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Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community
Open accessAbstract
Background: Christian beliefs have a role in conceptualising mental illness, which determines help-seeking behaviour and treatment choices. The topic of mental illness is controversial in many Christian circles and is often avoided because of the beliefs and teachings stemming from the Christian faith. Inadequate and inaccurate knowledge about mental illness and its causes negatively impacts the attitudes towards mental illness, the mentally ill, and ultimately help-seeking behaviour. Aim: This study aimed to explore knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community. Setting: A descriptive, quantitative cross-sectional survey was conducted, comprising 300 congregants from a Pentecostal Christian charismatic church - Assemblies of God in KwaZulu-Natal. Methods: A socio-demographic tool was used to capture the relevant social, demographic, and religious information. Existing self-administered questionnaires were used to collect information in four areas: Mental Health Knowledge Schedule, the Reported and Intended Behaviour Scale, Community Attitudes Towards Mentally Ill scale and the Dimensions of Religiosity Scale to determine the degree of religiosity. Results: The population studied demonstrates high levels of mental health knowledge and a tolerant attitude towards persons who have mental illness. There is a high preference for professional treatment. Conclusion: The high knowledge in this Christian community is associated with a reduction in stigma and a positive attitude towards mental illness. If mental health awareness is encouraged, it helps to encourage positive help-seeking practices tolerance, and treatment outcomes. Contribution: This study highlights levels of knowledge and its influence on help-seeking practices and stigma in a Christian community.
Overview
CoChat Summary
TL;DR
In a cross-sectional survey of 300 Pentecostal Assemblies of God congregants in KwaZulu-Natal, the study found moderate-to-high mental health knowledge, generally tolerant attitudes, and a preference for professional help-seeking. Higher knowledge was associated with less stigma and more favourable attitudes, while greater religiosity correlated with less favourable attitudes and intended behaviour.
Key findings
- On the MAKS, 141 (47%) had high mental health knowledge, 110 (37%) moderate, and 49 (16%) low; schizophrenia and bipolar disorder were recognised as mental illness by 76.3% and 71.7%, respectively, while depression and drug addiction were recognised by 61% and 58%.
- On the CAMI, 141 (46.8%) had medium scores and 96 (31.6%) had high/favourable attitudes; males had more favourable attitudes than females (92.0 vs 80.7), and stigma was lowest in ages 31–40 and 41–50 and highest in ages 18–20 (75.9 vs 95.98).
- On the RIBS, 139 (46%) had medium and 95 (31.6%) high past contact with mental illness; intended-behaviour mean was 12.47 (SD 5.78), and CAMI scores were positively correlated with RIBS scores (r = 0.594, p < 0.05).
- Help-seeking most commonly named hospital/clinic (108; 36.0%), followed by church pastor (76; 25.3%), Christian professional (62; 20.7%), lay Christian counsellor (46; 15.3%), and traditional healer (7; 2.3%); high religiosity correlated negatively with attitudes (r = -0.203, p < 0.005) and RIBS (r = -0.175, p < 0.005), with no significant correlation with MAKS.
Methods
- Descriptive, quantitative cross-sectional survey of 300 congregants from a Pentecostal Christian charismatic church — Assemblies of God in KwaZulu-Natal; inclusion required age 18+, ability to consent, and English literacy, with only KwaZulu-Natal branches included.
- Data collected via socio-demographic tool and self-administered questionnaires: Mental Health Knowledge Schedule (MAKS), Reported and Intended Behaviour Scale (RIBS), Community Attitudes Towards Mentally Ill scale (CAMI), and Dimensions of Religiosity Scale; survey administered online through Google Forms, WhatsApp, and email.
- Analysis used IBM SPSS version 27 with descriptive statistics, bivariate analysis, and logistic regression; statistical significance set at p < 0.05.
Limitations
- Stated: anonymous self-report questionnaires may not fully represent the Christian population; possible neutral response bias, untruthful reporting, loss of introspective ability, and reporting bias.
- Stated: instruments had not yet been validated in the South African context, and inclusion of only one denominational cluster reduces generalisability; the sample is a small representation of many Christian followers and denominations, so results are explorative rather than conclusive.
- Evident from the text: the cross-sectional design cannot establish causality, and the online, self-selected convenience sample restricted to KwaZulu-Natal branches and English-literate adults may further limit generalisability.
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Claims the paper makes
0 Valid · 0 Not valid · 20 Not checked · 69 Own results and interpretations
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, it was found that individuals who have been practising Christianity for 11–20 years displayed the highest level of knowledge.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper states — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The majority of participants prefer hospitals, clinics or professional help when dealing with mental illness.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Discussion > Help seeking attitude
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across the ethnic groups, most scores were in the 50th percentile with intermediate attitude.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Community Attitudes towards Mentally Ill scale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on 2 assumptions not shown here.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Depression and drug addiction were less often recognised as mental illnesses (61% and 58% of respondents, respectively).”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Mental Health Knowledge Schedule
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on 2 assumptions not shown here.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A level of education beyond high school predicted a favourable attitude (r = 0.015 p < 0.005).”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“There was no significant correlation between attitude and age or length of time as a Christian.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“| Duration ofChristian belief(years) | | < 0.001‡ | - | < 0.001‡ | - | < 0.001‡ |”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“There was no significant correlation between attitude and age or length of time as a Christian.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“| Age (years) | - | < 0.001‡ | - | < 0.001‡ | - | < 0.001‡ |”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“the number of years as a Christian was not predictive of the level of knowledge of mental illness and did not predict attitude significantly (p = < 0.005, r = 0.188)”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Research methods and design > Statistical analysis
“Statistical significance was set at p < 0.05.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“The highest mean scores were in the 31–40-year age group while the lowest knowledge scores were found in the 50+ age group (43.41 vs 40.64, p < 0.001).”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Bivariate analysis
“| 18–20 | 75.9 ± 12.17 | - | 43.41 ± 4.04 | - | 8.99 ± 5.93 | - | | 21–30 | 85.63 ± 16.01 | - | 42.92 ± 5.06 | - | 13.75 ± 5.12 | - | | 31–40 | 95.98 ± 19.27 | - | 45.3 ± 4.61 | - | 14.41 ± 4.94 | - |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Discussion > Help seeking attitude
“The majority of participants showed a preference for a hospital in help-seeking.”
§ Knowledge, attitudes, and help-seeking behaviour for mental illness in a Christian community > Results > Socio-demographic characteristics of the participants
“| Who are participants likely to consult? | Hospital or clinic | 108 | 36.0 |”
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Citations
Cites
The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., Üstün, T. B., & Wang, P. S. (2009) · Epidemiologia e Psichiatria Sociale · doi:10.1017/s1121189x00001421 · Cited by 1,895
Research on Religion, Spirituality, and Mental Health: A Review
Koenig, H. G. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905400502 · Cited by 1,442 · cited 2×
“6,13,14 There are varying approaches to addressing mental health issues among Christians.”
BackgroundMental Illness Stigma, Help Seeking, and Public Health Programs
Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.301056 · Cited by 959
Scaling Community Attitudes Toward the Mentally Ill
Taylor, S. M., & Dear, M. J. (1981) · Schizophrenia Bulletin · doi:10.1093/schbul/7.2.225 · Cited by 854
Development and psychometric properties of the Mental Health Knowledge Schedule
Evans-Lacko, S., Little, K., Meltzer, H., Rose, D., Rhydderch, D., Henderson, C., & Thornicroft, G. (2010) · The Canadian Journal of Psychiatry · doi:10.1177/070674371005500707 · Cited by 402
Evans-Lacko, S., Rose, D., Little, K., Flach, C., Rhydderch, D., Henderson, C., & Thornicroft, G. (2011) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796011000308 · Cited by 363
Community attitudes toward and knowledge of mental illness in South Africa
Hugo, C. J., Boshoff, D. E. L., Traut, A., Zungu-Dirwayi, N., & Stein, D. J. (2003) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-003-0695-3 · Cited by 255
Religious and ethnic group influences on beliefs about mental illness: A qualitative interview study
Cinnirella, M., & Loewenthal, K. M. (1999) · British Journal of Medical Psychology · doi:10.1348/000711299160202 · Cited by 162
Abi Doumit, C., Haddad, C., Sacre, H., Salameh, P., Akel, M., Obeid, S., Akiki, M., Mattar, E., Hilal, N., Hallit, S., et al. (2019) · PLOS ONE · doi:10.1371/journal.pone.0222172 · Cited by 131
Mental Health Literacy Affects Mental Health Attitude: Is There a Gender Difference?
Lee, H. Y., Hwang, J., Ball, J. G., Lee, J., Yu, Y., & Albright, D. L. (2020) · American Journal of Health Behavior · doi:10.5993/ajhb.44.3.1 · Cited by 112
Research works printed but not linked: 1
- Cornah D. The impact of spirituality on mental health: A review of the literature. Mental Health Foundation [homepage on the Internet]. 2006 [cited n.d.]. Available from: https://www.elament.org.uk/self-help-resources/the-mental-health-foundation-the-impact-of-spirituality-a-literature-review/
Cited by
Primary Healthcare Nurses: Key Role Players in Early Recognition of Mental Health Issues
Jansen, R., & Morifi, M. G. (2025) · Issues in Mental Health Nursing · doi:10.1080/01612840.2025.2571624 · Cited by 5
Negotiating Faith in Therapy: A Qualitative Study of Christian Clients in Secular Psychotherapy
Lloyd, C. E. M., Reid, G., & Cathcart, J. (2026) · Pastoral Psychology · doi:10.1007/s11089-025-01292-6 · Cited by 5
Kakinda, A. I., Croudace, T. J., Plouffe, R. A., & Amone‐P’Olak, K. (2026) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2026.10250 · Cited by 2
Dlamini, Z. T., Poliah, V., & Govender, N. (2025) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v31i0.2399 · Cited by 2
Edosomwan, H. S. (2025) · Spiritual Psychology and Counseling · doi:10.37898/spiritualpc.1544456 · Cited by 1
Metadata
- Authors
- Hlongwane, N., & Juby, V.
- Affiliations
- University of KwaZulu-Natal (ZA)
- Corresponding author
- Hlongwane, Nomthandazo
- Venue
- South African Journal of Psychiatry
- Publisher
- AOSIS
- Published
- 2023-11-07
- Volume
- 29
- Pages
- 2139-2139
- ISSN
- 1608-9685 (ISSN-L)
- 2078-6786
- PMC
- PMC10696576
- OpenAlex
- W4388456911
- Cited by
- 11
- References
- 31
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 1
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- South African Journal of Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- mental illness, help-seeking, mental health knowledge, attitudes toward mental illness, stigma, religiosity, Christian faith, Pentecostal churches, Assemblies of God, church members, mental health awareness
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