Abstract
BackgroundStigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi.MethodsA cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”.Results210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample.ConclusionsOur study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.
Highlights
Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty
Our study found less stigmatising beliefs in terms of social distance compared with Nigerian samples (8.1% of our sample compared with 82.9% in Nigeria)
Though it is possible that older participants were more conservative and so were more likely to consider those with mental illness a nuisance, and that younger participants might have had more experience of alcohol and illicit drugs as a direct cause of mental illness, it needs to be borne in mind that we found no consistent differences in stigmatising beliefs between demographic groups, only single question associations
Summary
Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Work in the field suggested that stigma might be less common in Africa, in Muslim countries [6] Evidence to discredit this view (or “contrary to this view”) began to emerge from Islamic states such as Morocco where stigma was found to be a major burden to families [7]. In surveys of community attitudes to mental illness in South Africa, members of the general public have been found to attribute mental illness to stress or a lack of willpower rather than a medical illness [9]
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