Carapace of Prevailing Beliefs: Association of Perceived Public Stigma With Mental Health Attitudes and Self-Rated Health Outcomes Among Pakistani Adolescents and Young Adults.

PURPOSE: The consequences of prevailing public stigma toward mental illness for mental health and social behavior are well-established. Nevertheless, studies in the Pakistani context highlight the interplay between cultural beliefs and mental health perceptions, which in turn influence stigmatizing attitudes and social distancing behaviors. Building on this body of research, this study examines how culturally embedded stereotypes encountered by adolescents and young adults in their daily activities are associated with their personal stigma, and social distancing behaviors, as well as their reluctance to report mental health outcomes. Additionally, the study explores the influence of socio-economic and demographic factors on these associations. METHODS: This cross-sectional study employed a multistage cluster sampling technique to select 1,328 adolescents and young adults aged 15 to 24 from twelve public colleges in Layyah, Punjab, Pakistan. The relationship between perceived public and personal stigma attitudes, social distancing and mental health outcomes was assessed using vignette(s), using multilevel (hierarchical linear) models while accounting for socio-demographic variables as covariatesResults:The analysis revealed that higher levels of perceived public stigma relate to higher levels of social distancing, personal stigma, and social dysfunction. However, perceived public stigma beliefs did not significantly relate to anxiety or depression. Gender and residential area, as key socio-demographic characteristics, emerged as moderators of the relationship between perceived public stigma and the dependent variables. CONCLUSION: This study highlights the significant role of perceived public stigma beliefs in the formation of mental health attitudes outcomes among Pakistani adolescents and young adults. It underscores the necessity of addressing stereotypical attitudes within social environments to mitigate their adverse effects. We propose that future research in Pakistan further explore the mechanisms underlying these relationships and develop interventions tailored to diverse socio-demographic contexts.