Stigma and stigma by association: Findings from a child and adolescent mental health service (CAMHS), Sri Lanka

Background: Young people with mental illness are known to be subjected to prejudice, verbal abuse and to be left out of activities, which leads to social isolation and impairs daily functioning. Parents of children with mental illness also experience an extension of this stigma, which can result in increased caregiving stress and decreased caregiver wellbeing.Aim: We aimed to assess the extent of stigma against mental illness in children and adolescents and identify associated factors in order to design interventions to minimize stigma against children with mental illness.Method: A descriptive cross-sectional study was conducted at a CAMHS in Sri Lanka. Perceived stigma was measured using a specifically designed questionnaire with 30-items. The Cronbach’s Alpha for the 30-item scale was 0.852, showing good internal consistency. A ROC curve was used to identify the cut off scores of 52.5 for the stigma questionnaire, with a sensitivity of .08 and specificity of 0.78. Chi square was used to analyze the association between categorical variables.Results: Of the 150 participants, 44% felt that their child had been discriminated in education. More than a quarter (27.3%) have been blamed by others for their child’s mental health problems and 23.3% of children have been attacked or physically threatened. Perceived stigma was significantly higher in parents whose children had behavioural problems (p<0.01) and those diagnosed as having ADHD (p<0.05).Conclusions: Anti-stigma interventions, specially focused on educational settings, are needed to reduce stigma against children with mental illness.