The mediating role of knowledge on the contact and stigma of mental illness in Hong Kong

Abstract

Background: Although knowledge is a crucial component in contact theory delineating how prejudice changes toward out-groups with stigmatized conditions, little is known about the mediating role of knowledge on contact, stigmatizing attitudes, and behaviors toward mental illness. Aim: This study aimed to examine the mechanism underlie contact and stigma change by knowledge. Methods: A total of 366 participants including family members (FM), mental health providers (MHP), and community residents (CR) recruited across communities in Hong Kong and completed measures of contact level, contact quantity, contact quality, mental health related knowledge, prejudice, and discriminatory behaviors. Structural equation modeling was adopted to test the association among the key variables. Results: Higher level of contact was significantly correlated with better knowledge, less prejudice, and less discriminatory behaviors. Knowledge was directly and negatively correlated with prejudicial attitudes but was not significantly related to discriminatory behaviors. Furthermore, lower levels of prejudice were associated with less discriminatory behaviors. Conclusion: Enhancement of contact may increase understanding toward people with mental illness (PMI) and diminish stigmatizing attitudes and behaviors. Although prejudicial attitudes may be reduced by broadening mental health knowledge, increasing knowledge only might not ameliorate discriminatory behaviors. Future research should test mediators on contact and stigma by using longitudinal data.

Longitudinal study on prenatal depression and anxiety during the COVID-19 pandemic

“…In contrast to previous research, our study did not identify significant effects of sociodemographic variables, such as age (Wu et al 2020 ), financial problems (Zhang and Ma 2020 ), or educational level (Dong et al 2020 ). However, the sample of our study is quite homogeneous: most of the women reported a high educational level and a low financial affectation.…”

Knowledge, contact and stigma of mental illness: Comparing three stakeholder groups in Hong Kong

“…Among the general public, research found knowledge to have a small-to-medium effect in reducing stigma (Morgan et al, 2018). Among FM and MHW, knowledge is especially crucial in facilitating better understanding and management of PMI’s conditions (Fang et al, 2020; Madianos et al, 2005; Shin, 2004).…”

“…Such moralizing views may contribute to more severe public stigma towards mental illness (Chien et al, 2014; Lee et al, 2005). Community residents (CR) have limited mental health knowledge, fear PMI’s propensity to violence and oppose psychiatric rehabilitation facilities near their residence (Chan et al, 2016; Fang et al, 2020; Siu et al, 2012). Moreover, stigmatizing views are commonly shared by FM and MHW in Hong Kong (Chien et al, 2014; Lee et al, 2006).…”

“…The enhancing contact model (ECM) was proposed firstly by M.S. Ran for addressing the role of contact, especially positive contact, on reducing the stigma of mental illness (Li et al, 2020; Fang et al, 2020). However, further studies should be conducted to test the ECM.…”

Reducing Mental Health Stigma in Primary Healthcare Workers in a Rural Chinese County: a Contact-based Family-centric Approach

“…Although our ndings are promising with regards to reducing stigmatizing attitudes, increasing willingness to engage in relationships with people with mental illness, and increasing provider empathy, these short-term results need to be interpreted with caution because of small sample size and the lack of a comparison condition. Nevertheless, the current study contributes to a limited body of research from low-and middle-income countries that examined interventions to reduce mental health-related stigma among healthcare providers (12).…”