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Attitudes towards mental illness in Malawi: a cross-sectional survey

Jim Crabb123*, Robert C Stewart23, Demoubly Kokota23, Neil Masson234, Sylvester Chabunya2 and Rajeev Krishnadas5

Author Affiliations

1 Forth Valley Royal Hospital, Stirling Road, Larbert, UK

2 Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi

3 Scotland-Malawi Mental Health Education Project, c/o Royal Edinburgh Hospital, Edinburgh, UK

4 Wishaw General Hospital, Netherton St, Wishaw, UK

5 Sackler Institute of Psychobiological Research, Section of Psychological Medicine, Southern General Hospital, Glasgow, UK

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BMC Public Health 2012, 12:541  doi:10.1186/1471-2458-12-541

Published: 23 July 2012



Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi.


A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”.


210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample.


Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.