.S.-based Latinx residents ages 13-86 with diverse language/cultural media preferences was recruited to self-complete a survey about mental health information acquisition in 2021. Assessments ascertained frequency of Spanish/Latinx and English media use and mental health content scanning and seeking (α = 0.86-0.94); and items from the General Social Survey about mental illness neurobiological-psychosocial causal beliefs (α = 0.72)-genetics, brain chemistry, environment, stress; treatment beliefs-mental illness improves with treatment or on its own; and stigma beliefs-violent/dangerous and bad character stereotypes and unwillingness to socialize with a person with mental illness. Structural equation models estimated total, direct, and indirect effects of Spanish/Latinx and English media exposures on treatment and stigma beliefs via neurobiological-psychosocial beliefs, net individual/family factors. RESULTS Spanish/Latinx media reduced, while English media increased, neurobiological-psychosocial beliefs (p < 0.01). Neurobiological-psychosocial beliefs, in turn, increased treatment and stigma beliefs (p < 0.01), simultaneously. Indirect pathways were also significant (p < 0.05). Proportion mediated on treatment beliefs was one-third for Spanish/Latinx and two-thirds for English media. Proportion mediated on stigma beliefs for all media exposures averaged ≥1. CONCLUSIONS While consumers of Spanish/Latinx media report lower neurobiological-psychosocial knowledge that impedes treatment beliefs, consumers of English media report greater neurobiological-psychosocial and treatment knowledge and, consequently, more stigma. Innovation in public mental health communication is needed to counter stigma and health inequity.
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Affiliation(s)
- Melissa J DuPont-Reyes
- Departments of Sociomedical Sciences and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
| | - Alice P Villatoro
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | - Lu Tang
- Department of Communication and Journalism, Texas A&M University, College Station, TX, United States
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Carrasco JP, Saucier AM, Whitley R. Spanish media coverage of youth mental health issues during the COVID-19 pandemic. BMC Psychiatry 2023; 23:579. [PMID: 37563600 PMCID: PMC10413772 DOI: 10.1186/s12888-023-05054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND The media portrayal of mental health is relevant in shaping the population's attitudes towards mental disorders. However, there is little information about the representation of young mental health issues in the Spanish-language press, especially in the context of the COVID-19 pandemic. The general objective of this study was to analyse the tone and content of Spanish newspaper articles about mental disorders in youth during the COVID-19 pandemic. METHODS We collected media articles from the 10 most read news sources over a 6 month period (January-June 2021). These articles were coded for content using a standardised codebook, followed by an inductive thematic analysis. A total of 205 news items were evaluated. RESULTS Results showed that the majority of the news items had an overall positive tone (68.3%), only 5.4% were stigmatising and only 7.3% were related to violence. However, few articles offered help seeking information (6%), adolescents were rarely quoted (14%) and children were never quoted. Substantial differences are described in terms of age, gender and disorder. The thematic analysis led to three emergent themes: (i) violence and victimisation; (ii) the COVID-19 pandemic; and (iii) technology and social media. CONCLUSIONS The percentage of news in the Spanish media that refer to young people's mental health in a stigmatising way or in a way associated with violence is very low. Furthermore, the COVID-19 pandemic may have promoted more positive discussion about youth mental health. However, major challenges remain to be addressed, as patients are seldom quoted, very few articles offer help-seeking information, and a narrative of victimisation without appropriate discussion of resilience regularly occurs.
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Affiliation(s)
- Juan Pablo Carrasco
- Deparment of Psychiatry, Hospital Clínico Universitario de Valencia, 46010, Valencia, Spain.
- Instituto de Investigación Sanitaria del Hospital Clínico de Valencia (INCLIVA), Valencia, Spain.
| | | | - Rob Whitley
- Douglas Mental Health University Institute, Verdun, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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DuPont-Reyes MJ, Villatoro AP, Datzman J, Phelan JC, Painter K, Barkin K, Link BG. Inequities Gone or Enduring? Evaluating the Effects of a School-Based Antistigma Intervention on Race/Ethnic and Gender Intersectional Disparities in Mental Illness Stigma. STIGMA AND HEALTH 2023; 8:381-392. [PMID: 37636031 PMCID: PMC10454522 DOI: 10.1037/sah0000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
While significant mental illness stigma disparities across race/ethnicity and gender exist, little is known about the efficacy of anti-stigma interventions in reducing these intersectional disparities. We examine the two-year effects of school-based anti-stigma interventions on race/ethnic and gender intersectional stigma disparities among adolescents. An ethnically and socioeconomically diverse sixth grade sample (N = 302) self-completed surveys assessing stigma before randomly receiving an anti-stigma curriculum and/or contact intervention versus no intervention. Surveys were also self-completed two-years post-intervention. Stigma measures assessed general mental illness knowledge/attitudes, awareness/action, and social distance. Stigma towards peers with specific mental illnesses were examined using vignettes-two adolescent characters were described as having bipolar (Julia) and social anxiety (David) disorder. Race/ethnicity and gender were cross-classified into six intersectional groups (Latina/o, Non-Latina/o Black, and Non-Latina/o White girls and boys). Linear regressions adjusting for poverty and mental illness familiarity examined anti-stigma intervention effects across intersectional groups in sixth and eighth grade. The school-based anti-stigma intervention reduced intersectional stigma disparities over the two-year study period. While Non-Latino Black boys and Latino boys/girls reported greater disparities in stigma at baseline compared to Non-Latina White girls, these disparities (14 total) were predominantly eliminated in the two-year follow-up following receipt of the curriculum and contact components to just one remaining disparity post-intervention among Non-Latino Black boys. By identifying differences in how school-based anti-stigma interventions reduce mental illness stigma for unique race/ethnic and gender intersectional groups, we can better understand how to shape future anti-stigma interventions for diverse intersectional populations.
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Affiliation(s)
- Melissa J. DuPont-Reyes
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
- Department of Epidemiology, Columbia University Mailman School of Public Health
| | | | - Jared Datzman
- Department of Epidemiology and Biostatistics, Texas A&M University
| | - Jo C. Phelan
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
| | - Kris Painter
- School of Social Work, The University of Texas in Arlington
| | | | - Bruce G. Link
- School of Public Policy, University of California, Riverside
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Buitron V, Jiménez-Colón G, Duarté-Vélez Y. Mental health services use and social support among Latinx families with adolescents who engage in suicidal behavior. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 8:194-205. [PMID: 37383484 PMCID: PMC10299760 DOI: 10.1080/23794925.2023.2183433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Latinx communities experience a significant child mental health disparity. Research is needed to examine mental health services use and social support in Latinx adolescents, with particular attention to acculturative factors and youth who have high levels of clinical severity. The current study examined whether acculturation and enculturation, and related proxies, are associated with prior history of services use and social support in Latinx families with adolescents who had a recent suicidal crisis. Participants were 110 youths, recently admitted to psychiatric hospitalization, ages 12 to 17 years and their caregivers. Results indicated that approximately 20% of the overall sample did not access any formal mental health services (e.g., outpatient mental health care, primary care support, school staff support) before high acuity hospital care. First generation status and higher caregiver enculturation were associated with a lower likelihood of formal mental health services use, even when controlling for clinical covariates. Adolescent preference for Spanish was associated with lower social support. Findings suggest that families with higher enculturation and first-generation immigrant families (both caregivers and youth born outside of the U.S.), in the context of severe clinical impairment, experience systemic and sociocultural barriers conducive to limited engagement with mental health support. Implications for improving the accessibility of mental health supports are reviewed.
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Affiliation(s)
| | - Gisela Jiménez-Colón
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital and Brown University, Coro West Suite 1.300, Box #36, 25 Hoppin St., Providence, RI 02903
| | - Yovanska Duarté-Vélez
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital and Brown University, Coro West Suite 1.300, Box #36, 25 Hoppin St., Providence, RI 02903
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DuPont-Reyes MJ, Hernandez-Munoz JJ, Tang L. TV Advertising, Corporate Power, and Latino Health Disparities. Am J Prev Med 2022; 63:496-504. [PMID: 35680481 DOI: 10.1016/j.amepre.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/08/2022] [Accepted: 04/14/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study identifies mental health, tobacco prevention, alcohol/beer, food/beverage, pharmaceutical, and other health-related advertisements across Spanish- and English-language TV networks owned by the same parent media company in the U.S. as commercial determinants of health disparities for Latino populations and/or viewers of Spanish-language TV. METHODS A 3-week composite sample of Telemundo and National Broadcasting Company prime-time TV owned by the same parent media company was randomly drawn from March 31, 2021 to June 12, 2021 in Houston, Texas. A total of 1,593 health-related advertisements were yielded for systematic content analysis. Analyses included intercoder reliability, descriptive and bivariate analysis, and rate ratio and rate difference calculations. RESULTS Telemundo had significantly more health-adverse and fewer health-beneficial advertisements than National Broadcasting Company. Telemundo broadcasted about 11 more alcohol (95% CI=9.1, 12.5) and 5 more unhealthy/noncore food/beverages (95% CI=2.0, 7.2) advertisements per hour of TV advertisement programming than the National Broadcasting Company. Telemundo also broadcasted about 1 fewer mental health/tobacco prevention (95% CI= -0.9, -0.2), 3 fewer healthy/core food/beverages (95% CI= -1.5, -4.3), and 4 fewer pharmaceutical (95% CI= -2.4, -5.7) advertisements per hour of advertisement programming than the National Broadcasting Company. CONCLUSIONS Overall greater health-adverse and fewer health-beneficial advertisements are broadcasted on Spanish-language than on English-language TV. Unchecked corporate marketing strategies may serve as a commercial determinant of health disparities for Latino populations by Spanish-language TV.
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Affiliation(s)
- Melissa J DuPont-Reyes
- Department of Sociomedical Sciences (SMS), Mailman School of Public Health, Columbia University, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
| | - Jose J Hernandez-Munoz
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, College Station, Texas
| | - Lu Tang
- Department of Communication, College of Liberal Arts, Texas A&M University, College Station, Texas
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Abstract
Efforts that destigmatize mental health, especially media campaigns, have not fully penetrated Latinx and Spanish-language media and have not reached consumers. This lack of reach conceivably contributes to high stigma and low use of mental health care services among young, diverse, and growing Latinx populations. Latinx and Spanish-language media have been historically excluded from media-related research examining stigmatizing content and help-seeking resources. Moreover, Latinx populations are rarely included in antistigma efficacy trials. Such exclusion has plausibly restricted mental health service utilization for Latinx communities, thereby perpetuating mental health inequities. Addressing these inequities can help support effective future antistigma efforts that leverage Latinx and Spanish-language mass media to rapidly reach Latinx audiences and narrow treatment gaps.
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Affiliation(s)
- Melissa J DuPont-Reyes
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas. Roberto Lewis-Fernández, M.D., and Jessica Isom, M.D., M.P.H., are editors of this column
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Measurement Invariance of the Self-Stigma of Mental Illness Scale: A Cross-Cultural Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042344. [PMID: 35206530 PMCID: PMC8874424 DOI: 10.3390/ijerph19042344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/05/2022] [Accepted: 02/12/2022] [Indexed: 12/10/2022]
Abstract
The current study assessed the measurement invariance of the Self-stigma of Mental Illness scale (SSOMI) across Chinese and US samples and assessed whether the SSOMI differentially relates to distress levels across Chinese and US participants. We included 487 participants in China and 550 in the US (mean age was 19.52 in China and 19.29 in the US). The results indicated that partial measurement invariance of the SSOMI scale across China and the United States participants was established. Furthermore, we observed validity evidence for the SSOMI scale through its correlations with a well-established self-stigma measure and measures of depression, anxiety, and stress. Finally, we found that the SSOMI scale is more strongly linked to symptoms of depression, anxiety, and stress in China than it is in the United States, supporting previous research. These findings enable researchers to utilize the scale cross-culturally (i.e., with participants of Chinese and US origin), and to develop and implement interventions targeting mental illness stigma in both China and the United States.
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Rahbar MH, Dobrescu I, Gillani S, Hessabi M, Kim S, Stancu M, Rad F. Construct validity for the self-reported competency and sub-construct associated characteristics of Romanian physicians in autism spectrum disorder. BMC MEDICAL EDUCATION 2021; 21:588. [PMID: 34801018 PMCID: PMC8605522 DOI: 10.1186/s12909-021-02999-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lack of physicians' knowledge regarding mental health, including Autism Spectrum Disorder (ASD) could have adverse effects on affected individuals' health and quality of life. The purpose of this study was to provide construct validity for a modified questionnaire in order to determine the self-reported competency for underlying sub-constructs in ASD, make inferences on perceived competence in ASD based on a sample of Romanian physicians, and identify physicians' characteristics associated with these sub-domains of competency. METHODS For this survey, we modified a questionnaire that was used in Pakistan and Turkey, and administered it to a sample of 383 practicing physicians in Romania to assess their perceived competency regarding ASD. Exploratory factor analysis on 12 knowledge questions revealed five sub-domains: stigma, potential causes, children's behavior, misconceptions, and educational needs associated with ASD knowledge. Using General Linear Models, we determined physicians' characteristics that predict the total competency score and various competency sub-scores. RESULTS Seventy-five percent of the responding physicians were female and 30% had over 30 years practicing medicine. The majority (73-94%) of physicians have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians were more knowledgeable about potential causes of ASD than older physicians (Adjusted Mean Score (AMS): 2.90 vs. 2.18, P < 0.01), while older physicians knew more about the behavior of children with ASD (AMS: 0.64 vs. 0.37, P = 0.02). We found a significant interaction (P < 0.01) between television as source of ASD knowledge and city where the clinic is located in relation to knowledge of the physicians regarding stigma related to ASD. However, the total score was not associated with the variables associated with sub-domains. CONCLUSION Using factor analysis, we demonstrated construct validity of five sub-domains related to Romanian physicians' knowledge about ASD that include stigma, potential causes, behavior in ASD children, special education needs, and misconceptions related to ASD. The lack of significant association of the knowledge of physicians on ASD neither with the Psychiatry nor the Pediatric ward rotations at medical school may support the need for improving the curriculum on ASD in Romanian medical schools.
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Affiliation(s)
- Mohammad H. Rahbar
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030 USA
| | - Iuliana Dobrescu
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
| | - Shezeen Gillani
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030 USA
| | - Manouchehr Hessabi
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
| | - Sori Kim
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Department of Biostatistics & Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Mihaela Stancu
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
| | - Florina Rad
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
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