|Year : 2019 | Volume
| Issue : 2 | Page : 83-88
Attitude, Belief, and Perception Toward Mental Illness Among Indian Youth
Akshat Chowdhury1, Kavita Gupta2, Ashok Kumar Patel3
1 Clinical Psychology, AMITY University Jaipur, Rajasthan, India
2 Clinical Psychology, Indira Gandhi National Open University New Delhi, India
3 Clinical Psychologist, Mental Health Unit, District Hospital Balrampur, Uttar Pradesh, India
|Date of Web Publication||20-Aug-2019|
M. Phil (Clinical Psychology) Ashok Kumar Patel
Clinical Psychologist, Room No. 23 Mental Health Unit, District Hospital Balrampur, Uttar Pradesh-271201
Source of Support: None, Conflict of Interest: None
Background: According to World Health Organization (1999), mental health is defined as “subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization that deals with the individual’s awareness, attitude, and belief about the mental disorders.” Hence, the present study was conducted among Indian college students to assess belief, attitude, and perception about causes and treatment of mental disorder (illness) with respect to depression and schizophrenia. Material and Methods: The present descriptive study was undertaken at Amity university, Rajasthan, with a sample of 150 college undergraduate and postgraduate students in the age group of 18 to 27 years by using cases “Vignettes of Depression and Schizophrenia” and “Short Version of Orientation Toward Mental Illness Scale (OMI).” Results: The present study indicated that depression was easily recognizable as compared to schizophrenia among college students. Stressful factors were considered as the primary cause for both depression and schizophrenia. Majority of the participants were convinced of the favorable outcome of both depression and schizophrenia. Conclusion: It was concluded that majority of the participants had negative attitude toward folk therapy, psychosocial manipulation, and physical method of treatment with the perception of family as a main source for seeking help regarding mental illness. Moreover, majority of participants had a belief that mental disorder is a cause for depression and stress is the main cause for schizophrenia among the mental illness. Therefore, the prognosis of both depression and schizophrenia was considered good.
Keywords: Attitude, belief, depression, mental health, mental illness, perception, schizophrenia
|How to cite this article:|
Chowdhury A, Gupta K, Patel AK. Attitude, Belief, and Perception Toward Mental Illness Among Indian Youth. MAMC J Med Sci 2019;5:83-8
|How to cite this URL:|
Chowdhury A, Gupta K, Patel AK. Attitude, Belief, and Perception Toward Mental Illness Among Indian Youth. MAMC J Med Sci [serial online] 2019 [cited 2021 May 6];5:83-8. Available from: https://www.mamcjms.in/text.asp?2019/5/2/83/264781
| Introduction|| |
“World Mental Health Day” is celebrated on 10th October every year. The term mental health literacy is defined as “knowledge, beliefs, and attitude toward mental disorders which aid in their recognition, management, and prevention.” Recognizing mental illnesses is the key aspect of mental health literacy that influences individual’s behavior and attitude toward the mentally ill. Generally, physical illness tends to be associated with fewer stigmas than mental illness thereby leading toward low mental health literacy.
The prevalence of mental health conditions in India is approximately 18 to 207 out of 1000 population whereas about 2% to 3% are known to suffer from major mental illnesses. The slow pace of development in the field of mental health is a major concern worldwide. A large proportion of the population in India remains deprived of mental health care due to stigma and expensive healthcare expenditures and suffers the adverse consequences of the poor quality of care.,,
Through the various literature reviewed, it was observed that major proportion of the general population is unable to identify mental disorders correctly, has a poor understanding of the underlying causal factors, fears those who are perceived as mentally ill, reluctant to seek help for mental illness, has mistaken beliefs about treatment effectiveness, and is unsure regarding how to help others.
People’s attitudes and beliefs toward mental illness frame how they perceive and express the emotional problems and psychological distress and whether they disclose these symptoms and seek care thereby affecting quality of life. Attitudes and beliefs about mental illness potentially emerge and are shaped by personal knowledge and preexisting belief systems about mental illness and interventions, knowing and interacting with someone living with mental illness, cultural stereotypes about mental illness, media stories, and familiarity with institutional practices and past restrictions., When such attitudes and beliefs are expressed positively, they can result in supportive and inclusive behaviors. When such attitudes and beliefs are expressed negatively, they may result in avoidance, exclusion from daily activities, exploitation, and discrimination.
It has been found that despite the advancement of technology in the last decade, there are few studies published on mental health literacy focusing on public belief, attitude, and perception toward mental illness. This has created a large gap between public opinion and evidence-based treatment strategies thereby affecting help-seeking behavior. So, looking at this situation of neglect of mental health literacy in India, a need was felt to examine the mental health literacy among college youth as students have more access to information through internet and media.
| Material and Methods|| |
The present cross-sectional study was conducted between January and July 2016 among undergraduate and postgraduate students of Amity University, Rajasthan. The sample size consisted 150 college students (77 males and 73 females) within the 15 to 27 years of age group in the university where they were pursuing either undergraduation or postgraduation in either the science, commerce, or arts streams. The study followed purposive sampling.
This study attempted to investigate attitude, belief, and perception towards mental illnesses regarding sources of help, recognition of mental disorder, etiology of the mental illness, treatment intervention, and seeking first aid help among college students in Amity University of Jaipur.
Administrative approval for the study was obtained from the head of the departments of the university. Ethical approval was taken from the Institutional Ethics Committee of the university. After obtaining formal permission from the participants, the investigator explained the aims and methods of the study to all participants. Questions regarding the study were invited from the participants and they were given freedom to leave the study whenever they desired. Written informed consent was obtained before data collection. Participants were assured of the confidentiality and the study did not disrupt the academic schedule of the students.
| Tools|| |
The data were collected using a self-administered pretested semistructured questionnaire. A questionnaire booklet was developed covering the following domains: sociodemographic profile, two case vignettes followed by questions that described depression and schizophrenia, and “Short Version of Orientation Toward Mental Illness Scale (OMI): 67 items with alpha-coefficient reliability of 0.93” by Prabhu (1983).
In this study, the depression and schizophrenia vignettes [Table 1] were used with minimal modification from the original to fit the Indian context and was validated by experts in the field of clinical psychology and public health. The description of symptoms in the vignettes was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and International Classification of Diseases, Tenth Edition diagnostic criteria for depression and schizophrenia. Questions were included on whether they could identify the mental disorder in the vignette and their beliefs regarding the sources of help and prevention as well as their opinion on the interventions. Descriptive data were reported for sociodemographic characteristics. Calculation of percentages and frequencies were done using STATA [[Table 1]].
| Results|| |
From [[Table 2]], it could be depicted that the mean age of the participants pondent was 20.5 years (standard deviation, SD = 1.79). There were 51% males who participated in this study. Almost all the participants were unmarried. As far as education is concerned, 82.7% participants were undergraduates and 17.3% participants were postgraduates. Most of the participants who participated in this study belonged to Hindu religion. Only 7.3% participants were Muslims and 4% participants were Sikhs.
|Table 2 Distribution of participants according to their sociodemographic characteristics|
Click here to view
None of the participants were diagnosed of having history of psychiatric illness in the past. On the other hand, 144 participants (96%) reported no history of psychiatric illness in family, whereas six participants (4%) reported presence of family history of psychiatric illness.
From [[Table 3]], it could be depicted that on vignette-1 (depression), 43% participants were able to recognize it as depression and 17% of participants reported it as mental illness, whereas remaining 40% participants reported it as uneasiness, stress, social issues, tiredness, workload, work tension, etc.
|Table 3 Distribution of participants ability to recognize depression and schizophrenia|
Click here to view
On the other hand, on vignette-2 (schizophrenia), only 1.5% participants were able to recognize it as schizophrenia and 30% felt that it was mental illness. Remaining 69% believed that it could be stress, social isolation, sadness, childhood problem, loneliness, hopelessness, etc.
From [[Table 4]], it could be depicted that for the depression vignette, 22% participants reported mental disorder as a cause for depression followed by family pressure (9.82%), stress (8.09%), work pressure (6.35%), relationship problem (9.24%), diet (5.20%), loneliness (4.04%), motivation (4.04%), health problem (3.46%), friends (5.20%), career problem (2.31%), financial problem (2.31%), and sleep problems (2.31%). The remaining 15.60% participants gave other responses like anxiety, daily life issues, education, weight loss, and uninteresting daily schedule.
|Table 4 Attitude, belief, and perception of participants regarding possible causes of depression and schizophrenia|
Click here to view
However, for the schizophrenia vignette, it was observed that 15% participants reported stress as the cause for schizophrenia followed by anxiety (13%), loneliness (8.07%), failure (8.07%), lack of thinking (7.45%), unemployment (6.83%), work pressure (4.34%), depression (3.72%), lack of confidence (3.72%), family problem (3.10%), self-esteem (3.10%), and isolation (2.48%). The remaining 21% participants gave other responses like low motivation level, losing hope, lack of knowledge, unfamiliar surroundings, and past events.
From [[Table 5]], it could be depicted that on the depression vignette, 36% participants reported family as the most helpful followed by friends (29%), doctor (12.28%), partner (1.69%), relatives (1.69%), mental health professionals (15.67%), herself (0.84%), teachers (0.84%), medical help (0.42%), and boss (0.42%). For the schizophrenia vignette, 45.3% participants reported family as the most helpful followed by friends (35.12%), counselor (7.31%), close relatives (3.41%), life partner (2%), girlfriend (0.97%), medical help (1.95%), teacher (0.97%), travelling (0.97%), himself (0.97%), manager (0.4%), and yoga (0.48%).
|Table 5 Perception of sources of help seeking to address depression and schizophrenia|
Click here to view
From [[Table 6]], it could be depicted that on depression vignette, 40% participants endorsed that depression would recover whereas 24% participants believed that depression would not recover. For schizophrenia vignette, 40% participants endorsed that schizophrenia would recover whereas 27.3% participants believed that schizophrenia would not recover.
From [[Table 7]], individual factors could be analyzed. The first factor is causation of mental illness with the mean of 88 (SD = 14.23). The second factor is perception of mentally ill with the mean of 42 (SD = 7.71), third refers to the treatment and therapy with the mean of 31.98 (SD = 5.19), and fourth one refers to aftereffects with the mean of 40.96 (SD = 7.94).
The causes include folk belief, psychosocial stress, and organic causation. The mean value of folk belief was 32 (SD = 8.10), the mean value of psychosocial stress was 43 (SD = 7.02), and the mean value of organic causation was 13 (SD = 2.85). The total mean value of the causation was observed to be 88 (SD = 14.23). Perception includes nonrestrained behavior, weak cognitive control, fidgety behavior, and bizarre behavior. The mean value of nonrestrained behavior was 18 (SD = 4.79), the mean value of weak cognitive control was 9.5 (SD = 2.04), the mean value of fidgety behavior was 6.11 (SD = 1.50), and the mean value of bizarre behavior was 8.39 (SD = 2.30). The total mean value of perception was 42 (SD = 7.71). Therapy includes folk therapy, psychosocial manipulation, and physical methods of treatment. The mean value of folk therapy was 16.6 (SD = 3.18), the mean value of psychosocial manipulation was 10.84 (SD = 2.33), and the mean value of physical methods of treatment was 4.51 (SD = 1.72). The total mean value for therapy was 31.98 (SD = 5.19). The aftereffects include hopelessness, hypofunctioning, and rejection of the mentally ill. The mean value of hopelessness was 16.08 (SD = 4.28), the mean value of hypofunctioning was 13.18 (SD = 2.81), and the mean value of rejection of mentally ill was 11.70 (SD = 2.96). The total mean value for aftereffects was 40.96 (SD = 7.94).
Thus, performance on orientation toward mental illness measured negative attitude toward folk therapy, psychosocial manipulation, and physical method of treatment through the subscale “therapy and treatment.” In the present study, respondents obtained a mean of 32 (SD = 5.19) on the therapy and treatment subscale.
| Discussion|| |
During the study, it was observed that males were more cooperative than females and majority of the participants were pursuing BTech and MBA courses.
It was observed that depression was easily recognized than schizophrenia among participants. The results were consistent with the previous studies in terms of high recognition of depression.,,,, In a study, it was found that depression was four times more likely to be diagnosed than psychosis (18.75% vs. 4.94%). Similarly, it was noted that almost half of the participants were able to identify depression correctly, whereas only a quarter among them identified psychosis correctly. In a study conducted to determine the degree of recognition and understanding of schizophrenia and depression, it was observed that schizophrenia vignette was correctly recognized by 3.9% and a further 16.2% recognized the condition as depressive episode. In another Indian study, it was found that 43% respondents were able to recognize depressive vignette as depression whereas 16% respondents recognized schizophrenia vignette. The possible reason could be that depression as a term is used more commonly by people in their day-to-day lives to describe their lower emotional states.
In the present study, findings revealed that stressful factors have been endorsed by the participants as the main reason for mental disorders that is consistent with other studies.,,Biological factors have been reported as less important causation factor in other studies.,, Stressful factors have been endorsed as the most important cause for both depression and schizophrenia.,
In this study, most commonly mentioned sources of help for both vignettes was family and friends that was consistent with the similar study conducted. The possible reason for this could be due to collectivistic culture as the people believe that by sharing one’s problems with close relatives like family and friends, mental illnesses could recover. Similar findings have been reported by several researchers,,, that is consistent with the present study.
The study findings revealed that most of the participants could recover from depression and schizophrenia that is consistent with the Indian study. It was believed that the participants were very enthusiastic and optimistic with respect to prognosis for both depression and schizophrenia. It was believed that 70% participants could recover from schizophrenia and 48% participants could recover from depression.
| Conclusion|| |
The results showed that there is a gap in attitude, beliefs, and perception toward mental illness among arts and technology students in the university.
Education regarding mental health with focus on depression and schizophrenia as a real mental illness should be scaled up to a larger level through awareness campaigns, vibrant educational workshops, and training sessions that should be evaluated over time for the substantial changes it had brought about in the attitudes and behaviors of the participants. Additional information on various mental health issues could also be posted through social media, celebrity endorsements, documentaries, and internet-based resources that could aid in mental health awareness at college level.
Professionals and students should work together to disseminate scientific knowledge about symptoms, causes, risk factors, and management of mental disorders. Moreover, government should improve mental health budgets and identify economic and resource barrier that hinder mental health practice and policy.
Thus, the present study might help to understand attitude, belief, and perception toward mental illness and develop program to enhance mental health literacy.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. Public beliefs about causes and risk factors for depression and schizophrenia. Soc Psych Psych Epidemiol 1997;32:143-8.
Skre I, Friborg O, Breivik C, Johnsen LI, Arnesen Y, Wang CE. A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial. BMC Public Health 2013;13:873.
Patel V, Parikh R, Nandraj S, Balasubramaniam P, Narayan K, Paul VK. Assuring health coverage for all in India. Lancet 2015;386:2422-35.
Kumar R, Menon S. Enhancing mental health literacy in India to reduce stigma. J Public Mental Health 2014;13:146-58.
Sinha LN, Kishore GS. A study of college students towards mental illness and mentally ill persons. Indian J Appl Psychol 1973;10:40.
Corrigan PW, Markowitz FE, Watson AC. Structural levels of mental illness: stigma and discrimination. Schizophrenia Bull 2004;20:481-91.
Wahl OF. News media portrayal of mental illness. Am Behav Sci 2003;46:1594-600.
Prabhu GG. Mental illness: public attitudes and public education. First Prof, M.V. Gopalaswamy memorial oration. Indian J Clin Psychol 1983;10-3.
Srinivasan TN, Tara R. Belief about causation of schizophrenia, do Indian families believe in supernatural causes? J Soc Psychiatry Psychiatr Epidemiol 2001;136:134-40.
Grover N, Tripathi R. Mental health literacy among post graduate students. J Soc Psychiatry 2010;26:138-45.
Kermode M, Bowen K. Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. J Social Psychiatry Psychiatr Epidemiol 2009;44:1087-96.
Ganesh K. Knowledge and attitude of mental illness among general public of southern India. J Commun Med 2011;2:210-5.
Vijaylakshmi P, Math S. Mental health literacy among caregivers of persons with mental illness: a descriptive survey. J Neurosci Rural Prac 2013;6:355-60.
Kumar R. Attitude to people with mental illness: a mental health literacy survey from Punjab state. Int J Health Sci Res 2013;3:134-45.
Mccarthy J, Bruno M. Evaluating mental health literacy and adolescent depression: what do teenagers know. J Professional Counselor 2011;1:133-42.
Gibbons J, Einer B. Beliefs and attitudes towards mental illness: an examination of the sex differences in mental health literacy in a community sample. J Peer Rev 2015;3:1004-8.
Ogorchukwu J, Sekaran V. Mental health literacy among late adolescents of South India: what they know and what attitudes drive them. J Indian Psychologic Med 2016;38:234-41.
Tartani E. Mental health literacy about depression and schizophrenia among adolescents in Sweden. J Eur Psychiatry 2011;28:404-11.
Marcus M, Westra H. Mental health literacy in Canadian young adults: results of a national survey. J J Commun Mental Health 2012;31:1–15.
Suhail K. A study investigating mental health literacy in Pakistan. J Mental Health 2005;14:167-81.
Wright A, Harris MG, Wiggers JH, Jorm AF, Cotton SM, Harrigan SM et al.
Recognition of depression and psychosis by young Australians and their beliefs about treatment. Med J Aust 2005;183:18-23.
Salah E, Adel A. Knowledge of symptoms and treatment of schizophrenia and depression among Kuwaiti population. Arab J Psychiatry 2005;16:62-77.
Sandra D, Michael B, Bujantug B, Kenzine D, Matschinger H, Angermeye MC. The relationship between public causal beliefs and social distance toward mentally ill people. Aust N Z J Psychiatry 2004;38:348-54.
Schomerus G, Matschinger H, Angermeyer MC. Public beliefs about the causes of mental disorders revisited. J Psychiatry Res 2006;144:233-6.
Jorm A. Mental health literacy public knowledge and beliefs about mental disorders. J Br Psychiatry 2000;177:396-401.
Wong K. Gender differences in mental health literacy of university students. J Western Undergrad Psychol 2016;4.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]