Attitude, Literacy, and Social Stigma Toward Mental Illness Among Islamic Religious Leaders (Imams) in Bangladesh: A Cross-Sectional Study.

BACKGROUND: More than 90% of people in Bangladesh are Muslims and a good portion of persons with mental illness visit religious leaders in the country. Attitude, literacy, and stigma toward mental illness affect the referral of persons with mental illness to mental health systems. OBJECTIVES: We aimed to see attitudes, literacy, and social stigma toward mental illness among Islamic religious leaders in Bangladesh. METHODS: Data were collected for this cross-sectional study by a self-reporting semi-structured questionnaire from 358 Imams by convenience sampling from September 2024 to January 2025. RESULTS: The mean age of the participants was 31.7 years. The majority of the participants were aged 30 years or younger (54.5%), were married (68.4%), maulanas (59.8%), and 8.1% had a history of psychiatric illness. Mental illness was perceived as highly biological, influenced by sinful acts and spiritual influence, and was poorly associated with external issues like jinn, evil eye, and black magic by the participants. A favorable scenario was noted while assessing the social stigma of mental illness, while persons with mental illness were considered dangerous. Participants correctly identified depression (92.5%), anxiety (90%), obsessive-compulsive disorder (83%), and Schizophrenia (88%). CONCLUSIONS: This study revealed findings related to attitude, social stigma, and literacy among religious leaders in a Muslim-majority country. Studies assessing the association between these variables and referral patterns to mental health services are warranted to consider the findings in policymaking.