Internalized Stigma in Persons With Mental Illness in Qatar: A Cross-Sectional Study.

Vahe Kehyayan,Suhaila Ghuloum,Tamara Marji,Hassen Al-Amin,Ziyad Mahfoud

doi:10.3389/fpubh.2021.685003

Abstract

Stigma impacts persons with mental illness (PWMI), their families and network of friends, the public and health care professionals. Stigma is a major barrier for PWMI to seeking treatment, which contributes to the burden of disease, disability, and mortality. Research on stigma is relatively scant in the Middle East region and particularly in Qatar. To address stigma effectively in each culture, it is essential to study its nature in the context where the PWMI experience stigma. The purpose of this study was to assess the prevalence of internalized stigma in PWMI in Qatar. A cross-sectional study of PWMI receiving outpatient mental health services in Qatar was done. We interviewed 417 PWMI using a modified 18-item version of the short form of the Internalized Stigma of Mental Illness (ISMI) Scale. Descriptive and regression models were used to analyze the data. The Cronbach alpha for the modified 18-items ISMI was 0.87. Participants' average score on this scale was 2.07 ± 0.38 with 41 (9.8%) of them scoring more than 2.5 which is considered “high” stigma score. In multivariate logistic regression, high stigma (modified ISMI score >2.5) was significantly higher among PWMI with no formal education and among those who reported lower levels of social support. The reported levels of internalized stigma in this vulnerable population of Qatar fall at the lower spectrum reported worldwide. An anti-stigma education program designed for the context of Qatar emphasizing on education and support for PWMI may be conducive to creating an all-inclusive society.

Highlights

Mental illness-related stigma and discrimination is widespread worldwide in the general public, health care professions, health service providers and policy makers, and even in persons with mental disorders [1,2,3,4,5,6]
The Mental Health Service (MHS) is governed by the Hamad Medical Corporation (HMC): the principal provider of secondary and tertiary health care in Qatar
Over 52% (n = 217) were Arabs with Qatari nationals making up 14.39% (n = 60)

Summary

Introduction

Mental illness-related stigma and discrimination is widespread worldwide in the general public, health care professions, health service providers and policy makers, and even in persons with mental disorders [1,2,3,4,5,6]. Stigma is a subjective and complex concept because individuals’ experiences of stigma are influenced by their beliefs and culture [16]. Studies have shown an association between experienced self-stigma and culture [7, 17, 18]. A study that compared public attitudes toward auditory hallucinations in persons with mental illness reported more negative attitudes in Saudi Arabia than

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