Public stigma towards people with mental disorders in Singapore - Has anything changed?

The stigmatization of people with mental illness is a global phenomenon.

The current study aimed to (i) assess the extent of stigma and social distancing towards seven mental disorders, and track changes since the last mental health literacy study, and (ii) examine the socio-demographic and other correlates of stigma in the general population of Singapore, using a vignette approach.

We conducted interviews with 4195 Singapore Residents (aged 18-65) from September 2022 to February 2024, with a response rate of 62.3 %. Respondents were administered the Personal and Perceived scales of the Depression Stigma Scale and the Social Distance Scale to measure personal stigma and social distance, respectively. Multivariable linear regression analyses were conducted to examine associations.

Mean stigma scores were significantly lower across all dimensions : 'weak-not-sick' (9.4 vs 10.2, p < 0.001), 'dangerous/unpredictable' (11.3 vs 11.6, p = 0.005), and 'social distance' (11.6 vs 12.0, p = 0.004) in the current study as compared to the previous study conducted in 2015. However, the magnitude of reduction varied substantially. The largest decline was observed in the 'weak-not-sick' dimension (-8.4 %), while 'dangerous/unpredictable' (-3.1 %) and 'social distance' (-2.8 %) showed smaller reductions.

The significant reduction in the 'weak-not-sick' dimension parallels large-scale anti-stigma initiatives in Singapore. However, the persistence of 'social distance' highlights a critical gap between improved public knowledge and intended behavior. Ongoing surveillance is necessary to determine whether these trends are sustained and to identify specific strategies that are effective in reducing behavioral stigma.