Attitude towards mental illness among doctors working in a tertiary care centre: A cross-sectional study


  • Neeraja N Varma Intern, MOSC Medical College, Kolenchery, Kerala
  • Sreeja Sreekumar Assistant Professor, Department of Psychiatry, MOSC Medical College, Kolenchery, Kerala
  • P Joseph Varghese Professor and Former HOD, Department of Psychiatry, MOSC Medical College, Kolenchery, Kerala



Attitude, Doctors, Mental illness, Psychiatry


Background: Stigma towards mental illness, can limit patients from seeking help at the right time. Considering the disproportionate workforce of psychiatrists among the Indian population, a person needing psychiatric care may be first seen by a physician. This study assesses the attitude of doctors because they play a vital role in the pathway to the care of a psychiatric patient. Methods: It is a cross-sectional analytical study conducted in MOSC Medical College, Kolenchery, including all doctors, except those specialized in psychiatry. A semi-structured questionnaire and a 34-item Attitude Scale for Mental Illness (ASMI) were employed for assessing the attitude. Attitudes were studied using the independent sample t-test and Mann-Whitney U test. Results: Out of 188 doctors consisting of 152 (80.8%) clinicians and 36 (19.2%) non-clinicians, the majority had more than ten years of experience. The mean attitude score was 73.55 [Standard Deviation (SD) = 13.78] with 119 (63%) having negative attitude. The average attitude of clinicians was 72.48 (SD = 12.36) and non-clinicians was 78.02 (SD = 18.17), which did not show statistically significant difference (p = 0.086). Non-clinicians were found to show more separatism (p = 0.05). There was no statistically significant difference in attitude when gender and experience were considered. Conclusion: The study shows negative attitude of doctors, clinicians and non-clinicians alike, towards mental illness. This may be, in part, due to limited exposure to individuals with mental illness during undergraduate training. This study highlights the need to broaden undergraduate curriculum to include more exposure to mental illness.


Sartorius N. The meanings of health and its promotion. Croat Med J 2006;47:662-4.

Dudley JR. Confronting Stigma within the Services System. Social Work 2000;45:449–55.

Challapallisri V, Dempster LV. Attitude of doctors towards mentally ill in Hyderabad, India: Results of a prospective survey. Indian J Psychiatry 2015;57:190-5. doi: 10.4103/0019-5545.158190.

Wahl OF. Mental health consumers' experience of stigma. Schizophr Bull 1999;25(3):467-78. doi: 10.1093/oxfordjournals.schbul.a033394.

Hamilton S, Pinfold V, Cotney J, Couperthwaite L, Matthews J, Barret K, et al. Qualitative analysis of mental health service users' reported experiences of discrimination. Acta Psychiatr Scand 2016;134 (Suppl 446):14-22. doi: 10.1111/acps.12611.

Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest 2014;15:37-70. doi: 10.1177/1529100614531398.

Henderson C, Noblett J, Parke H, Clement S, Caffrey A, Gale-Grant O, et al. Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry 2014;1:467-82. doi: 10.1016/S2215-0366(14)00023-6.

Thornicroft G, Rose D, Kassam A. Discrimination in health care against people with mental illness. Int Rev Psychiatry 2007;19:113-22. doi: 10.1080/09540260701278937.

Brickell TA, McLean C. Emerging issues and challenges for improving patient safety in mental health: a qualitative analysis of expert perspectives. J Patient Saf 2011;7:39-44. doi: 10.1097/PTS.0b013e31820cd78e.

Desai ND, Chavda PD. Attitudes of undergraduate medical students toward mental illnesses and psychiatry. J Educ Health Promot 2018;7:50. doi: 10.4103/jehp.jehp_87_17.

Poreddi V, Thimmaiah R, Math SB. Attitudes toward people with mental illness among medical students. J Neurosci Rural Pract 2015;6:349-54. doi: 10.4103/0976-3147.154564.

Aruna G, Mittal S, Yadiyal MB, Acharya C, Acharya S, Uppulari C. Perception, knowledge, and attitude toward mental disorders and psychiatry among medical undergraduates in Karnataka: A cross-sectional study. Indian J Psychiatry 2016;58:70-6. doi: 10.4103/0019-5545.174381.

Chawla JM, Balhara YPS, Sagar R, Shivaprakash. Undergraduate medical students' attitude toward psychiatry: a cross-sectional study. Indian J Psychiatry 2012;54:37-40. doi:10.4103/0019-5545.94643.

Naeem F, Ayub M, Javed Z, Irfan M, Haral F, Kingdon D. Stigma and psychiatric illness. A survey of attitude of medical students and doctors in Lahore, Pakistan. J Ayub Med Coll Abbottabad 2006;18:46-9.

Sujaritha V, Partheeban M, Thiviya T, Sowmiya M. Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India. Int J Res Med Sci 2017; 5:3059-64.

Sathyanath S, Mendonsa RD, Thattil AM, Chandran VM, Karkal RS. Socially restrictive attitudes towards people with mental illness among the non-psychiatry medical professionals in a university teaching hospital in South India. Int J Soc Psychiatry 2016;62:221-6. doi: 10.1177/0020764015623971.

GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry 2022;9:137-50.

Reddy.BV, Gupta A, Lohiya A, Kharya P. Mental health issues and challenges in India: a review. Int J Sci Res Publ 2013;3:1-3. (ISSN: 2250-3153).

Garg K, Kumar CN, Chandra PS. Number of psychiatrists in India: Baby steps forward, but a long way to go. Indian J Psychiatry 2019;61:104-5.

Regier DA, Goldberg ID, Taube CA. The de facto US mental health services system: a public health perspective. Arch Gen Psychiatry 1978;35:685-93.

Konwar R, Pardal PK, Prakash J, Rythem. Does psychiatry rotation in undergraduate curriculum bring about a change in the attitude of medical student toward concept and practice of psychiatry: A comparative analysis. Ind Psychiatry J 2012;21:144-7. doi: 10.4103/0972-6748.119630.

Noblett JE, Lawrence R, Smith JG. The attitudes of general hospital doctors toward patients with comorbid mental illness. Int J Psychiatry Med 2015;50:370-82. doi: 10.1177/0091217415612721.

Arbanas G, Rožman J, Bagari? Š. The attitudes of medical doctors, nurses and lay people towards schizophrenia, depression and PTSD. Psychiatr Danub 2019;31(Suppl 1):84-91.

Ohtsuki T, Kodaka M, Sakai R, Ishikura F, Watanabe Y, Mann A, et al. Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study. BMC Res Notes 2012;5:441. doi: 10.1186/1756-0500-5-441.

Nauta K, Boenink AD, Wimalaratne IK, Menkes DB, Mellsop G, Broekman B. Attitudes of general hospital consultants towards psychosocial and psychiatric problems in Netherlands. Psychol Health Med. 2019;24:402-13. doi: 10.1080/13548506.2018.1546020.

Al-Atram AA. Physicians' knowledge and attitude towards mental health in Saudi Arabia. Ethiop J Health Sci 2018;28:771-78. doi: 10.4314/ejhs.v28i6.12.

Norton JL, Pommié C, Cogneau J, Haddad M, Ritchie KA, Mann AH. Beliefs and attitudes of French family practitioners toward depression: the impact of training in mental health. Int J Psychiatry Med 2011;41:107-22. doi: 10.2190/PM.41.2.a.

Ubaka CM, Chikezie CM, Amorha KC, Ukwe CV. Health professionals' stigma towards the psychiatric ill in Nigeria. Ethiop J Health Sci 2018;28:483-94. doi: 10.4314/ejhs.v28i4.14.

Haddad M, Waqas A, Qayyum W, Shams M, Malik S. The attitudes and beliefs of Pakistani medical practitioners about depression: a cross-sectional study in Lahore using the Revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry 2016;16:349. doi: 10.1186/s12888-016-1069-1.

Chandramouleeswaran S, Rajaleelan W, Edwin NC, Koshy I. Stigma and attitudes toward patients with psychiatric illness among postgraduate Indian physicians. Indian J Psychol Med 2017;39:746-9. doi: 10.4103/IJPSYM.IJPSYM_84_17.

Yuan Q, Picco L, Chang S, Abdin E, Chua BY, Ong S, et al. Attitudes to mental illness among mental health professionals in Singapore and comparisons with the general population. PLoS One 2017;12:e0187593. doi: 10.1371/journal.pone.0187593.

Nauta K, Boenink AD, Wimalaratne IK, Menkes DB, Mellsop G, Broekman B. Attitudes of general hospital consultants towards psychosocial and psychiatric problems in Netherlands. Psychol Health Med 2019;24:402-13. doi: 10.1080/13548506.2018.1546020.

Cremonini V, Pagnucci N, Giacometti F, Rubbi I. Health care professionals attitudes towards mental illness: observational study performed at a public health facility in Northern Italy. Arch Psychiatr Nurs 2018;32:24-30. doi: 10.1016/j.apnu.2017.09.007.

Oliveira AM, Machado D, Fonseca JB, Palha F, Silva Moreira P, Sousa N, et al. Stigmatizing attitudes toward patients with psychiatric disorders among medical students and professionals. Front Psychiatry 2020;11:326. doi: 10.3389/fpsyt.2020.00326.

Ng P, Chan KF. Sex differences in opinion towards mental illness of secondary school students in Hong Kong. Int J Soc Psychiatry 2000;46:79–88.




How to Cite

Varma, N. N., S. Sreekumar, and P. J. Varghese. “Attitude towards Mental Illness Among Doctors Working in a Tertiary Care Centre: A Cross-Sectional Study”. Kerala Journal of Psychiatry, vol. 36, no. 1, May 2023, pp. 50-58, doi:10.30834/KJP.36.1.2023.363.



Research Report