Stigma among the stigmatized? Preferred social distance and associated factors among outpatients at a psychiatry clinic in Benin City, Nigeria

Background: Researchers, hitherto, have focused largely on public stigma towards people with mental illness; literature evidence appears inadequate on stigma and discrimination among the psychiatric patients themselves, creating a prominent gap in literature and limiting interventions that could improve tolerant attitude among them and successful treatment outcome.

Aims: To determine the prevalence of moderate to high social distance among participating psychiatric patients and elucidate the factors that are associated with desire for high social distance among them.

Methods: A descriptive cross-sectional design was employed and participants included psychiatric patients attending the out-patient clinic of a tertiary hospital in Benin City, Nigeria. Data was collected using a socio-demographic data collection sheet, The Bogardus Social Distance Scale, The World Psychiatric Association Stigma Questionnaire, and The Brief Psychiatric Rating Scale. Version 21 of SPSS was used to analyze the data at a statistically significant level of P< 0.05.

Results: The prevalence of moderate to high social distance was 67.8% and social distance had significant association with belief about heredity and evil spirit causation of mental illness (Chi2=4.858, P=0.025 and Chi2=5.947, P=0.015 respectively); belief about treatment outcome of mental illness (Chi2=15.796, P=<0.001), and belief that people with mental illness are dangerous (Chi2=7.367, P=0.007); all of which, apart from dangerousness, independently predicted moderate to high social distance among the patients.

Conclusion: The findings of this study presented an emerging evidence of high social distance and stigmatization among psychiatric patients towards one another akin to reported public stigma against them. Misconceptions that influence high social distance in the public are also shared by the patients. This development warrants conscious and concerted efforts to stem the tide.