Australian national mental health policy outlines the need for a nationally coordinated strategy to address stigma and discrimination, particularly towards people with complex mental illness that is poorly understood in the community. To inform implementation of this policy, this review aimed to identify and examine the effectiveness of existing Australian programs or initiatives that aim to reduce stigma and discrimination. Programs were identified via a search of academic databases and grey literature, and an online survey of key stakeholder organisations. Eligible programs aimed to reduce stigma towards people with complex mental illness, defined as schizophrenia, psychosis, personality disorder, or bipolar disorder; or they focused on nonspecific ‘mental illness’ but were conducted in settings relevant to individuals with the above diagnoses, or they included the above diagnoses in program content. Key relevant data from programs identified from the literature search and survey were extracted and synthesized descriptively. We identified 61 programs or initiatives currently available in Australia. These included face-to-face programs (n = 29), online resources (n = 19), awareness campaigns (n = 8), and advocacy work (n = 5). The primary target audiences for these initiatives were professionals (health or emergency), people with mental illness, family or carers of people with mental illness, and members of the general population. Most commonly, programs tended to focus on stigma towards people with non-specific mental illness rather than on particular diagnostic labels. Evidence for effectiveness was generally lacking. Face-to-face programs were the most well-evaluated, but only two used a randomised controlled trial design. This study identified areas of strength and weakness in current Australian practice for the reduction of stigma towards people with complex mental illness. Most programs have significant input from people with lived experience, and programs involving education and contact with a person with mental illness are a particular strength. Nevertheless, best-practice programs are not widely implemented, and we identified few programs targeting stigma for people with mental illness and their families, or for culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander communities and LGBTIQ people. These can inform stakeholder consultations on effective options for a national stigma and discrimination reduction strategy.

中文翻译：

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审查澳大利亚减少对复杂精神疾病患者污名化的举措：什么存在，什么有效？

澳大利亚国家精神卫生政策概述了需要在全国范围内采取协调一致的战略来解决污名和歧视问题，特别是针对社区中知之甚少的复杂精神疾病患者。为了告知该政策的实施，本次审查旨在确定和检查旨在减少污名和歧视的现有澳大利亚计划或举措的有效性。通过搜索学术数据库和灰色文献，以及对主要利益相关者组织的在线调查，确定了项目。符合条件的计划旨在减少对患有复杂精神疾病（定义为精神分裂症、精神病、人格障碍或双相情感障碍）的人的污名化；或者他们专注于非特定的“精神疾病”，但在与上述诊断的个人相关的环境中进行，或者他们在节目内容中包含了上述诊断。从文献检索和调查中确定的项目的关键相关数据被提取和综合描述。我们确定了澳大利亚目前可用的 61 项计划或举措。其中包括面对面计划（n = 29）、在线资源（n = 19）、宣传活动（n = 8）和宣传工作（n = 5）。这些举措的主要目标受众是专业人员（健康或急诊）、精神疾病患者、精神疾病患者的家人或照顾者，以及一般人群。最常见的是，项目倾向于关注对非特定精神疾病患者的污名，而不是特定的诊断标签。有效性的证据普遍缺乏。面对面的课程是最受好评的，但只有两个使用了随机对照试验设计。这项研究确定了当前澳大利亚实践中在减少对复杂精神疾病患者的耻辱感方面的优势和劣势领域。大多数项目都有来自有生活经验的人的重要投入，涉及教育和与精神疾病患者接触的项目是一个特别的优势。然而，最佳实践计划并未得到广泛实施，我们发现很少有针对精神疾病患者及其家人、文化和语言多样化社区、土著和托雷斯海峡岛民社区以及 LGBTIQ 人群的污名化计划。这些可以为利益相关者就国家减少污名和歧视战略的有效选择进行磋商提供信息。这项研究确定了当前澳大利亚实践中在减少对复杂精神疾病患者的耻辱感方面的优势和劣势领域。大多数项目都有来自有生活经验的人的重要投入，涉及教育和与精神疾病患者接触的项目是一个特别的优势。然而，最佳实践计划并未得到广泛实施，我们发现很少有针对精神疾病患者及其家人、文化和语言多样化社区、土著和托雷斯海峡岛民社区以及 LGBTIQ 人群的污名化计划。这些可以为利益相关者就国家减少污名和歧视战略的有效选择进行磋商提供信息。这项研究确定了当前澳大利亚实践中在减少对复杂精神疾病患者的耻辱感方面的优势和劣势领域。大多数项目都有来自有生活经验的人的重要投入，涉及教育和与精神疾病患者接触的项目是一个特别的优势。然而，最佳实践计划并未得到广泛实施，我们发现很少有针对精神疾病患者及其家人、文化和语言多样化社区、土著和托雷斯海峡岛民社区以及 LGBTIQ 人群的污名化计划。这些可以为利益相关者就国家减少污名和歧视战略的有效选择进行磋商提供信息。