Assess the Perception about Mental Illness and Help-Seeking
Behaviors among Caregivers and Noncaregivers

Mishra SS and Sonalika S

doi:10.23880/nhij-16000284

Nursing & Healthcare International Journal Research Article 12 min read

Assess the Perception about Mental Illness and Help-Seeking Behaviors among Caregivers and Noncaregivers

Mishra SS and Sonalika S^*

^* Corresponding author

ISSN: 2575-9981 10.23880/nhij-16000284 Received: March 16, 2023 Published: April 14, 2023

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Keywords

Perception Help-seeking behaviour Caregivers and non-caregivers

Abstract

A community based descriptive survey research design was adopted and a purposive sampling technique was used to select 200 samples. A self-report questionnaire was used to collect the demographic variables, a standardized tool (CAMI Scale) for assessing the perception of caregivers and non-caregivers on mental illness (ATSPPH-SF Scale). The findings showed that the majority of the mentally ill people (68%) suffered from schizophrenia, (48%) suffered more than 6 months, (59%) mentally ill people belonged to the age group of 18-34 years, caregivers (46%) belonged to the age group of 35-49 years, the noncaregiver (60%) belonged to the age group of 18-34 years, caregivers (69%) were female, non-caregivers (55%) were female, caregivers(62%) were married, non-caregivers(88% ) were married,(97%) of caregivers were Hindu, 100% of non-caregivers were Hindu, non-caregivers(51%) studied up to degree and above, caregivers (59%) were not working, non-caregivers (56%) were not working, caregivers(73%) belonged from a nuclear family, non-caregivers (50%) belonged from a nuclear family, caregiver (47%) had income above 20,000, non-caregivers (53%) had income above 20,000, caregivers (37%) were parents. The findings of the study show that caregivers had more positive perception towards mental illness but non-caregivers have more help-seeking behavior than caregivers and there is no relation between perception and help-seeking behavior of caregivers and non-caregivers.

Introduction

Mental illnesses are health conditions involving changes in thinking, emotion, or behavior (American psychiatric Association). Over many years mental illness is experienced by people although the type, intensity of the disease condition, duration of symptoms differs from person to person. According to the world health report 2001, more than 25% of people at a global level are experiencing mental and behavioral disorders at some point in their lifetime [1].

Mentally ill people most of the time suffers from stigmatization, discrimination, and human right abuses. They have educational difficulties; suffer from poverty, deprived of good jobs and opportunities to socialize with others. Families also face difficulty to manage the stress related to handling disturbing symptoms, financial demands of the disease, fear of other members of the family inheriting a mental illness.

Mental illness also causes a huge economic loss to the nation. Loss of productivity and expenditure occurs as a result of mental disorders in the nation [2].

Mental and behavioral problems exist all over the world, in men and women, in all stages of life, among poor and rich, and among rural and urban people. Worldwide more than 450 million people suffer from mental and behavioral disorders at any given time. It is estimated that the lifetime prevalence rate for the mental and behavioral disorder is 12.25 to 48.6% and the 12-month prevalence rate is 8.25%- 29.1% [3].

In most of the world, mostly in developing and underdeveloped countries mental health and mental illness are largely ignored or neglected. It is not given the same importance as physical health, increasing the treatment gap and burden of mental disorders in the community. After three decades of launching a national mental health program, the program is not reached each part of the country, widening inequalities in economic status, widespread poverty, poor living conditions, expensive treatment in private settings, lack of infrastructures resulting in less attention towards the program. In India, mental illness has far too long been the subject of ridicule. The condition is perceived as frightening, shameful, imaginary, feigned, incurable and the patients are perceived as dangerous, unpredictable, untrustworthy, unstable, worthless, and/or helpless in the community [4].

Need for the Study

Without mental health there can be no true physical health. Yet mental health failed to get much attention it deserves. Mental disorders have a huge impact on the economies of nations, communities as well as families [2].

India is a vast country with a 1.3 billion population. According to a report by the world health organization in India 56 million people are suffering from depression, 38 million people are suffering from anxiety disorders. Mental distress is a key cause of student suicide in the country [3].

In India, the prevalence rate of mental and behavioral disorders are ranging from 9.54 to 370 per 1000 population.7However Indian people’s attitude towards mental illness and the mentally ill is not helping [4].

Studies have shown that community people have a negative perception of mental illness, and the perception is due to a local understanding of the causes and nature of the mental illness. The negative perception of mental illness of community people affects professional help-seeking behavior, ignores availability of advanced treatment, and restricts social reintegration of mentally ill people [1].

Poor knowledge of caregivers on mental illness affects early detection and early treatment of mental disorders while the negative perception of caregivers on mental illness prevents or delays professional help-seeking behavior and encourages social stigma and discrimination on mental illness. Untreated mental disorders worsen the condition with time and deepen the emotional, social, and economic burden of the community and caregivers [2].

Problem Statement

Assess the perceptions about mental illness and help- seeking behaviors among caregivers in selected hospitals, Cuttack and non-caregivers in the selected community, Bhubaneswar.

Objectives

To assess the perception of mental illness of caregivers and non-caregivers in selected hospitals and community areas.
To assess the help-seeking behavior of caregivers and non-caregivers in selected hospitals and community areas.
To compare the perceptions about mental illness between caregivers and non-caregivers in selected hospitals and community areas.
To compare the help-seeking behavior of caregivers and non-caregivers in selected hospitals and community areas.
To find out the correlation between perception and help- seeking behavior of caregivers in selected hospitals.
To find out the correlation between perception and help-seeking behavior of non-caregivers in a selected community area.
To determine the association between perception about mental illness and help-seeking behavior with socio- demographic variables of caregivers.
To determine the association between perception about mental illness and help-seeking behavior with socio- demographic variables of non-caregivers.

Assumption

There is a difference in perception and help-seeking behavior among caregivers and non-caregivers.
Perception and help-seeking behavior among caregivers are more than non-caregivers.
Many factors influence perception and help-seeking behavior among caregivers and non-caregivers.

Null Hypothesis

HO1: There is no significant difference between the

perception of caregivers and non-caregivers at a 0.05 level of significance. HO2: There is no significant difference between the help- seeking behavior of caregivers and non-caregivers at a 0.05 level of significance. HO3: There is no significant relationship between perception and help-seeking behavior of caregivers at a 0.05 level of significance. HO4: There is no significant relationship between perception and help-seeking behavior of non-caregivers at a 0.05 level of significance. HO5: There is no association between perception and help-seeking behavior with socio-demographic variables among caregivers at a 0.05 level of significance. HO6: There is no association between perception and help- seeking behavior with socio-demographic variables among non-caregivers at a 0.05 level of significance.

Research Methodology

Research Approach

The study investigator was used Quantitative survey approach.

Research Design

Descriptive Survey research design.

Setting of the Study

District Hospital, Bhubaneswar.

Population

In this present study population consists of all caregivers of people with mental illness admitted in the psychiatric ward of hospitals. And all family members with no psychiatric illness in the family in a community area.

Sampling Technique

Samples were selected by using the purposive sampling technique.

Sample Size

The study sample comprised of 100 non-caregivers and 100 caregivers who fulfilled the inclusion standards.

Criteria for Selecting Samples

Inclusion criteria: For the selection of patients:-

Those who are 18years and above.
Those who are diagnosed with psychotic and mood- related disorders for more than 6 months.
Those who came from the village area.
For the selection of caregivers
This study includes people aged 18 years and above who give care to psychotic and mood-related disorder people for more than 6 months.
And must come from the village area.
Must be a family member of the diagnosed patient.
For the selection of non-caregivers
All family members who are 18 years and above.
All family members with no psychiatric illness in the family in a selected community area.

Results

Distribution of sample with demographic variables.

The data described that 68% of people had schizophrenia, 12% people had bipolar disorder, 14% people had depression, 6% people had mania.
The data according to duration of diagnosis 48% people were diagnosed before 6months, 10% people were diagnosed before 1 year and 42% people were diagnosed before 2 years
Age of mentally ill people describes that 59% people belonged to 18-34 years age group,35% were in the age group 35-49 years and 6% were in the age group 50-70 years.
Data were presented according to age 36% of caregivers and 60% of non-caregivers were in the age group 18-34 years,46% of caregivers and 20% of non-caregivers were in the age group 35-49 years,17% of caregivers and 20% of non-caregivers were in the age group 50-70 years and 1% of caregivers were in the age group above 70 years.
Habitat of mentally ill people describes that 100% mentally ill people were living in the village area. Habitat of caregivers 100% of caregivers were living in the village area.
The distribution of participants according to the gender that 31% of caregivers and 45% of non-caregivers were male, 69% of caregivers, and 55% of non-caregivers were female.
According to the marital status that 62% of caregivers and 88% of non-caregivers were married, 29% of caregivers and 12% of non-caregivers were unmarried,1% caregivers were divorced and 8% caregivers were a widow.
Participants according to the religion were 97% of caregivers and 100% of non-caregivers were Hindu and 3% of caregivers were Islam.
Participants according to the education 11% of caregivers and 2% of non-caregivers were illiterate, 22% of caregivers and 11% of non-caregivers were studied up to primary level, 13% of caregivers and 21% of non- caregivers were studied up to high school level, 21% of caregivers and 15% of non-caregivers were studied up to diploma, 33% of caregivers and 51% of non-caregivers were studied up to degree and above.
According to the occupation 59% of caregivers and 56% of non-caregivers were not working, 17% of caregivers and 21% of non-caregivers had government jobs,11% of caregivers and 13% of non-caregivers had private jobs, 13% of caregivers and 10% non-caregivers were self- employed.
According to the relationship of the caregivers with the mentally ill people were the 33% of caregivers were siblings, 4% of caregivers were blood-related relatives, 15% of caregivers were spouse, 37% caregivers were parents, and 11% caregivers were the child of the mentally ill person (Table 1).

SN	Variables	Mean± SD	SE	Df	t-value	P value
1	Perception of caregivers	122.28 ± 3.328	0.333	198	7.55174	.0001*
2	Perception of non-caregivers	127.54 ± 6.119	0.612	198	7.55174	.0001*

Table 1: Unpaired ‘t’ test to compare the perception of caregivers and non-caregivers on mental illness.

Comparison between perception on mental illness of caregivers and non-caregivers was analyzed by using unpaired “t” test were mean score of perception of caregivers and non-caregivers was 122.28 ± 3.328 and 127.54 ± 6.119 respectively. The unpaired t value was 7.55174 at 198 degrees of freedom at p-value .0001, which is statistically significant.

The correlation between the perception of mental illness and the help-seeking behavior of caregivers was analyzed by using Pearson’s correlation coefficient formula. The investigator found that the mean score of perception on mental illness and help-seeking behavior of non-caregivers was 127.54 ± 6.119 and 13.13± 3.897 respectively (Table 2). The result shows that there was a negative correlation between perception and help-seeking behavior of non- caregivers. The ‘R-value was -0.3918 at p-value 0.01, which is statistically significant. Thus the null hypothesis was rejected and the research hypothesis was accepted. n=100 Section: The correlation between the perception of mental illness and the help-seeking behavior of caregivers was analyzed by using Pearson’s correlation coefficient formula.

The mean score of perception on mental illness and help-seeking behavior of caregivers was 122.28 ± 3.328 and 14.19 ± 2.019 respectively. The result shows that there was a negative correlation between perception and help- seeking behavior of caregivers. The ‘R-value was -0.4320 at p-value 0.01, which is statistically significant. Thus the null hypothesis was rejected and the research hypothesis was accepted.

Demographic variables	Caregiver’s	Perception	P-value
	Chi-square	Df
Diagnosis of patient	7.688	3	0.053
Duration of diagnosis	6.045	2	.049*
Age of patient	12.657	2	.002*
Age of caregiver	6.378	3	0.095
Gender of caregiver	12.011	1	.0005*
Marital status of caregiver	11.89	3	.008*
Education of caregiver	25.617	4	.0001*
Occupation of caregiver	8.303	3	.040*
Type of family of caregivers	3.012	1	0.083
Family monthly income of caregiver	18.02	3	.0001*
Relation with patient	16.104	4	.003*

Table 2: Association of perception about mental illness and help-seeking behavior with socio-demographic variables of caregivers

The calculated chi-square value of the diagnosis of the patient, age of caregivers, and type of family were 7.688,6.378 and 3.012 respectively which is less than the tabulated value at 0.05 significant level which implies there was no association between perception of caregivers with the diagnosis of the patient, age of caregivers and type of family. Hence research hypothesis was rejected and the null hypothesis (HO5) was accepted. So it is inferred that perception of caregivers was not influenced by the diagnosis of the patient, age of caregivers, and type of family (Table 3). n=100

Demographic variables	Non-caregiver’s	Perception	P value
	Chi-square	Df
Age	10.963	3	.012*
Gender	0.121	1	0.728
Marital status	2.578	1	0.108
Education	6.582	4	0.16
Occupation	9.372	3	.025*
Type of family	5.832	2	0.054
Family monthly income	3.853	3	0.278

Table 3: Association of perception about mental illness and help-seeking behavior with socio-demographic variables of non- caregi

The calculated chi-square value of the duration of diagnosis, diagnosis of the patient, age of the patient, gender of caregivers, occupation of caregivers type of family, and relationship with the patient were 1.395, 1.336, 0.550, 1.872, 2.895,0.008 and 7.095 respectively which is less than the tabulated value at 0.05 significant level which implies there was no association between help-seeking behavior of caregivers with a duration of diagnosis, diagnosis of the patient, age of the patient, gender of caregivers, occupation of caregivers type of family and relationship with the patient.

Discussion

Findings Related To the Relationship between Perception and Help-Seeking behavior of Non- Caregivers on Mental Illness

The results of the study showed that there was a negative correlation between perception and help-seeking behavior of non-caregivers (r=-0.3918 at p-value 0.01) which is statistically significant at a 0.05 level of significance.

The results of the present study are similar to a study conducted in South Korea among 402 women which showed a significant but weakly positive correlation between perceived need and help-seeking intentions on Mental illness(r = 0.09, p < 0.05) [6].

The findings of the present study are also supported by the study “The impacts of stigma on Determinants of Mental Health Help-chasing behavior conducted by Rita Digioacchino Debate, et al. (2018) in the Southern United States of America among 1,242 students of University of South Florida which showed a week positive relationship between perception of Mental illness and help-seeking behavior of Southern States students among information and motivation (r = .363, p < .01), information and behavioral skills (r = .166, p < .01), and motivation and behavioral skills (r = .399, p < .01) [7].

Findings Related To Association between Perception about Mental Illness and Help- Seeking behavior with Socio-Demographic Variables of Caregivers

Chi-square analysis was done to discover the association

between the perception and help-seeking behavior on mental illness of caregivers and selected socio-demographic variables. The findings of the study revealed that perception of caregivers was extremely significant with a duration of diagnosis (ᵪ2=6.045), age of the patient (ᵪ2=12.657), gender of caregivers (ᵪ2=12.011), marital status of caregivers (ᵪ2=11.890), education of caregivers (ᵪ2=25.617), occupation of caregivers (ᵪ2=8.303), an income of caregivers (ᵪ2=18.020) and relationship with the patient (ᵪ2=16.104) at 0.05 level of significance.

The discoveries of the study revealed that help-seeking behavior of caregivers was extremely significant with the age of caregivers (ᵪ2=35.662), marital status of caregivers (ᵪ2=25.550), education of caregivers (ᵪ2=33.712) and income of caregivers (ᵪ2=20.312) at 0.05 level of significance [8]. The findings of the study are also supported by a study “ perception and help-seeking behavior among parents for their children with a psychiatric disorder” conducted by Rakesh Narayan Patil, et al. (2016) in Maharastra among 257 parents of children having psychiatric disorders showed that perception of psychiatric morbidity was higher in parents of a male child (ᵪ2=6.63, p=<0.05), highly educated mothers ( ᵪ2=6.20,p=< 0.05) and small family size (ᵪ2=6.63, p=<0.05). Help-seeking behavior of parents for their children was better, in parents of a male child (ᵪ2=4.39, p= 004), highly educated parents (ᵪ2= 10.31, p= 0.006), employed parents (ᵪ2=6.13, p=0.01) and less family size (ᵪ2=7.40, p= 0.03) [9].

Findings Related to Association between Perception about Mental Illness and Help- Seeking Behavior with Socio-Demographic Variables of Non-Caregivers

To find out the association between the perception and help-seeking behavior on mental illness of non-caregivers and selected socio-demographic variable chi-square analysis was done. The findings of the study revealed that perception of non-caregivers was extremely significant with age (ᵪ2=10.963) and occupation (ᵪ2=9.372) at a 0.05 level of significance.

The findings of the investigation revealed that the help- seeking behavior of non-caregivers was extremely significant with age (ᵪ2=56.006) and family monthly income (ᵪ2=24.592) at 0.05 level of significance.

The study findings are supported by a study conducted on “Attitudes toward psychological illness, mentally ill persons, and help-seeking among the Saudi public and socio- demographic correlates” conducted by Mostafa A Abolfotouh (2019) in Riyadh, Saudi Arabia among 650 adult people showed that marital status (ᵪ2=-3.12, p=0.002), sex (ᵪ2=- 2.72, p=0.007), employment (ᵪ2=3.05, p=0.002) and monthly income (ᵪ2=2.79, p=0.005) [10].

Conclusion

The investigators concludes that most of the people of Odisha still prefer traditional and religious healers for the treatment of mental illnesses. The result of the study shows that non-caregivers have a more positive perception towards mental illness but caregivers have more help-seeking behavior than caregivers and there is no relation between perception and help-seeking behavior of caregivers and non- caregivers.

Acknowledgement

The investigator expresses cordial thanks to the Correspondent for their permission and support. The investigator expresses her gratitude to study participants and their family members for extending their co-operation. Diction is not enough to express our regards to all family members whose support enable us to complete this project.

References

Benedicto M, Mndeme E, Mwakagile DSM, Tumbwene E (2016) Community Knowledge Attitudes and Perception towards Mental Illness in Dodoma Municipality, Tanzania 1(3):10-18.
Okyere GA (2015) Perceptions about mental disorders and help-seeking behavior of Akwatia residents, Ghana.
Johannesen E, Hvingel C, Aschan M, Bogstad B (2007) Survey based estimation of consumption: spatial and seasonal aspects of cod predation on shrimp, pp: 17.
Ali OM, Milstein G (2012) Mental Illness Recognition and Referral Practices Among Imams in the United States 6(2): 3-13.
Benti M, Ebrahim J, Awoke T, Yohannis Z, Bedaso A (2016) Community Perception towards Mental Illness among Residents of Gimbi Town, Western Ethiopia.
Salve H, Goswami K, Sagar R, Nongkynrih B, Sreenivas V (2013) Perception and attitude towards mental illness in an urban community in South Delhi - A community- based study. Indian J Psychol Med 35(2): 154-158.
Kumar D, Kumar P, Singh AR, Bhandari SS (2012) Knowledge and attitude towards mental illness of key informants and general population : a comparative study. Dysphrenia 3(1): 57-64.
Shyamanta D, Ram PH (2013) Knowledge, attitude, perception and belief (K.AP.B) of patients relatives towards mental illness: A cross-sectional study.
Böge K, Zieger A, Mungee A, Tandon A, Fuchs LM, et al. (2016) Perceived stigmatization and discrimination of people with mental illness : A survey-based study of the general population in five metropolitan cities in India 60(1): 24-31.
Abolfotouh MA (2013) Knowledge and perceptions about mental illnesses among Kenyan Immigrants Living in Jyvaskyla, Finland, pp: 1-48.

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