Fear of Stigma and Delay in Psychiatric Consultation Among Outpatients at Federal Neuropsychiatric Hospital, Calabar, Cross River State

Stigma-related fear is a well-documented barrier to timely psychiatric consultation in Nigeria, resulting in delayed treatment and poor outcomes for individuals with mental disorders. This study examines the role of fear of stigma in delaying psychiatric consultation among new outpatients at Federal Neuropsychiatric Hospital, Calabar, Cross River State, South South Nigeria. A cross-sectional descriptive design will recruit 200 new outpatients aged 18 and above through consecutive sampling over a 12-week period. A structured questionnaire capturing duration of illness before first psychiatric contact, help-seeking pathway (traditional healer, religious leader, or general practitioner), and the Stigma Scale for Mental Illness (SSMI) will be administered. Bivariate and multivariate regression analyses will test associations between fear of stigma and treatment delay. Prior studies at Nigerian neuropsychiatric facilities indicate a median delay of 12 to 36 months before first psychiatric contact, with stigma as the most frequently cited barrier. This study will provide site-specific data to guide outreach campaigns and community liaison psychiatry programs in Cross River State. Keywords: stigma, psychiatric consultation, treatment delay, Calabar, Cross River State