Abstract:
Background: Self stigma among people with mental illness results from multiple cognitive and environmental
factors and processes. It can negatively affect adherence to psychiatric services, self esteem, hope, social
integration and quality of life of people with mental illness. The purpose of this study was to measure the level of
self stigma and its correlates among people with mental illness at Jimma University Specialized Hospital,
Psychiatry clinic in southwest Ethiopia.
Methods: Facility based cross-sectional study was conducted on 422 consecutive samples of people with mental
illness using interviewer administered and pretested internalized stigma of mental illness (ISMI) scale. Data was
entered using EPI-DATA and analysis was done using STATA software. Bivariate and multivariate linear regressions
were done to identify correlates of self stigma.
Results: On a scale ranging from 1 to 4, the mean self stigma score was 2.32 (SD = 0.30). Females had higher self
stigma (std. β = 0.11, P < 0.05) than males. Patients with a history of traditional treatment had higher self
stigma (std. β = 0.11, P < 0.05). There was an inverse relationship between level of education and self-stigma
(std. β = −0.17, P < 0.01). Perceived signs (std. β = 0.13, P < 0.05) and supernatural causes of mental illness
(std. β = 0.16, P < 0.01) were positively correlated with self stigma. Higher number of drug side effects were
positively correlated (std. β = 0.15, P < 0.05) while higher self esteem was negatively correlated (std. β = −0.14,
P < 0.01) with self stigma.
Conclusions: High feeling of inferiority (alienation) but less agreement with common stereotypes (stereotype
endorsement) was found. Female showed higher self stigma than male. History of traditional treatment and
higher perceived supernatural explanation of mental illness were associated with higher self stigma. Drug side
effects and perceived signs of mental illness were correlated with increased self stigma while education and self
esteem decreased self stigma among people with mental illness. Patient empowerment psychosocial
interventions and strategies to reduce drug side effects can be helpful in reducing self stigma among people
with mental illnesses.
