Mental Health Awareness and Stigma Among Rural and Urban Populations of Bihar

Mental health awareness and stigma are critical determinants of help-seeking behavior and utilization of mental health services. Rural–urban disparities in socio-economic conditions, education, and access to healthcare may significantly influence public perceptions of mental illness. The present cross-sectional, descriptive, and comparative study assessed mental health awareness and stigma-related attitudes among rural and urban populations in Bihar, India. A total of 675 adult participants were included, comprising 350 respondents from the rural area of Bikramganj and 325 respondents from the urban area of Patna. Data were collected using a structured questionnaire that included socio-demographic information, a mental health awareness scale, and a mental health stigma scale. Descriptive and inferential statistical analyses were performed to compare awareness and stigma scores between rural and urban populations. The results revealed substantial rural–urban differences in both awareness and stigma. The mean mental health awareness score was significantly lower among rural participants compared to urban participants, while stigma scores were notably higher in the rural population. Box plot analysis demonstrated greater variability in awareness and stigma scores among rural respondents, indicating heterogeneous levels of mental health literacy and attitudes. Urban participants showed higher and more consistent awareness levels along with lower stigma scores. These findings suggest an inverse relationship between mental health awareness and stigma and highlight the role of socio-demographic factors in shaping public attitudes toward mental illness. The study underscores the need for targeted mental health education and stigma-reduction interventions, particularly in rural settings. Community-based awareness programs and integration of mental health services into primary healthcare may help reduce disparities and promote equitable mental health care.