Exploring changes in recognition and stigmatisation towards individuals with schizophrenia in Singapore

Schizophrenia is a debilitating illness that causes long-term impairment in individuals and imposes an economic burden on society. Early recognition is essential for successful treatment outcomes. Mental health literacy-including recognition of and stigma towards mental illnesses-is crucial for guiding policy and informing targeted interventions. This study examined changes in schizophrenia recognition and stigma in Singapore over an 8-year period (2015-2023), as well as current trends in their sociodemographic correlates.

The study used data from 2 nationwide cross-sectional studies on mental health literacy using a vignette approach. Singapore residents aged 18-65 years were recruited via disproportionate stratified sampling. Respondents were presented with a vignette of a person with schizophrenia, and recognition was assessed using an open-ended question. Stigmatising attitudes were assessed using the Personal Stigma Scale and the Social Distance Scale.

Correct recognition of schizophrenia increased from 11.5% to 15.1%, though the difference was not statistically significant. A lower "weak-not-sick" stigma score in the 2023 survey persisted after adjusting for sociodemographic differences between survey cohorts. Younger age and social contact with individuals with schizophrenia were associated with better recognition and less stigma. Individuals of Malay and Indian ethnicities attributed schizophrenia to a personal weakness but showed less social distancing.

The lack of significant improvement in recognition may reflect the continued need for schizophreniaspecific public education. The lower personal stigma score observed in the 2023 survey may also reflect broader changes in mental health awareness. Future initiatives should focus on culturally tailored anti-stigma interventions for schizophrenia that are accessible to older individuals and leverage social contact.