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Rural vs urban residence and experience of discrimination among people with severe mental illnesses in Ethiopia.
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- معلومة اضافية
- المصدر:
Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE
- بيانات النشر:
Original Publication: London : BioMed Central, [2001-
- الموضوع:
- نبذة مختصرة :
Background: Few studies have addressed mental illness-related discrimination in low-income countries, where the mental health treatment gap is highest. We aimed to evaluate the experience of discrimination among persons with severe mental illnesses (SMI) in Ethiopia, a low-income, rapidly urbanizing African country, and hypothesised that experienced discrimination would be higher among those living in a rural compared to an urban setting.
Methods: The study was a cross-sectional survey of a community-ascertained sample of people with SMI who underwent confirmatory diagnostic interview. Experienced discrimination was measured using the Discrimination and Stigma Scale (DISC-12). Zero-inflated negative binomial regression was used to estimate the effect of place of residence (rural vs. urban) on discrimination, adjusted for potential confounders.
Results: Of the 300 study participants, 63.3% had experienced discrimination in the previous year, most commonly being avoided or shunned because of mental illness (38.5%). Urban residents were significantly more likely to have experienced unfair treatment from friends (χ 2 (1) = 4.80; p = 0.028), the police (χ 2 (1) =11.97; p = 0.001), in keeping a job (χ 2 (1) = 5.43; p = 0.020), and in safety (χ 2 (1) = 5.00; p = 0.025), and had a significantly higher DISC-12 score than those living in rural areas (adjusted risk ratio: 1.66; 95% CI: 1.18, 2.33).
Conclusions: Persons with SMI living in urban settings report more experience of discrimination than their rural counterparts, which may reflect a downside of wider social opportunities in urban settings. Initiatives to expand access to mental health care should consider how social exclusion can be overcome in different settings.
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- Grant Information:
16/136/54 United Kingdom DH_ Department of Health; R01 MH100470 United States MH NIMH NIH HHS; MR/M025470/1 United Kingdom MRC_ Medical Research Council; MR/R023697/1 United Kingdom MRC_ Medical Research Council; MR/S001255/1 United Kingdom MRC_ Medical Research Council
- Contributed Indexing:
Keywords: Bipolar disorder; Discrimination; Global mental health; Mental illness; Psychotic disorders; Stigma; Urbanization
- الموضوع:
Date Created: 20191107 Date Completed: 20200619 Latest Revision: 20231019
- الموضوع:
20231019
- الرقم المعرف:
PMC6833167
- الرقم المعرف:
10.1186/s12888-019-2345-7
- الرقم المعرف:
31690297
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