EFFECT OF STIGMA ON ADHERENCE TO MEDICAL ADVICE AMONG MENTAL HEALTH PATIENTS: A CASE STUDY OF KAJIADO REFERRAL HOSPITAL IN KAJIADO COUNTY, KENYA

Abstract

This study investigates the effect of stigma on adherence to medical advice among mental health patients at Kajiado Referral Hospital in Kajiado County, Kenya. The main objective was to examine how stigma influences patients’ adherence to prescribed treatment plans. Specifically, the study assessed the effects of perceived public stigma, self-stigma, family stigma and fear of labeling on adherence to medical advice. Findings are expected to inform interventions, policies and strategies to improve mental health outcomes in Kenya. A descriptive research design was employed, targeting 273 adult mental health patients aged 18 years and above diagnosed with common mental disorders, including depression, anxiety, bipolar disorder and schizophrenia. Using simple random sampling, 30% of the population was selected, yielding 82 respondents to ensure equal representation. Data were collected via structured questionnaires on a 5-point Likert scale, measuring perceived public stigma, self-stigma, family stigma, fear of labeling and adherence to medical advice. A pilot study involving 10% of the sample ensured reliability and validity of the instrument. Authorization was obtained from the Management University of Africa and Kajiado Referral Hospital, with trained research assistants facilitating administration and collection of questionnaires. Data were coded and analyzed using descriptive statistics in Microsoft Excel, including frequencies, percentages, means and standard deviations and presented through tables, bar graphs and pie charts. Ethical considerations, including informed consent, voluntary participation, confidentiality, privacy and anonymity, were strictly observed. The study achieved a 92.7% response rate, with 76 respondents participating. Findings revealed high levels of perceived public stigma, with 53 respondents feeling judged by the community and 51 experiencing social avoidance. Self-stigma was significant, with 52 reporting lowered self-esteem and 51 engaging in self-isolation. Family stigma was noted, as 44 respondents experienced secrecy and emotional neglect, while fear of labeling affected 52 respondents who avoided disclosing their condition. Despite these barriers, 56 respondents adhered consistently to prescriptions, dosage instructions and appointments. The study concluded that perceived public stigma, self-stigma, family stigma and fear of labeling negatively influence adherence to medical advice, creating psychological and social barriers to effective treatment. Recommendations include implementing community awareness campaigns, sensitizing families, providing counseling to address self-stigma, establishing supportive and confidential healthcare environments and developing peer support networks. These interventions aim to reduce stigma, improve treatment adherence and enhance mental health outcomes among patients in Kenya.