Attitudes, Stigma and Social Distance Toward Mental Illness Among Family members and the General Public in Rawalpindi–Islamabad, Pakistan: A Cross-Sectional Analytical Study

Abstract

Objective: To compare the levels of attitudes, personal stigma, and social distance toward mental illness between family members of individuals with mental illness and members of the general public in Rawalpindi-Islamabad.

 Methodology: We conducted a community-based cross sectional analytical study from January to March 2024 using purposive sampling technique. Two groups; group I (immediate family members of individuals with psychiatric disorder) and group II (general public) were enrolled. Of 433 approached, 400 were included (200 in each group). The Attribution Questionnaire (AQ-27), Bogardus Social Distance Scale, and Personal Stigma Scale (PSS) were used for data collection. Mean and percentages were calculated and independent samples t-test was applied.

Results: On AQ-27, coercion pity and help were highest in both groups while anger and dangerousness were lowest. The only significant between-group difference was avoidance, with higher scores in the general public than family members (p=0.012). Bogardus responses showed a clear role gradient (most willing as close friend 22.5% and citizen 18.8%; least willing as partner 12.5% and tourist 8.5%). On the PSS, group means were similar (group I = 3.88; group II = 3.84). Within families, stigma varied by kinship (children highest; grandparents lowest), and by education (religious-only stream highest).

Conclusion: Findings indicate broadly sympathetic views with selective distance in closer roles. Priorities include routine caregiver support to address avoidance linked to burden, and targeted mental-health literacy, especially where prior schooling offers limited mental-health Content. Future work should test whether these strategies reduce avoidance and social distance over time.

Keywords: Attitude, Social distance, Stigma, Mental illness, Cross-sectional Studies