Table 3 Summary of results

Types and forms of stigma and discrimination

• Internalized stigma

• Externalized stigma

Experiences of externalized stigma

1. From health professionals and in health facilities

• General ill-treatment from clinic staff:

• Avoiding attending to PWMIs and other ill treatment from nurses

2. From family members

• Being; denied of food;

• made fun of;

• neglected;

• beaten;

• tied to a tree

3. From community members (neighbours, employers and friends)

• Being; labelled

• made fun of

• pushed around

• denied entrance to shopping outlets

• made to do filthy jobs

• denied wages for jobs done

• lack of support and empathy

Causes of psychiatric stigma

Stigmatizing misconceptions about mental illness

• Mental illness being a deliberate act

• PWMIs are aggressive

• Mental illness is a result of the individual’s weakness

Traditional explanatory models of mental illness which may lead to delay in seeking help

• Mental illness caused by witchcraft

• Mental illness being a sign indicating a call to be a ‘Sangoma’

Impact of stigma on service users

• Being unable to lead normal lives

• Worsened state of health

Interventions to curb psychiatric stigma: participants perspectives

1. Education

i. Education/awareness raising for:

• Family members

• Community members

• Service users

• Service providers

ii. Education methods:

• Health education

• Media (pamphlets, TV, radio)

• Town hall/community meetings

• Health talks at clinics

iii. Psycho-education and psychosocial rehabilitation for family members and service users

2. Acceptance and support by family and community members

3. Supervision of health care service providers

4. Integration at health facilities

5. Sanctions/legal action against agents of discrimination