Knowledge, Attitudes and Perceptions about Mental Illness in Ekom Iman Community in Akwa Ibom State, South-South Nigeria

Knowledge and beliefs a community holds about mental illness, has remarkable impact on help seeking path to care and stigmatizing attitudes expressed towards the mentally ill. Aims: This study examines causal attributions, the perceptions and attitudes towards mental illness and the help seeking behaviour of a community in the south-south region of Nigeria. Materials and Methods: This is cross sectional descriptive study which was conducted among residents of Ekom Iman community in Akwa Ibom State in the South-South region of Nigeria between March, 2019 and July, 2019. Multistage sampling technique was employed to select the study participants. Causal belief, attitude toward mental illness and help seeking behaviour were assessed using a structured questionnaire. Results: A total of 130 respondents participated in the study. The average age of respondents was 31.62±8.2 years, consisting of 64.4% males and 35.6% females. Majority, 74.6% had secondary education. Poor knowledge of mental illness and stigmatizing attitudes are common. Most of the respondents prefer to keep a high social distance from the mentally ill and are unwilling to maintain close social contacts with them expressed as refusal to share a room (74.7%), marry (92.5%), keeping friendship with them (66.4%). Many believe psychoactive substance abuse (86.2%), brain illnesses/trauma (55.4%) and supernatural factors (72.6%) are etiologic to mental illness. Most respondents considered faith healers (64.3%) and orthodox medical professionals (30.8%) as first choices of treatment and the options best able to treat them. Conclusion: Causal beliefs of mental illness affects help seeking behavior. Poor knowledge and exposure to mental illness was common. Attitudes towards mental illness were generally negative and stigmatizing. Multidisciplinary community interventions are required to ensure high social acceptance and preference for orthodox professional treatment of mental illness.

“It’s When the Trees Blossom”: Explanatory Beliefs, Stigma, and Mental Illness in the Context of HIV in Botswana

Mental illness is a common comorbidity of HIV and complicates treatment. In Botswana, stigma impedes treatment of mental illness. We examined explanatory beliefs about mental illness, stigma, and interactions between HIV and mental illness among 42 adults, from HIV clinic and community settings, via thematic analysis of interviews. Respondents endorse witchcraft as a predominant causal belief, in addition to drug abuse and effects of HIV. Respondents describe mental illness as occurring “when the trees blossom,” underscoring a conceptualization of it as seasonal, chronic, and often incurable and as worse than HIV. Consequently, people experiencing mental illness (PEMI) are stereotyped as dangerous, untrustworthy, and cognitively impaired and discriminated against in the workplace, relationships, and sexually, increasing vulnerability to HIV. Clinical services that address local beliefs and unique vulnerabilities of PEMI to HIV, integration with peer support and traditional healers, and rehabilitation may best address the syndemic by facilitating culturally consistent recovery-oriented care.

Explanation of observational data engenders a causal belief about smoking and cancer

Most researchers do not deliberately claim causal results in an observational study. But do we lead our readers to draw a causal conclusion unintentionally by explaining why significant correlations and relationships may exist? Here we perform a randomized controlled experiment in a massive open online course run in 2013 that teaches data analysis concepts to test the hypothesis that explaining an analysis will lead readers to interpret an inferential analysis as causal. We test this hypothesis with a single example of an observational study on the relationship between smoking and cancer. We show that adding an explanation to the description of an inferential analysis leads to a 15.2% increase in readers interpreting the analysis as causal (95% confidence interval for difference in two proportions: 12.8%–17.5%). We then replicate this finding in a second large scale massive open online course. Nearly every scientific study, regardless of the study design, includes an explanation for observed effects. Our results suggest that these explanations may be misleading to the audience of these data analyses and that qualification of explanations could be a useful avenue of exploration in future research to counteract the problem. Our results invite many opportunities for further research to broaden the scope of these findings beyond the single smoking-cancer example examined here.

Space, Time, and Causality

This chapter explores how the understanding of causality relates to the understanding of space and time. Traditionally, spatiotemporal contiguity is regarded as a cue toward causality. While concurring with this view, this chapter also reviews some boundary conditions of this approach. Moreover, temporal information goes beyond merely helping to identify causal relations; it also shapes the types of causal inferences that reasoners draw. Recent developments further show that the relation between time and causality is bi-directional: not only does temporal information shape and guide causal inferences, but once one holds a causal belief, one’s perception of time and space is distorted such that cause and effect appear closer in space-time. Spatiotemporal contiguity thus supports causal beliefs, which in turn foster impressions of contiguity.