Community attitudes toward and knowledge of mental illness in South Africa

Background Although recent advances in psychiatry have increased our understanding of psychiatric disorders,many people with chronic or severe psychiatric disorders may be unaware that effective treatment is available. It is possible that ignorance and stigma prevent such persons from seeking appropriate help, and that community attitudes and beliefs play a role in determining the help-seeking behaviour and successful treatment of the mentally ill. Nevertheless, there is little research on the attitudes of lay persons toward mental illness within the South African community. Objectives The aim of this study was to investigate the knowledge and attitudes of the general South African public toward mental illness, specifically regarding the causes of illness and treatment options. Method The study design employed a questionnaire survey. Structured interviews (n=667) were conducted with members of the general public. One of eight vignettes, portraying depression, schizophrenia, panic disorder or substance abuse, with subtle or obvious symptoms, was presented to each respondent. Results The main findings were that cases were most often conceptualised as stress-related or due to a lack of willpower rather than as medical disorders. Treatment advocated was more often to talk the problem over than to consult professional medical help. Psychotherapy was the preferred treatment option, particularly in vignettes where symptom presentation was subtle, and in cases of substance abuse. Conclusions These data suggest that stigma and misinformation regarding mental illness exist, influencing preferred treatment modality and help-seeking behaviour. More work needs to be done to educate the public about the psychobiological underpinnings of psychiatric disorders and about the value of effective treatments. A better understanding of these disorders amongst the public would presumably lessen stigmatisation and encourage the use of currently available and effective interventions.