Stigma is integral to understanding mental health disparities among racial and ethnic minority groups in the United States. We conducted a systematic review to identify empirical studies on cultural aspects of mental illness stigma (public, structural, affiliative, self) among three racial and ethnic minority groups (Asian Americans, Black Americans, Latinx Americans) from 1990 to 2019, yielding 97 articles. In comparison studies (N = 25), racial and ethnic minority groups often expressed greater public and/or self-stigma than White American groups. In within-group studies (N = 65; Asian American, n = 21; Black American, n = 18; Latinx American; n = 26), which were primarily qualitative (73%), four major cultural themes emerged: 1) service barriers including access and quality (structural stigma); 2) family experiences including concealment for family’s sake, fear of being a burden, and stigma extending to family (affiliative stigma); 3) lack of knowledge about mental illness and specific cultural beliefs (public stigma); and 4) negative emotional responses and coping (self-stigma). These findings confirmed stigma has both similar and unique cultural aspects across groups. Despite this, few studies tested stigma reduction interventions (N = 7). These cultural insights can inform contextual change at the health systems and community levels to reduce stigma, and empowerment at the interpersonal and individual levels to resist stigma.

中文翻译：

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对美国种族和少数族裔群体的耻辱感和精神疾病的文化方面的系统评价：干预措施的意义

污名对于了解美国种族和少数族裔群体之间的心理健康差异是不可或缺的。我们进行了一项系统评价，以确定 1990 年至 2019 年三个种族和少数族裔群体（亚裔美国人、黑人美国人、拉丁裔美国人）中精神疾病污名（公共、结构、附属、自我）的文化方面的实证研究，产生了 97 篇文章. 在比较研究 ( N  = 25) 中，种族和少数族裔群体通常比美国白人群体表现出更大的公众和/或自我污名。在组内研究中（N  = 65；亚裔美国人，n  = 21；美国黑人，n  = 18；拉丁美洲人；n = 26)，主要是定性的 (73%)，出现了四大文化主题：1) 服务障碍，包括获取和质量（结构性污名）；2) 家庭经历，包括为家庭隐瞒、害怕成为负担、污名延伸到家庭（亲缘污名）；3) 缺乏对精神疾病和特定文化信仰的了解（公众污名）；4）消极的情绪反应和应对（自我污名）。这些发现证实了污名在不同群体之间具有相似和独特的文化方面。尽管如此，很少有研究测试减少污名的干预措施（N  = 7）。这些文化见解可以为卫生系统和社区层面的背景变化提供信息，以减少污名，并在人际和个人层面赋予权力以抵制污名。