Understanding of Medical Students’ Attitudes towards Mental Illness: A Cross-Sectional Study at the State University of Zanzibar

Introduction: Mental illness imposes a significant global health burden, often compounded by stigma that hinders care. Medical students, as future healthcare providers, play a crucial role in shaping perceptions of mental health and service delivery. Understanding their attitudes toward mental illness is essential for improving outcomes. Objectives: To assess attitudes toward mental illness among medical students at the State University of Zanzibar (SUZA). Methods: A cross-sectional study was conducted among 156 SUZA medical students using a self-administered questionnaire adopted from the Mental Illness: Clinician’s Attitudes Scale, version 2 (MICA-2). Attitudes were measured on a 16-item, 6-point Likert scale. Independent variables included socio-demographic and educational factors. Students were stratified based on the year of study, while a simple random sampling was used to choose a specific number of students from each group. Results: Overall, 50.6% of students exhibited negative attitudes, while 49.4% demonstrated positive attitudes. Year of study (χ² = 18.393, p = .001) and close contact with a person with mental illness (χ² = 5.635, p = .018) were significantly associated with attitudes. Students in their earlier years were more positive, but those in their third and fifth years were more negative. Having close contact with someone with a mental illness was unexpectedly associated with more negative attitudes. Other factors, such as gender, age, socioeconomic status, workshop attendance, and personal or family history, showed no significant association. While most students showed some positive views, like seeing the scientific value of psychiatry and supporting respectful communication and care, they still held misconceptions, particularly regarding recovery and the belief that people with mental illness are dangerous. Conclusion: The SUZA medical students had a mix of positive and negative attitudes toward mental illness. Although the students were aware of mental health issues, this awareness did not always reduce the stigma. The findings show a need for specific educational programs, especially for students in their later years of study, to address ongoing misunderstandings about mental illness.