A perioperative management elective as a transition-to-practice intervention: effects on preparedness, professional identity, and career decision-making.

Mental health within the Caribbean is a significant, yet long-neglected issue and remains greatly underrepresented in the global mental health literature. There is considerable historical and ongoing mental health stigma in the Caribbean. This hinders the understanding of this topic within the cultural context and the development of relevant interventions. In this qualitative study, we explored the lived experiences of mental health stigma and help-seeking among young people in Barbados living with mental health conditions. The findings highlight the integral role of culture and social networks in mental health perspectives, understandings and experiences, as well as the negative impact of anticipated and experienced stigma on help-seeking. Furthermore, opinions and experiences of formal health care point to the need for greater community care and improved quality and accessibility of services. This study contributes to understanding the significant burden mental health stigma places on well-being and how it acts as a pervasive barrier to help-seeking, especially in young people. It provides locally grounded, novel insights, which can serve as a valuable resource to support practice, policy and research implications within the community in Barbados. It is estimated that at least 1 in 10 children and young people globally experience mental health challenges (Kaushik et al., ), with 50% of these challenges starting by age 14 and 75% by age 24 (Kessler et al., ). Untreated mental ill health in young people has been found to continue into adulthood, supporting the essential need for early identification and intervention (Radez et al., ). Poor mental health among young people can negatively impact emotions, behaviours, relationships, physical health, education, employment and quality of life, and can increase the risk of suicide (Dattani et al., ; Moitra et al., ). Although evidence-based mental health interventions are available (Reynolds et al., ), there are many reasons why young people often do not receive the care they need, including difficulty detecting mental health conditions and limited availability of services (Gulliver et al., ). Notably, one of the leading contributors to the exacerbation of mental health challenges and delays in seeking and accessing mental health treatment is stigma. Mental health stigma can be defined as a problem of knowledge (i.e., a lack of or ignorance), negative attitudes (i.e., prejudice) and negative behaviour from stereotypes, misunderstandings or prejudice (i.e., discrimination) towards people with mental health conditions (Thornicroft et al., ). Literature has identified many types of stigma, including public stigma, internalised stigma, stigma by association and structural discrimination (Thornicroft et al., ). Public stigma refers to society’s beliefs and reactions towards those with mental health conditions. Internalised stigma, also known as self-stigma, references the internalisation of negative attitudes or beliefs commonly held by others. Stigma by association occurs due to one’s association with someone who is stigmatised. Structural discrimination describes the discrimination in laws, policies and practices. Individuals may also experience intersectional stigma, whereby multiple aspects of one’s identity are stigmatised, which converge, leading to unique experiences of disadvantage (Butler et al., ).