Understanding mental health stigma and discrimination in Ethiopia: A qualitative study

Abstract

Background: Stigma is significantly impacted by cultural and contextual value systems. People with mental health conditions frequently have to deal with the condition itself and the associated stigma and discrimination. Contextual understanding is essential to design measures and interventions.Objective: This study aimed to explore the experiences and perceptions of people with mental health conditions, their families and key stakeholders. Method: A qualitative method used to understand mental health-related stigma and its local contexts. Sixteen participants, including service users, caregivers, service providers and health service administrators, were interviewed. Result: People with mental health conditions and their caregivers experienced various forms of stigmatization which is linked to attributions about the causality of the illness, overt manifestations of mental health condition leading to easy identification and functional impairments that adversely affect participation. Social contact, lived experiences sharing and training of service providers are relevant intervention strategy to address stigma. Implication: Stigma and exclusion are prominent in the experiences of people with mental health conditions and their caregivers in this rural Ethiopian setting. Measurement of stigma and the development of interventions should consider how stigma is socially constructed. Antistigma interventions need to be implemented alongside expanded local access to mental healthcare. Impact statementPeople with mental health conditions (MHCs) face major challenges due to negative stereotypes and prejudice generated by misconceptions about MHCs. While research has gone a long way toward understanding the multiple adverse impacts of MHCs in low-and middle-income countries (LMICs), it is just starting to explain the social construct of mental health-related stigma. Contextualization of stigma measures and development of anti-stigma programs in LMICs are still limited. This study offers a valuable perspective on the experience of stigma and the mechanisms underlying the stigmatization of individuals with mental illnesses and key stakeholders. This enables a thorough investigation of the local context, focusing on the viewpoints and understandings of persons who reside and work in the area. That also looked at the stigma associated with mental health issues more broadly than from the perspective of a particular illness or diagnosis. The present study can be effective in targeting the consequences of stigma and understanding the interpretation of this stigma can aid in the development of context-specific anti-stigma interventions in Ethiopia and provides input into the process of assessing the implications and concept of stigma at a cross-national level. These interventions endorse the use of social contact approaches to reduce stigma, which are acceptable as long as they are combined with measures that foster a supportive environment, such as increased availability of mental health services.