The Psychometric Properties of Scales Assessing Family Context Stigma in Severe Mental Illness: A Systematic Review

Stigma experienced and/or conveyed by family members of individuals with mental health conditions may impact on their health and wellbeing, and on the quality of care and health outcomes of people with lived experience of mental illness. However, most of the research on stigma and mental illness has been on public attitudes and behaviors of patients rather than what is expressed by or experienced within families. We aimed to identify scales that assess stigma in the context of family life, and to evaluate their psychometric properties. A literature search across Web of Science, PsycINFO, Medline, Scopus, and ProQuest Social Science (up to August 2025) yielded 14 eligible studies, reported via PRISMA. None of the 14scales directly or solely assesses family-context stigma, but includes dimensions of self or public stigma, especially related to schizophrenia, possibly neglecting other forms of severe mental illness (SMI). In addition, existing tools often overlook the full range of family relationships and diverse caregiving experiences. There is a need for measures that more adequately and comprehensively capture the often complex and nuanced experience of mental illness stigma within families.