Current research evaluating the consequences of stigma towards people with mental illness is not nuanced in emphasizing the critical distinction between stigma as negative attitudes and discrimination as harmful behaviours that limit access to services, employment, and social inclusion. Understanding these distinctions is essential for designing targeted, evidence-based universal, targeted and indicated interventions to improve the quality of life and well-being. This review evaluates the evidence on the consequences of stigma towards people with mental illness. Using PRISMA guidelines, we analysed 448 studies (294 quantitative, 154 qualitative) investigating stigma's negative outcomes. Findings were categorized into health, service use, psychosocial, economic, and structural impacts. Although stigma is consistently associated with adverse outcomes across life domains, evidence of a causal link between negative attitudes and poorer outcomes for individuals with mental disorders remains limited. Furthermore, there is a striking scarcity of research from low- and middle-income countries, with significant regional gaps, and studies addressing structural stigma embedded in societal institutions are particularly rare. Efforts to combat stigma must distinguish between attitudes and behaviours, focusing on reducing discrimination while enhancing public mental health literacy and access to effective interventions. Tackling these challenges requires a comprehensive, evidence-informed approach to improving mental health outcomes for all.

Association for the Improvement of Mental Health Programmes 20 Chemin Colladon CH 1209 Geneva Switzerland

Department of Global Public Health Karolinska Institutet Stockholm Sweden

Department of Psychiatry 2 Ulm University and BKH Günzburg Lindenallee 2 89312 Günzburg Germany

Department of Psychiatry Psychosomatic Medicine and Psychotherapy University Hospital Goethe University Heinrich Hoffmann Straße 10 60528 Frankfurt am Main Germany

Department of Psychology Faculty of Arts Charles University Celetná 20 116 42 Prague Czech Republic

Department of Public Mental Health National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

Department Psychiatry A Razi Hospital La Manouba Rue Des Oranges 2010 Manouba Tunisia

European Alliance Against Depression Heinrich Hoffman Strasse 10 Frankfurt Germany

Faculty of Medicine of Tunis University of Tunis El Manar R534 F9H Rue de la Faculte de Medecine Tunis Tunisia

Institute of Psychiatry Psychology and Neuroscience King's College London United Kingdom

WHO Collaborating Center for Public Mental Health Research and Service Development National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

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Thornicroft G., Sunkel C., Aliev A.A., et al. The lancet commission on ending stigma and discrimination in mental health. Lancet. 2022;400(10361):1438–1480. PubMed

Lasalvia A., Zoppei S., Van Bortel T., et al. Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet. 2013;381(9860):55–62. PubMed

Rüsch N. Elsevier; Oxford UK: 2023. The stigma of mental illness: strategies against social exclusion and discrimination.

Corrigan P.W., Markowitz F.E., Watson A.C. Structural levels of mental illness stigma and discrimination. Schizophr Bull. 2004;30(3):481–491. PubMed

Hatzenbuehler M.L. Structural stigma: research evidence and implications for psychological science. Am Psychol. 2016;71(8):742. PubMed PMC

Link B.G., Phelan J.C. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–385.

Mehta N., Thornicroft G. In: Global mental health: principles and practice. Patel V., Minas H., Cohen A., Prince M.J., editors. Oxford University Press; 2014. Stigma, discrimination, and promoting human rights.

Corrigan P.W., Mittal D., Reaves C.M., et al. Mental health stigma and primary health care decisions. Psychiatry Res. 2014;218(1–2):35–38. PubMed PMC

Kamaradova D., Latalova K., Prasko J., et al. Connection between self-stigma, adherence to treatment, and discontinuation of medication. Patient Prefer Adherence. 2016;10:1289. PubMed PMC

Perlick D.A., Rosenheck R.A., Clarkin J.F., et al. Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatr Serv. 2001;52(12):1627–1632. PubMed

Fekadu A., Medhin G., Kebede D., et al. Excess mortality in severe mental illness: 10-Year population-based cohort study in rural Ethiopia. Br J Psychiatry. 2015;206(4):289–296. PubMed

Wahlbeck K., Westman J., Nordentoft M., Gissler M., Laursen T.M. Outcomes of nordic mental health systems: life expectancy of patients with mental disorders. Br J Psychiatry. 2011;199(6):453–458. PubMed

Walker E.R., McGee R.E., Druss B.G. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA. 2015;72(4):334–341. PubMed PMC

Livingston J.D., Boyd J.E. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150–2161. PubMed

Corrigan P.W., Watson A.C. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16–20. PubMed PMC

Corrigan P.W., Rafacz J., Rüsch N. Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Res. 2006;144(3):311–322. PubMed PMC

Ahmedani B.K. Mental health stigma: society, individuals, and the profession. J Soc Work Val Ethics. 2011;8(2):41–416. PubMed PMC

Goffman E. Simon & Schuster; 2009. Stigma: notes on the management of spoiled identity. [first published 1963]

Andersen M.M., Varga S., Folker A.P. On the definition of stigma. J Eval Clin Pract. 2022;28(5):847–853. PubMed PMC

Kurzban R., Leary M.R. Evolutionary origins of stigmatization: the functions of social exclusion. Psychol Bull. 2001;127(2):187. PubMed

Thornicroft G., Mehta N., Clement S., et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet. 2016;387(10023):1123–1132. PubMed

Peters M.D., Godfrey C.M., Khalil H., McInerney P., Parker D., Soares C.B. Guidance for conducting systematic scoping reviews. JBI Evid Implement. 2015;13(3):141–146. PubMed

World Health Organization . World Health Organization; 2015. The ICD-11 classification of mental and behavioural disorders: diagnostic criteria for research.

Corbin J., Strauss A. Sage Publications; 2014. Basics of qualitative research: techniques and procedures for developing grounded theory.

Streiner D.L. Finding our way: an introduction to path analysis. Can J Psychiatry. 2005;50(2):115–122. PubMed

Thomas J., Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8(1):45. PubMed PMC

Moher D., Liberati A., Tetzlaff J., Altman D.G., Group T.P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7) PubMed PMC

Hipes C., Lucas J., Phelan J.C., White R.C. The stigma of mental illness in the labor market. Soc Sci Res. 2016;56:16–25. PubMed

Ilic M., Reinecke J., Bohner G., et al. Belittled, avoided, ignored, denied: assessing forms and consequences of stigma experiences of people with mental illness. Basic Appl Soc Psych. 2013;35(1):31–40.

Rüsch N., Heekeren K., Theodoridou A., et al. Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis. Schizophr Res. 2015;166(1–3):43–48. PubMed

Xu Z., Müller M., Lay B., et al. Involuntary hospitalization, stigma stress and suicidality: a longitudinal study. Soc Psychiatry Psychiatr Epidemiol. 2018;53(3):309–312. PubMed

Boyd J.E., Bassett E.D., Hoff R. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months. Psychiatry Res. 2016;240:253–259. PubMed

Ritsher J.B., Phelan J.C. Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Res. 2004;129(3):257–265. PubMed

Pellet J., Golay P., Nguyen A., et al. The relationship between self-stigma and depression among people with schizophrenia-spectrum disorders: a longitudinal study. Psychiatry Res. 2019;275:115–119. PubMed

Cavelti M., Kvrgic S., Beck E.M., Rüsch N., Vauth R. Self-stigma and its relationship with insight, demoralization, and clinical outcome among people with schizophrenia spectrum disorders. Compr Psychiatry. 2012;53(5):468–479. PubMed

Rüsch N., Corrigan P.W., Wassel A., et al. Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use. Br J Psychiatry. 2009;195(6):551–552. PubMed PMC

Pearl R.L., Forgeard M.J., Rifkin L., Beard C., Björgvinsson T. Internalized stigma of mental illness: changes and associations with treatment outcomes. Stigma Health. 2017;2(1):2.

Ben-Zeev D., Frounfelker R., Morris S.B., Corrigan P.W. Predictors of self-stigma in schizophrenia: new insights using mobile technologies. J Dual Diag. 2012;8(4):305–314. PubMed PMC

Pyle M., Morrison A.P. “It's just a very taboo and secretive kind of thing”: making sense of living with stigma and discrimination from accounts of people with psychosis. Psychosis. 2014;6(3):195–205.

Nilsson K.K., Kugathasan P., Straarup K.N. Characteristics, correlates and outcomes of perceived stigmatization in bipolar disorder patients. J Affect Disord. 2016;194:196–201. PubMed

Yen C.F., Chen C.C., Lee Y., Tang T.C., Ko C.H., Yen J.Y. Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders. Depress Anxiety. 2009;26(11):1033–1039. PubMed

Xu Z., Mayer B., Müller M., et al. Stigma and suicidal ideation among young people at risk of psychosis after one year. Psychiatry Res. 2016;243:219–224. PubMed

Oexle N., Rüsch N., Viering S., et al. Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci. 2017;267(4):359–361. PubMed

Yen C.F., Lee Y., Tang T.C., Yen J.Y., Ko C.H., Chen C.C. Predictive value of self-stigma, insight, and perceived adverse effects of medication for the clinical outcomes in patients with depressive disorders. J Nerv Ment Dis. 2009;197(3):172–177. PubMed

Xu Z., Lay B., Oexle N., et al. Involuntary psychiatric hospitalisation, stigma stress and recovery: a 2-year study. Epidemiol Psychiatr Sci. 2019;28(4):458–465. PubMed PMC

Farrelly S., Jeffery D., Rüsch N., Williams P., Thornicroft G., Clement S. The link between mental health-related discrimination and suicidality: service user perspectives. Psychol Med. 2015;45(10):2013–2022. PubMed

Oexle N., Ajdacic-Gross V., Kilian R., et al. Mental illness stigma, secrecy and suicidal ideation. Epidemiol Psychiatr Sci. 2017;26(1):53–60. PubMed PMC

Lundberg B., Hansson L., Wentz E., Björkman T. Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services. Social Psychiatry Psychiatr Epidemiol. 2007;42(4):295–300. PubMed

Holubova M., Prasko J., Hruby R., et al. Coping strategies and self-stigma in patients with schizophrenia-spectrum disorders. Patient Prefer Adherence. 2016;10:1151. PubMed PMC

Jormfeldt H., Arvidsson B., Svensson B., Hansson L. Construct validity of a health questionnaire intended to measure the subjective experience of health among patients in mental health services. J Psychiatr Ment Health Nurs. 2008;15(3):238–245. PubMed

Bahm A., Forchuk C. Interlocking oppressions: the effect of a comorbid physical disability on perceived stigma and discrimination among mental health consumers in Canada. Health Soc Care Community. 2009;17(1):63–70. PubMed

Alonso J., Vilagut G., Adroher N.D., et al. Disability mediates the impact of common conditions on perceived health. PLoS One. 2013;8(6) PubMed PMC

Burke E., Wood L., Zabel E., Clark A., Morrison A.P. Experiences of stigma in psychosis: a qualitative analysis of service users' perspectives. Psychosis. 2016;8(2):130–142.

Tanaka C., Tuliao M.T., Tanaka E., Yamashita T., Matsuo H. A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines. BMC Psychiatry. 2018;18(1):1–3. PubMed PMC

Egbe C.O., Brooke-Sumner C., Kathree T., Selohilwe O., Thornicroft G., Petersen I. Psychiatric stigma and discrimination in South Africa: perspectives from key stakeholders. BMC Psychiatry. 2014;14(1):1–4. PubMed PMC

Schulze B., Angermeyer M.C. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med. 2003;56(2):299–312. PubMed

McColl L. ‘they just don't care’: the experiences of mental health consumers in a Queensland bush community. Aust EJ Adv Ment Health. 2007;6(2):138–146.

Clement S., Schauman O., Graham T., et al. Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27. PubMed

Oexle N., Müller M., Kawohl W., et al. Self-stigma as a barrier to recovery: a longitudinal study. Eur Arch Psychiatry Clin Neurosci. 2018;268(2):209–212. PubMed

Fung K.M., Tsang H.W., Chan F. Self-stigma, stages of change and psychosocial treatment adherence among Chinese people with schizophrenia: a path analysis. Soc Psychiatry Psychiatr Epidemiol. 2010;45(5):561–568. PubMed

Feldhaus T., Falke S., von Gruchalla L., et al. The impact of self-stigmatization on medication attitude in schizophrenia patients. Psychiatry Res. 2018;261:391–399. PubMed

Kalisova L., Michalec J., Hadjipapanicolaou D., Raboch J. Factors influencing the level of self-stigmatisation in people with mental illness. Int J Soc Psychiatry. 2018;64(4):374–380. PubMed

Xu Z., Müller M., Heekeren K., et al. Self-labelling and stigma as predictors of attitudes towards help-seeking among people at risk of psychosis: 1-year follow-up. Eur Arch Psychiatry Clin Neurosci. 2016;266(1):79–82. PubMed

Schomerus G., Stolzenburg S., Freitag S., et al. Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness. Eur Arch Psychiatry Clin Neurosci. 2019;269(4):469–479. PubMed

Byrow Y., Pajak R., McMahon T., Rajouria A., Nickerson A. Barriers to mental health help-seeking amongst refugee men. Int J Environ Res Public Health. 2019;16(15):2634. PubMed PMC

Sickel A.E., Seacat J.D., Nabors N.A. Mental health stigma: impact on mental health treatment attitudes and physical health. J Health Psychol. 2019;24(5):586–599. PubMed

Chen H., Fang X., Liu C., Hu W., Lan J., Deng L. Associations among the number of mental health problems, stigma, and seeking help from psychological services: a path analysis model among Chinese adolescents. Child Youth Serv Rev. 2014;44:356–362.

Lin C.L., Kopelowicz A., Chan C.H., Hsiung P.C. A qualitative inquiry into the Taiwanese mentally ill persons' difficulties living in the community. Arch Psychiatr Nurs. 2008;22(5):266–276. PubMed

Windell D., Norman R.M. A qualitative analysis of influences on recovery following a first episode of psychosis. Int J Soc Psychiatry. 2013;59(5):493–500. PubMed

Karanci N.A., Aras A., Kumpasoğlu G.B., et al. Living with schizophrenia: perspectives of Turkish people with schizophrenia from two patient associations on how the illness affects their lives. Int J Soc Psychiatry. 2019;65(2):98–106. PubMed

Lloyd C., Sullivan D., Williams P.L. Perceptions of social stigma and its effect on interpersonal relationships of young males who experience a psychotic disorder. Aust Occup Ther J. 2005;52(3):243–250.

Rose D., Willis R., Brohan E., et al. Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiol Psychiatr Sci. 2011;20(2):193–204. PubMed

Kranke D.A., Floersch J., Kranke B.O., Munson M.R. A qualitative investigation of self-stigma among adolescents taking psychiatric medication. Psychiatr Serv. 2011;62(8):893–899. PubMed

Robinson W.D., Springer P.R., Bischoff R., et al. Rural experiences with mental illness: through the eyes of patients and their families. Fam Syst Health. 2012;30(4):308. PubMed

Jansen J.E., Wøldike P.M., Haahr U.H., Simonsen E. Service user perspectives on the experience of illness and pathway to care in first-episode psychosis: a qualitative study within the TOP project. Psychiatr Q. 2015;86(1):83–94. PubMed

Link B.G., Struening E.L., Neese-Todd S., Asmussen S., Phelan J.C. Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv. 2001;52(12):1621–1626. PubMed

Lysaker P.H., Davis L.W., Warman D.M., Strasburger A., Beattie N. Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: associations across 6 months. Psychiatry Res. 2007;149(1–3):89–95. PubMed

Livingston J. Self-stigma and quality of life among people with mental illness who receive compulsory community treatment services. J Comm Psychol. 2012;40(6):699–714.

Rüsch N., Malzer A., Oexle N., et al. Disclosure and quality of life among unemployed individuals with mental health problems: a longitudinal study. J Nerv Ment. 2019;207(3):137–139. PubMed

Chung L., Pan A.W., Hsiung P.C. Quality of life for patients with major depression in Taiwan: a model-based study of predictive factors. Psychiatry Res. 2009;168(2):153–162. PubMed

Vauth R., Kleim B., Wirtz M., Corrigan P.W. Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Res. 2007;150(1):71–80. PubMed

Oliveira S.E., Carvalho H., Esteves F. Internalized stigma and quality of life domains among people with mental illness: the mediating role of self-esteem. J Ment Health. 2016;25(1):55–61. PubMed

Morgades-Bamba C.I., Fuster-Ruizdeapodaca M.J., Molero F. The impact of internalized stigma on the well-being of people with schizophrenia. Psychiatry Res. 2019;271:621–627. PubMed

Chan K.K., Fung W.T. The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong. Qual Life Res. 2019;28(8):2171–2182. PubMed

Rüsch N., Müller M., Heekeren K., et al. Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis. Schizophr Res. 2014;158(1–3):82–84. PubMed

Cavelti M., Rüsch N., Vauth R. Is living with psychosis demoralizing?: insight, self-stigma, and clinical outcome among people with schizophrenia across 1 year. J Nerv Ment. 2014;202(7):521–529. PubMed

Markowitz F.E. Modeling processes in recovery from mental illness: relationships between symptoms, life satisfaction, and self-concept. J Health Soc Behav. 2001;42:64–79. PubMed

Lysaker P.H., Tunze C., Yanos P.T., Roe D., Ringer J., Rand K. Relationships between stereotyped beliefs about mental illness, discrimination experiences, and distressed mood over 1 year among persons with schizophrenia enrolled in rehabilitation. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):849–855. PubMed PMC

Vass V., Morrison A.P., Law H., et al. How stigma impacts on people with psychosis: the mediating effect of self-esteem and hopelessness on subjective recovery and psychotic experiences. Psychiatry Res. 2015;230(2):487–495. PubMed

Yanos P.T., West M.L., Gonzales L., Smith S.M., Roe D., Lysaker P.H. Change in internalized stigma and social functioning among persons diagnosed with severe mental illness. Psychiatry Res. 2012;200(2–3):1032–1034. PubMed PMC

Chien W.T., Lam C.K., Ng B.F. Predictors of levels of functioning among C hinese people with severe mental illness: a 12-month prospective cohort study. J Clin Nurs. 2015;24(13–14):1860–1873. PubMed

Berry C., Greenwood K. Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis. Schizophr Res. 2018;193:197–203. PubMed

Assefa D., Shibre T., Asher L., Fekadu A. Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study. BMC Psychiatry. 2012;12(1):239. PubMed PMC

Grover S., Avasthi A., Singh A., et al. Stigma experienced by patients with severe mental disorders: a nationwide multicentric study from India. Psychiatry Res. 2017;257:550–558. PubMed

Drapalski A.L., Lucksted A., Perrin P.B., et al. A model of internalized stigma and its effects on people with mental illness. Psychiatr Serv. 2013;64(3):264–269. PubMed

James T.T., Kutty V.R. Assessment of internalized stigma among patients with mental disorders in thiruvananthapuram district, Kerala, India. Asia Pac J Public Health. 2015;27(4):439–449. PubMed

Sarısoy G., Kaçar Ö.F., Pazvantoğlu O., et al. Internalized stigma and intimate relations in bipolar and schizophrenic patients: a comparative study. Compr Psychiatry. 2013;54(6):665–672. PubMed

Lacey M., Paolini S., Hanlon M.C., Melville J., Galletly C., Campbell L.E. Parents with serious mental illness: differences in internalised and externalised mental illness stigma and gender stigma between mothers and fathers. Psychiatry Res. 2015;225(3):723–733. PubMed

Gupta M.N., Mohanty S. Stigma and expressed emotion in spouses of schizophrenic patients. Indian J Community Psychol. 2016;12(1):98–107.

Ebuenyi I.D., Guxens M., Ombati E., Bunders-Aelen J.F., Regeer B.J. Employability of persons with mental disability: understanding lived experiences in Kenya. Front Psychiatry. 2019;10:539. PubMed PMC

Heydari A., Saadatian V., Soodmand P. Black shadow of stigma: lived experiences of patients with psychiatric disorders on the consequences of stigma. Iran J Psychiatry Behav Sci. 2017;11(3):e6201.

Loganathan S., Murthy S.R. Experiences of stigma and discrimination endured by people suffering from schizophrenia. Indian J Psychiatry. 2008;50(1):39. PubMed PMC

Hall T., Kakuma R., Palmer L., Minas H., Martins J., Kermode M. Social inclusion and exclusion of people with mental illness in timor-leste: a qualitative investigation with multiple stakeholders. BMC Public Health. 2019;19(1):1–3. PubMed PMC

Krupchanka D., Chrtková D., Vítková M., et al. Experience of stigma and discrimination in families of persons with schizophrenia in the Czech Republic. Soc Sci Med. 2018;212:129–135. PubMed

Lyons C., Hopley P., Horrocks J. A decade of stigma and discrimination in mental health: plus ça change, plus c'est la même chose (the more things change, the more they stay the same) J Psychiatr Ment Health Nurs. 2009;16(6):501–507. PubMed

Koschorke M., Padmavati R., Kumar S., et al. Experiences of stigma and discrimination of people with schizophrenia in India. Soc Sci Med. 2014;123:149–159. PubMed PMC

Loganathan S., Murthy R.S. Living with schizophrenia in India: gender perspectives. Transcult Psychiatry. 2011;48(5):569–584. PubMed PMC

Alonso J., Buron A., Rojas-Farreras S., et al. Perceived stigma among individuals with common mental disorders. J Affect Disord. 2009;118(1–3):180–186. PubMed

Elkington K.S., McKinnon K., Mann C.G., Collins P.Y., Leu C.S., Wainberg M.L. Perceived mental illness stigma and HIV risk behaviors among adult psychiatric outpatients in Rio de Janeiro, Brazil. Community Ment Health J. 2010;46(1):56–64. PubMed PMC

Mathias K., Kermode M., Sebastian M.S., Koschorke M., Goicolea I. Under the banyan tree-exclusion and inclusion of people with mental disorders in rural North India. BMC Public Health. 2015;15(1):446. PubMed PMC

Koskela S.A., Pettitt B., Drennan V.M. The experiences of people with mental health problems who are victims of crime with the police in England: a qualitative study. Br J Criminol. 2016;56(5):1014–1033.

Liegghio M., Jaswal P. Police encounters in child and youth mental health: could stigma informed crisis intervention training (CIT) for parents help? J Soc Work Practic. 2015;29(3):301–319.

Forchuk C., Nelson G., Hall G.B. “It's important to be proud of the place you live in”: housing problems and preferences of psychiatric survivors. Perspect Psychiatr Care. 2006;42(1):42–52. PubMed

Dickerson F.B., Sommerville J., Origoni A.E., Ringel N.B., Parente F. Experiences of stigma among outpatients with schizophrenia. Schizophr Bull. 2002;28(1):143–155. PubMed

Baert S., De Visschere S., Schoors K., Vandenberghe D., Omey E. First depressed, then discriminated against? Soc Sci Med. 2016;170:247–254. PubMed

Buizza C., Schulze B., Bertocchi E., Rossi G., Ghilardi A., Pioli R. The stigma of schizophrenia from patients' and relatives' view: a pilot study in an Italian rehabilitation residential care unit. Clin Pract Epidemiol Ment Health. 2007;3(1):1–8. PubMed PMC

Kapungwe A., Cooper S., Mwanza J., et al. Mental illness-stigma and discrimination in Zambia. Afr J Psychiatry. 2010;13(3):192–203. PubMed

Nithsdale V., Davies J., Croucher P. Psychosis and the experience of employment. J Occup Rehabil. 2008;18(2):175–182. PubMed

Kleintjes S., Lund C., Swartz L. Barriers to the participation of people with psychosocial disability in mental health policy development in South Africa: a qualitative study of perspectives of policy makers, professionals, religious leaders and academics. BMC Int Health Hum Rights. 2013;13(1):17. PubMed PMC

Ackerson B.J. Coping with the dual demands of severe mental illness and parenting: the parents' perspective. Fam Soc. 2003;84(1):109–118.

Reupert A., Maybery D. Fathers' experience of parenting with a mental illness. Fam Soc. 2009;90(1):61–68.

Lempp H., Abayneh S., Gurung D., et al. Service user and caregiver involvement in mental health system strengthening in low-and middle-income countries: a cross-country qualitative study. Epidemiol Psychiatr Sci. 2018;27(1):29–39. PubMed PMC

Abayneh S., Lempp H., Alem A., et al. Service user involvement in mental health system strengthening in a rural African setting: qualitative study. BMC Psych. 2017;17(1):1–4. PubMed PMC

Gwaikolo W.S., Kohrt B.A., Cooper J.L. Health system preparedness for integration of mental health services in rural Liberia. BMC Health Serv Res. 2017;17(1):508. PubMed PMC

Hamilton S., Pinfold V., Cotney J., et al. Qualitative analysis of mental health service users' reported experiences of discrimination. Acta Psychiatr Scand. 2016;134:14–22. PubMed PMC

Mannarini S., Rossi A. Assessing mental illness stigma: a complex issue. Front Psychol. 2019;9:2722. PubMed PMC

Agius S. Qualitative research: its value and applicability. Psychiatrist. 2013;37(6):204–206.

Hatzenbuehler M.L., Link B.G. Introduction to the special issue on structural stigma and health. Soc Sci Med. 2014;103:1–6. PubMed

Holley L.C., Tavassoli K.Y., Stromwall L.K. Mental illness discrimination in mental health treatment programs: intersections of race, ethnicity, and sexual orientation. Community Ment Health J. 2016;52(3):311–322. PubMed

Staiger T., Waldmann T., Oexle N., Wigand M., Rüsch N. Intersections of discrimination due to unemployment and mental health problems: the role of double stigma for job-and help-seeking behaviors. Soc Psychiatry Psychiatr Epidemiol. 2018;53(10):1091–1098. PubMed

Vogel D.L., Bitman R.L., Hammer J.H., Wade N.G. Is stigma internalized? The longitudinal impact of public stigma on self-stigma. J Couns Psychol. 2013;60(2):311. PubMed