Attitudes Toward Mental Illness Among Primary School Students in Uganda: A Cross-Sectional Study

Background: While the existence of mental health stigma and its negative impact on help-seeking behavior is well documented in high-income countries and some low- and middle-income countries, studies examining mental health stigma among children and adolescents in schools in sub-Saharan Africa are limited. Hence, we examined mental health stigma among school-going children (ages 8 to 13) in Uganda. Methods: Baseline data from children (n = 100) in two public primary schools selected using convenience sampling were analyzed for the study. Mental health stigma was measured using social distance and attitudes about mental health scales. Descriptive statistics were used for item-by-item analysis, and independent sample t-tests were used to examine the relationship between age, gender, grade level, and social distance and attitudes about mental health. Results: Results showed moderate levels of positive attitudes about mental health (mean = 51.83, SD = 6.66) and willingness to interact with someone with mental illness (mean = 27.70, SD = 6.75). However, an item-by-item analysis revealed areas where mental health stigma, misconceptions, and a lower willingness to interact remained persistent. There were no significant differences in willingness to interact with people with mental illness (social distance) by age, gender, or grade level. However, there was a significant difference in attitudes about mental health by grade (t(96) = -2.67, p = 0.009), where upper primary students reported significantly more positive attitudes toward mental illness (M = 53.97, SD = 5.63) compared to lower primary students (M = 50.41, SD = 6.95). Conclusion: The results suggest that mental health literacy and stigma programs are needed in school settings in Uganda. The item-by-item analysis provides insights into tailoring school-based programs to address persistent misconceptions and stigmatizing attitudes.