Affiliate stigma among primary caregivers of adult patients with severe mental illness: a facility-based cross-sectional study in Addis Ababa, Ethiopia.

introductionWhilst caregivers are crucial in the treatment and recovery of patients, numerous studies have indicated that primary caregivers of adults with severe mental illnesses (SMI) face widespread stigmatisation and bear a significant burden. Nevertheless, research examining stigma and burden among primary caregivers of adults with SMI in developing nations remains scarce.

objectivesThe present study aimed to evaluate affiliate stigma amongst caregivers of adults with SMI at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.

methodsA facility-based cross-sectional study design was applied. Systematic random sampling method was employed to recruit caregivers of adults with SMI (n = 398). The gathered information encompassed tools and structured questionnaires, including the family stigma scale, attitude toward mental illness questionnaire, family burden interview, Oslo 3-items social support scale, sociodemographic and clinical characteristics of both caregivers and patients, and caregiver burden. The data were analyzed using descriptive statistics and binary logistic regression.

resultsCaregivers (n = 375) of patients with bipolar disorder (13.3%), anxiety disorders (21.9%), major depressive disorders (26.67%) and schizophrenia (37.3%) participated in the study. The response rate was 94.2%, with a proportional gender distribution among participants (female = 49.87%). The findings revealed that approximately half (54.9%) of the caregivers experienced or perceived stigma. The factors that were associated with stigma among caregivers were caregiving patients with schizophrenia (AOR: 1.91; 95% CI: 0.86, 4.2; p = 0.003), attitude towards people with mental illness (AOR: 2.1; 95% CI: 1.23, 3.4; p = 0.005), social support (AOR: 0.5; 95% CI: 0.30, 0.82; p = 0.006), patient history of psychiatric admission (AOR: 0.32; 95% CI: 0.18, 0.57; p < 0.0001) and superstitious belief (AOR: 0.28; 95% CI: 0.15, 0.52; p < 0.0001). The findings also illustrated that a large proportion of caregivers (89%) had moderate to severe burden.

conclusionsThe study identified the high levels of stigma and burden faced by caregivers of adults with SMI, emphasizing the pressing need for interventions. These interventions should include psychoeducation and tailored support for caregivers, as well as efforts to enhance public awareness about mental health issues. Furthermore, the study identified that types of illness, social support, attitude towards people with mental illness, patient history of psychiatric admission, and superstitious beliefs are important determinants of stigma.