Rich Goncalves is a medical doctor currently undergoing Psychiatry specialist training at the University of Cape Town, South Africa. He has a keen interest in Addiction Medicine, particularly regarding Stigma, Task-sharing and Motivational Interviewing. He hopes, through collaborative research, to help shift policies that result in better care for those that use substances.
Abstract
Exploring stigma towards patients with major depressive & substance use disorders amongst non-specialist health workers in South Africa
As mental illness-related stigma is a significant barrier to seeking and receiving healthcare, high stigma amongst non-specialist health workers (NSHW’s) towards patients with major depressive disorder (MDD) and substance use disorder (SUD) could negatively affect the provision of mental health services in South Africa. The aims of this study were to examine the level of stigma towards mental illness in NSHW’s working in primary care settings in South Africa and to assess whether there are any socio-demographic variables that are associated with raised stigma levels in this cadre of workers. 81 NSHW’s completed a self-administered questionnaire, which included a modified Bogardus Social Distance Scale to measure stigma towards a hypothetical patient with MDD, and one with SUD. A cumulative social distance scale (SDS) score was determined, with a higher score representing more stigma. The average MDD SDS score was 8.99 (SD =3.65) and the SUD SDS score was 11.65 (SD=4.37). This shows that social distance towards the patients in both vignettes was raised and significantly higher social distance was observed towards the vignette with SUD, as opposed to MDD (t(76)= -7.21, p <.001). In conclusion, there is significant stigma towards mental illness amongst NSHW’s, particularly towards those patients with SUD.