Affiliate stigma and caring burden among primary caregivers of adult patients with severe mental illness: a facility-based cross-sectional study

Abstract Introduction: Although caregivers play an important role in the treatment and recovery of various patients, several studies showed that primary caregivers of adults with severe mental illness (AWSMI) experience widespread stigma and have a high burden. However, there are limited studies in developing countries that assessed stigma and burden among primary caregivers of AWSMI. Objectives: The present study aimed to assess affiliate stigma and caring burden among caregivers of AWSMI at St. Paul’s Hospital Millennium Medical College(SPHMMC), Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study design was applied. A total of 375 caregivers of AWSMI were recruited using a systematic random sampling technique. Data were collected usinga systematic random sampling method. The collected data includes tools and structured questionnaires including the family stigma scale, attitude toward mental illness questionnaire, family burden interview, Oslo 3-items social support scale, sociodemographic and clinical characteristics of the caregivers and the patients, and burden of caregivers. Descriptive and binary logistic regression were performed to analyze the data. Results: Caregivers (n =375) of patients with bipolar disorder (n = 50), anxiety disorders (n= 82), MDDs (n =103) and schizophrenia (n = 140) participated in the study, with a response rate of 95.7%. Half of the participants (187) were female. The results showed that around half (54.9%) of the caregivers experienced or perceived stigma. The factors that were associated with stigma among caregivers were caregiving patients with schizophrenia (AOR: 1.91; 95% CI: 0.86, 4.2; p = 0.003), attitude towards people with mental illness (AOR: 2.1; 95% CI: 1.23, 3.4; p = 0.005), social support (AOR: 0.5; 95% CI: 0.30, 0.82; p = 0.006), patient history of psychiatric admission (AOR: 0.32; 95% CI: 0.18, 0.57; p < 0.0001) and superstitious belief (AOR: 0.28; 95% CI: 0.15, 0.52; p < 0.0001). The findings also illustrated that a large proportion of caregivers (89%) had moderate to severe burden. Conclusions: Overall, the current findings showed that stigma and burden among caregivers of AWSMI are high, indicating the urgent need to provide interventions such as psycho-education and contextualized support for caregivers and improving public’s awareness about mental illness. Furthermore, types of illness, social support, attitude towards people with mental illness, patient history of psychiatric admission and superstitious beliefs are important determinants of stigma.