Education as a predictor of mental illness familiarity and attitudes in a Muslim community.

Background: Mental illness is a leading cause of disability in South Africa, where stigma, educational disparities, and cultural beliefs are critical barriers to care. Research has largely overlooked the South African Muslim community, particularly regarding how education influences mental illness familiarity and attitudes within a context where spiritual interpretations may uniquely shape stigma. This study investigated the association between level of education and mental illness familiarity and attitudes toward people with mental illness among South African Muslims. Methods: Using a cross-sectional study design, we recruited 119 South African Muslim adults (81.5% female; mean age = 30.92, SD = 13.01) using purposive snowball sampling, identifying initial participants through Muslim community groups and social media platforms. Eligibility was open to adults (18+) who identified as Muslim, were South African residents, proficient in English, and reported no history of a psychiatric diagnosis. Participants completed an online survey assessing familiarity with mental illness (FMI scale) and attitudes (Beliefs toward Mental Illness scale). We conducted two separate multiple regression analyses to test whether higher education level was associated with greater familiarity and more positive attitudes, controlling for age, gender, employment status, and income. Results: Participants reported familiarity primarily through indirect exposure (e.g., 85.7% had observed someone in public). Overall attitudes were neutral-to-positive (M = 52.40, SD = 10.06), yet negative stereotypes about incurability and poor social skills persisted. After adjusting for covariates, higher education level remained significantly associated with familiarity (B = 0.83, 95% CI [0.44, 1.22], Conclusion: We found that higher education is associated with greater mental illness familiarity but not with reduced stigmatizing attitudes in this community. The findings suggest that educational attainment alone is insufficient to counteract stigma potentially rooted in cultural and spiritual belief systems. Public health efforts should complement educational outreach with culturally sensitive interventions, developed in partnership with religious communities, to effectively address deeply held stigmatizing beliefs.