Values, belief systems and mental health stigma - a scoping review and synthesis of quantitative evidence

Stigma related to individuals with mental health problems is a relevant global public health issue. Values, as guiding principles, influence attitudes and behaviors, thus potentially informing the social functions of stigma.

To provide a comprehensive overview and synthesis of quantitative evidence on values and belief systems studied in association with mental health stigma. Preregisteration in PROSPERO.

To match conceptual vagueness and provide a starting point for future research, a scoping review was performed. A systematic search across multiple databases without publication year restrictions was performed, and the results were synthesized according to the PRISMA-ScR guidelines and the Peer Review of Electronic Search Strategies checklist. A quality appraisal was conducted as per adapted Cochrane Collaborations´ suggested inclusions.

A total of 49 original studies published in English or German were included after full-text screening and synthesized into five value clusters: cultural, political, religious/spiritual, personal and milieu-specific dimensions. Across studies, we observed a heterogeneous operationalization of value dimensions, which complicated comparability and synthesis. Overarching trends are illustrated graphically; e.g. conservative values are consistently associated with greater stigma, although they must be read as preliminary and do not allow for causal explanations.

There is a growing interest in contextual aspects such as values studied in association with stigma towards people living with mental health problems. Future research should focus on refining conceptual frameworks and validating value-sensitive approaches that help fuel a deeper understanding of the contextuality of stigma functions.