Mental health literacy and community stigma: a cross-sectional study

Abstract

This study aims to examine the association between mental health literacy and community stigma towards individuals with mental illness in a community sample from Kerala, India, and explored sociodemographic variations in knowledge and attitudes. A cross-sectional survey was conducted among 400 adults using convenience sampling. Mental health literacy was assessed using the Mental Health Knowledge Schedule (MAKS), and community stigma was measured using the Community Attitudes towards the Mentally Ill (CAMI) scale. Data were analysed using descriptive statistics, Pearson’s correlation, linear regression, independent-samples t-tests and one-way ANOVA. Most participants reported high knowledge (78%) and relatively low stigma (54.5%). Mental health literacy showed a small but significant positive association with community attitudes (r = 0.102, p = 0.041). Regression analysis indicated that literacy significantly predicted attitudes but explained only 1% of the variance. Sociodemographic differences were observed across religion, education, occupation and socioeconomic status. The cross-sectional design and convenience sampling limit causal inference and generalizability. Findings suggest that stigma is influenced by multiple social and cultural factors beyond knowledge alone. Community-based, culturally responsive interventions combining education with dialogue and contact-based strategies are recommended to reduce stigma and promote inclusion. Improving community attitudes may enhance social inclusion, reduce discrimination and strengthen support for individuals living with mental illness. This study provides context-specific evidence from South India on the relationship between mental health literacy and stigma, contributing to the limited literature on community mental health and social inclusion in low- and middle-income settings.