Effectiveness of Mental Health Literacy and Stigma Interventions for Latino/a Adults in the United States: A Systematic Review

Background and Purpose:

Despite the remarkable growth of the Latino/as population in the U.S., their mental health care needs are still not being met. Latino/as face persistent mental health care disparities, even after adjusting for education, health insurance, and socioeconomic factors. Mental health stigma and low mental health literacy limit help-seeking and use of services, treatment engagement, and quality of care. While there has been increased attention on mental health stigma and mental health literacy, no systematic literature review currently exists of interventions developed to reduce mental health stigma and increase mental health literacy in the Latino/a community. The aims of this review were to: (1) examine the methodological rigor of these intervention studies; (2) describe the mental health literacy and stigma interventions developed for Latinos/as in the U.S., and (3) summarize the outcomes of these studies focusing on mental health literacy and stigma outcomes.

Methods:

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to inform our systematic literature review. This study identified peer-reviewed publications through a systematic search of ten databases. Studies were included if they met the following criteria: (1) published in English or Spanish in a peer-reviewed journal between 2000 and February 2020 and conducted in the U.S.; (2) described a mental health literacy and/ or stigma intervention delivered to Latinos/a adults 18 years of age or older; and (4) evaluated the impact of the intervention on mental health literacy and stigma outcomes for Latino/as. The methodological rigor of each study was assessed using an adapted version of the Methodological Quality Rating Scale.

Results:

Seven articles met the inclusion criteria for this review. The methodological rigor of the studies were limited. Three articles used a randomized control group design and four articles utilized single group pre/post designs. The majority of studies were small pilot studies with small samples and short follow-up periods of less than a month. The interventions focused on depression and psychosis and incorporated various cultural and linguistic elements to make them relevant, salient, and culturally-appropriate to Latino/as. These interventions showed promising results for improving knowledge of mental disorders and mixed results for reducing stigma towards people with mental illness and mental health treatments.

Conclusions and Implications:

Findings highlight a significant deficit of mental health literacy and stigma interventions for the Latino/a population. As the Latino/a population continues to grow, future research should continue investigating and developing more evidence-based interventions, particularly addressing mental health stigma. More intensive and prolonged mental health stigma interventions that use multiple media platforms (e.g., radio, television, website, print, and social media) are needed to help reduce mental health care disparities in this population.