Social Contact and Stigma Towards People With Mental Illness: Evaluating the Moldovan Mental Health Reform

Abstract

Stigma has been identified as a significant barrier to the success of mental health promotions and programs. Therefore, understanding stigma towards individuals with mental illness is crucial for promoting inclusion and advancing the mental health systems. However, there is limited research focused on factors that contribute to stigma reduction. The Moldovan government in collaboration with the Swiss Agency for Development and Cooperation have been implementing a mental health reform (MENSANA) in Moldova, aimed to establish a community based mental health system. This study is aimed to examine the differences in stigma levels using the Community Attitudes towards the Mentally Ill (CAMI) scale across various socio-demographic characteristics. Additionally, the study explored the association of piloting districts with the mental health reform and the overall score of CAMI. In a cross-sectional study, the sample comprised 2973 adults. One-way ANOVA and T-test were used to assess the difference in CAMI scores across socio-demographic variables. Moderation analysis was conducted using PROCESS version 3.5. Results from the analysis of variances indicated slightly higher stigma levels among individuals with lower educational attainment (F=10.813, df1=3, df2=2969, p-value=<0.001). The independent t-test revealed that stigma levels were slightly higher among males who lacked social contact with individuals with mental illness (t=-4.257, df=2971, p<0.001; t=-5.322, df=2971, p<0.001). Although social contact was not found to be a moderator of piloting districts with mental health, a significant main effect was found, demonstrating that stigma was lower among those who have prior social contact experiences with individuals with mental illness (B=0.0855, SE=0.0167, t=5.1149, p<0.001). This study demonstrated that prior contact experiences with the mentally ill is a significant predictor of stigma level. To that end, follow-up research is needed to concretize the results into a stigma reduction program in Moldova