Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan

Abstract

Background The evidence base for stigma in mental health largely originates from high-income countries. Aims This study from Pakistan aimed to address the gap in literature on stigma from low- and middle-income countries. Method This cross-sectional study surveyed 1470 adults from Karachi, Pakistan. Participants from three groups (healthcare professionals, healthcare students and the general public) completed the adapted Bogardus Social Distance Scale (SDS) as a measure of stigma. Results All three groups reported higher scores of stigma toward mental disorders compared with physical disorders. SDS scores for mental illness in the general public were significantly higher than in healthcare students (mean difference (MD) 6.93, 95% CI 5.45–8.45, P < 0.001) and healthcare professionals (MD 6.93, 95% CI 5.48–8.38, P < 0.001). However, SDS scores between healthcare students and healthcare professionals were not significantly different (MD 0.003, 95% CI −1.14–1.14, P > 0.99). Being female was associated with lower stigma scores and being over the age of 30 years was associated with higher stigma scores. Conclusions Stigma campaigns in Pakistan need to target the general population. However, evidence of negative attitudes toward mental illness in healthcare students and healthcare professionals supports the need for stronger emphasis on psychiatric education within undergraduate and postgraduate training in Pakistan.

Impact of discrimination and coping on Veterans’ willingness to seek treatment for physical and mental health problems.

“…Unfortunately, mental health conditions are also more stigmatized than physical health conditions. A wealth of literature has found that mental health conditions (e.g., addiction, psychosis, depression, suicide) are seen as more “onset-controllable” (individuals are responsible or to blame for these conditions) and elicit less pity and willingness to assist than physical health conditions (e.g., cancer, diabetes, heart disease; Corrigan et al, 2000; Cryer et al, 2020; Husain et al, 2020; Weiner et al, 1988). Addiction seems to be especially stigmatized relative to other mental health conditions and physical disabilities (Corrigan et al, 2009; Rundle et al, 2021).…”

“…This study examined the prevalence of and willingness to seek treatment for physical and mental health problems in a racially diverse sample of Veterans. First, because mental health conditions tend to be more stigmatized than physical health conditions (Corrigan et al, 2009; Cryer et al, 2020; Husain et al, 2020), we hypothesized that Veterans would report greater willingness to seek treatment for physical than mental health conditions. Given the prevalence and elevated stigma associated with alcohol-related problems in military and Veteran populations (Barlas et al, 2013; Rundle et al, 2021), responses were examined both in the full sample and the subsample who reported hazardous drinking in the past year.…”

Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners

“…Contrary to other studies assessing this dimension, which have specifically focused on stigma towards individuals with substance use disorders (van Boekel et al, 2013), our results suggest that the higher perception of dangerousness and responsibility among GPs is unspecific and applies to mental illness in general. Score in these dimensions tends to depend on exposure to, and knowledge about, mental illness (Husain et al, 2020), both of which are higher among psychiatrists. As such, we argue that these results may reflect GP’s lack of knowledge and distorted social views on mental illness.…”

“…Second, we found male physicians to exhibit significantly higher OS scores than female doctors, particularly in the dimensions of permanence, labelling, responsibility, diagnostic overshadowing and coercion . The influence of gender on stigma is controversial in the literature, as some studies report female doctors to express either more (Castillejos et al, 2018; Reavley et al, 2014), less (Eksteen et al, 2017; Husain et al, 2020) or similar (Cremonini et al, 2018) stigmatizing beliefs than their male colleagues. We propose these differences could be due to the individual’s cultural and educational background, and gender expectations in different countries/contexts.…”

“…Responsibility ( 8 in these dimensions tends to depend on exposure to, and knowledge about, mental illness (Husain et al, 2020), both of which are higher among psychiatrists. As such, we argue that these results may reflect GP's lack of knowledge and distorted social views on mental illness.…”