The Impact of Stigma on Mental Health Service Utilization and Treatment Adherence: A Systematic Review
Echezonachukwu Sandra Eziechi MD1, Chinonso Felistas Eziechi MD2, Joshua Tess Green MD3, Ohiri Chiamaka Judith MD4, Akinyemi Akinwumiju MD5, Opemipo Adetifa MD6, Soji Ojo MD, MPH7, Chisom Okaro O. MD8
Abstract
Background: Mental health conditions are widespread, yet many people either delay seeking help or do not remain in treatment once they start. Stigma, whether felt personally, expressed by others, or reinforced by institutions, continues to play a major role in shaping these behaviors. Because stigma can limit service use and disrupt adherence, it is important to understand how it operates across different settings. Methods: Following PRISMA guidelines, a systematic review was undertaken. Searches were carried out in PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between January 2015 and July 2025. Eligible papers examined stigma as a factor influencing help-seeking, service use, or treatment adherence. Study quality was evaluated with the R-AMSTAR tool, and findings were summarized thematically. Findings: Twenty-six studies were included: 10 systematic reviews and meta-analyses, 9 observational studies, and 7 intervention or implementation studies. Public stigma was consistently linked with reduced help-seeking, with those perceiving high stigma being about half as likely to pursue care. Self-stigma was strongly tied to treatment dropout and poor adherence, while structural stigma compounded barriers in low- and middle-income countries. Interventions showing promise ranged from peer support and school-based initiatives to provider training and broader policy reforms. Conclusion: Stigma remains a major barrier to mental health care worldwide. Tackling it requires strategies that work at multiple levels and are sensitive to cultural contexts, with the ultimate goal of reducing barriers, supporting adherence, and narrowing the global treatment gap.
Keywords
stigma; mental health; treatment adherence; help-seeking; systematic review; service utilization.
Cite This Article
Eziechi, E. S., Eziechi, C. F., Green, J. T., Judith, O. C., Akinwumiju, A., Adetifa, O., Ojo, S., & Okaro, C. O. (2025). The Impact of Stigma on Mental Health Service Utilization and Treatment Adherence: A Systematic Review. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 5: Sep – Oct 2025, Pages 837-846 URL: https://www.ijscia.com/wp-content/uploads/2025/09/Volume6-Issue5-Sep-Oct-No.938-837-846.pdf
Volume 6 | Issue 5: Sep – Oct 2025
