Social Distance Towards People with Mental Illness in Southwestern Nigeria

Abstract

Objective: Recent research findings have challenged earlier claims that stigmatizing attitudes towards the mentally ill are less evident in non-Western cultures. A knowledge base of the attitude of the community towards the mentally ill is needed before embarking on an active anti-stigma programme in sub-Saharan Africa. The aim of the present study was to assess the lay public's attitude (social distance) towards people with mental illness in southwestern Nigeria and examine the factors correlating with such an attitude. Method: A cross-sectional survey was carried out in which respondents (n=2078) selected from three different communities in southwestern Nigeria completed questionnaires detailing sociodemographic variables, familiarity with mental illness, perceived causation of mental illness, perceived personal attributes of mental illness and perceived prognosis of mental illness. Their preferred social distance towards people with mental illness was measured with a modified version of the Bogardus Social Distance Scale. Results: The level of desired social distance towards the mentally ill was seen to increase with the level of intimacy required in the relationship, with 14.5% of the participants categorized as having low social distance, 24.6% as having moderate social distance and 60.9% as having high social distance towards the mentally ill. The independent correlates of high social distance towards the mentally ill included having never cared for the mentally ill (odds ratio (OR)=3.31, 95% confidence interval (CI)=2.14–5.21), age over 50 years (OR=1.93, 95%CI=1.59–2.33), perceived supernatural causation of mental illness (OR=1.82, 95%CI=1.51–2.18) and perceived ‘dangerousness’ stereotype of the mentally ill (OR=1.54, 95%CI=1.28–1.85). Conclusions: There is emerging evidence of a high level of social distance and stigmatization of mental illness in sub-Saharan Africa. There is need to incorporate anti-stigma educational programmes into the mental health policies of countries in sub-Saharan Africa. Such policy should include community education regarding the causation, manifestation, treatment and prognosis of mental illness.