Stigma and discrimination among persons with mental illness in a tertiary care medical institution in Southern India.

Abstract

The proportional contribution of mental disorders to the total disease burden in India has almost doubled since 1990. Stigma and discrimination are major barriers to seeking treatment for persons with mental illness (PMI). Stigma reduction strategies are thus crucial, and for this, there needs to be an understanding of the various factors associated with them. The current study intended to assess stigma and discrimination in PMI visiting the department of psychiatry in a teaching hospital in Southern India and their association with various clinical and sociodemographic factors in them. The index study was a descriptive cross-sectional study involving consenting adults who presented to the department of psychiatry with mental disorders from August 2013 to January 2014. Socio-demographic and clinical data were collected using a semi-structured proforma, and the Discrimination and Stigma Scale (DISC-12) was used to assess discrimination and stigma. Most of PMI suffered from bipolar disorder, followed by depression, schizophrenia, and other disorders, such as obsessive-compulsive disorder, somatoform disorder, and substance use disorder. Discrimination was experienced by 56% of them and 46% had stigmatizing experiences. Both discrimination and stigma were found to be significantly associated with their age, gender, education, occupation, place of residence, and illness duration. While PMI suffering from depression experienced the highest discrimination, those with schizophrenia faced the stronger stigma. Binary logistic regression revealed depression, family history of psychiatric illness, age of less than 45 years, and rural locality of residence to be the significant determinants of discrimination and stigma. The study thus found that stigma and discrimination were associated with multiple social, demographic, and clinical factors in PMI. A rights-based approach to PMI is the need of the hour to tackle stigma and discrimination, which is already included in recent Indian acts and statutes. Implementation of these approaches is the need of the hour.