Table 2.

Summary of study characteristics from youth-assessments of stigma in India

(Author, Year)	Aspect of mental health	Sample size, Site: Urban(U)/ Rural(R)	Age (mean or range)	% of female	Location	Participant profile	Stigma component/s [Knowledge (K); Attitude (A); Behaviour (B)]	Knowledge (K)	Attitude (A)	Actual or intended behaviour (B)
Abraham et al., 2014 [33]	Nomophobia - fear of being without or being unable to use one’s phone	200 (U)	18–23	NR	Karnataka	College students	K	89% had poor knowledge	–	–
Aggarwal et al., 2016 [34]	Mental illness	289 (U)	20.5	54.7	Delhi	Medical, psychology & other college students	KAB	Causes of mental illness - genetic, brain damage; God’s punishment, stress, biological factors and physical and sexual abuse	Mentally ill tend to be ‘mentally retarded’ and of low intelligence; need prescription drugs to control; marriage or psychotherapy can successfully treat mental illness	Majority would not maintain a friendship and would feel ashamed if they were related to a person with mental illness
Ahuja et al., 2017 [35]	Mental illness	50 (U)	18–21	54	Delhi-National Capital Region	College students of History, English, Business and Journalism	A	–	15% negatively labelled mental health problems and 77% used negative descriptions such as ‘stubborn, untidy and unclean’	–
Bell et al., 2010 [36]	Mental illness	106 (U)	20/19–23	57	Maharashtra	Pharmacy	AB	–	Perception that people will never recover	18.75+/− 3.57
Bell et al., 2008 [37]	Epilepsy	106 (U)	21/19–24	58	Maharashtra	Pharmacy	A	–	People with depression will never recover and people with schizophrenia will never recover	–
Bhise et al., 2016 [38]	Mental illness	94 (U)	21.9 (0.7); 20.6 (0.8)	44.6;88.3	Maharashtra	Psychiatry and physiotherapy	A	–	3.3–3.4 (0.94, Kruskal Wallis p = 0.3)	–
Chawla et al., 2012 [39]	Mental illness	210 (U)	20.2 (1.63)	30.9	NR	Undergraduate medical students	KA	Mental illness - occurs among people who have excessive emotions (66%) or are lonely (52%); is caused by past sins/evil spirits (16%); is not treatable (7%).	46% felt fear, anger or hatred when they met a psychiatric patient
D’Sa et al., 2016 [40]	Substance use	487 (U)	< 18	NR	Mangalore, Karnataka	School students and college students	K	58% knew where people can access alcohol	–	–
Etzersdorfer et al., 1998 [41]	Suicide	100 (U)	18.4	51.5	Chennai, India	Medical students	A	–	70% said suicide by someone most near was cowardly; 37% said it was deliberate	18% would likely commit suicide because they had a mental illness
Gulati et al., 2014 [42]	Mental illness	135 (NR)	20.3	57.3	North India	Medical students (yr. 1 and 2) and interns - upper middle class and middle class	KA	29–65% felt that people with mental illness are easy to recognize, and are different from patients suffering from other illness	68% felt that persons with mental illness should not be treated in the same hospital with people with physical illness. 65–75% prefer locking such patients.	–
Hiremath & Wale, 2017 [43]	Adjustment problems	100 (U)	22–25	70	Tumkur, Karnataka	Third-year B.Sc. Nursing students	KA	15% had poor knowledge about adjustment problems	20% had negative attitudes regarding adjustment problems
Joshi et al., 2012 [44]	Epilepsy	798 (U)	14–16	33.2	Bareilly, Uttar Pradesh	School students	KAB	Cause of epilepsy: 36% did not know that epilepsy is a brain disorder. 5% believed that epilepsy is infectious. 69% felt that epilepsy can be cured. 4% felt it can be treated by a spiritual healer. Perceived causes for epilepsy: inherited (71%), non-vegetarian diet (49%), evil spirits (5%).	40% believed that average IQ of an epileptic patient is less than a normal person. Most (89%) of the students felt pity/sad for an epileptic patient, and 37% of them thought that an epileptic patient is dangerous. 72% thought that children with epilepsy should study in a special school.	During a seizure, 51.5% of the students would take the person to the hospital, 23.43% would throw water on the person and 22.69% would make the person smell a shoe or an onion.
Kalra, 2012 [61]	Mental illness	11 (U)	NR	NR	Mumbai, Maharashtra	Psychiatry trainees	A	–	Society stereotyping psychiatrists as ‘mad doctors’ Other medical colleagues do not take them seriously and they felt ‘stigmatized along with the psychiatric patients’	–
Kodakandla et al., 2016 [45]	Mental illness	176 (U)	23.2 years (1.06)	81.25	Hyderabad, Telangana	Participants wereInterns, who completed their psychiatry rotation	KA	31% believed that psychological illness is unlikely to becured regardless of the treatment. 76% believed that psychological disorder is recurrent. 68% were of the opinion that people who have once received psychologicaltreatment are likely to need further treatment in the future.	76% believed that a mentally ill person is more likely to harm others. 62% believed that it may be difficult for mentally ill patients to follow social rules and that they are less likely to function well as parents (63%). 82% believe that mentally ill patients should have a job with minor responsibilities. 79% felt that behaviour of patients with psychologicaldisorder is unpredictable.
Madhan et al., 2012 [46]	Mental illness	212 (U)	NR	NR	Guntur, India	Dental students	A	–	Regard was the highest for persons with intellectualdisability, followed by acute mental illness, and substance misuse.	–
Mahto et al., 2009 [47]	Mental illness	100 (U)	18–35	50	Ranchi, Jharkhand	postgraduate department college	A	–	Females had more neutral attitudes compared to males, although no significant difference overall.	–
Mehrotra et al., 2013 [62]	Mental illness	536 (NR)	21(2.3)/ 17–30	59	NR	Graduate and undergraduate college students	K	Mental health defined positively, although cognitive functioning was stressed.	–	–
Nebhinani et al., 2017 [48]	Suicide	205 (U)	21.9	46	Rohtak, Haryana	Final year medical students	A	–	23% perceived that people with serious suicidal intent do not talk about it. Suicide as attention-seeking.	–
Nebhinani et al., 2013 [49]	Substance use	192 (U)	16.57 (1.63); 19.49 (1.24)	49 and 38%	Chandigarh	College and school students	KA	More college studentsconsidered substance related harm as temporary (7%vs. 1%); 26% considered no treatmentfor substance use.	15% had negative attitude towards substance abusers (labelled them ‘bad people’and added that they should not be helped). and 81% felt that subjects may quit substance with willpower, despite a longer duration of intake.	–
Poreddi et al., 2016 [50]	Mental illness	271 (U)	20.9 (1.7)	80.9	Bangalore, Karnataka	Medical and nursing undergraduates after a psychiatry course	A	–	People with mental illness - should have limited input in to deciding medication to be used (44%); can’t handle too much responsibility (41%).	–
Poreddi et al., 2017 [51]	Mental illness	322 (U)	19.57–20.87	83.9	Bangalore, Karnataka	Medical and nursing undergraduates after completing psychiatry course	AB	–	Medical students reported better attitudes than nursing students regarding stereotyping, restrictiveness, benevolence and pessimistic prediction. Nursing students had better attitude regarding separatism.	Stigmatization among medical students 8.37 ± 2.81) and 9.27 ± 2.48) among nursing students
Poreddi et al., 2015 [52]	Mental illness	116 (U)	20.96 (0.90)	98.3	NR	Nursing undergraduate	A	–	80% said people with mental illness are unpredictable. 71% said they cannot handle too much responsibility, 84% felt they are more likely to commit offences or crimes and 44% believe they are more likely to be violent.	–
Prasad & Theodore, 2016 [53]	Mental illness	400 (U)	NR	82.75	Bangalore, Karnataka	B.Sc. nursing students	K	70% had inadequate knowledge of human rights related to mental illness	–	–
Ram et al., 2017 [54]	Suicide	339 (U)	17–31 (21.80 ± 2.18)	68.7	Mysuru, Karnataka	Undergraduate, postgraduate and interning medical students and paramedical students	KA	36% were unable to identify symptoms of depression; 64% felt that talking about suicide increases risk of suicide, 62% more men commit suicide than women; 65% happens to few people; 52% of people with depression need to be hospitalized.	45.42% would not disclose suicidal ideation; 49.55% - people with mental illness change their mind quickly
Roy et al., 2017 [55]	Substance use	379 (U)	13.6	NR	Patiala, Punjab	Nr	KA	19% did not know that alcohol is a drug. 22% assumedthat smaller doses of alcohol do no harm.	8% expected alcohol to improvetheir sexual activity.	–
Shanthi et al., 2015 [56]	Substance use	100 (U)	14–17	0	Mangalore, Karnataka	School students	K	Regarding alcoholism and its effects: 80% had average knowledge, 17% hadpoor knowledge and 3% had good knowledge	–	–
Sureka et al., 2016 [57]	Epilepsy	411 (U)	NR	NR	Jaipur, Rajasthan	Nursing and medical students	KAB	Causes of epilepsy: epilepsy is a mentalillness (27–40%); birthdefect and blood disorder (25%); family history (21–39%) and supernatural power (5%) Symptoms of epilepsy: loss ofconsciousness and convulsions (55–58%) Treatment by allopathic medicine, followed by ayurvedic and homeopathic (40–50%)	Epilepsy is a hindrance in life (50–76%). An “epileptic person” should not marry (25–33%). Among both groups, most participants would like to play/study with epileptic child. 23% thoughtepileptics have committed sins in past life.	During an epileptic attack, majority would take a patient to the hospital and 16%in one group would put water/ shoe/ onion on the person’sface.
Thakur & Olive, 2016 [58]	Nomophobia - fear of being without or being unable to use one’s phone	100 (U)	NR	NR	Jalandhar, Punjab	College students of nursing, technology and engineering	K	68% had poor knowledge of nomophobia	–	–
Thomas et al., 2015 [59]	Substance use	60 (U)	13–15	50	Malkapur, Maharashtra	School students	K	23% had poor knowledge regarding substance use	–	–
Vijayalakshmi et al., 2013 [60]	Mental illness	268 (U)	NR	100	Bangalore, Karnataka	Nursing and management students	KAB	Stereotyping sub-scale: 22% (n = 33) of the nursing and 12% (n = 14) BBM students felt that people with mental illness cannot be easily identified by their behaviour. People with mental illness have a lower IQ according to 35.8% nursing students (n = 95) and 78.3% BBM students (n = 26). More nursing (n = 92, 62.2%) than BBM students (n = 34, 28.3%) accepted that ‘everyone faces the possibility of becoming mentally ill’.	Separatism sub-scale: more nursing students (n = 128, 86.5%) than BBM students (n = 86, 71.7%) would not move out of the community if a mental health facility was set up. More nursing (n = 26, 17.6%) than BBM students (n = 15, 12.5%) disagreed that people with mental illness are violent and dangerous. 76.3% (n = 113) of nursing students compared to 52.5% (n = 63) of BBM students agreed that the ‘mentally ill should be able to have children’. More nursing (n = 69, 46.7%) than BBM students (n = 21, 17.5%) agreed that ‘people with mental illness can hold a job	More nursing students (n = 50, 33.8%) than BBM students (n = 38, 31.6%) felt that the ‘mentally illshould not disclose their illness’. Both nursing (n = 112, 75.7%) and BBM students (n = 82, 68.3%) agreed that they ‘should not laugh at the mentally ill’