Community Attitudes Toward Mental Health Treatment in Sokoto State

Mental health service utilization in northwestern Nigeria is severely constrained by stigma, cultural explanatory models of mental illness, and preference for traditional and religious healing. This study examines community attitudes toward mental health treatment in Sokoto State, assessing the prevalence of stigmatizing beliefs and identifying factors associated with treatment-seeking behavior. A descriptive cross-sectional survey was conducted using the Community Attitudes toward the Mentally Ill scale, adapted for the local cultural context and administered to 360 adult respondents across Sokoto, Wamako, and Kware local government areas. Key informant interviews were also conducted with six community health workers and four traditional healers. Results indicate that 72% of respondents attributed mental illness primarily to spiritual causes including possession, witchcraft, and divine punishment. Only 28% indicated a psychiatric facility as the preferred first point of contact for a family member presenting with mental illness symptoms, compared to 54% who preferred a traditional healer and 18% who preferred an Islamic scholar. Contact with a mentally ill person in the family was associated with more accepting attitudes, consistent with international contact hypothesis findings. Education level above secondary school was the strongest predictor of positive attitudes toward formal psychiatric care. Age and gender were not significant attitude predictors. The study recommends community-based mental health awareness campaigns delivered through established religious networks, training of Islamic scholars as mental health first responders, and culturally adapted information materials for primary healthcare workers in Sokoto. Keywords: mental health attitudes, stigma, Sokoto State, traditional healing, treatment-seeking.