Stigma Toward Mental Illness and Its Impact on Access to Mental Health Services Among Young Adults in Sub-Saharan Africa
Abstract
The mental health problems in young adults are really severe in sub-Saharan Africa, but access to the service is extremely limited. One of the core obstacles is stigma towards mental illness, although there is limited empirical evidence to measure its effects in this regard. This is a study that involved examination of the relationships between three types of stigma (public, self, and structural), and access to mental health services among young adults (aged 18-30 years) in sub-Saharan Africa, with consideration to the moderating roles of mental health literacy, social support, socioeconomic status and cultural beliefs. A cross-sectional design, including 405 young adults who were selected using multi-stage cluster sampling among tertiary institutions and workplaces. Likert-scale questionnaires were used to collect data, which were analysed using IBM SPSS Statistics version 29.
All instruments showed acceptable-excellent reliability (a = 0.73-0.93). The proportion of prior service use was only 16.5%. The overall types of stigma were significant predictors of decreased access to services (b = -0.28 to -0.58, p < 0.001), with self-stigma being the strongest predictor, accounting for up to 52 percent of the perceived barriers. The effects of stigma were moderated significantly by mental health literacy and social support (b = 0.14 to 0.22, p < 0.05). Socioeconomic status selectively moderated the effect of structural stigma (b = 0.16, p = 0.007). Mental health literacy and social support buffered the effects of stigma, whereas cultural beliefs showed complex, non-significant moderating effects.
Sub-Saharan African young adults have low access to mental health services, and self-stigma is the most powerful obstacle. Both enhancing access and combating all types of stigma require the use of multi-level interventions that focus on mental health literacy and social support.Keywords
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