Structural stigma and its impact on healthcare for borderline personality disorder: a scoping review.
Borderline personality disorder
Carers
Consumers
Crisis care
Families
Health practitioners
Health services
Health systems
Healthcare
Structural stigma
Journal
International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224
Informations de publication
Date de publication:
29 Sep 2022
29 Sep 2022
Historique:
received:
19
05
2022
accepted:
05
09
2022
entrez:
29
9
2022
pubmed:
30
9
2022
medline:
30
9
2022
Statut:
epublish
Résumé
People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners. A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, and the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data. A total of 57 citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in health systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis and BPD-related stigma surrounding health and crisis care services. Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. It is anticipated that results of this review will inform future research, policy, and practice to address BPD-related stigma in health systems, as well as approaches for improving the delivery of responsive health services and care for consumers with BPD and their carers/families. Open Science Framework ( https://osf.io/bhpg4 ).
Sections du résumé
BACKGROUND
BACKGROUND
People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners.
METHODS
METHODS
A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, and the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data.
RESULTS
RESULTS
A total of 57 citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in health systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis and BPD-related stigma surrounding health and crisis care services.
CONCLUSION
CONCLUSIONS
Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. It is anticipated that results of this review will inform future research, policy, and practice to address BPD-related stigma in health systems, as well as approaches for improving the delivery of responsive health services and care for consumers with BPD and their carers/families.
REVIEW REGISTRATION
BACKGROUND
Open Science Framework ( https://osf.io/bhpg4 ).
Identifiants
pubmed: 36175958
doi: 10.1186/s13033-022-00558-3
pii: 10.1186/s13033-022-00558-3
pmc: PMC9520817
doi:
Types de publication
Journal Article
Langues
eng
Pagination
48Subventions
Organisme : Suicide Prevention Australia
ID : # 576.43400
Informations de copyright
© 2022. The Author(s).
Références
Syst Rev. 2021 Jan 11;10(1):23
pubmed: 33423674
Am Psychol. 2016 Nov;71(8):742-751
pubmed: 27977256
Psychiatr Serv. 2009 Aug;60(8):1128-31
pubmed: 19648203
Issues Ment Health Nurs. 1998 Mar-Apr;19(2):97-112
pubmed: 9601307
Psychiatr Serv. 2017 Feb 1;68(2):167-172
pubmed: 27691382
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
Psychiatr Serv. 2014 Jun 1;65(6):802-7
pubmed: 24585205
Front Psychiatry. 2017 Aug 04;8:136
pubmed: 28824467
Harv Rev Psychiatry. 2004 Mar-Apr;12(2):94-104
pubmed: 15204804
J Psychiatr Ment Health Nurs. 2008 Nov;15(9):703-9
pubmed: 18844794
J Psychosoc Nurs Ment Health Serv. 2013 Jan;51(1):20-9
pubmed: 23244348
Int J Ment Health Nurs. 2020 Oct;29(5):868-877
pubmed: 32304273
BMC Med. 2019 Feb 15;17(1):41
pubmed: 30770756
Neuropsychiatr Dis Treat. 2016 Sep 22;12:2439-2448
pubmed: 27703362
Compr Psychiatry. 2007 Jul-Aug;48(4):329-36
pubmed: 17560953
J Ment Health. 2016;25(1):5-9
pubmed: 26360788
Community Ment Health J. 2016 Apr;52(3):262-71
pubmed: 26173403
Int J Ment Health Nurs. 2013 Oct;22(5):465-71
pubmed: 23294488
Psychiatr Clin North Am. 1994 Dec;17(4):715-30
pubmed: 7533284
J Psychiatr Ment Health Nurs. 2012 May;19(4):341-7
pubmed: 22070628
Borderline Personal Disord Emot Dysregul. 2015 May 05;2:9
pubmed: 26401311
BMC Psychiatry. 2015 Jan 22;15:2
pubmed: 25609479
Arch Psychiatr Nurs. 2000 Feb;14(1):12-8
pubmed: 10692802
Community Ment Health J. 2013 Dec;49(6):643-8
pubmed: 23054157
Psychiatry Res. 2015 Aug 30;228(3):963-5
pubmed: 26184990
Front Psychiatry. 2015 Jul 08;6:101
pubmed: 26217243
Aust N Z J Psychiatry. 2008 Jul;42(7):578-84
pubmed: 18612861
J Pers Disord. 2016 Aug;30(4):567-76
pubmed: 26111249
World Psychiatry. 2014 Jun;13(2):153-60
pubmed: 24890068
Soc Sci Med. 2014 Dec;123:7-17
pubmed: 25462600
J Pers Disord. 2004 Jun;18(3):226-39
pubmed: 15237043
Int J Qual Stud Health Well-being. 2019 Dec;14(1):1667133
pubmed: 31526310
J Psychiatr Ment Health Nurs. 2015 May;22(4):234-43
pubmed: 25857849
Personal Ment Health. 2013 Aug;7(3):242-53
pubmed: 24343967
J Psychiatr Ment Health Nurs. 2007 Oct;14(7):670-8
pubmed: 17880661
Personal Ment Health. 2019 Nov;13(4):230-238
pubmed: 31411004
J Pers Disord. 2016 Dec;30(6):848-856
pubmed: 26623537
Australas Emerg Care. 2019 Mar;22(1):34-41
pubmed: 30998870
Contemp Nurse. 2006 Feb-Mar;21(1):120-30
pubmed: 16594889
Int J Ment Health Nurs. 2019 Jun;28(3):757-765
pubmed: 30779279
J Pers Disord. 2014 Oct;28(5):734-50
pubmed: 25248122
Int J Ment Health Nurs. 2020 Oct;29(5):972-981
pubmed: 32426937
BMC Med. 2019 Feb 15;17(1):25
pubmed: 30764806
J Ment Health. 2019 Mar 12;:1-21
pubmed: 30862201
Eur Child Adolesc Psychiatry. 1996 Apr;5(1):11-7
pubmed: 9117533
Int J Ment Health Nurs. 2002 Sep;11(3):186-91
pubmed: 12510596
Hosp Community Psychiatry. 1991 Oct;42(10):1015-21
pubmed: 1959892
CMAJ. 2010 Dec 14;182(18):E839-42
pubmed: 20603348
BMC Psychiatry. 2017 Jun 15;17(1):221
pubmed: 28619017
BMC Med Res Methodol. 2018 Nov 19;18(1):143
pubmed: 30453902
Int J Evid Based Healthc. 2015 Sep;13(3):132-40
pubmed: 26360830
Asian Nurs Res (Korean Soc Nurs Sci). 2019 Dec;13(5):287-294
pubmed: 31756513
J Psychiatr Ment Health Nurs. 2003 Aug;10(4):393-401
pubmed: 12887630
BJPsych Open. 2019 Jan;5(1):e1
pubmed: 30575497
Harv Rev Psychiatry. 2013 Sep-Oct;21(5):248-58
pubmed: 24651557
Soc Sci Med. 2015 Oct;142:82-9
pubmed: 26298091
J Clin Psychiatry. 2008 Apr;69(4):533-45
pubmed: 18426259
Schizophr Bull. 2004;30(3):481-91
pubmed: 15631241
Health (London). 2013 Jan;17(1):37-56
pubmed: 22674745
Compr Psychiatry. 2011 Sep-Oct;52(5):548-55
pubmed: 21130423
J Nerv Ment Dis. 2015 Jan;203(1):8-12
pubmed: 25536098
Res Nurs Health. 1999 Aug;22(4):285-93
pubmed: 10435546
Arch Psychiatr Nurs. 2011 Dec;25(6):e69-76
pubmed: 22114808
J Psychiatr Ment Health Nurs. 2021 Apr;28(2):208-236
pubmed: 32367638
Psychiatr Clin North Am. 2018 Dec;41(4):561-573
pubmed: 30447724
Personal Ment Health. 2018 Nov;12(4):309-320
pubmed: 30094955
Br J Clin Psychol. 2003 Sep;42(Pt 3):243-56
pubmed: 14565891
Psychiatr Serv. 1998 Feb;49(2):173-4
pubmed: 9574999
Arch Psychiatr Nurs. 2005 Aug;19(4):160-8
pubmed: 16088854
J Clin Nurs. 2009 Feb;18(3):440-50
pubmed: 19191992
Biol Psychiatry. 2007 Sep 15;62(6):553-64
pubmed: 17217923
Contemp Nurse. 2006 Feb-Mar;21(1):43-9
pubmed: 16594881
BMJ Open. 2019 Feb 27;9(2):e026616
pubmed: 30819713
J Psychiatr Ment Health Nurs. 2015 Sep;22(7):510-21
pubmed: 26122817
J Ment Health. 2019 Aug;28(4):443-457
pubmed: 28686468
J Psychiatr Pract. 2010 May;16(3):145-54
pubmed: 20485102
Medicina (Kaunas). 2019 May 28;55(6):
pubmed: 31142033
Cochrane Database Syst Rev. 2012 Jun 13;(6):CD009353
pubmed: 22696385
Lancet Psychiatry. 2018 Sep;5(9):747-764
pubmed: 29680468
Psychiatr Serv. 2019 Sep 1;70(9):772-781
pubmed: 31138059
J Psychiatr Ment Health Nurs. 2021 Aug;28(4):670-681
pubmed: 33202081
J Pers Disord. 2011 Dec;25(6):806-12
pubmed: 22217226
Curr Psychiatry Rep. 2016 Jan;18(1):11
pubmed: 26780206
PLoS One. 2016 Aug 09;11(8):e0160515
pubmed: 27504634
Int J Environ Res Public Health. 2018 Dec 06;15(12):
pubmed: 30563256
Innov Clin Neurosci. 2013 May;10(5-6):39-43
pubmed: 23882440
Int J Nurs Stud. 2016 Apr;56:114-27
pubmed: 26747180
Aust N Z J Psychiatry. 2008 Nov;42(11):981-8
pubmed: 18941964
J Psychiatr Ment Health Nurs. 2015 Oct;22(8):623-33
pubmed: 26148873
Nurs Res Pract. 2012;2012:601918
pubmed: 22577537
J Ment Health. 2014 Oct;23(5):251-5
pubmed: 25222368
J Psychiatr Ment Health Nurs. 2019 Sep;26(7-8):244-253
pubmed: 31237384
Syst Rev. 2022 May 30;11(1):108
pubmed: 35637499
Harv Rev Psychiatry. 2006 Sep-Oct;14(5):249-56
pubmed: 16990170
J Clin Nurs. 2019 Jul;28(13-14):2613-2623
pubmed: 30830704
J Nerv Ment Dis. 2018 Nov;206(11):865-869
pubmed: 30371640