Interventions for Reducing Mental Health-Related Stigma in Emergency Medicine: An Integrative Review

The prevalence and impact of mental health disorders are increasing worldwide. A growing number of people with mental health problems require ambulance and emergency department care, many of whom face stigmatization from health care professionals in these environments. Interpersonal stigma comprises insufficient knowledge (ignorance or misinformation), negative attitudes (negative emotional reactions, such as prejudice), and negative behaviors (such as avoidance or rejection).

An integrative review was conducted to assess the current landscape of interventions aimed at reducing stigmatization among health care professionals in ambulance and emergency department settings.

Of the 18 publications included, 1 targeted stigma reduction. Although 2 additional studies examined interventions not specifically aimed at reducing stigma, these studies have examined the impact of interventions on stigma. The other included studies reported measures of attitudes. One study involved patients evaluating the intervention, whereas the rest relied on assessments by health care professionals. Four studies mentioned patient involvement in the development of interventions. The predominant approach in these studies involved educational and training interventions associated with improvements in knowledge levels and attitudes. However, the direct impact of these changes on reducing stigmatizing behavior remains unclear. It is concerning that national practice guidelines in ambulance and emergency care hardly address mental health-related stigma despite longstanding awareness of this issue.

The findings underscore the urgent need for concerted efforts in practice, research, and policy within ambulance and emergency department settings to address and combat stigmatizing behaviors toward patients with mental health challenges by enhancing knowledge and reshaping attitudes.