Author, Year and Journal | Literature type | Sample size and study participants | Study area | Measurement tool/scale | Extracted themes from the literature | Main finding of the study |
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Forthal S. et al. (2019). (BMC Psychiatry) | Quantitative cross-sectional study | 300 participants with severe mental illness | Community based study in Sodo district, rural South-central Ethiopia | Semi-structured operational CRITeria for research (OPCRIT) interview, discrimination and stigma scale (DISC12), brief psychiatric rating scale—expanded version (BPRS-E), The 36-item World Health Organization disability assessment schedule (WHODAS-2.0) questionnaire, alcohol use disorders identification test (AUDIT) self-reported version, Oslo 3-item social support scale (OSSS-3) | Service users’ perspectives on public stigma against people with mental illness | High level of experienced discrimination and significant difference was found between urban and rural people with schizophrenia |
Tesfaw G. et al. (2020). (International journal of mental health systems) | Quantitative cross-sectional study | 423 people with schizophrenia | Institution (Amanuel mental specialized hospital) based study at Addis Ababa, Urban central Ethiopia | OSSS-3, positive and negative syndrome scale (PANSS) and perceived devaluation and discrimination (PDD) Scale | Service users’ perspectives on public stigma against people with mental illness | High perceived stigma among people with schizophrenia |
Girma E. et al. (2013). (PLoS One) | Quantitative cross-sectional study | 845 participants from the community | Community based study at gilgel gibe field research center, rural Southwest Ethiopia | Community attitudes towards the mentally Ill (CAMI) scale, | Public perspectives on public stigma against people with mental illness | Lower stigma was related with better education and perceived explanatory causes (supernatural/psychosocial/biological) of mental illness |
Girma E. et al. (2013). (International journal of mental health systems) | Quantitative cross-sectional study | 422 people with severe mental illness | Institution (Jimma university specialized hospital) based study at Jimma town, Urban Southwest Ethiopia | Internalized Stigma of Mental Illness (ISMI) Scale | Service users’ perspectives on self-stigma and interventions to reduce stigma against people with mental illness | There was high feeling of inferiority but less alignment with common stereotypes about people with mental illness |
Hadera E. et al. (2019). (Psychiatry Journal) | Quantitative cross-sectional study | 384 outpatient service users | Institution (Jimma university specialized hospital) based study at Jimma town, Urban Southwest Ethiopia) based study | Perceived devaluation and discrimination (PDD) scale | Service users’ perspectives on public stigma against people with mental illness | Perceived prevailing stigma among outpatient mental health care service users |
Reta Y. et al. (2016). (PLoS One) | Quantitative cross-sectional study | 820 participants from the community | Community based study at Jimma town, Urban Southwest Ethiopia | Community attitudes toward the mentally Ill (CAMI) scale | Public perspectives on public stigma against people with mental illness | Prevailing negative attitude against people with mental illness |
Hailemariam M. et al. (2017). (Int J Equity Health) | Qualitative study | 50 In-depth interviews with service users, care givers and service providers in the facility and 2 FGDs (10 per group) with community service providers | Community based study in Sodo district, rural South-central Ethiopia | Interview guide was developed for countries implementing PRIME | Service users’, caregivers’ and service providers’ perspectives on public stigma against people with mental illness | Financial problems and in accessibility of mental health facility and the medication were the main barriers for the engagement to care’ |
Abayneh Lempp. et al. (2017). (BMC Psychiatry) | Qualitative study | 39 interviews with service users, care givers, managers and policy makers/planners/service developers at national and regional level | Community based study at Butajira (rural central part of Ethiopia) and with national representatives | Interview guide was developed for Emerging mental health systems in low- and middle-income countries (Emerald) cross-country study | Service users’, caregivers’ and service providers’ perspectives on public stigma, structural stigma and intervention on stigma | Despite the increasing access of mental health care, there were barriers in relation to stigma and awareness |
Hanlon C. et al. (2017). (International journal of mental health systems) | Qualitative study | 17 in-depth interviews with national and regional policy makers, service developers and district level health office managers | Community based study in Sodo district, rural South-central Ethiopia | Interview guide was derived from the adapted health system governance (HSG) evaluation framework | Policy makers’ and service developers’ perspectives on structural stigma | There are improved government support and commitment to scale-up mental health care. however, the leadership and coordination among different administrative levels needs to be strengthened in addition to addressing awareness problems |
Hailemariam M. et al. (2019). (International Journal of Mental Health Systems) | Quantitative cross-sectional study | 369 participants with probable cases of severe mental illness | Community based study in Sodo district, rural South-central Ethiopia | Barriers to access to care evaluation (BACE-3), short explanatory model interview (SEMI), WHO 12 item Disability Assessment Schedule (WHODAS 2.0), Oslo-3 scale, alcohol use disorders identification test (AUDIT), discrimination and stigma scale (DISC-12), Brief physical impairment rating checklist (BPIRC), Washington Group’s disability measure and Work, Family and Well-being (WFW) scales | Service users’ perspectives on structural stigma, interventions to reduce stigma and impact of stigma on help-seeking of people with severe mental illness | Integrating mental health care into primary care highly improves the level of equitable contact coverage |
Abayneh S. et al. (2020). (International journal of mental health systems) | Qualitative study, theory of change (ToC) development | 31 participants (4 psychiatrists, 3 researchers, 24 stakeholders involved in service planning) | Community and institution-based study at sodo district (rural south-central Ethiopia) and Addis Ababa (urban central Ethiopia) respectively | ToC Maps, workshop and meeting minutes | Service providers’ and service developers’ and administers’ perspectives on structural stigma and interventions to reduce stigma | In order to mobilize and empower service users and caregivers for mental health system improvement, the service user and caregiver program level was the main intervention component identified in the ToC |
Girma E. et al. (2014). (Journal of multidisciplinary healthcare) | Quantitative cross-sectional study | 422 participants who were caregivers | Institution (Jimma University Specialized hospital) based study at Jimma town, Urban Southwest Ethiopia) based study | Questionnaire adopted from WHO family interview schedule stigma items and other literatures | Care givers’ perspectives on self-stigma due to family members’ mental illness | Even though the care givers’ self-stigma was found to be low, it might have an impact on help seeking behavior of people mental illness |
Girma E. et al. (2014). (BMC international health and human rights) | Quantitative cross-sectional study | 845 participants from the community | Community based study at gilgel gibe field research center, rural Southwest Ethiopia | Questionnaire adopted from devaluation of consumer families scale and other literatures | Care givers’ perspectives on public stigma due to family members’ mental illness | There was moderate level of perceived public stigma against family members of PWMI and it was negatively correlated with perceived symptoms and explanatory causes (supernatural/psychosocial/biological) of mental illness |
Assefa D. et al. (2012). (BMC Psychiatry) | Quantitative cross-sectional study | 212 individuals with schizophrenia | Institution (Amanuel Mental Specialized Hospital) based study at Addis Ababa, Urban Central Ethiopia | Internalized stigma of mental illness (ISMI) Scale and diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) | Service users’ perspectives towards self-stigma among people with schizophrenia | Internalized stigma was indicated to be the prevailing problem among people with schizophrenia as nearly half of them had the problem |
Bifftu B. B. et al. (2014). (BMC Psychiatry) | Quantitative cross-sectional study | 411 individuals with schizophrenia | Institution (Amanuel mental specialized hospital) based study at Addis Ababa, Urban Central Ethiopia | Internalized stigma of mental illness (ISMI) scale | Service users’ perspectives towards self-stigma among people with schizophrenia | Low stigma resistance was reported by nearly half of the participants with schizophrenia |
Zewdu S. et al. (2019). (Substance abuse treatment, prevention, and policy) | Quantitative cross-sectional study | 1500 adults from the community | Community based study in Sodo district, rural South-central Ethiopia | Alcohol use disorder identification tool (AUDIT), patient health questionnaire (PHQ-9) for depression, WHO composite international diagnostic interview (CIDI), WHO disability assessment schedule (WHODAS) version 2.0, with 12 items, list of threatening experiences (LTE) questionnaire, 3-item Oslo social support (OSS) questionnaire and internalized stigma of mental illness inventory (ISMI) | Service users’ perspectives towards self-stigma among people with alcohol use disorder | The twelve-month prevalence of alcohol use disorder was 13.9% and most of whom didn’t seek medical help and had high internalized stigma |
Asher L. et al. (2017). (Globalization and Health) | Qualitative study (RISE study) | 35 participants (5 in-depth interviews and 5 focus group discussions) composed of people with schizophrenia, their caregivers, community leaders and primary and community service providers | Community based study in Sodo district, rural South-central Ethiopia | Used topic guide as part of rehabilitation intervention for people with schizophrenia in Ethiopia (RISE) project | Care givers’ perspectives on the impact of stigma on help-seeking behavior of people with mental illness | Physical restraint of people with schizophrenia was common practice which could restrict them from attending the needed medical care |
Fekadu A. et al. (2019). (BMC Psychiatry) | Quantitative cross-sectional study | 300 participants with psychosis | Community based study in Butajira, rural central part of Ethiopia | The Butajira treatment gap questionnaire (TGQ), brief psychiatric rating scale- expanded version (BPRS- E), WHO disability assessment schedule (WHODAS 2.0), Oslo 3 social support scale (OSS), Operational Criteria for Research (OPCRIT) | Service users’ perspectives towards the impact of stigma on help-seeking behavior of people with mental illness | Nearly six out of ten participants had current access gap to biomedical care, which could affect their work function and might experience discrimination |
Souraya S. et al. (2018). (Globalization and Health) | Qualitative study | 18 in depth interviews (people with schizophrenia, caregivers, service providers and officials) and 2 FGDs with community- based rehabilitation workers | Community based study in Sodo district, rural South-central Ethiopia | Used topic guide as part of rehabilitation intervention for people with schizophrenia in Ethiopia (RISE) project | Service users’ and caregivers’ perspectives towards the impact of stigma on help-seeking behavior of people with mental illness | It is not common practice to involve service users and care givers in decision making towards the treatment options |
Girma E. and M. Tesfaye (2011). (BMC Psychiatry) | Quantitative cross-sectional study | 384 participants with psychosis | Institution (Jimma University Specialized Hospital) based study at Jimma town, Urban Southwest Ethiopia | Questionnaire was developed based on WHO Encounter Form for Pathways to care and good’s pathway model | Service users’ perspectives towards the impact of stigma on help-seeking behavior of people with mental illness | There was significant delay in treatment seeking behavior among people with psychosis |
Tsigebrhan R. et al. (2014). (Schizophrenia Research) | Quantitative comparative cross-sectional study | 201 participants with severe mental illness | Community based study in Butajira, rural central part of Ethiopia | Questionnaire was prepared based on the macarthur violence interview, modified version of the historical, clinical and risk management (HCR-20) scale and other literatures | Service users’ perspectives towards the impact of stigma on help-seeking behavior of people with mental illness | There significantly higher level of violence and violence victimization among people with severe mental illness which alarms the need improvement in mental health care access |
Tirfessa K. et al. (2020). (Tropical medicine & international health) | Quantitative controlled before-after study | 239 participants with severe mental illness and 273 participants as control households | Community based study in Sodo district, rural South-central Ethiopia | Household food insecurity access scale (HFIAS), discrimination and stigma scale‐12 (DISC‐12), WHO Disability Assessment Schedule (WHODAS) 2.0 12‐item version, longitudinal interval follow‐up evaluation‐range of impaired functioning tool (LIFE‐RIFT) and 24‐item brief psychiatric rating scale‐expanded version (BPRS‐E) | Service users’ perspectives towards interventions to reduce stigma against people with mental illness | The improvement in access to mental health care led to improvement in the households’ food security of more than half of the households with people with severe mental illness |
Habtamu K. et al. (2018). (Social psychiatry and psychiatric epidemiology) | Quantitative cross-sectional study | 324 participants with severe mental illness | Community based study at Butajira, rural central part of Ethiopia | WHO Disability Assessment Schedule (WHODAS-2.0), Butajira functioning scale (BFS), brief psychiatric rating scale (BPRS-E), Composite International Diagnostic Interview (CIDI) substance abuse module, Mini International Neuropsychiatric Interview (MINI) Suicidality Scale, Antipsychotic Side effects Checklist (ASC), Life Chart Schedule (LCS), Internalized Stigma of Mental Illness (ISMI) scale | Service users’ perspectives towards interventions to reduce stigma against people with mental illness | Functional impairment was determined by symptom severity, poverty, medication side effects, and internalized stigma among people with severe mental illness |
Asher L. et al. (2015). (PloS One) | Qualitative study | Two consecutive workshops with 8 mental health experts and 12 community leaders respectively, 16 in-depth interviews and 5 FGDs with service users (people with schizophrenia), caregivers and service providers | Intervention development work in sodo district, rural South-central Ethiopia | workshop notes, site visits and in-depth consultation, data extraction and interview guide | Service users’, care givers’ and providers’ perspectives towards interventions to reduce stigma against people with mental illness | People with schizophrenia have challenges in maintaining work function, social and family role and experienced stigma which are perceived to be addressed with culturally appropriate, acceptable and feasible community-based rehabilitation intervention |
Asher L. et al. (2018). (BMC Psychiatry) | Follow up mixed method (qualitative and quantitative) pilot study | 31 individuals (people with schizophrenia, caregivers, community members and service providers) | Community based pilot study at Sodo district, rural South-central Ethiopia | Used topic guide, data extraction form, and measurement scales; Discrimination and Stigma Scale-12 (DISC-12) subscale 1, Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire-9 (PHQ-9), Involvement Evaluation Questionnaire (IEQ), WHO Disability Assessment Schedule (WHODAS) 2.0 and Clinical Global Impression (CGI) | Service users’, care givers’ and providers’ perspectives towards interventions to reduce stigma against people with mental illness | Community-based rehabilitation intervention was proven to be acceptable and feasible approach which should be used with the existing facility-based care for people with schizophrenia |
Hanlon C. et al. (2019). (Epidemiology and psychiatric sciences) | Quantitative interventional cohort study (PRIME study) | 245 participants with severe mental illness | Institution based study at Sodo district, rural South-central Ethiopia | Brief Psychiatric Rating Scale, expanded version (BPRS-E), WHO Disability Assessment Schedule (WHODAS), ‘unfair treatment’ subscale of the Discrimination and Stigma Scale-12 (DISC-12), Alcohol Use Disorder Identification Test (AUDIT), locally validated version of the Patient Health Questionnaire (PHQ-9) and three-item oslo social support scale (OSS-3) | Service users’ perspectives towards discrimination and interventions to reduce stigma against people with mental illness | Nearly less than one third of participants had received the minimum required treatment available at district level. The follow up has revealed that those who received the treatment had significant improvement in severe mental illness symptoms, disability measures, depression symptoms, discrimination, restraining, alcohol use disorder and suicidal attempt |
Asher L. et al. (2021). (Lancet preprint) | Quantitative study (cluster-randomized controlled trial) | In intervention and control arm, 79 and 87 participants with schizophrenia respectively | Community based study at Sodo district, rural South-central Ethiopia | WHO Disability Assessment Schedule (WHODAS 2·0), Brief Psychiatric Rating Scale-Expanded (BPRSE) score, Clinical Global Impression (CGI), Butajira Functioning Scale score, Chart Schedule, Adapted Client Service Receipt Inventory (CSRI), Discrimination and Stigma Scale-12 (DISC-12), Involvement Evaluation Questionnaire (IEQ) and Patient Health Questionnaire-9 (PHQ-9) | Service users’ perspectives towards interventions to reduce stigma against people with mental illness | After 12 months of community based rehabilitation intervention, disability was effectively reduced. However, it didn’t found evidence on reduction stigma |