Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India

Abstract

Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India.Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face.Results: Level of education (B = −0.192, ß = −0.320, p < 0.000) and urban-rural comparison (B = −0.272, ß = −0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals.Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.

Reliability and validity of Malayalam version of 12-item Community Attitude Towards Mental Illness (CAMI-12) questionnaire

“…34 Our study has found that 28% of participants had high levels of stigma towards people with mental illness, and this finding is consistent with other Indian studies as well as studies from Kerala. [18][19][20][21][22][23][24] Our study was conducted in a tertiary care setting and would have resulted in a Berksonian bias as majority of the patients attending our centre are having severe MI. The readministration of CAMI-12 at four weeks may have contributed to a recall bias.…”

“…19 Another explanatory mixed-method study conducted in India among 395 participants aged between 18 to 65 years regarding rural community attitude towards mental health revealed that the major barriers to mental healthcare were the denial of mental illness by patients due to fear of social stigma, lack of availability of mental health services and faith on religious healers. 20 A descriptive cross-sectional study conducted in India among 300 relatives of patients with MI, using the public perceptions of mental illness questionnaire, indicated that there is a poor understanding regarding the nature of mental illness, its implications for social integration, and management among the general public. 21 A study from Kerala aimed at exploring the stigma in the Indian context by considering the experience of patients, caregivers and community members found that the experiences similar to that of stigma in Europe and the United States were elicited, but local dimensions specific to the Indian context were observed to be important.…”