Avaliação das intervenções para redução do estigma relacionado a pessoas com transtornos mentais: revisão sistemática com análise crítica

Abstract

Stigma is still a very present phenomenon in our society, consequently often leading to the loss of dignity due to the prejudice of other people. The compromise of the right to health occurs in the most varied forms of stigma, due to preconceived views that weaken health care. The objective of this study was to identify the ways of managing the stigma of mental disorders, evaluating the effectiveness of strategies to reduce and eliminate stigma. This is a review of systematic reviews, which used the Prisma protocol and is registered in PROSPERO as a CRD42022369853. The research recruited articles published from 2019 to 2023 without language restrictions, in the SciELO, Medline (by PubMed) and Google Scholar databases. In this research, three psychiatrists participated in the stages of: selection process; data collection and selection; - risk of bias; methodological quality. To assess risk bias, ROBIS for SR and the Cochrane Manual for the Development of Systematic Reviews of Intervention for RCTs were used, while the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence assessed methodological quality. After peer review, 13 articles were included with intervention to the stigma of mental disorders, depressive and anxiety disorder, bipolar affective disorder, and schizophrenia. Mental health literacy interventions that applied video or contact to people who had experience with mental disorders presented a statistically significant result in the post- intervention (p=0.03). Positive outcome for interventions for biomedical message groups when compared to group with recommended messages. On-line psychoeducation program that contained videos of people with lived experience with depression and anxiety, decline in post- test stigma score: depression (p < 0.001); anxiety (p < 0.001). Educational program for pharmacists containing a lecture with a psychiatrist and activity (interview with patients, discussion to clarify patients' experience, and learning from experience with patients), showed marked improvements. Limitations found in the study: a) stigma reduction was not a primary outcome in some studies; b) little statistical presentation in the reported results. In view of the results found, it is evident that there must be constant implementation of interventions aimed at reducing stigma, and that they are effective and capable of being replicated in various intervention groups.