A qualitative insight on stereotypes and prejudices toward mental disorders in Burkina Faso: the interaction of shame and fear as underlying influences of stigma

Background: Worldwide, stigma is recognized as a barrier limiting access to psychiatric care. The scope of the stigma varies across cultural contexts and contributes to the social inequalities in health observed in many low- and middle-income countries. Aim and methods: In this paper, we explore the way mental disorders are stigmatized in Bobo-Dioulasso (Burkina Faso). We conducted 7 focus groups and 25 individual interviews with patients, family members, caregivers, and key informants. Interviews focused on stereotypes and attitudes toward individuals identified with mental disorders. Results: A set of stereotypes is socially conveyed about people with mental disorders. The perceptions that these individuals are fragile, useless, dangerous, marginal, and adopt strange behaviors are common. These stereotypes could be related to emotional reactions, such as sadness, compassion, indifference, fear, disgust, and shame that justify, in some cases, discrimination and unequal treatments. Discussion: This study suggests that affective reactions are crucial to understand stigma in Burkina Faso. The notion of shame seems to be rooted in a set of cultural norms and values, and fear seems to be related to structural stigma. Our results offer some insights for future anti-stigma programs in a context where resources are limited and where cultural characteristics must be considered.