Common mental disorders are
prevalent in Nigeria. Due to stigma and a limited number of trained
specialists, only 10% of adults with mental illness in Nigeria receive any
care.
The Healthy Beginning Initiative is a community-based maternal/child health program that includes screening for perinatal depression and was implemented by lay, volunteer, church-based health advisors (CHAs).
The aim of the study was to assess the beliefs and attitudes about mental illness among the CHAs. The study used a cross-sectional survey of 57 CHAs, who completed a 43-item, self-administered questionnaire that assessed their beliefs and attitudes about mental illness.
The response rate was 71%. Respondents were mostly female (79%), married (83%) and aged 40-49 years (M = 41.16 SD = 10.48). Most endorsed possession by evil spirits (84%), traumatic events (81%) and witchcraft (60%) as causes of mental illness. A majority (69%) believed that people with mental illness were a nuisance, and less than half (46%) believed that mental disorders were illnesses like any other illness.
It is concluded that stigmatizing attitudes and beliefs about mental illness are common among the CHAs. Training for lay health workers in Nigeria should include education on the known bio-psycho-social basis of mental disorders and the role of social inclusion in recovery.
The Healthy Beginning Initiative is a community-based maternal/child health program that includes screening for perinatal depression and was implemented by lay, volunteer, church-based health advisors (CHAs).
The aim of the study was to assess the beliefs and attitudes about mental illness among the CHAs. The study used a cross-sectional survey of 57 CHAs, who completed a 43-item, self-administered questionnaire that assessed their beliefs and attitudes about mental illness.
The response rate was 71%. Respondents were mostly female (79%), married (83%) and aged 40-49 years (M = 41.16 SD = 10.48). Most endorsed possession by evil spirits (84%), traumatic events (81%) and witchcraft (60%) as causes of mental illness. A majority (69%) believed that people with mental illness were a nuisance, and less than half (46%) believed that mental disorders were illnesses like any other illness.
It is concluded that stigmatizing attitudes and beliefs about mental illness are common among the CHAs. Training for lay health workers in Nigeria should include education on the known bio-psycho-social basis of mental disorders and the role of social inclusion in recovery.
Differences in beliefs and attitudes by gender, education and area of living.
| Gender | Education | Area of living | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Male | Female | Primary/ Secondary | Tertiary | Rural | Urban | ||||
| Cause of mental illness | N (%) (n = 12) | N (%) (n = 47) | p | N (%) (n = 21) | N (%) (n = 38) | p | N(%) (n = 22) | N (%) (n = 35) | p |
| Drug /alcohol use | 11 (91.7) | 44 (93.6) | 0.8 | 18 (85.7) | 37 (97.4) | 0.08 | 22 (100) | 32 (91.4) | 0.16 |
| Evil spirit | 11 (91.7) | 37 (78.7) | 0.3 | 16 (76.2) | 32 (84.2) | 0.44 | 19 (86.4) | 27 (77.1) | 0.39 |
| Traumatic event | 11 (91.7) | 35 (74.5) | 0.2 | 16 (76.2) | 30 (78.9) | 0.8 | 20 (90.9) | 25 (71.45) | 0.08 |
| Stress | 8 (66.7) | 15 (31.9) | 0.03 | 7 (33.3) | 16 (42.1) | 0.5 | 13 (59.1) | 10 (28.6) | 0.02 |
| Genetic inheritance | 10 (83.3) | 41 (87.2) | 0.7 | 15 (71.4) | 36 (94.7) | 0.01 | 21 (95.4) | 29 (82.95) | 0.15 |
| Physical abuse | 4 (33.3) | 18 (38.3) | 0.7 | 6 (28.6) | 16 (42.1) | 0.3 | 11 (50) | 10 (28.6) | 0.1 |
| Biological factors | 7 (58.3) | 33 (70.2) | 0.43 | 12 (57.1) | 28 (73.7) | 0.19 | 15 (68.2) | 24 (68.6) | 0.97 |
| God's punishment | 5 (41.7) | 25 (53.2) | 0.47 | 10 (47.6) | 20 (52.6) | 0.71 | 9 (40.9) | 20 (57.1) | 0.23 |
| Witchcraft | 9 (75) | 25 (53.2) | 0.17 | 13 (61.9) | 21 (55.7) | 0.62 | 11 (50) | 23 (65.7) | 0.23 |
| Brain disease | 11 (91.7) | 40 (85.1) | 0.55 | 16 (76.2) | 35 (92.1) | 0.08 | 21 (95.4) | 29 (82.8) | 0.16 |
| Poverty | 5 (41.7) | 14 (29.8) | 0.43 | 4 (19.1) | 15 (39.5) | 0.12 | 11 (50) | 8 (22.9) | 0.03 |
| Curse | 8 (66.7) | 24 (51.1) | 0.33 | 13 (61.9) | 19 (50) | 0.38 | 12 (54.5) | 19 (54.3) | 0.98 |
| People with mental illness | |||||||||
| Can be treated outside the hospital | 8 (66.7) | 30 (63.8) | 0.85 | 13 (61.9) | 25 (65.8) | 0.76 | 16 (72.7) | 22 (62.8) | 0.44 |
| Tend to be mentally retarded | 8 (66.7) | 25 (53.2) | 0.4 | 6 (28.6) | 27 (71.1) | 0.002 | 14 (63.6) | 18 (51.4) | 0.36 |
| Are a public nuisance | 10 (83.3) | 26 (55.3) | 0.07 | 11 (52.4) | 25 (65.8) | 0.31 | 17 (77.3) | 18 (51.4) | 0.05 |
| Can work in regular jobs | 3 (250 | 7 (14.9) | 0.4 | 4 (19.1) | 6 (15.8) | 0.75 | 4 (18.2) | 6 (17.1) | 0.92 |
| Are dangerous because of violent behavior | 10 (83.3) | 39 (82.9) | 0.97 | 17 (80.9) | 32 (84.2) | 0.74 | 19 (86.4) | 29 (82.9) | 0.72 |
| In interacting with someone with mental illness, I would be | |||||||||
| Unwilling to share a room | 8 (66.7) | 32 (68.15) | 0.92 | 10 (47.6) | 30 (78.9) | 0.01 | 18 (81.8) | 21 (60) | 0.08 |
| Would you invite somebody in to your home if you knew they suffered from mental illness | 4 (33.3) | 21 (44.7) | 0.48 | 5 (23.8) | 20 (52.6) | 0.03 | 11 (50) | 13 (37.1) | 0.34 |
| On social acceptance of someone with mental illness | |||||||||
| A woman would be foolish to marry a man with mental illness even though he seems fully recovered | 3 (25.5) | 13 (33.3) | 0.58 | 10 (55.6) | 6 (18.25) | 0.006* | 3 (14.3) | 11 (39.3) | 0.04* |
| Anyone with mental illness should not be given any responsibility | 8 (66.7) | 11 (26.8) | 0.01 | 7 (36.8) | 12 (35.3) | 0.91 | 10 (47.6) | 8 (26.7) | 0.12 |
| Virtually anyone can become mentally ill | 11 (91.7) | 34 (85) | 0.34* | 17 (94.4) | 28 (82.3) | 0.18* | 21 (100) | 23 (79.3) | 0.02* |
| People with mental illness are far less of a danger than most people suppose | 11 (91.7) | 27 (61.4) | 0.03* | 10 (52.6) | 28 (75.7) | 0.05* | 15 (71.4) | 22 (66.7) | 0.22* |
| The best therapy for mentally ill people is to be a part of a normal community | 10 (83.3) | 22 (48.9) | 0.03* | 13 (65) | 19 (51.5) | 0.14* | 14 (63.6) | 18 (54.5) | 0.18* |
| Residents have nothing to fear from people coming into their neighborhood to obtain mental health services | 7 (58.3) | 36 (80) | 0.09* | 13 (65) | 30 (81.1) | 0.10* | 13 (59) | 28 (84.8) | 0.02* |
| Mental hospitals are an outdated means of treating people with mental illness | 5 (45.5) | 20 (44.5) | 0.26* | 11 (57.9) | 14 (37.8) | 0.08* | 6 (27.3) | 19 (59.4) | 0.01* |
Note: Results shaded in grey were considered statistically significant when p < .05. *Fisher's exact; DF = 1.
Full article at: http://goo.gl/YlpgZw
By:
- 1Department of Psychiatry, Yale University School of Medicine (http://medicine.yale.edu/psychiatry/), New Haven , USA.
- 2Avalon University School of Medicine , Girard , USA.
- 3HealthySunrise Foundation , Las Vegas , USA.
- 4Prevention, Education, Treatment, Training and Research Global Solutions , Enugu , Nigeria.
- 5HealthySunrise Foundation, Las Vegas, USA; University of Nevada School of Medicine, Las Vegas, USA.
- 6HealthySunrise Foundation, Las Vegas, USA; Prevention, Education, Treatment, Training and Research Global Solutions, Enugu, Nigeria.
- Int J Cult Ment Health. 2016 Jan 2;9(1):1-13. Epub 2015 Sep 11.
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