<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="editorial">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Psychiatry</journal-id>
<journal-title>Frontiers in Psychiatry</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Psychiatry</abbrev-journal-title>
<issn pub-type="epub">1664-0640</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fpsyt.2023.1136995</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Psychiatry</subject>
<subj-group>
<subject>Editorial</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Editorial: Mental-health-related stigma and discrimination: Prevention, role, and management strategies</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Shalbafan</surname> <given-names>Mohammadreza</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn002"><sup>&#x02020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/954865/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>El Hayek</surname> <given-names>Samer</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x02020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1010079/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>de Filippis</surname> <given-names>Renato</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<xref ref-type="author-notes" rid="fn004"><sup>&#x02020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/591845/overview"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences</institution>, <addr-line>Tehran</addr-line>, <country>Iran</country></aff>
<aff id="aff2"><sup>2</sup><institution>Medical Department, Erada Center for Treatment and Rehab in Dubai</institution>, <addr-line>Dubai</addr-line>, <country>United Arab Emirates</country></aff>
<aff id="aff3"><sup>3</sup><institution>Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro</institution>, <addr-line>Catanzaro</addr-line>, <country>Italy</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited and reviewed by: Wulf R&#x000F6;ssler, Charit&#x000E9; Universit&#x000E4;tsmedizin Berlin, Germany</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Renato de Filippis &#x02709; <email>defilippisrenato&#x00040;gmail.com</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry</p></fn>
<fn fn-type="other" id="fn002"><p>&#x02020;ORCID: Mohammadreza Shalbafan <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0002-4536-3441">orcid.org/0000-0002-4536-3441</ext-link></p></fn>
<fn fn-type="other" id="fn003"><p>Samer El Hayek <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0002-7975-6104">orcid.org/0000-0002-7975-6104</ext-link></p></fn>
<fn fn-type="other" id="fn004"><p>Renato de Filippis <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0001-6928-1224">orcid.org/0000-0001-6928-1224</ext-link></p></fn></author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>01</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>14</volume>
<elocation-id>1136995</elocation-id>
<history>
<date date-type="received">
<day>03</day>
<month>01</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>04</day>
<month>01</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2023 Shalbafan, El Hayek and de Filippis.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Shalbafan, El Hayek and de Filippis</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license> </permissions>
<related-article id="RA1" related-article-type="commentary-article" xlink:href="https://www.frontiersin.org/research-topics/30477/mental-health-related-stigma-and-discrimination-prevention-role-and-management-strategies" ext-link-type="uri">Editorial on the Research Topic <article-title>Mental-health-related stigma and discrimination: Prevention, role, and management strategies</article-title></related-article>
<kwd-group>
<kwd>community psychiatry</kwd>
<kwd>internalized stigma</kwd>
<kwd>prejudice</kwd>
<kwd>psychiatric disorders</kwd>
<kwd>public health</kwd>
<kwd>social stigma</kwd>
<kwd>stereotyping</kwd>
<kwd>stigmatization</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="6"/>
<page-count count="3"/>
<word-count count="1739"/>
</counts>
</article-meta>
</front>
<body>
<p>Stigmatizing attitudes toward patients suffering from mental illnesses and their caregivers, psychotropic medications, mental health institutions and stakeholders, remain a common public health concern, with major repercussions across countries and cultures worldwide (<xref ref-type="bibr" rid="B1">1</xref>). Indeed, a negative attitude toward mental health can lead to avoiding approaching mental health providers, delaying timely diagnosis, poor treatment adherence, and worst disease prognosis and patients&#x00027; quality of life (<xref ref-type="bibr" rid="B2">2</xref>). This phenomenon is particularly evident, but not limited, to patients suffering from mental disorders and has amplified following the COVID-19 pandemic (<xref ref-type="bibr" rid="B3">3</xref>&#x02013;<xref ref-type="bibr" rid="B6">6</xref>).</p>
<p>In the Research Topic entitled &#x0201C;<italic>Mental-Health-Related Stigma and Discrimination: Prevention, Role, and Management Strategies</italic>,&#x0201D; we collected 15 articles discussing several aspects of mental-health-related stigma and discrimination from different perspectives and countries, with a particular focus on strategies tackling them. Our editorial aims to summarize their key-points and invite the audience to read this collection.</p>
<p>Several articles highlight the role of psychiatric stigma amongst medical students from various perspectives and how this negative attitude could impact patients with mental illness, particularly those affected by challenging diseases such as schizophrenia spectrum disorders. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.961538">Movahedi et al.</ext-link> assessed the attitudes of Iranian specialty trainees, who are frontliners dealing with this group of patients, toward providing psychiatric services to patients and their families. They conclude that internal medicine and cardiology residents have more stigmatizing attitudes while psychiatric residents show a more positive behavior toward their patients. In another study conducted in Iran, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.880331">Zare-Bidaki et al.</ext-link> evaluated the effect of virtual reality on stigma, empathy, and knowledge of medical students toward patients with psychotic disorders. They concluded that this novel tool can be a potential effective instrument in decreasing stigma and increasing empathy and knowledge among medical students (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.880331">Zare-Bidaki et al.</ext-link>). Moreover, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.860117">Rezvanifar et al.</ext-link> introduced an educational package for improving the attitude of medical students toward patients with mental disorders based on a scoping review and an expert consensus conducted through a Delphi panel. The developed package contained four interactive interventions: (1) showing a movie and discussing it, (2) implementing psychiatric training including contact with patients living with psychiatric disorders, (3) adopting social communication with patients with psychiatric disorders, and (4) setting up a group discussion on defining stigma and personal experiences (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.860117">Rezvanifar et al.</ext-link>). Moreover, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.1027377">Mohebbi et al.</ext-link> performed a systematic review to determine Eastern Mediterranean (EMR) medical students&#x00027; attitudes toward psychiatry, concluding that EMR medical students generally have positive attitudes and predispositions toward the field. On the other hand, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.1027304">Porfyri et al.</ext-link> studied stigma among Greek healthcare professionals and reported that, despite the high level of familiarity, the employees displayed a rather poor willingness to interact with patients with mental illness, and endorsed significant prejudice toward them.</p>
<p>Another group of articles investigated mental-health-related stigma among some influential groups in societies, and which interventions may improve their attitudes toward patients. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.864806">Taghva et al.</ext-link> performed a two-day training workshop to improve the attitude of clergymen toward patients with mental disorders. Findings showed that the awareness and attitude of ecclesiastics toward mental health and its consequential stigma were relatively good, and significantly improved upon holding the workshop (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.864806">Taghva et al.</ext-link>). In addition, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.990815">Eissazade et al.</ext-link> investigated the attitude of a group of Iranian theater artists toward patients with mental disorders, as well as their own mental health. Participants&#x00027; strongest fears were to allow an individual with a severe mental disorder to take care of their children and the possibility of patients in this group to obtain a hunting license. Twenty-five percent of participants were at risk of moderate to severe anxiety, and 17.3% participants were at risk of moderate to severe depression (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.990815">Eissazade et al.</ext-link>).</p>
<p>Several other articles investigated stigma among general populations, as well as some strategies to fight this issue. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.951894">Ruiz et al.</ext-link> reported findings of a survey on stigma among university students in Valencia, Spain. They found that women show fewer stigmatizing attitudes than men but similar stereotypes and prejudice toward people with mental disorders. The survey as also found students of medicine, psychology, and teaching to have fewer stigmatizing attitudes than students of economics and data science, but differences between degrees were more subtle in terms of stereotypes and prejudice toward people with mental disorders (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.951894">Ruiz et al.</ext-link>). In an opinion piece, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.954602">Saboury Yazdy et al.</ext-link> shared their experience using a smartphone application called &#x0201C;Be my Voice&#x0201D; to break social stigma against domestic violence in Iran. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.1010720">Sawaguchi et al.</ext-link> reported their findings on COVID-19-related stigma and its relationship with mental wellbeing using a cross-sectional analysis of a cohort study in Japan. They concluded that people aged &#x02265; 70 years are more likely to exhibit COVID-19-related stigma. Additionally, the results indicate that COVID-19-related stigma negatively impacts quality of life secondary to the underlying psychological distress (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.1010720">Sawaguchi et al.</ext-link>).</p>
<p>Two other articles focused on the relationship between stigma and suicide as a major public mental health problem. In a perspective piece, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.894524">Shoib et al.</ext-link> raised concerns on the relationship between suicide, stigma, and COVID-19 in low- and middle-income countries. The article particularly addresses the potential link between social stigma and suicide in the wake of the current coronavirus pandemic and proposes some practical ideas for reducing mental-health-related stigma (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.894524">Shoib et al.</ext-link>). <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.1026451">Masoomi et al.</ext-link> in another perspective piece, also raised the issue of stigma as a barrier to suicide prevention strategies in Iran.</p>
<p>Two other publications evaluated psychometric properties of stigma-related questionnaires. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.1017273">Dinmohammadi et al.</ext-link> evaluated psychometric properties of the Self-Stigma Inventory for Iranian families of persons who use drugs, and concluded that it is a valid and reliable scale with three factors and 14 items. Additionally, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.951347">Burzee et al.</ext-link> re-evaluated Stuart&#x00027;s Police Officer Stigma Scale and their findings imply that this scale is reliable but needs to include two components rather than one.</p>
<p>Last but not the least, <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.953621">de Filippis et al.</ext-link> performed a clinical study on internalized-stigma and dissociative experiences in a sample of patients affected by bipolar disorder in a clinical outpatient setting in Catanzaro, Italy. Their findings suggest that self-stigma is associated with dissociative symptoms, reducing overall quality of life. Thus, authors recommended the early identification of at-risk patients with previous lifetime abuse and high perceived stigma, which could lead the way for an ever more precise tailoring of treatment management in bipolar disorder (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyt.2022.953621">de Filippis et al.</ext-link>).</p>
<p>All in all, the articles collected in this Research Topic reemphasize the importance of mental-health-related stigma as a major public health issue. Due to ongoing substantial research in this field, &#x0201C;<italic>Community Series in Mental-Health-Related Stigma and Discrimination: Prevention, Role, and Management Strategies &#x02013; Volume II</italic>&#x0201D; has been launched for further submissions and we are looking forward to continue exploring this topic.</p>
<sec sec-type="author-contributions" id="s1">
<title>Author contributions</title>
<p>All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.</p></sec>
</body>
<back>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s2">
<title>Publisher&#x00027;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<label>1.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Henderson</surname> <given-names>C</given-names></name> <name><surname>Noblett</surname> <given-names>J</given-names></name> <name><surname>Parke</surname> <given-names>H</given-names></name> <name><surname>Clement</surname> <given-names>S</given-names></name> <name><surname>Caffrey</surname> <given-names>A</given-names></name> <name><surname>Gale-Grant</surname> <given-names>O</given-names></name> <etal/></person-group>. <article-title>Mental health-related stigma in health care and mental health-care settings</article-title>. <source>Lancet Psychiatry</source>. (<year>2014</year>) <volume>1</volume>:<fpage>467</fpage>&#x02013;<lpage>82</lpage>. <pub-id pub-id-type="doi">10.1016/S2215-0366(14)00023-6</pub-id><pub-id pub-id-type="pmid">30176952</pub-id></citation></ref>
<ref id="B2">
<label>2.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rezvanifar</surname> <given-names>F</given-names></name> <name><surname>Shariat</surname> <given-names>SV</given-names></name> <name><surname>Amini</surname> <given-names>H</given-names></name> <name><surname>Rasoulian</surname> <given-names>M</given-names></name> <name><surname>Shalbafan</surname> <given-names>M</given-names></name></person-group>. <article-title>A scoping review of questionnaires on stigma of mental illness in persian</article-title>. <source>Iran J Psychiatry Clin Psychol</source>. (<year>2020</year>) <volume>26</volume>:<fpage>240</fpage>&#x02013;<lpage>56</lpage>. <pub-id pub-id-type="doi">10.32598/ijpcp.26.2.2619.1</pub-id></citation>
</ref>
<ref id="B3">
<label>3.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Adiukwu</surname> <given-names>F</given-names></name> <name><surname>Byty&#x000E7;i</surname> <given-names>DG</given-names></name> <name><surname>Hayek</surname> <given-names>SE</given-names></name> <name><surname>Gonzalez-Diaz</surname> <given-names>JM</given-names></name> <name><surname>Larnaout</surname> <given-names>A</given-names></name> <name><surname>Grandinetti</surname> <given-names>P</given-names></name> <etal/></person-group>. <article-title>Global perspective and ways to combat stigma associated with COVID-19</article-title>. <source>Indian J Psychol Med</source>. (<year>2020</year>) <volume>42</volume>:<fpage>569</fpage>&#x02013;<lpage>74</lpage>. <pub-id pub-id-type="doi">10.1177/0253717620964932</pub-id><pub-id pub-id-type="pmid">33354085</pub-id></citation></ref>
<ref id="B4">
<label>4.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ransing</surname> <given-names>R</given-names></name> <name><surname>Ramalho</surname> <given-names>R</given-names></name> <name><surname>de Filippis</surname> <given-names>R</given-names></name> <name><surname>Ojeahere</surname> <given-names>MI</given-names></name> <name><surname>Karaliuniene</surname> <given-names>R</given-names></name> <name><surname>Orsolini</surname> <given-names>L</given-names></name> <etal/></person-group>. <article-title>Infectious disease outbreak related stigma and discrimination during the COVID-19 pandemic: drivers, facilitators, manifestations, and outcomes across the world</article-title>. <source>Brain Behav Immun</source>. (<year>2020</year>) <volume>89</volume>:<fpage>555</fpage>&#x02013;<lpage>8</lpage>. <pub-id pub-id-type="doi">10.1016/j.bbi.2020.07.033</pub-id><pub-id pub-id-type="pmid">32731007</pub-id></citation></ref>
<ref id="B5">
<label>5.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>de Filippis</surname> <given-names>R</given-names></name> <name><surname>El Hayek</surname> <given-names>S</given-names></name> <name><surname>Shalbafan</surname> <given-names>M</given-names></name></person-group>. <article-title>Editorial: Mental illness, culture, and society: Dealing with the COVID-19 pandemic</article-title>. <source>Front Psychiatry</source>. (<year>2022</year>) <volume>13</volume>:<fpage>1073768</fpage>. <pub-id pub-id-type="doi">10.3389/fpsyt.2022.1073768</pub-id><pub-id pub-id-type="pmid">36506444</pub-id></citation></ref>
<ref id="B6">
<label>6.</label>
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>El Hayek</surname> <given-names>S</given-names></name> <name><surname>de Filippis</surname> <given-names>R</given-names></name> <name><surname>Shalbafan</surname> <given-names>M</given-names></name></person-group>. <article-title>Editorial: Community series in mental illness, culture, and society: Dealing with the COVID-19 pandemic&#x02014;Volume II</article-title>. <source>Front Psychiatry</source>. (<year>2022</year>) <volume>13</volume>:<fpage>1092845</fpage>. <pub-id pub-id-type="doi">10.3389/fpsyt.2022.1092845</pub-id><pub-id pub-id-type="pmid">36506444</pub-id></citation></ref>
</ref-list> 
</back>
</article>