Gender differences in attitudes toward mental illness: a cross-sectional study among the Saudi community in Jizan,...

Despite recent improvements in attitudes toward mental illness, persistent stigma in some communities continues to negatively impact those affected. This study aimed to assess gender differences in attitudes toward mental illness among the Saudi community in Jizan.

A cross-sectional study was conducted between January and July 2024, enrolling 586 participants (267 males and 319 females) recruited using a non-probability convenience sampling from public places. Attitudes toward mental illness were assessed using the 40-item Community Attitudes toward Mental Illness (CAMI) scale, with negatively worded items reverse-coded. The 25th, 50th and 75th percentiles of the scale score were considered as cutoff points to describe low, medium, and high scores, respectively. Gender differences in the CAMI total score and its predefined subscales (Authoritarianism, Benevolence, Social Restrictiveness, and Community Mental Health Ideology) were examined using independent sample t-tests. Associations between demographic factors and attitudes toward mental illness were evaluated using multivariate linear regression (MLR), with regression models incorporating interaction terms to examine gender differences.

The mean CAMI score for the participants was 107.16 ± 9.38, with males scoring significantly higher than females (108.64 ± 9.52 vs. 105.92 ± 9.10, p < 0.001 CI:1.20, 4.23), with a small effect size (Cohen's d = 0.29, p < 0.001). Based on descriptive percentile-based cutoffs (≤ 101, 102-113, ≥ 114), more than half of the participants were classified as having moderate stigma (50.68%), with smaller proportions categorized as low (27.13%) and high (22.18%). Female participants showed a significantly more benevolent attitude toward individuals with mental illness than males (39.57 ± 4.61 vs. 38.72 ± 4.96, p = 0.033, CI: ‑1.62, -0.07), while males exhibited stronger social restrictiveness than females (25.74 ± 5.88 vs. 23.88 ± 5.24, p < 0.001, CI: 0.94, 2.72). No significant gender differences were observed in authoritarianism and community mental health ideology attitudes. Older and higher-educated males showed more negative attitudes, whereas being unmarried, unemployed, and having a low monthly income were significantly associated with the stigmatizing attitudes among female participants.

This exploratory study revealed gender disparities in attitudes toward mental illness, underscoring the necessity of incorporating gender considerations in mental health awareness initiatives. Future research should focus on selected mental health conditions and targeted demographics to maximize intervention effectiveness. Future confirmatory studies with representative samples that focus on specific psychiatric disorders across populations with diverse characteristics are needed to enhance the effectiveness of anti-stigma interventions.