Mental Illness Stigma Among Middle Eastern Canadians: A Mixed Methods Study

Mental illness stigma (MIS) is a global phenomenon, which perpetuates the distress associated with the symptoms of mental illness by acting as a deterrent to treatment (Tzouvara, Papadopoulos, & Randhawa, 2016). Research has highlighted disparities in the expression of MIS cross-culturally. However, little is known about MIS in the Middle Eastern Canadian (MEC) context. To address this gap in the literature, the current study employed a concurrent mixed methods design to assess the impact and explore the nature of MIS among Middle Eastern relative to White, Black, and South Asian Canadians (n = 424). A hierarchical regression analysis was performed to determine whether the perception of MIS in ones ethno-racial community acts as a greater deterrent to help-seeking in Middle Eastern versus White participants, after controlling for social desirability, familiarity with mental illness, and degree of identification with ones ethno-racial group. A second set of hierarchical regression analyses, alongside a qualitative content analysis, were used to explore the nature of MIS among MEC. As for the impact of MIS, results showed that perceived public MIS was a greater deterrent to help-seeking among MEC than it was among those identifying as White. No differences were found between the Middle Eastern and the South Asian or Black groups. In terms of the nature of MIS, quantitative findings suggested that MEC endorsed higher levels of anxiety and social distance, both proxies for MIS, than White and Black Canadian groups respectively. In all cases, the effect of ethno-racial group on MIS was small. Between group differences on six other subscales assessing prejudice toward persons affected by mental illness (PABMI) were not significant after accounting for the effect of familiarity with mental illness on the dependent variables. Qualitative findings extended these results by highlighting other stereotypes about PABMI endorsed by MEC, not captured in the quantitative measures, namely, that PABMI are inadequate, crazy, different, a failure and a nuisance, and that their experience is invalid. Findings underscore the importance of incorporating contact with PABMI in anti-stigma campaigns, and of adapting these to the stereotypes about PABMI commonly held by members of a particular ethno-racial group