Stigma among international students is associated with knowledge of mental illness

Increasing numbers of international students require Japanese universities to provide mental health support as one of their primary responsibilities. The problem with the provision of such support is that the stigma of mental disorder causes many individuals to avoid seeking help. We aim to clarify the association between stigma and mental illness to develop anti-stigma education. We performed a cross-sectional observational study. The target population comprised international students enrolled in a Japanese university. Online questionnaires were used to assess self-stigma, perceived stigma, recognized knowledge of schizophrenia and depression, gender, country and region, general mental health status, parents' income, non-clinical and clinical help-seeking attitudes, and Japanese and English language ability. Logistic regression model was used to estimate odds ratios (ORs) for self-stigma and perceived stigma after adjusting for the above factors. A total of 119 students were invited to participate, 61 (51.3%) of whom were enrolled. Students with good knowledge of depression/schizophrenia did not indicate more severe self-stigma compared with those without such knowledge. Students with good knowledge of schizophrenia indicated more severe perceived stigma compared with those without such knowledge (OR 3.78 [95% confidence intervals; CI, 1.21-11.78]). Students with good knowledge of depression indicated less severe perceived stigma compared with those without such knowledge (OR 0.31 [95% CI, 0.10-0.94]). In this study, among international students, higher perceived stigma was associated with knowledge of schizophrenia and lower knowledge of depression.