Mental Health Stigma and Attitudes: A Comparative Cross - Sectional Study among Psychiatric Patients and Their Caregivers in the Malwa Region

Background: Stigma is one of the major obstacles to timely mental health service use and engagement. While caregivers may act to shorten treatment delay, they may act to transmit stigmatizing beliefs that influence the help-seeking behavior of patients. This study compared self-stigma of seeking help and attitudes of community toward mental illness between psychiatric patients and their primary care givers in the Malwa region using the Self Stigma of Seeking Help (SSOSH) and the 12 item Community Attitudes toward the Mentally Ill scale (CAMI 12). Methods: In a hospital-based comparative cross - sectional design, psychiatric patients and their primary family caregivers were recruited consecutively from outpatient and inpatient psychiatry services for the study. Sociodemographic and clinical data were collected. SSOSH (10 items; higher scores = greater self-stigma of help seeking) and CAMI 12 (12 items; higher scores = less stigmatizing community attitudes after reverse coding) were performed with both groups. Group differences were tested, and after independent samples t tests, effect sizes. Multivariable linear regression was conducted to examine a set of predictors of SSOSH and CAMI 12 scores controlling for some key covariates. Results: A total of 160 patients and 160 caregivers were analyzed. Patients scaled higher SSOSH scores than caregivers, 31.6 (SD 7.5) and 25.4 (SD 6.8), mean difference 6.2, p