MENTAL ILLNESS STIGMA AND ASSOCIATED FACTORS IN PAKISTAN WITH SPECIAL EMPHASIS ON CENTRAL PUNJAB

Dr. Muhammad Sami Bilal*, Dr. Urooj Bari and Dr. Maryam Hafeez Khan

ABSTRACT

Background: Punjab is the most populous province of Pakistan having highest population density in its central region. Despite high levels of psychological distress among local population, low up take of mental health services has been demonstrated. Evidence suggests poor levels of mental health literacy (MHL) and high levels of stigmatizing attitudes among local populations, which may act as barriers to help seeking behaviors. This study aimed to explore the relationships between measures of mental illness stigma, socio-demographic factors and psychological distress, as well as to determine the factors associated with MHL (i.e., correct recognition of mental illness and knowledge of causes) among local population of central Punjab. Methods Participants were recruited from a reputed tertiary care Hospital located in hub of central Punjab that provided mental health services to major chunk of population in central Punjab. As this study is nested within an interventional pilot study evaluating a culturally tailored MHL program, only the pre-intervention survey responses for 80 participants were utilized. The survey measured key aspects of MHL (i.e., recognition of mental illness, knowledge of causes), levels of psychological distress (using Kessler Psychological Distress Scale – K10 scale), and stigmatizing attitudes towards mental illness (using personal stigma subscales and social distance scale). Results The Personal Stigma subscale of ‗Dangerous/unpredictable‘ was strongly positively correlated with participants ‘K10 psychological distress cores and strongly negatively correlated with years of education completed. There were moderate negative correlations between two Personal Stigma subscales (‗Dangerous/unpredictable‘ and ‗I-would-not-tell-anyone‘)and unemployment. Being female was associated with an increase in personal stigma demonstrated by higher scores for ‗I-would-not-tell-anyone‘ subscale than males. Similarly, increase in age was associated with decrease on scores of the personal stigma ‗Dangerous/unpredictable. Conclusions. While future research with larger sample size are needed, the study findings can be considered as adding to the evidence base on mental illness related stigma in local population of central Punjab. Further, this study provides a starting point in developing the rationale for why population sub-groups specific interventions are vitally essential.

Keywords: Central Punjab, Mental health, Mental health literacy, Mental illness, Stigma.