Abstract
The current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach. Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18-65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Exploratory structural equation modelling and confirmatory factor analysis were used to establish the dimensions of stigma. Multivariable linear regressions were conducted to examine factors associated with each of the stigma scale scores. The mean age of the respondents was 40.9 years and gender was equally represented (50.9% were males). The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising 'weak-not-sick' and 'dangerous/unpredictable' while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores. Those administered the alcohol abuse vignette were associated with higher social distance scores. This population-wide study found significant stigma towards people with mental illness and identified specific groups who have more stigmatising attitudes. The study also found that having a friend or family member with similar problems was associated with having lower personal as well as social distance stigma. There is a need for well-planned and culturally relevant anti-stigma campaigns in this population that take into consideration the findings of this study.
Highlights
Stigma is defined by the World Health Organisation (WHO) as ‘a mark of shame, disgrace or disapproval that results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society’ (World Health Organization, 2001)
Stigma has been linked to adverse outcomes for people with mental illness as it acts as a barrier to help-seeking as well as achievement of age-appropriate functional goals (Corrigan et al 2009; Clement et al 2015)
The current study aims to bridge this gap by examining stigma among the adult population in an Asian society
Summary
Stigma is defined by the World Health Organisation (WHO) as ‘a mark of shame, disgrace or disapproval that results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society’ (World Health Organization, 2001). Stigma has been linked to adverse outcomes for people with mental illness as it acts as a barrier to help-seeking as well as achievement of age-appropriate functional goals (Corrigan et al 2009; Clement et al 2015). In an attempt to circumvent the stigma associated with mental illness there is ‘label avoidance’ i.e. people are reluctant to be diagnosed with or be seen as seeking treatment for mental illness (Corrigan et al 2014). Public stigma can lead to ‘self-stigma’ (Link, 1987) among those with mental.
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