Abstract
Background: There is limited research on mental health literacy and stigmatization attitudes towards mental illness in Tunisia, despite the increasing need for such research to better understand its complexity in a specific country context. Using an exploratory mixed-method approach this study attempted to assess the needs and perceptions about mental health within a population of Tunis-based young adults.
 Methods: A sample of 80 participants completed an online survey on different aspects of mental health attitudes, mental illness literacy and stigma, with a subset of survey participants participating in one-on-one interviews.
 Results: Survey results show that 77% of respondents completely agreed or somewhat agreed that they would like to learn more about mental health. This study also found that 68% of the sample reported a lack of accessibility to mental healthcare services resulting in 49% reporting their preference to search their symptoms on the internet instead of informing someone. Throughout the interviews phase, the main factors identified to have a crucial impact on young adults' choice to openly communicate feelings and thoughts with each other and to seek professional help are: culture, gender roles, sexual orientation, and family approval.
 Conclusion: This study suggests a great desire among young adults to learn more about mental health, and highlights the cultural complexities regarding mental health stigmatization in Tunisia. It also highlights the need for culturally relevant approaches raising awareness about mental health.
Highlights
Stigmatization is defined as “ the action of describing or regarding someone or something as worthy of disgrace or great disapproval” (Lexico, 2020)
This research aims to address the following questions: what are the beliefs, attitudes and the shared knowledge related to mental health among young adults in Tunisia? And what are the social contributors that affect young adults access to mental health services? This study will provide a first snapshot of the perspectives of young adults on mental health in Tunis, Tunisia by investigating the intersection of individuals’ mental health literacy, social and personal stigmatization attitudes, and the existing social barriers in regards to access to mental health services
Participants were first asked to describe what “mental well-being” means to them by selecting concepts from a pool of options inspired from the World Health Organization definition of mental health: “Mental health is more than just the absence of mental disorders or disabilities
Summary
Stigmatization is defined as “ the action of describing or regarding someone or something as worthy of disgrace or great disapproval” (Lexico, 2020). Using an explanatory mixed-method approach this study attempted to assess the mental health stigmatization attitudes, literacy and access to services within a population of Tunis-based young adults. Conclusion: This study suggests a great desire among young adults to learn more about mental health, and highlights the cultural complexities regarding mental health stigmatization in Tunisia. It highlights the need for accessible mental health services and information as well as culturally relevant approaches to reducing stigma and raising awareness surrounding mental health
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