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High levels of stigma towards substance use and depression amongst non-specialist health workers in South Africa

As mental health-related stigma is a significant barrier to seeking and receiving healthcare, stigma amongst non-specialist health workers (NSHWs) towards patients with major depressive disorder (MDD) and substance use disorder (SUD) could negatively affect mental health service provision. This stud...

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Bibliographic Details
Main Author: Goncalves, Richard
Other Authors: Sibeko, Ntokozo
Format: Thesis
Language:English
Published: Department of Psychiatry and Mental Health 2023
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Summary:As mental health-related stigma is a significant barrier to seeking and receiving healthcare, stigma amongst non-specialist health workers (NSHWs) towards patients with major depressive disorder (MDD) and substance use disorder (SUD) could negatively affect mental health service provision. This study aimed to explore (1) the level of stigma towards MDD and SUD among NSHWs employed in primary care settings in South Africa, (2) the extent to which socio-demographic factors might be associated with stigma levels amongst these NSHWs, and (3) NSHWs' interest in receiving training for MDD or SUD. Overall, 81 NSHWs completed a culturally modified version of the Social Distance Scale (SDS) that assessed stigma towards a hypothetical patient with MDD and a hypothetical patient with SUD; higher cumulative SDS scores represented greater stigma. With a possible range of 6-24, we found a mean SDS score of 9.0 (SD=3.7) for MDD and 11.7 (SD=4.4) for SUD. Results show elevated levels of stigma towards both hypothetical patients, with significantly higher mean SDS scores for SUD compared to MDD (p <0.001). No socio-demographic variables were significantly associated with MDD or SUD stigma levels. When asked to rate their interest, more NSHWs were “very interested” in receiving training for MDD (90.0%) than for SUD (80.8%); this difference was statistically significant (p=0.027). High levels of self-reported stigma, coupled with a desire for further training, suggest that it would be prudent to incorporate stigma reduction measures into future MDD and SUD training programmes for NSHWs.