Social Distance and Community Attitudes Towards People with Psycho-Social Disabilities in Uttarakhand, India (original) (raw)
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Indian journal of psychiatry
India faces a significant gap between the prevalence of mental illness among the population and the availability and effectiveness of mental health care in providing adequate treatment. This discrepancy results in structural stigma toward mental illness which in turn is one of the main reasons for a persistence of the treatment gap, whereas societal factors such as religion, education, and family structures play critical roles. This survey-based study investigates perceived stigma toward mental illness in five metropolitan cities in India and explores the roles of relevant sociodemographic factors. Samples were collected in five metropolitan cities in India including Chennai ( = 166), Kolkata ( = 158), Hyderabad ( = 139), Lucknow ( = 183), and Mumbai ( = 278). Stratified quota sampling was used to match the general population concerning age, gender, and religion. Further, sociodemographic variables such as educational attainment and strength of religious beliefs were included in the...
Perception of stigma toward mental illness in South India
Journal of Family Medicine and Primary Care, 2015
Background: Stigma associated with mental illnesses is one of the principal causes for mentally ill people not receiving adequate mental health care and treatment. The study was conducted to assess the extent of stigma associated with mental illness and knowledge of mental illness among the community. Materials and Methods: Community-based, cross-sectional study was conducted among 445 respondents from Udupi district; the community attitude toward the mentally ill (CAMI) scale was used to assess stigma. The probability proportional to sampling size technique was adopted to select the wards/blocks. Household from blocks/wards were selected using convenience sampling. Self-administered semi-structured questionnaire was used to collect the information. Data was analyzed using the software SPSS version 15. Results: Of the total 445 respondents, the prevalence of stigma toward mentally ill people was 74.61% (95% confidence interval, 0.7057, 0.7866). The prevalence of stigma was high under all the four domains of CAMI scale. High prevalence of stigma was seen among females and people with higher income. Conclusions: The overall prevalence of stigma toward PWMI was found to be high. The stigma toward PWMI was associated with gender with respect to AU, BE and CMHI. Hence, the study suggests that there is a strong need to eliminate stigma associated with mental illness to improve the mental health status of the region.
A Rural Community-Based Study on Public Stigma towards Mental Illness from Eastern India
https://www.ijrrjournal.com/IJRR\_Vol.5\_Issue.10\_Oct2018/Abstract\_IJRR0021.html, 2018
Background: Considerable stigmatizing attitude exists towards persons suffering from mental illness in spite of considerable measures to counter stigma. The current study tried to explore level of public stigma towards mental illness from a rural community-based sample from Eastern India. Methods: It was an observational study with cross-sectional design done in a village in Howrah District, West Bengal, India, in 2017. The interview schedule consisted of a socio-demographic and clinical proforma, Attitudes to Mental Illness Questionnaire (AMIQ) and Perceived devaluation discrimination scale (PDD). Results: Of the 602 families, most respondents were females (60.1%) and members of nuclear family (60.6%). Negative attitude towards mental illness was found to be positively correlated to age of the responder, family size and monthly family income. A family history of use of prescription psychotropic medication in the family was found to be significantly correlated to less stigmatizing attitude to persons with mental illness (PMI). Conclusion: Significant public stigma and negative attitude to mental illness exists exist in our sample. There can be discreet attributes in PMI that is distinct from the illness characteristics that needs our attention in the future for success of the anti-stigma campaign. The major limitation of our study was the use of a cross-sectional design and use of sample of convenience.
Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India
Indian Journal of Psychological Medicine, 2019
Background: Stigma is an important factor that determines whether individuals seek treatment for mental illnesses. Studies assessing public perceptions regarding mental illnesses are scarce in India. This study documents the stigma perceived by a rural population toward patients with mental illness and their families. Materials and Methods: A cross-sectional pilot study was done in five villages, selected by simple random sampling, from a rural block in Vellore, Tamil Nadu. Households in each village were selected by systematic random sampling. From the selected households, 150 subjects aged 18-65 years, without known mental disorders, were chosen by convenience sampling, based on availability. Stigma was assessed using the Devaluation of Consumers Scale (DCS) and Devaluation of Consumer's Families Scale (DCFS). Results: The proportion with high perceptions of stigma associated with mentally ill persons was 63.8%, among the 150 interviewed rural respondents (women: 112, median age: 37 years). The proportion which perceived that there was public stigma toward families of those with mental illnesses was 43.4%. Older respondents (>37 years) had higher perceptions of stigma (odds ratio: 2.07; 95% confidence interval: 1.02-4.20) than others. Conclusion: The high perception of stigma associated with persons who are mentally ill as well as their families needs to be kept in mind while planning interventions to decrease the treatment gap for psychiatric morbidity, especially in rural areas.
Journal of Psychosocial Rehabilitation and Mental Health, 2015
Persons with mental illness experience discrimination due to the stigmatizing attitudes of the society. Desired social distance was greater for the person depicted in the psychosis, and the main predictor of greater social distance was perceiving the person as dangerous. In India men with schizophrenia reported being unmarried, hid their illness in job applications and from others, and experienced ridicule and shame. They reported that their experience of stigma was most acute at their places of employment. Women reported experiences of stigma in relation to marriage, pregnancy, and childbirth. The current paper narrates a step model community-based intervention programme that was attempted to reduce stigma prevailed in the community towards persons affected with mental illness and their family. Four members affected with mental illness from a family were reported to the psychiatric hospital with the help of a voluntary organization. Four of them were suffering from chronic schizophrenia and malnutrition. Psychiatric social work team made use of Home Visit, Family Burden Schedule and Stigma Questionnaire to assess the family condition. The assessments revealed that the family was facing serious discrimination in the village; neighbours were not coming home, children threw stones to the home and people considered the family was under the attack of evil spirits. All the family members were deprived of their basic needs like food, water and social living. Other than giving hospital-based treatment for the family members affected with mental illness, availing disability benefits, and rehabilitating the persons, the psychiatric social work team organized one day community-based intervention programme targeting knowledge and attitude of community members towards mental illness. The key elements of community-based intervention were home visits, one to one interaction, collaborative work with local governing bodies, street play, experience sharing by a person affected with mental illness, display and distribution of IEC material, interactive sessions and oath taking. The community-based intervention could bring changes in the stigma, reduced discrimination and increased social acceptance and social support of the family members.
Psychiatry Research, 2017
This study aimed to evaluate the stigma and its correlates among patients with severe mental disorders. Patients with diagnosis of schizophrenia (N=707), bipolar disorder (N=344) and recurrent depressive disorder (N=352) currently in clinical remission from 14 participating centres were assessed on Internalised Stigma of Mental Illness Scale (ISMIS). Patients with diagnosis of schizophrenia experienced higher level of alienation, sterotype endorsement, discrimination experience and total stigma when compared to patients with bipolar disorder and recurrent depressive disorder. Patients with bipolar disorder experienced higher stigma than those with recurrent depressive disorder in the domain of stigma resistance only. Overall compared to affective disorder groups, higher proportion of patients with schizophrenia
Data from: Mental illness, poverty and stigma in India: a case control study
2015
Objective: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Design: Matching case (hospital)–control (population) study. Setting: University Hospital (cases) and National Capital Region (controls), India. Participants: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Main outcome measures: Higher risk of poverty due to stigma among PSMI. Results: 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls (p<0.001) or controls from other castes (p<0.001). Conclusions: Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues
Mental illness, poverty and stigma in India: a case control study
Objective –To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Design – Matching Case (hospital) control (population) study. Setting – University Hospital (cases) and National Capital Region (NCR) (controls), India. Participants A case-control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Main outcome measures – Higher risk of poverty due to stigma among PSMI. Results - 38.5% of PSMI compared to 22.2% of controls were found poor on 6 dimensions or more. The difference in Multidimensional poverty index (MPI) was 69% between groups with employment and income the main contributors. Multidimensional poverty was strongly associated with stigma (odds ratio [OR] 2.60, 95% CI 1.27-5.31), scheduled castes/scheduled tribes/ other backward castes (SC/ST/OBC) (2.39, 1.39-4.08), mental illness (2.07, 1.25-3.41), and female gender (1.87, 1.36-2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls (p<0.001) or controls from other castes (p<0.001). Conclusions – Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. Particularly for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues. Article summary Strengths and limitations • There is little research on effects of stigma and poverty in developing settings • Lack of employment and income are major contributors to multidimensional poverty for PSMI • Intensity of multidimensional poverty is higher for PSMI, particularly women with SMI and those from SC/ST/OBC • Limitation: Stigma was operationalized through a single item question rather than a multiple-item scale and we could not assess reliability of this item. SMI was diagnosed for persons attending a public psychiatric department; PSMI not receiving medical treatment might be more marginalised and at greater risk of poverty than those receiving healthcare.
International Journal of Mental Health Systems
Stigma, discrimination, poor help seeking, dearth of mental health professionals, inadequate services and facilities all adversely impact the mental health treatment gap. Service utilization by the community is influenced by cultural beliefs and literacy levels. We conducted a situational analysis in light of the little information available on mental health related stigma, service provision and utilization in Haryana, a state in Northern India. This involved: (a) qualitative key informant interviews; (b) health facility records review; and (c) policy document review to understand the local context of Faridabad district in Northern India. Ethical approvals for the study were taken before the study commenced. Phone call in-depth interviews were carried out with a purposive sample of 13 participants (Mean = 38.07 years) during the COVID-19 pandemic, which included 4 community health workers, 4 people with mental illness, 5 service providers (primary health care doctors and mental heal...