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Published in: Social Psychiatry and Psychiatric Epidemiology 1/2016

01-01-2016 | Original Paper

Stigmatizing attitudes toward mental illness among primary school children in Kenya

Authors: David M. Ndetei, Victoria Mutiso, Anika Maraj, Kelly K. Anderson, Christine Musyimi, Kwame McKenzie

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2016

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Abstract

Background

Literature describing stigmatizing attitudes towards people with mental illness by children in the developing world is lacking. Children’s mental health issues in the Kenyan context are especially pertinent due to the increased likelihood of exposure to risk factors and the high prevalence of mental disorders. The objective of the current study was to examine socio-demographic factors associated with the endorsement of stigmatizing attitudes towards people with mental illness among Kenyan school children.

Methods

We analyzed cross-sectional survey data from 4585 primary school-aged children in standards one through seven in the Eastern Province of Kenya. We examined relationships between the endorsement of stigmatizing attitudes and age, gender, district, religion, being in the standard appropriate for one’s age, and parental employment status.

Results

Stigma scores decreased with increasing age (β = −0.83; 95 % CI = −0.99 to −0.67). Boys had higher stigma scores compared to girls (β = 1.55; 95 % CI = 0.86–2.24). Students from the rural district had higher average stigma scores as compared to those from the peri-urban district (β = 1.14; 95 % CI = 0.44–1.84). Students who were not in the standard appropriate for their age had lower stigma scores than those who were in the standard typical for their age (β = −1.60; 95 % CI = −2.43 to −0.77).

Conclusions

Stigmatizing attitudes toward the mentally ill exist among primary school children in Kenya; thus, anti-stigma interventions are needed, and our findings highlight particular subgroups that could be targeted.
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Literature
1.
go back to reference Mukolo A, Heflinger CA, Wallston KA (2010) The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry 49:92–103PubMedCentralPubMed Mukolo A, Heflinger CA, Wallston KA (2010) The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry 49:92–103PubMedCentralPubMed
2.
go back to reference Weiss MG, Ramakrishna J, Somma D (2006) Health-related stigma: rethinking concepts and interventions. Psychol Health Med 11:277–287CrossRefPubMed Weiss MG, Ramakrishna J, Somma D (2006) Health-related stigma: rethinking concepts and interventions. Psychol Health Med 11:277–287CrossRefPubMed
3.
go back to reference Hinshaw SP, Stier A (2008) Stigma as related to mental disorders. Ann Rev Clin Psychol 4:367–393CrossRef Hinshaw SP, Stier A (2008) Stigma as related to mental disorders. Ann Rev Clin Psychol 4:367–393CrossRef
4.
go back to reference Boyd CP, Hayes L, Sewell J, Caldwell K, Kemp E, Harvie L et al (2008) Mental health problems in rural contexts: a broader perspective: response to Jackson et al. (2007) Mental health problems in rural contexts: what are the barriers to seeking help from professional providers? Aust Psychol 43:2–6CrossRef Boyd CP, Hayes L, Sewell J, Caldwell K, Kemp E, Harvie L et al (2008) Mental health problems in rural contexts: a broader perspective: response to Jackson et al. (2007) Mental health problems in rural contexts: what are the barriers to seeking help from professional providers? Aust Psychol 43:2–6CrossRef
5.
go back to reference Barke A, Nyarko S, Klecha D (2011) The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views. Soc Psychiatry Psychiatr Epidemiol 46:1191–1202PubMedCentralCrossRefPubMed Barke A, Nyarko S, Klecha D (2011) The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views. Soc Psychiatry Psychiatr Epidemiol 46:1191–1202PubMedCentralCrossRefPubMed
6.
go back to reference Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K et al (2013) Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381:55–62CrossRefPubMed Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K et al (2013) Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381:55–62CrossRefPubMed
7.
go back to reference Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Stigma as a barrier to recovery: perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv 52:1615–1620CrossRefPubMed Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Stigma as a barrier to recovery: perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv 52:1615–1620CrossRefPubMed
8.
go back to reference St. Louis KO, Roberts PM (2013) Public attitudes toward mental illness in Africa and North America. Afr J Psychiatr 16:123–133 St. Louis KO, Roberts PM (2013) Public attitudes toward mental illness in Africa and North America. Afr J Psychiatr 16:123–133
9.
go back to reference Robles-Garcia R, Fresan A, Berlanga C, Martinez N (2013) Mental illness recognition and beliefs about adequate treatment of a patient with schizophrenia: association with gender and perception of aggressiveness-dangerousness in a community sample of Mexico City. Int J Soc Psychiatry 59:811–818CrossRefPubMed Robles-Garcia R, Fresan A, Berlanga C, Martinez N (2013) Mental illness recognition and beliefs about adequate treatment of a patient with schizophrenia: association with gender and perception of aggressiveness-dangerousness in a community sample of Mexico City. Int J Soc Psychiatry 59:811–818CrossRefPubMed
10.
go back to reference Dogra N, Omigbodun O, Adedokun T, Bella T, Ronzoni P, Adesokan A (2012) Nigerian secondary school children’s knowledge of and attitudes to mental health and illness. Clin Child Psychol Psychiatry 17:336–353CrossRefPubMed Dogra N, Omigbodun O, Adedokun T, Bella T, Ronzoni P, Adesokan A (2012) Nigerian secondary school children’s knowledge of and attitudes to mental health and illness. Clin Child Psychol Psychiatry 17:336–353CrossRefPubMed
11.
go back to reference Peluso EDTP, Blay SL (2004) Community perception of mental disorders: a systematic review of Latin American and Caribbean studies. Soc Psychiatry Psychiatr Epidemiol 39:955–961CrossRef Peluso EDTP, Blay SL (2004) Community perception of mental disorders: a systematic review of Latin American and Caribbean studies. Soc Psychiatry Psychiatr Epidemiol 39:955–961CrossRef
12.
go back to reference Alonso J, Buron A, Bruffaerts R, He Y, PosadaVilla J, Lepine JP et al (2008) Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatr Scand 118:305–314PubMedCentralCrossRefPubMed Alonso J, Buron A, Bruffaerts R, He Y, PosadaVilla J, Lepine JP et al (2008) Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatr Scand 118:305–314PubMedCentralCrossRefPubMed
13.
go back to reference Adewuya AO, Makanjuola ROA (2008) Social distance towards people with mental illness in southwestern Nigeria. Aust N Z J Psychiatry 42:389–395CrossRefPubMed Adewuya AO, Makanjuola ROA (2008) Social distance towards people with mental illness in southwestern Nigeria. Aust N Z J Psychiatry 42:389–395CrossRefPubMed
14.
go back to reference Gureje O, Lasebikan VO (2006) Use of mental health services in a developing country: results from the Nigerian survey of mental health and well-being. Soc Psychiatry Psychiatr Epidemiol 41:44–49CrossRefPubMed Gureje O, Lasebikan VO (2006) Use of mental health services in a developing country: results from the Nigerian survey of mental health and well-being. Soc Psychiatry Psychiatr Epidemiol 41:44–49CrossRefPubMed
15.
go back to reference Andersson LMC, Schierenbeck I, Strumpher J, Krantz G, Topper K, Backman G et al (2013) Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa. J Affect Disord 151:439–448CrossRefPubMed Andersson LMC, Schierenbeck I, Strumpher J, Krantz G, Topper K, Backman G et al (2013) Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa. J Affect Disord 151:439–448CrossRefPubMed
16.
go back to reference Hugo CJ, Boshoff DEL, Traut A, ZunguDirwayi N, Stein DJ (2003) Community attitudes toward and knowledge of mental illness in South Africa. Soc Psychiatry Psychiatr Epidemiol 38:715–719CrossRefPubMed Hugo CJ, Boshoff DEL, Traut A, ZunguDirwayi N, Stein DJ (2003) Community attitudes toward and knowledge of mental illness in South Africa. Soc Psychiatry Psychiatr Epidemiol 38:715–719CrossRefPubMed
17.
go back to reference Woodward LJ, Fergusson DM (2000) Childhood peer relationship problems and later risks of educational under-achievement and unemployment. J Child Psychol Psychiatry 41:191–201CrossRefPubMed Woodward LJ, Fergusson DM (2000) Childhood peer relationship problems and later risks of educational under-achievement and unemployment. J Child Psychol Psychiatry 41:191–201CrossRefPubMed
18.
go back to reference Ladd GW, Burgess KB (2001) Do relational risks and protective factors moderate the linkages between childhood aggression and early psychological and school adjustment? Child Dev 72:1579–1601CrossRefPubMed Ladd GW, Burgess KB (2001) Do relational risks and protective factors moderate the linkages between childhood aggression and early psychological and school adjustment? Child Dev 72:1579–1601CrossRefPubMed
20.
go back to reference Muga FA, Jenkins R (2008) Public perceptions, explanatory models and service utilisation regarding mental illness and mental health care in Kenya. Soc Psychiatry Psychiatr Epidemiol 43:469–476CrossRefPubMed Muga FA, Jenkins R (2008) Public perceptions, explanatory models and service utilisation regarding mental illness and mental health care in Kenya. Soc Psychiatry Psychiatr Epidemiol 43:469–476CrossRefPubMed
21.
go back to reference Kiima DM, Njenga FG, Okonji MMO, Kigamwa PA (2004) Kenya mental health country profile. Int Rev Psychiatry 16:48–53CrossRefPubMed Kiima DM, Njenga FG, Okonji MMO, Kigamwa PA (2004) Kenya mental health country profile. Int Rev Psychiatry 16:48–53CrossRefPubMed
22.
go back to reference Ndetei DM, Khasakhala L, Nyabola L, Ongecha-Owuor F, Seedat S, Mutiso V et al (2008) The prevalence of anxiety and depression symptoms and syndromes in Kenyan adolescents. J Child Adolesc Ment Health 20:33–51CrossRefPubMed Ndetei DM, Khasakhala L, Nyabola L, Ongecha-Owuor F, Seedat S, Mutiso V et al (2008) The prevalence of anxiety and depression symptoms and syndromes in Kenyan adolescents. J Child Adolesc Ment Health 20:33–51CrossRefPubMed
23.
go back to reference Harder VS, Mutiso VN, Khasakhala LI, Burke HM, Ndetei DM (2011) Postelection violence, posttraumatic stress, and comorbidity of behavioural and emotional problems among Kenyan youth. Compr Psychiatry 52:e7CrossRef Harder VS, Mutiso VN, Khasakhala LI, Burke HM, Ndetei DM (2011) Postelection violence, posttraumatic stress, and comorbidity of behavioural and emotional problems among Kenyan youth. Compr Psychiatry 52:e7CrossRef
24.
go back to reference Ndetei DM, Mutiso V, Ongecha-Owuor FA, Kokonya DA, Khasakhala LI (2009) Psychosocial and health aspects of drug use by students in public secondary schools in Nairobi, Kenya. Subst Abuse 30:61–66CrossRef Ndetei DM, Mutiso V, Ongecha-Owuor FA, Kokonya DA, Khasakhala LI (2009) Psychosocial and health aspects of drug use by students in public secondary schools in Nairobi, Kenya. Subst Abuse 30:61–66CrossRef
25.
go back to reference Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodum O et al (2011) Children and adolescent mental health worldwide: evidence for action. Lancet 378:1515–1525CrossRefPubMed Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodum O et al (2011) Children and adolescent mental health worldwide: evidence for action. Lancet 378:1515–1525CrossRefPubMed
26.
go back to reference Kenya National Bureau of Statistics and ICF Macro (2010) Kenya demographic and health survey 2008–09. Calverton, ICF Macro Kenya National Bureau of Statistics and ICF Macro (2010) Kenya demographic and health survey 2008–09. Calverton, ICF Macro
27.
go back to reference Ministry of State for Planning, National Development and Vision 2030 (2010) Millennium Development Goals Status Report for Kenya, 2009. Nairobi: Ministry of State for Planning, National Development and Vision 2030 Ministry of State for Planning, National Development and Vision 2030 (2010) Millennium Development Goals Status Report for Kenya, 2009. Nairobi: Ministry of State for Planning, National Development and Vision 2030
28.
go back to reference Corrigan PW, Watson AC, Barr L (2006) The self-stigma of mental illness: implications for self-esteem and self-efficacy. J Soc Clin Psychol 25:875–884CrossRef Corrigan PW, Watson AC, Barr L (2006) The self-stigma of mental illness: implications for self-esteem and self-efficacy. J Soc Clin Psychol 25:875–884CrossRef
29.
go back to reference Xiong NC (2011) Stigma of mental illness and depression in Hmong women. Dissertation, Alliant International University Xiong NC (2011) Stigma of mental illness and depression in Hmong women. Dissertation, Alliant International University
30.
go back to reference Fung KMT, Tsang HWH, Corrigan PW, Lam C, Cheng W (2007) Measuring self-stigma of mental illness in China and its implications for recovery. Int J Soc Psychiatry 53:408–418CrossRefPubMed Fung KMT, Tsang HWH, Corrigan PW, Lam C, Cheng W (2007) Measuring self-stigma of mental illness in China and its implications for recovery. Int J Soc Psychiatry 53:408–418CrossRefPubMed
31.
go back to reference StataCorp (2011) Stata Statistical Software: Release 12. StataCorp LP, College Station StataCorp (2011) Stata Statistical Software: Release 12. StataCorp LP, College Station
32.
go back to reference O’Driscoll C, Heary C, Hennessy E, McKeague L (2012) Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 53:1054–1062CrossRefPubMed O’Driscoll C, Heary C, Hennessy E, McKeague L (2012) Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 53:1054–1062CrossRefPubMed
33.
go back to reference Arbanas G (2008) Adolescents’ attitudes toward schizophrenia, depression, and PTSD. J Psychosoc Nurs Ment Health Serv 46:45–51CrossRefPubMed Arbanas G (2008) Adolescents’ attitudes toward schizophrenia, depression, and PTSD. J Psychosoc Nurs Ment Health Serv 46:45–51CrossRefPubMed
34.
go back to reference Watson AC, Miller FE, Lyons JS (2005) Adolescent attitudes toward serious mental illness. J Nerv Ment Dis 193:769–772CrossRefPubMed Watson AC, Miller FE, Lyons JS (2005) Adolescent attitudes toward serious mental illness. J Nerv Ment Dis 193:769–772CrossRefPubMed
35.
go back to reference Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K (2011) Predictors of stigmatizing attitudes towards people with mental disorders in a general population in Finland. Nordic J Psychiatry 65:125–132CrossRef Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K (2011) Predictors of stigmatizing attitudes towards people with mental disorders in a general population in Finland. Nordic J Psychiatry 65:125–132CrossRef
36.
go back to reference Wang J, Fick G, Adair C, Lai D (2007) Gender specific correlates of stigma toward depression in a Canadian general population sample. J Affect Disord 103:91–97CrossRefPubMed Wang J, Fick G, Adair C, Lai D (2007) Gender specific correlates of stigma toward depression in a Canadian general population sample. J Affect Disord 103:91–97CrossRefPubMed
37.
go back to reference Swords L, Heary C, Hennessy E (2011) Factors associated with acceptance of peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 52:933–941CrossRefPubMed Swords L, Heary C, Hennessy E (2011) Factors associated with acceptance of peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 52:933–941CrossRefPubMed
38.
go back to reference Wahl OF (2002) Children’s views of mental illness: a review of the literature. Am J Psychiatr Rehabil 6(2):134–158CrossRef Wahl OF (2002) Children’s views of mental illness: a review of the literature. Am J Psychiatr Rehabil 6(2):134–158CrossRef
39.
go back to reference Corrigan PW, Watson AC (2007) How children stigmatize people with mental illness. Int J Soc Psychiatry 53:526–546CrossRefPubMed Corrigan PW, Watson AC (2007) How children stigmatize people with mental illness. Int J Soc Psychiatry 53:526–546CrossRefPubMed
40.
go back to reference Whalen CK, Henker B, Dotemoto S, Hinshaw SP (1983) Child and adolescent perceptions of normal and atypical peers. Child Dev 54:1588–1598CrossRefPubMed Whalen CK, Henker B, Dotemoto S, Hinshaw SP (1983) Child and adolescent perceptions of normal and atypical peers. Child Dev 54:1588–1598CrossRefPubMed
41.
go back to reference Jackson H, Judd F, Komiti A, Fraser C, Murray G, Robins G et al (2007) Mental health problems in rural contexts: what are the barriers to seeking help from professional providers? Aust Psychol 42:147–160CrossRef Jackson H, Judd F, Komiti A, Fraser C, Murray G, Robins G et al (2007) Mental health problems in rural contexts: what are the barriers to seeking help from professional providers? Aust Psychol 42:147–160CrossRef
42.
go back to reference Kermode M, Bowen K, Arole S, Pathare S, Jorm AF (2009) Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Soc Psychiatry Psychiatr Epidemiol 44:1087–1096CrossRefPubMed Kermode M, Bowen K, Arole S, Pathare S, Jorm AF (2009) Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Soc Psychiatry Psychiatr Epidemiol 44:1087–1096CrossRefPubMed
43.
go back to reference Cinnirella M, Loewenthal KM (1999) Religious and ethnic group influences on beliefs about mental illness: a qualitative interview study. Br J Med Psychol 72:505–524CrossRefPubMed Cinnirella M, Loewenthal KM (1999) Religious and ethnic group influences on beliefs about mental illness: a qualitative interview study. Br J Med Psychol 72:505–524CrossRefPubMed
44.
go back to reference Lefley HP (1990) Culture and chronic mental illness. Hosp Community Psychiatry 41:277–286PubMed Lefley HP (1990) Culture and chronic mental illness. Hosp Community Psychiatry 41:277–286PubMed
45.
go back to reference Ng TP, Nyunt MSZ, Chiam PC, Kua EH (2011) Religion, health beliefs and the use of mental health services by the elderly. Aging Ment Health 15:143–149CrossRefPubMed Ng TP, Nyunt MSZ, Chiam PC, Kua EH (2011) Religion, health beliefs and the use of mental health services by the elderly. Aging Ment Health 15:143–149CrossRefPubMed
46.
go back to reference Ndetei DM, Mutiso V, Musyimi C, Anderson KK, McKenzie K, Musau A. The prevalence of mental disorders among upper primary school children in Kenya (Forthcoming) Ndetei DM, Mutiso V, Musyimi C, Anderson KK, McKenzie K, Musau A. The prevalence of mental disorders among upper primary school children in Kenya (Forthcoming)
47.
go back to reference Jackson D, Heatherington L (2006) Young Jamaicans’ attitudes toward mental illness: experimental and demographic factors associated with social distance and stigmatizing opinions. J Community Psychol 34:563–576CrossRef Jackson D, Heatherington L (2006) Young Jamaicans’ attitudes toward mental illness: experimental and demographic factors associated with social distance and stigmatizing opinions. J Community Psychol 34:563–576CrossRef
48.
Metadata
Title
Stigmatizing attitudes toward mental illness among primary school children in Kenya
Authors
David M. Ndetei
Victoria Mutiso
Anika Maraj
Kelly K. Anderson
Christine Musyimi
Kwame McKenzie
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 1/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-015-1090-6

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