Public Perception, Attitude and Awareness Toward Mental Illness in Palestine

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Mental health conditions, which the World Health Organization describes as significant disturbances in behavior, emotion, or thinking, are a public health issue across all age groups. Objective This study aimed to assess public perceptions, attitudes, and awareness toward mental illness in the Palestine. Methodology A cross-sectional design was utilized between October and November of 2025. The study population consisted of all Palestinians in the West Bank. The total sample size was 1,360 participants. Convenience sampling was used to collect the data. An online self-administered questionnaire, adopted from a similar study conducted in Iraq, was distributed in public places and on social media platforms. Results The respondents' awareness of the etiology of mental illness is nearly evenly split, with 48.75% being aware and 51.25% not aware. The majority of participants (84.3%) have a positive perception of people with mental illness. While 80.2% of the respondents hold a positive attitude toward people with mental illness, their attitudes toward the care and treatment of people with mental illness were negative, with 66.4% expressing negative views. Conclusions Our study's results demonstrate how attitudes, awareness, and perceptions of mental illness have changed in Palestine over time, indicating an increase in public knowledge and understanding. This change can be attributed to factors such as increased mental health education, global awareness campaigns, and the psychological effects of the region's ongoing political conflicts. Mental Health Mental Illness Perception Attitude Awareness Stigma Figures Figure 1 Introduction Mental illness stigma slows down the recovery of mentally ill patients. The negative responses to people with mental illnesses represent the main barrier to the development of mental health reduction programs (Do, M et al.; Stuart, 2016 ). In this context, it must be noted that mental illness includes depression, schizophrenia, bipolar disorder, addictive behaviors, and other related conditions (National Institutes of Health, 2020). Among these forms of mental illness, depression is a prevalent illness that adversely affects the way of feeling, thinking, and acting. The major causes of depression are a decline in the importance of leisurely activities and feelings of sadness. It may lead to diverse mood and health problems and/or reduce effectiveness and productivity at home and college (Vahia, 2013 ). Anxiety is another mental health disorder. It can be defined as an emotion accompanied by tension, worried thoughts, and physical changes like increased blood pressure (Vahia, 2013 ). Bipolar disease is also a mental problem that leads to unusual swings in mood, energy levels, and the ability to perform routine tasks (National Institutes of Health (NIMH), 2023). Concerning their prevalence, the World Health Organization estimated that the global prevalence of mental health disorders accounts for 25% (Mansfield, et al., 2020 ). Globally, increasing attention has been focused on mental illness among adolescents and young people (Mansfield, et al., 2020 ; Pedrelli, et al., 2015 ; Al Laham, et al., 2020 ; Abolfotouh et al., 2019 ; Abi Doumit et al., 2019 ). Proper knowledge and public perception aid in the recognition of these patients as community members with specific disorders, and thus, requiring special needs. Therefore, it is necessary to assess gaps in public knowledge toward mental illnesses, risk factors, treatments, and basic needs (Abolfotouh et al., 2019 ; Getachew et al. 2024 ). Studies show that help-seeking behavior improves the knowledge related to mental health problems (Alexander, et al. 2020; Sanghvi & Mehrotra, 2021 ). in indicate that mental health remains a significant public health concern in the United States. According to the National Institute of Mental Health, approximately 22.8% of adults (about 57.8 million people) experienced a mental illness in 2022, including 5.2% with serious mental illness (NIMH, 2023). Similarly, the Centers for Disease Control and Prevention report that nearly one in five adults experience symptoms of anxiety or depression annually, while the Substance Abuse and Mental Health Services Administration indicates that about 20% of adolescents are affected by mental health disorders each year (CDC, 2023). Despite the availability of effective treatments, more than half of individuals with mental illness do not receive appropriate care, highlighting persistent gaps in access to mental health services (SAMHSA, 2023 ; Levine et al., 2021 ).The findings of the Global Context of Mental Health Study showed that there was stigma towards people living with mental illness in different countries of the world. This points to the need to increase knowledge about mental health using strategies like educational programs. Alsubaie et al., 2020 ; Njaka et al. 2023 ; Yin, et al.,2020). Approximately 970 million people worldwide (one in eight) suffered from a mental illness in 2019, primarily depression and anxiety. In 2020, depression and anxiety increased by 28% and 26%, respectively, as a result of COVID-19. Despite the existence of treatments, the majority of people do not have access to care and experience discrimination, stigma, and human rights abuses. ( Shah et al. 2023; WHO, 2022). According to the World Health Organization, anxiety disorders are the most common mental illnesses. While most people recover, people with PTSD can suffer depression and anxiety for months or even years. The Palestinian people are especially at risk due to the political violence and lack of access to mental health services, education, and work. (Marie et al., 2020 ). In 2023, Palestine had 2,553 cases of mental health (86.9 per 100,000), distributed among 22 health centers, including 15 in the West Bank, with males making up 54.7% (1,396 cases), while females made up 45.3% (1,157 cases). In 2014, Palestine had 2,257 cases of mental health (89.0 per 100,000), with males making 980 cases, while females made 1,277, indicating a rise in the total number of cases and the percentage of males over the years. (MOH, 2024 ). Many Palestinians believe mental illness to be taboo or a cause of shame. As a result, as a result, mental health issues are frequently overlooked, and people affected may experience prejudice or marginalization from their communities (Marie et al., 2020 ). This study addresses limited data on mental health perceptions in Palestine and provides evidence to identify knowledge gaps, reduce stigma, and inform policies and interventions to improve mental health awareness and access to care.Therefore, the aim of this study was to assess the public perceptions, attitudes, and awareness toward mental illness in Palestine. Methodology Research design and population A quantitative, cross-sectional design was used to assess the perception, attitude, and awareness of people toward mental illnesses in the Palestine. The study was conducted in the Palestine, during the period from 8/10/2025 to 1/11/2025. The study population consists of all Palestinians in the Palestine. According to the Palestinian Central Bureau of Statistics in 2024, the Palestinian population was about 5.6 million (PCBS, 2024 ). Sampling and sample size The sample size was calculated by using Open EPI version 3.01 (Dean AG et al., 2013). The researcher assumed a 95% confidence level with a 5% margin of error. Furthermore, to obtain the maximum sample size we utilized an expected proportion (p = 0.5) in the population, based on these parameters, the total sample size was calculated to be 384. A convenience sampling technique which is not a probability sampling method was used to obtain the required sample size. The participants in the current study were quite cooperative, which is why we have a large sample size (1360). Inclusion and Exclusion Criteria Inclusion Criteria : Adults (≥ 18 years) from Palestine, Individuals from diverse demographic backgrounds (age, gender, education, residence), Participants able to read and understand the questionnaire and Individuals who provide informed consent to participate. Exclusion Criteria : Individuals under 18 years of age, Non-residents of Palestine, Participants with incomplete or missing questionnaire responses, Individuals unable to comprehend the survey due to cognitive or language barriers and Mental health professionals Data collection methods and instrument An online self-administered questionnaire was adopted from similar study conducted in Iraq, which was distributed in public places and on social media platforms (Sadik et al., 2010 ). Questionnaire Structure The questionnaire, which was adopted to assess public perception, attitude and awareness in Palestine toward mental illness, consists of five sections: sociodemographic information, subjects' awareness of the etiology of mental illness, subjects' perception of people with mental illness, subjects' perception of people with mental illness, subjects' attitude toward people with mental illness, and subjects' attitude toward the care and treatment of people with mental illness. Section I : This section includes all the demographic data, with 7 items: age group, gender, city, place of residence (city, village or camp), marital status, monthly income, and level of education. It also includes one question about having a person with mental illness in the family. Section II : This section includes 6 questions that assess the level of awareness about the etiology of mental illness. These items include Genetic inheritance, Substance abuse, Bad things happening to the person, Brain disease, Personal weakness, and God's punishment. A five-point Likert scale was used to answer these questions (agree, agree somewhat, neutral, disagree somewhat and disagree). Section III : This section includes 6 items that assess subjects' perception of people with mental illness. These items include: whether a mentally ill person is capable of working, whether mental illness can be identified by physical appearance, whether the mentally ill person is not capable of true friendship, whether they are usually dangerous, whether they are to blame for their own condition, and whether anybody can have mental illness. A five-point Likert scale was used to answer these questions (agree, agree somewhat, neutral, disagree somewhat, and disagree). Cut off point for this section is as follows: <3 poor perception, ≥ 3 good perception. A higher mean score indicates a good perception. Section IV : This section includes 12 items that assess subjects' attitudes toward people with mental illness. Cut-off point: <3 negative attitude, ≥ 3 positive attitude. A higher mean score indicates a positive attitude. Section V : This section includes 9 items that assess the subjects attitude toward the care and treatment of people with mental disorders. Cut-off point: <3 negative attitude, ≥ 3 positive attitude. A higher mean score indicates a positive attitude. Data collection procedures An online self-administered questionnaire was distributed in restaurants, coffee shops, parks, public places, hospitals, bakery stores using a barcode and through social media platforms like WhatsApp, Facebook and Instagram. Reliability A test was carried out by the researcher in order to examine the internal consistency of its questions. The values of Cronbach's alpha for each scale suggested that the scales are reliable for measuring these constructs in the study (Table 1 ). Table 1 Reliability Coefficients Dependent variables N Cronbach Alpha Awareness 6 0.70 Perception 6 0.71 Attitude 21 0.77 Validity of the tool and Pilot study Prior to the study, the questionnaire was tested for face validity by an expert panel consisting of five faculty members. A pilot study was conducted on 10% of the calculated sample size to assess the clarity and applicability of the questionnaire, and it was excluded from the sample size. Data analysis The collected data were analyzed by the Statistical Package for Social Sciences (SPSS) Version (27). Data analysis of descriptive and inferential statistics was conducted. Regarding descriptive statistics, frequency, percentages, mean score and Standard Deviation (SD) were used to describe the study variables. Regarding inferential statistics, independent t-test and One-Way ANOVA were conducted to assess the differences between variables after assessing the normality of the scores using Kolmogorov Smirnov and Shapiro-Will test (p ≥ 0.05). Ethical consideration This work has been carried out in accordance with the Declaration of Helsinki (2000) of the World Medical Association. This study was approved by the IRB of Modern University College (MUC) = 031- 2025), and informed consent was obtained from all participants. Each participant was given a clear explanation of the objective. The participant was informed that names were not required and that the data would only be used for scientific research. No private information was obtained and each respondent’s answers were anonymized to protect their research information and privacy. These procedures uphold protections to preserve the participants' rights and wellbeing while validating the study's ethical features. Results Demographic Variables The study sample (n = 1,360) was mostly young adults aged 20–29 (77.6%), with 59.5% females and 40.5% males. Participants were primarily from Hebron (31.3%) and Ramallah (28.4%), living in cities (45.9%) or villages (47.8%), with 6.3% from camps. Most were single (65.4%) and earned under 2,000 NIS monthly (40.0%), while 13.5% earned ≥ 5,000 NIS. Educationally, 58.7% held a Bachelor’s degree, 21.4% a diploma, 8.9% primary education, and 11.0% higher education. Table 2 Demographic variables of the subjects (n = 1360) Demographic variables N % Age group < 20 years old 20–29 years old ≥ 30 years old 121 1056 183 8.9% 77.6% 13.5% Sex Male Female 551 809 40.5% 59.5% City Hebron Ramallah Jerusalem Bethlehem Nablus Tulkarem Jericho Jenin Qalqilya Tubas 426 386 145 58 97 37 24 115 50 22 31.3% 28.4% 10.7% 4.3% 7.1% 2.7% 1.8% 8.5% 3.7% 1.5% Place of residence City Village Camp 624 650 86 45.9% 47.8% 6.3% Marital status Single Married Divorced Widowed 889 445 15 11 65.4% 32.7% 1.1% 0.8% Monthly Income < 2000 NIS 2000–2999 NIS 3000–3999 NIS 4000–4999 NIS ≥ 5000 NIS 544 305 198 129 184 40.0% 22.4% 14.6% 9.5% 13.5% Level of education Primary Diploma Bachelor’s Degree Higher education 121 291 798 150 8.9% 21.4% 58.7% 11.0% Prevalence of Having a Person with a Mental Illness The results indicate that the prevalence of individuals having a person with a mental illness in their lives is relatively low, with only 16.5% of respondents reporting "Yes," while the majority, 83.5%, indicated "No." awareness on the etiology of mental illness Table 3 : Participants showed mixed knowledge of mental illness causes: 58.2% recognized substance abuse, 49.3% brain disease, and 67.6% were unaware of genetics. Misconceptions were common, with 84.5% blaming “bad things happening” and 54.0% citing “personal weakness,” though 85.9% rejected “God’s punishment,” highlighting persistent gaps in understanding. Table 3 awareness on the etiology of mental illness (n = 1360) Cause Aware Not Aware n % n % 1. Genetic inheritance. 440 32.4% 920 67.6% 2. Substance abuse. 791 58.2% 569 41.8% 3. Bad things happening to the person 1149 84.5% 211 15.5% 4. Brain disease. 671 49,3% 689 50,7% 5. Personal weakness. 735 54.0% 625 46.0% 6. God's punishment. 192 14.1% 1168 85.9% Total mean 663 48.75% 697 51.25 Reversed item Higher mean score means aware or unaware, Cut off point as follow; <50% unaware, ≥ 50% aware perceptions of people with mental illness Table 4 participants showed generally positive views of people with mental illness (Mean = 3.30), supporting statements like “Capable of work” (3.88), though some stereotypes and negative beliefs remained, such as “Usually dangerous” (3.11) and “Blame for own condition” (2.98), indicating overall good attitudes but room to reduce stigma. Table 4 perceptions of people with mental illness (n = 1360) Item Mean SD Status 1. Capable to work 3.88 .845 Good 2. Tell by physical appearance* 3.01 1.101 Good 3. Not capable of true friendship* 2.97 1.115 Poor 4. Usually dangerous* 3.11 1.025 Good 5. Blame for own condition* 2.98 1.046 Poor 6. Anybody can have mental illness 3.85 .892 Good Total Mean Score 3.30 .416 Good * Reversed item Higher mean score means good perception Cut off point as follow; <3 poor perception, ≥ 3 good perception Attitude Toward People with Mental Illness Table 5 : The findings show a generally positive attitude toward people with mental illness (Mean = 3.38, SD = 0.516). Participants supported statements like “Should have same rights” (3.88) and “Could maintain friendship” (3.56), but showed reservations on “Could marry someone with mental illness” (2.53) and “Would hide own mental illness” (2.82), indicating lingering stigma despite overall positive attitudes. Table 5 Attitude Toward People with Mental Illness (n = 1360) Item Mean SD Status 1. Mentally ill person should be prevented from having children* 3.28 1.12 Good 2. Mentally ill person should not get married* 3.27 1.13 Good 3. One should avoid all contact with mentally ill* 3.84 0.92 Good 4. Mentally ill person should not be allowed to make decisions* 3.53 1.01 Good 5. I could maintain friendship with someone with mental illness 3.56 0.94 Good 6. I could marry someone with mental illness 2.53 1.02 Poor 7. I would be afraid to have conversation with mentally ill person* 3.43 1.02 Good 8. Person with mental illness should have same rights 3.88 0.96 Good 9. I would be upset and disturbed working on same job as mentally ill person* 3.41 0.97 Good 10. I would be ashamed if family member diagnosed with mental illness* 3.78 1.01 Good 11. I would not want people to know if suffering from mental illness* 2.82 1.15 Poor 12. People generally caring and sympathetic towards people with mental illness 3.27 1.09 Good Total Mean Score 3.38 .516 Good * Reversed item, Higher mean score means positive attitude, Cut off point as follow; <3 negative attitude, ≥ 3 positive attitude Attitudes Towards Care and Treatment of People with Mental Illness Table 6 attitudes towards care and treatment of people with mental illness The results reveal a generally negative attitude toward mental health care (Mean = 2.82, SD = 0.295, “Poor”). Participants scored low on statements like “Mental illness can be treated outside a hospital” (2.05) and “One should hide mental illness from family” (2.73), reflecting stigma. Some positive views existed, such as recognizing PHC clinics’ role in providing care (3.35–3.78), indicating awareness of support options but persistent skepticism about treatment. Table 6 Subjects’ attitudes towards care and treatment of people with mental illness (n = 1360) Item Mean SD Status 1. Mental illness can be treated outside a hospital 2.05 0.97 Poor 2. Majority of people with mental illnesses recover 3.03 1.11 Good 3. I would feel comfortable discussing a mental health issue of family member or myself with someone at PHC 2.18 0.93 Poor 4. One should hide mental illness from family* 2.73 1.11 Poor 5. Mental illness cannot be cured* 2.30 0.86 Poor 6. Mentally ill people should be in an institution to be under supervision and control* 2.90 0.94 Poor 7. Information about mental illness is available at my PHC 3.35 0.89 Good 8. Mental health services available in my community 3.13 0.91 Good 9. PHC clinics can provide good care for mental illnesses 3.78 0.87 Good Total Mean Score 2.82 .295 Poor * Reversed item, Higher mean score means positive attitude, Cut off point as follow; <3 negative attitude, ≥ 3 positive attitude Differences between demographic variable of the subjects in terms of awareness sum score Table 7 The analysis found significant differences in mental health awareness by age, marital status, and education. Older participants (≥ 30 years) scored higher (Mean = 3.13, F = 6.104, p = .002), divorced individuals had the highest awareness (Mean = 3.67) compared to widowed (Mean = 1.73, F = 3.780, p = .010), and higher education was associated with greater awareness (Mean = 3.19, F = 8.347, p < .001). No other demographic factors showed significant differences. Table 7 Differences between demographic variable of the subjects in terms of awareness sum score (n = 1360) Demographic variables n Mean SD Statistical values P-value Age group < 20 years old 20–29 years old ≥ 30 years old 121 2.54 1.52 F = 6.104 df = 2 .002* Sex Male Female 1056 2.93 1.44 t = 1.935 df = 1358 .053 City Hebron Ramallah Jerusalem Bethlehem Nablus Tulkarem Jericho Jenin Qalqilya Tubas 183 3.13 1.56 F=.862 df = 9 .559 Place of residence City Village Camp 551 3.02 1.55 F = 1.973 df = 2 .139 Marital status Single Married Divorced Widowed 809 2.86 1.40 F = 3.780 df = 3 .010* Monthly Income < 2000 NIS 2000–2999 NIS 3000–3999 NIS 4000–4999 NIS ≥ 5000 NIS 426 2.99 1.45 F = 1.528 df = 4 .192 Level of education Primary Diploma Bachelor’s Degree Higher education 386 2.91 1.48 F = 8.347 df = 3 < .001* *Significant at p-value < 0.05, Independent sample and One Way ANOVA tests Differences between demographic variable of the subjects in terms of perception mean score The analysis shows that perceptions of mental health vary by age, gender, residence, and education. Older adults (≥ 30 years) and females had higher perception scores (Mean = 3.34), indicating more positive views (F = 3.631, p = .027; T = − 3.571, p < .001). Geographic differences were noted, with Nablus residents scoring highest (3.43) and Jericho lowest (3.11, F = 2.546, p = .007). Higher education also correlated with better perceptions (Mean = 3.34, F = 5.314, p < .001), highlighting these factors’ influence on mental health perceptions. Table 8 Differences between demographic variable of the subjects in terms of perception mean score (n = 1360). Demographic variables n Mean SD Statistical values P-value Age group < 20 years old 20–29 years old ≥ 30 years old 121 1056 183 3.22 3.31 3.34 0.44 0.41 0.43 F = 3.631 df = 2 .027* Sex Male Female 551 809 3.26 3.34 0.43 0.41 T=-3.571 df = 1358 < .001* City Hebron Ramallah Jerusalem Bethlehem Nablus Tulkarem Jericho Jenin Qalqilya Tubas 426 386 145 58 97 37 24 115 50 22 3.28 3.29 3.36 3.25 3.43 3.37 3.11 3.32 3.35 3.42 0.42 0.41 0.40 0.46 0.37 0.42 0.52 0.40 0.47 0.39 F = 2.546 df = 9 .007* Place of residence City Village Camp 624 650 86 3.30 3.31 3.33 0.42 0.42 0.40 F=.367 df = 2 .693 Marital status Single Married Divorced Widowed 889 445 15 11 3.31 3.30 3.14 3.15 0.42 0.42 0.43 0.42 F = 1.312 df = 3 .269 Monthly Income < 2000 NIS 2000–2999 NIS 3000–3999 NIS 4000–4999 NIS ≥ 5000 NIS 544 305 198 129 184 3.31 3.25 3.30 3.37 3.33 0.42 0.40 0.41 0.42 0.42 F = 2.304 df = 4 .056 Level of education Primary Diploma Bachelor’s Degree Higher education 121 291 798 150 3.22 3.25 3.33 3.34 0.44 0.42 0.41 0.42 F = 5.314 df = 3 < .001* *Significant at p-value < 0.05, Independent sample and One Way ANOVA test Differences Between Demographic Variable of the Subjects in Terms of Attitude Mean Score Table 9 : the analysis shows that attitudes toward mental health vary by gender, income, and education. Males had slightly higher scores than females (Mean = 3.17 vs. 3.12, T = 2.905, p = .004). Participants earning 3,000–4,999 NIS had the most positive attitudes (Mean = 3.19, F = 2.537, p = .038), and those with primary or diploma education scored highest (Mean = 3.19 and 3.17, F = 3.586, p = .013), indicating these factors influence attitudes toward mental health. Table 9 Differences between demographic variable of the subjects in terms of attitude mean score (n = 1360) Demographic variables n Mean SD Statistical values P-value Age group < 20 years old 20–29 years old ≥ 30 years old 121 1056 183 3.19 3.14 3.16 0.27 0.32 0.28 F = 1.904 df = 2 .149 Sex Male Female 551 809 3.17 3.12 0.28 0.33 T = 2.905 df = 1358 .004* City Hebron Ramallah Jerusalem Bethlehem Nablus Tulkarem Jericho Jenin Qalqilya Tubas 426 386 145 58 97 37 24 115 50 22 3.15 3.14 3.13 3.19 3.11 3.07 3.14 3.11 3.23 3.27 0.29 0.32 0.29 0.35 0.31 0.30 0.21 0.32 0.41 0.32 F = 1.482 df = 9 .149 Place of residence City Village Camp 624 650 86 3.14 3.14 3.16 0.31 0.31 0.30 F=.189 df = 2 .828 Marital status Single Married Divorced Widowed 889 445 15 11 3.14 3.17 2.98 3.07 0.31 0.31 0.38 0.24 F = 2.574 df = 3 .053 Monthly Income < 2000 NIS 2000–2999 NIS 3000–3999 NIS 4000–4999 NIS ≥ 5000 NIS 544 305 198 129 184 3.13 3.12 3.19 3.19 3.15 0.30 0.31 0.31 0.33 0.32 F = 2.537 df = 4 .038* Level of education Primary Diploma Bachelor’s Degree Higher education 121 291 798 150 3.19 3.17 3.12 3.17 0.27 0.34 0.31 0.27 F = 3.586 df = 3 .013* *Significant at p-value < 0.05, Independent sample and One Way ANOVA tests Discussion The majority were women aged between 20 and 29 years, mostly from Hebron, Ramallah, and Jerusalem, with fewer from the camps; they were mostly single, had a bachelor's degree, and earned less than 2,000 NIS. Stigma remains widespread in Palestine; the majority of the people, at 83.5%, had little personal experience with mental illness. Prejudice, marginalization, and avoidance of treatment are all driven by negative stereotypes. Awareness toward mental illness etiology However, awareness of mental illness causes differs, with 46.4% in Iraq and more than half in Palestine being aware of substance abuse, although not all in these countries are aware of it. Moreover, in China, a study done in 2020 revealed low awareness of the causes, treatments, and prevention of mental illness. (Yin et al., 2020 ). Lack of knowledge of the genetic basis of mental illness is also low in both regions, but more in Palestine (67.6%) than in Iraq (28.6%), though more people in Palestine are aware of its hereditary role (32.4%) than in Iraq (27.8%) (Sadik et al., 2010 ). Belief that mental illness is divine punishment is low in both countries, with 14.1% in Palestine and 16.8% in Iraq endorsing it. Rejection is higher in Palestine (85.9%) than Iraq (42.8%), indicating stronger dismissal of this belief in Palestine. (Sadik et al., 2010 ). Public understanding of mental health has improved over time due to awareness campaigns, education, and reduced stigma. Younger generations are more exposed to scientific information, while cultural shifts and a declining influence of traditional beliefs also shape changing attitudes. Perceptions of People with Mental Illness The study found generally positive perceptions of people with mental illness, with 84.3% of participants expressing positive views, including beliefs in their ability to work and that anyone can develop mental illness. In Palestine, this may relate to widespread exposure to psychological stressors such as conflict and displacement, increasing awareness. Similar findings were reported in Japan, where most participants recognized treatability, though some stigma persists. (Kasahara-Kiritani et al., 2018 ). Contrary to our findings in Palestine (84.3% positive perception), studies in Gimbie and Oman report more negative attitudes. In Ethiopia, lower education was linked to poorer perceptions, while in Oman, stigma persists with a preference for traditional or religious treatments due to misconceptions about mental illness. (Benti et al., 2016 ). In addition, the second study conducted in Oman revealed that mental illness is stigmatized in Omani society and that there is a lack of accurate knowledge and understanding of it. The results showed that many people prefer traditional or religious treatment over medical treatment because they believe that mental illness is caused by a lack of moral character or religious belief (Al-Alawi et al., 2017 ; Amro N et al., 2020 ). In Palestine, growing awareness of mental illness is supported by research institutions and international efforts, including the World Health Organization. Despite generally positive perceptions, some negative beliefs persist (e.g., inability to form friendships or self-blame), and 15.7% still show poor perceptions. Stigma remains a barrier, especially in rural areas, where limited awareness programs hinder understanding and help-seeking. Attitude Toward People with Mental Illness In our study, the positive attitude toward mentally ill people in Palestine was at 80.2%, similar to the Chinese sample. However, negative attitudes toward mentally ill people in personal relationships and trust were evident in that 55.3% believed that people would take the mentally ill person less seriously in personal relationships, 70.6% believed that women would be reluctant to date them, and 68.2% believed that mentally ill people were inappropriate caregivers. However, the ability of the sample to accept the mentally ill person as a close friend was at 43.3%. (Yin et al., 2020 ). In Palestine, negative stereotypes of mentally ill persons are common, such as the belief that mental illness is caused by lack of will, or supernatural powers such as the evil eye or spirits, and can only be cured by traditional healers. There is also the belief that mentally ill persons are unfit for parenting due to hereditary concerns. However, due to political conflicts in Palestine, especially in Gaza, mental health problems are becoming common and accepted, creating empathy among Palestinians towards mentally ill persons. Attitudes Towards Care and Treatment of People with Mental Illness In terms of attitude toward care and treatment, the majority of participants (66.4%) expressed a negative attitude toward the care and treatment of individuals with mental illnesses. This is consistent with the public perception of mental health in Iraq (Sadik et al., 2010 ), In Iraq, 66% of people believed that people with mental illness should be hospitalized and controlled, as stereotypes portray that people with mental illness are incapable. Furthermore, only 15% believed that primary healthcare provided sufficient care for people with mental illness, and only 14% believed that primary healthcare provided people with mental illness with sufficient information. These beliefs are due to cultural beliefs that mental illness is shameful and affects family prestige, as seen in East Asian, Latino, and African American communities (Chiu, vet al., 2015). Tanaka et al. ( 2018 ) found that individuals concerned about their appearance may hide their mental illness due to fear of self-stigma, hindering help-seeking. Mak et al. ( 2015 ) noted that Austrians may experience lower self-stigma than Palestinians because of community-based rehabilitation and public health education. Media can play a key role in reducing stigma, and stigma toward mental health professionals should also be addressed, as it affects occupational stress and patient outcomes. Domingo et al. (2023) suggest that mental health practitioners may stigmatize their patients due to perceived challenges in connecting with them and limited societal acceptance of those with mental illnesses. Physicians working in mental health may face misunderstanding and skepticism from their families and the wider public. (Luo, et al., 2018 ) found that, worse still, evidence indicated that professional stigma was negatively associated with job satisfaction and the quality of treatment (Do, M et al. 2024, Walsh et al. 2024). Therefore, there is a need to create a more inclusive and supportive environment for people with mental illness and advocate for policies that promote access to mental health care and support services. It is critical to fight these negative views and promote a more optimistic and understanding perspective on mental illness. Public education about mental illness and efforts to eliminate misunderstandings should be maintained, while establishing a more welcoming and supportive atmosphere for those with mental illnesses. Conclusion and Recommendations This study demonstrates a gradual improvement in public knowledge and attitudes toward mental illness in Palestine, influenced by mental health education, global awareness initiatives, and the psychological impact of ongoing political conflicts. Despite this progress, stigma, misconceptions about mental health causes, and limited access to care—especially in rural areas—remain significant challenges. Negative attitudes toward treatment highlight the need for continued public education, stigma reduction, and the expansion of mental health services. To address these issues, efforts should focus on raising awareness through education and media campaigns, conducting further research to identify factors influencing perceptions, and improving access to counseling and treatment facilities, while fostering supportive environments that ensure respect and care for individuals with mental illness. Limitations This study had no significant restrictions, except for financial and time constraints. The political environment forced the researcher to collect data via an online survey. Some people refused to fill out the questionnaire due to fear, the political atmosphere in their community, or a lack of education that prevented them from recognizing the importance of the research. Declarations Corresponding Author Rebhi Bsharat, [email protected] Competing interests The authors declare that they have no known competing financial, personal, or professional interests that could have appeared to influence the work reported in this Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors Author Contribution Every author contributed significantly to the work reported, whether it was in the conception, study design, execution, data acquisition, analysis, and interpretation. all of these areas, developed the research questions and conceptualized the work, acquired the data. analyzed the data and interpreted the findings and drafted the manuscript, contributed to the interpretation of the findings and critically reviewed the manuscript. Data Availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. 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Levine GN, Cohen BE, Commodore-Mensah Y, Fleury J, Huffman JC, Khalid U, Spatz ESJC. Psychological health, well-being, and the mind-heart-body connection: a scientific statement from the American. Heart Association. 2021;143(10):e763–83. Luo A, He H, Mohamed S, Rosenheck RJC, Medicine, Psychiatry. (2018). Medical student attitudes towards people with mental illness in China: a qualitative study. 42 , 535–51. Mak WW, Ho CY, Wong VU, Law RW, Chan RCJD, Dependence A. (2015). Cultural model of self-stigma among Chinese with substance use problems. 155 , 83–9. Mansfield R, Patalay P, Humphrey N. A systematic literature review of existing conceptualisation and measurement of mental health literacy in adolescent research: Current challenges and inconsistencies. BMC Public Health. 2020;20:607. Marie M, SaadAdeen S, Battat MJB. p. (2020). Anxiety disorders and PTSD in Palestine: a literature review. 20 , 1–18. MOH. (2024). Retrieved from palestine: https://site.moh.ps/ National Institute of Mental Health. (2023). Mental illness statistics . https://www.nimh.nih.gov Njaka S, Ogbodo BA, Okpua NC, Uwa AN. J. I. J. o. A. N. S. (2023). A systematic review on prevalence and perceived impacts of associative stigma on mental health professionals. 18 , 100533. PCBS. (2024). the Palestinian Central Bureau of Statistics. Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College Students: Mental health problems and treatment considerations. Acad Psychiatry. 2015;39:50311. Sadik S, Bradley M, Al-Hasoon S, Jenkins R. J. I. j. o. m. h. s. Public Percept mental health Iraq. 2010;4:1–11. Sanghvi PB, Mehrotra S. Help-seeking for mental health concerns: review of Indian research and emergent insights. Journal of Health Research. Available from: https://doi.org/10.1108/JHR-02-2020-0040 . 2021. Shah BB, Nieweglowski K, Corrigan PWJ. J. o. M. H. (2022). Perceptions of difference and disdain on the self-stigma of mental illness. 31 (1), 22–28. Substance Abuse and Mental Health Services Administration. (2023). National Survey on Drug Use and Health (NSDUH). https://www.samhsa.gov Stuart H. Reducing the stigma of mental illness. Glob Ment Health (Camb) 2016;3: e17 e. doi: 10.1017/gmh. 2016.11. Tanaka C, Tuliao MTR, Tanaka E, Yamashita T, Matsuo HJB p. A qualitative study on the stigma experienced by people with mental. health Probl epilepsy Philippines. 2018;18:1–13. Vahia VN. Diagnostic and statistical manual of mental disorders 5: A quick glance. Indian J Psychiatry. 2013;55:2203. Walsh D, Foster JJB p. Understanding the public stigma of mental illness: a mixed-methods, multi-level. exploratory triangulation study. 2024;12(1):403. WHO. (2024). Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders World Health Organization. (1992). Yin H, Wardenaar KJ, Xu G, Tian H, Schoevers RAJB. p. (2020). Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study. 20 , 1–10. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 14 May, 2026 Reviewers agreed at journal 10 May, 2026 Reviews received at journal 10 May, 2026 Reviewers agreed at journal 10 May, 2026 Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 19 Apr, 2026 Reviewers invited by journal 17 Apr, 2026 Editor assigned by journal 17 Apr, 2026 Editor invited by journal 09 Apr, 2026 Submission checks completed at journal 08 Apr, 2026 First submitted to journal 08 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9325935","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":625813699,"identity":"9b32ed8e-6a09-4c05-abff-0a79e26a0923","order_by":0,"name":"Sanaa Salman","email":"","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":false,"prefix":"","firstName":"Sanaa","middleName":"","lastName":"Salman","suffix":""},{"id":625813700,"identity":"1383b379-ed8f-47cb-a977-d19239112738","order_by":1,"name":"Rebhi Bsharat","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYFACHjaGBIYDDAZgTgVETIJ4LQfOEKuFAablYBsRWszbe489eMBwx96c/ezDzx/nbUvsb2A+eJsHKIJLi8yZc+kGCQzPEnf2pBtLHNx2O3HGAbZkax6gSAMOLRISOWYSCQyHEwwOpDGAtWxg4DGT5gGK4LJFQv4NWIu9wflnzD8OzgFp4f8G0oLTYRISPGAtjBtupLFJHGwA28IG0sKI02E8eWkSCQbPEjfceMZmcebYbeMZh9mMLecY4PEL+9ljkj8q7gAdlsZ8o6Lmtmx/e/PDG28qcIcYBBggc5jBIgfw68AGyNAyCkbBKBgFwxUAAE9KWy4aVa5bAAAAAElFTkSuQmCC","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":true,"prefix":"","firstName":"Rebhi","middleName":"","lastName":"Bsharat","suffix":""},{"id":625813701,"identity":"cbb19004-cb17-4090-a899-e7ae526578d9","order_by":2,"name":"Areen Abed","email":"","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":false,"prefix":"","firstName":"Areen","middleName":"","lastName":"Abed","suffix":""},{"id":625813702,"identity":"66ab3cf4-6fd7-426d-adcb-6469075bfaf9","order_by":3,"name":"Besan Karaga","email":"","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":false,"prefix":"","firstName":"Besan","middleName":"","lastName":"Karaga","suffix":""},{"id":625813703,"identity":"27429f5c-7224-4557-a3eb-0905e53b2d07","order_by":4,"name":"mosa khalaileh","email":"","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":false,"prefix":"","firstName":"mosa","middleName":"","lastName":"khalaileh","suffix":""},{"id":625813704,"identity":"50798df2-843c-419c-b8c9-1479227b3c0b","order_by":5,"name":"Bashar Behais","email":"","orcid":"","institution":"Modern University College, Palestine","correspondingAuthor":false,"prefix":"","firstName":"Bashar","middleName":"","lastName":"Behais","suffix":""},{"id":625813705,"identity":"4bec7ca5-07a1-4fe2-a72a-352360923496","order_by":6,"name":"Ahmed hanani","email":"","orcid":"","institution":"An-najah National University Faculty of Medicine and Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"hanani","suffix":""}],"badges":[],"createdAt":"2026-04-05 11:38:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9325935/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9325935/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107838838,"identity":"67abcd56-05e3-4245-ae6f-e4a9d36e6c6b","added_by":"auto","created_at":"2026-04-26 17:13:37","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":9568,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9325935/v1/bf8e808970df5247536aa5e8.png"},{"id":107870678,"identity":"a6c6014d-6f6d-4964-82ae-3f2a03ecb322","added_by":"auto","created_at":"2026-04-27 07:40:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":592993,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9325935/v1/c771ffd5-b646-45e3-a099-f2506af3fbc7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Public Perception, Attitude and Awareness Toward Mental Illness in Palestine","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMental illness stigma slows down the recovery of mentally ill patients. The negative responses to people with mental illnesses represent the main barrier to the development of mental health reduction programs (Do, M et al.; Stuart, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). In this context, it must be noted that mental illness includes depression, schizophrenia, bipolar disorder, addictive behaviors, and other related conditions (National Institutes of Health, 2020). Among these forms of mental illness, depression is a prevalent illness that adversely affects the way of feeling, thinking, and acting. The major causes of depression are a decline in the importance of leisurely activities and feelings of sadness. It may lead to diverse mood and health problems and/or reduce effectiveness and productivity at home and college (Vahia, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Anxiety is another mental health disorder. It can be defined as an emotion accompanied by tension, worried thoughts, and physical changes like increased blood pressure (Vahia, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Bipolar disease is also a mental problem that leads to unusual swings in mood, energy levels, and the ability to perform routine tasks (National Institutes of Health (NIMH), 2023). Concerning their prevalence, the World Health Organization estimated that the global prevalence of mental health disorders accounts for 25% (Mansfield, et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Globally, increasing attention has been focused on mental illness among adolescents and young people (Mansfield, et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e ; Pedrelli, et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Al Laham, et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Abolfotouh et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Abi Doumit et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2019\u003c/span\u003e ). Proper knowledge and public perception aid in the recognition of these patients as community members with specific disorders, and thus, requiring special needs. Therefore, it is necessary to assess gaps in public knowledge toward mental illnesses, risk factors, treatments, and basic needs (Abolfotouh et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Getachew et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e ). Studies show that help-seeking behavior improves the knowledge related to mental health problems (Alexander, et al. 2020; Sanghvi \u0026amp; Mehrotra, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). in indicate that mental health remains a significant public health concern in the United States. According to the National Institute of Mental Health, approximately 22.8% of adults (about 57.8\u0026nbsp;million people) experienced a mental illness in 2022, including 5.2% with serious mental illness (NIMH, 2023). Similarly, the Centers for Disease Control and Prevention report that nearly one in five adults experience symptoms of anxiety or depression annually, while the Substance Abuse and Mental Health Services Administration indicates that about 20% of adolescents are affected by mental health disorders each year (CDC, 2023). Despite the availability of effective treatments, more than half of individuals with mental illness do not receive appropriate care, highlighting persistent gaps in access to mental health services (SAMHSA, 2023 ; Levine et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).The findings of the Global Context of Mental Health Study showed that there was stigma towards people living with mental illness in different countries of the world. This points to the need to increase knowledge about mental health using strategies like educational programs. Alsubaie et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Njaka et al. \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Yin, et al.,2020).\u003c/p\u003e \u003cp\u003eApproximately 970\u0026nbsp;million people worldwide (one in eight) suffered from a mental illness in 2019, primarily depression and anxiety. In 2020, depression and anxiety increased by 28% and 26%, respectively, as a result of COVID-19. Despite the existence of treatments, the majority of people do not have access to care and experience discrimination, stigma, and human rights abuses. ( Shah et al. 2023; WHO, 2022). According to the World Health Organization, anxiety disorders are the most common mental illnesses. While most people recover, people with PTSD can suffer depression and anxiety for months or even years. The Palestinian people are especially at risk due to the political violence and lack of access to mental health services, education, and work. (Marie et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn 2023, Palestine had 2,553 cases of mental health (86.9 per 100,000), distributed among 22 health centers, including 15 in the West Bank, with males making up 54.7% (1,396 cases), while females made up 45.3% (1,157 cases). In 2014, Palestine had 2,257 cases of mental health (89.0 per 100,000), with males making 980 cases, while females made 1,277, indicating a rise in the total number of cases and the percentage of males over the years. (MOH, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Many Palestinians believe mental illness to be taboo or a cause of shame. As a result, as a result, mental health issues are frequently overlooked, and people affected may experience prejudice or marginalization from their communities (Marie et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This study addresses limited data on mental health perceptions in Palestine and provides evidence to identify knowledge gaps, reduce stigma, and inform policies and interventions to improve mental health awareness and access to care.Therefore, the aim of this study was to assess the public perceptions, attitudes, and awareness toward mental illness in Palestine.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eResearch design and population\u003c/h2\u003e \u003cp\u003eA quantitative, cross-sectional design was used to assess the perception, attitude, and awareness of people toward mental illnesses in the Palestine. The study was conducted in the Palestine, during the period from 8/10/2025 to 1/11/2025. The study population consists of all Palestinians in the Palestine. According to the Palestinian Central Bureau of Statistics in 2024, the Palestinian population was about 5.6\u0026nbsp;million (PCBS, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSampling and sample size\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated by using Open EPI version 3.01 (Dean AG et al., 2013). The researcher assumed a 95% confidence level with a 5% margin of error. Furthermore, to obtain the maximum sample size we utilized an expected proportion (p\u0026thinsp;=\u0026thinsp;0.5) in the population, based on these parameters, the total sample size was calculated to be 384. A convenience sampling technique which is not a probability sampling method was used to obtain the required sample size. The participants in the current study were quite cooperative, which is why we have a large sample size (1360).\u003c/p\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003e \u003cb\u003eInclusion Criteria\u003c/b\u003e: Adults (\u0026ge;\u0026thinsp;18 years) from Palestine, Individuals from diverse demographic backgrounds (age, gender, education, residence), Participants able to read and understand the questionnaire and Individuals who provide informed consent to participate. \u003cb\u003eExclusion Criteria\u003c/b\u003e: Individuals under 18 years of age, Non-residents of Palestine, Participants with incomplete or missing questionnaire responses, Individuals unable to comprehend the survey due to cognitive or language barriers and Mental health professionals\u003c/p\u003e\n\u003ch3\u003eData collection methods and instrument\u003c/h3\u003e\n\u003cp\u003eAn online self-administered questionnaire was adopted from similar study conducted in Iraq, which was distributed in public places and on social media platforms (Sadik et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eQuestionnaire Structure\u003c/h3\u003e\n\u003cp\u003eThe questionnaire, which was adopted to assess public perception, attitude and awareness in Palestine toward mental illness, consists of five sections: sociodemographic information, subjects' awareness of the etiology of mental illness, subjects' perception of people with mental illness, subjects' perception of people with mental illness, subjects' attitude toward people with mental illness, and subjects' attitude toward the care and treatment of people with mental illness. \u003cb\u003eSection I\u003c/b\u003e: This section includes all the demographic data, with 7 items: age group, gender, city, place of residence (city, village or camp), marital status, monthly income, and level of education. It also includes one question about having a person with mental illness in the family. \u003cb\u003eSection II\u003c/b\u003e: This section includes 6 questions that assess the level of awareness about the etiology of mental illness. These items include Genetic inheritance, Substance abuse, Bad things happening to the person, Brain disease, Personal weakness, and God's punishment. A five-point Likert scale was used to answer these questions (agree, agree somewhat, neutral, disagree somewhat and disagree). \u003cb\u003eSection III\u003c/b\u003e: This section includes 6 items that assess subjects' perception of people with mental illness. These items include: whether a mentally ill person is capable of working, whether mental illness can be identified by physical appearance, whether the mentally ill person is not capable of true friendship, whether they are usually dangerous, whether they are to blame for their own condition, and whether anybody can have mental illness. A five-point Likert scale was used to answer these questions (agree, agree somewhat, neutral, disagree somewhat, and disagree). Cut off point for this section is as follows: \u0026lt;3 poor perception, \u0026ge;\u0026thinsp;3 good perception. A higher mean score indicates a good perception. \u003cb\u003eSection IV\u003c/b\u003e: This section includes 12 items that assess subjects' attitudes toward people with mental illness. Cut-off point: \u0026lt;3 negative attitude, \u0026ge;\u0026thinsp;3 positive attitude. A higher mean score indicates a positive attitude. \u003cb\u003eSection V\u003c/b\u003e: This section includes 9 items that assess the subjects attitude toward the care and treatment of people with mental disorders. Cut-off point: \u0026lt;3 negative attitude, \u0026ge;\u0026thinsp;3 positive attitude. A higher mean score indicates a positive attitude.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedures\u003c/h2\u003e \u003cp\u003eAn online self-administered questionnaire was distributed in restaurants, coffee shops, parks, public places, hospitals, bakery stores using a barcode and through social media platforms like WhatsApp, Facebook and Instagram.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eReliability\u003c/h3\u003e\n\u003cp\u003eA test was carried out by the researcher in order to examine the internal consistency of its questions. The values of Cronbach's alpha for each scale suggested that the scales are reliable for measuring these constructs in the study (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReliability Coefficients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependent variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCronbach Alpha\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eValidity of the tool and Pilot study\u003c/h3\u003e\n\u003cp\u003ePrior to the study, the questionnaire was tested for face validity by an expert panel consisting of five faculty members. A pilot study was conducted on 10% of the calculated sample size to assess the clarity and applicability of the questionnaire, and it was excluded from the sample size.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThe collected data were analyzed by the Statistical Package for Social Sciences (SPSS) Version (27). Data analysis of descriptive and inferential statistics was conducted. Regarding descriptive statistics, frequency, percentages, mean score and Standard Deviation (SD) were used to describe the study variables. Regarding inferential statistics, independent t-test and One-Way ANOVA were conducted to assess the differences between variables after assessing the normality of the scores using Kolmogorov Smirnov and Shapiro-Will test (p\u0026thinsp;\u0026ge;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e This work has been carried out in accordance with the Declaration of Helsinki (2000) of the World Medical Association. This study was approved by the IRB of Modern University College (MUC)\u0026thinsp;=\u0026thinsp;031- 2025), and informed consent was obtained from all participants. Each participant was given a clear explanation of the objective. The participant was informed that names were not required and that the data would only be used for scientific research. No private information was obtained and each respondent\u0026rsquo;s answers were anonymized to protect their research information and privacy. These procedures uphold protections to preserve the participants' rights and wellbeing while validating the study's ethical features.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Variables\u003c/h2\u003e \u003cp\u003eThe study sample (n\u0026thinsp;=\u0026thinsp;1,360) was mostly young adults aged 20\u0026ndash;29 (77.6%), with 59.5% females and 40.5% males. Participants were primarily from Hebron (31.3%) and Ramallah (28.4%), living in cities (45.9%) or villages (47.8%), with 6.3% from camps. Most were single (65.4%) and earned under 2,000 NIS monthly (40.0%), while 13.5% earned\u0026thinsp;\u0026ge;\u0026thinsp;5,000 NIS. Educationally, 58.7% held a Bachelor\u0026rsquo;s degree, 21.4% a diploma, 8.9% primary education, and 11.0% higher education.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eDemographic variables of the subjects (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20 years old\u003c/p\u003e \u003cp\u003e20\u0026ndash;29 years old\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e1056\u003c/p\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9%\u003c/p\u003e \u003cp\u003e77.6%\u003c/p\u003e \u003cp\u003e13.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e551\u003c/p\u003e \u003cp\u003e809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.5%\u003c/p\u003e \u003cp\u003e59.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHebron\u003c/p\u003e \u003cp\u003eRamallah\u003c/p\u003e \u003cp\u003eJerusalem\u003c/p\u003e \u003cp\u003eBethlehem\u003c/p\u003e \u003cp\u003eNablus\u003c/p\u003e \u003cp\u003eTulkarem\u003c/p\u003e \u003cp\u003eJericho\u003c/p\u003e \u003cp\u003eJenin\u003c/p\u003e \u003cp\u003eQalqilya\u003c/p\u003e \u003cp\u003eTubas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e426\u003c/p\u003e \u003cp\u003e386\u003c/p\u003e \u003cp\u003e145\u003c/p\u003e \u003cp\u003e58\u003c/p\u003e \u003cp\u003e97\u003c/p\u003e \u003cp\u003e37\u003c/p\u003e \u003cp\u003e24\u003c/p\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e50\u003c/p\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.3%\u003c/p\u003e \u003cp\u003e28.4%\u003c/p\u003e \u003cp\u003e10.7%\u003c/p\u003e \u003cp\u003e4.3%\u003c/p\u003e \u003cp\u003e7.1%\u003c/p\u003e \u003cp\u003e2.7%\u003c/p\u003e \u003cp\u003e1.8%\u003c/p\u003e \u003cp\u003e8.5%\u003c/p\u003e \u003cp\u003e3.7%\u003c/p\u003e \u003cp\u003e1.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003cp\u003eVillage\u003c/p\u003e \u003cp\u003eCamp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e624\u003c/p\u003e \u003cp\u003e650\u003c/p\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.9%\u003c/p\u003e \u003cp\u003e47.8%\u003c/p\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e889\u003c/p\u003e \u003cp\u003e445\u003c/p\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.4%\u003c/p\u003e \u003cp\u003e32.7%\u003c/p\u003e \u003cp\u003e1.1%\u003c/p\u003e \u003cp\u003e0.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2000 NIS\u003c/p\u003e \u003cp\u003e2000\u0026ndash;2999 NIS\u003c/p\u003e \u003cp\u003e3000\u0026ndash;3999 NIS\u003c/p\u003e \u003cp\u003e4000\u0026ndash;4999 NIS\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5000 NIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e544\u003c/p\u003e \u003cp\u003e305\u003c/p\u003e \u003cp\u003e198\u003c/p\u003e \u003cp\u003e129\u003c/p\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.0%\u003c/p\u003e \u003cp\u003e22.4%\u003c/p\u003e \u003cp\u003e14.6%\u003c/p\u003e \u003cp\u003e9.5%\u003c/p\u003e \u003cp\u003e13.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e291\u003c/p\u003e \u003cp\u003e798\u003c/p\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9%\u003c/p\u003e \u003cp\u003e21.4%\u003c/p\u003e \u003cp\u003e58.7%\u003c/p\u003e \u003cp\u003e11.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of Having a Person with a Mental Illness\u003c/h2\u003e \u003cp\u003eThe results indicate that the prevalence of individuals having a person with a mental illness in their lives is relatively low, with only 16.5% of respondents reporting \"Yes,\" while the majority, 83.5%, indicated \"No.\"\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eawareness on the etiology of mental illness\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: Participants showed mixed knowledge of mental illness causes: 58.2% recognized substance abuse, 49.3% brain disease, and 67.6% were unaware of genetics. Misconceptions were common, with 84.5% blaming \u0026ldquo;bad things happening\u0026rdquo; and 54.0% citing \u0026ldquo;personal weakness,\u0026rdquo; though 85.9% rejected \u0026ldquo;God\u0026rsquo;s punishment,\u0026rdquo; highlighting persistent gaps in understanding.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eawareness on the etiology of mental illness (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCause\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eAware\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eNot Aware\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Genetic inheritance.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e440\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Substance abuse.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e791\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e569\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Bad things happening to the person\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Brain disease.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e671\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49,3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e689\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50,7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Personal weakness.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e735\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. God's punishment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e85.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e663\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e48.75%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e697\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e51.25\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eReversed item Higher mean score means aware or\u003c/em\u003e unaware, \u003cem\u003eCut off point as follow; \u0026lt;50%\u003c/em\u003e unaware, \u003cem\u003e\u0026ge;\u0026thinsp;50% aware\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eperceptions of people with mental illness\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003c/strong\u003e \u003cp\u003eparticipants showed generally positive views of people with mental illness (Mean\u0026thinsp;=\u0026thinsp;3.30), supporting statements like \u0026ldquo;Capable of work\u0026rdquo; (3.88), though some stereotypes and negative beliefs remained, such as \u0026ldquo;Usually dangerous\u0026rdquo; (3.11) and \u0026ldquo;Blame for own condition\u0026rdquo; (2.98), indicating overall good attitudes but room to reduce stigma.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eperceptions of people with mental illness (n\u0026thinsp;=\u0026thinsp;1360)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStatus\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Capable to work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.845\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Tell by physical appearance*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Not capable of true friendship*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Usually dangerous*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Blame for own condition*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. Anybody can have mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.892\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Mean Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e3.30\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.416\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eGood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*\u003cem\u003eReversed item Higher mean score means good perception Cut off point as follow; \u0026lt;3 poor perception, \u0026ge;\u0026thinsp;3 good perception\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eAttitude Toward People with Mental Illness\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: The findings show a generally positive attitude toward people with mental illness (Mean\u0026thinsp;=\u0026thinsp;3.38, SD\u0026thinsp;=\u0026thinsp;0.516). Participants supported statements like \u0026ldquo;Should have same rights\u0026rdquo; (3.88) and \u0026ldquo;Could maintain friendship\u0026rdquo; (3.56), but showed reservations on \u0026ldquo;Could marry someone with mental illness\u0026rdquo; (2.53) and \u0026ldquo;Would hide own mental illness\u0026rdquo; (2.82), indicating lingering stigma despite overall positive attitudes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eAttitude Toward People with Mental Illness (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStatus\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Mentally ill person should be prevented from having children*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Mentally ill person should not get married*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. One should avoid all contact with mentally ill*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Mentally ill person should not be allowed to make decisions*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. I could maintain friendship with someone with mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. I could marry someone with mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7. I would be afraid to have conversation with mentally ill person*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8. Person with mental illness should have same rights\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9. I would be upset and disturbed working on same job as mentally ill person*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10. I would be ashamed if family member diagnosed with mental illness*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11. I would not want people to know if suffering from mental illness*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12. People generally caring and sympathetic towards people with mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Mean Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e3.38\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.516\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eGood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*\u003cem\u003eReversed item, Higher mean score means positive attitude, Cut off point as follow; \u0026lt;3 negative attitude, \u0026ge;\u0026thinsp;3 positive attitude\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eAttitudes Towards Care and Treatment of People with Mental Illness\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e\u003c/strong\u003e \u003cp\u003e \u003cem\u003eattitudes towards care and treatment of people with mental illness\u003c/em\u003e \u003c/p\u003e \u003c/p\u003e \u003cp\u003eThe results reveal a generally negative attitude toward mental health care (Mean\u0026thinsp;=\u0026thinsp;2.82, SD\u0026thinsp;=\u0026thinsp;0.295, \u0026ldquo;Poor\u0026rdquo;). Participants scored low on statements like \u0026ldquo;Mental illness can be treated outside a hospital\u0026rdquo; (2.05) and \u0026ldquo;One should hide mental illness from family\u0026rdquo; (2.73), reflecting stigma. Some positive views existed, such as recognizing PHC clinics\u0026rsquo; role in providing care (3.35\u0026ndash;3.78), indicating awareness of support options but persistent skepticism about treatment.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eSubjects\u0026rsquo; attitudes towards care and treatment of people with mental illness (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStatus\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Mental illness can be treated outside a hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Majority of people with mental illnesses recover\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. I would feel comfortable discussing a mental health issue of family member or myself with someone at PHC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. One should hide mental illness from family*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Mental illness cannot be cured*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. Mentally ill people should be in an institution to be under supervision and control*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7. Information about mental illness is available at my PHC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8. Mental health services available in my community\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9. PHC clinics can provide good care for mental illnesses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Mean Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2.82\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.295\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePoor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*\u003cem\u003eReversed item, Higher mean score means positive attitude, Cut off point as follow; \u0026lt;3 negative attitude, \u0026ge;\u0026thinsp;3 positive attitude\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eDifferences between demographic variable of the subjects in terms of awareness sum score\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003c/strong\u003e \u003cp\u003eThe analysis found significant differences in mental health awareness by age, marital status, and education. Older participants (\u0026ge;\u0026thinsp;30 years) scored higher (Mean\u0026thinsp;=\u0026thinsp;3.13, F\u0026thinsp;=\u0026thinsp;6.104, p = .002), divorced individuals had the highest awareness (Mean\u0026thinsp;=\u0026thinsp;3.67) compared to widowed (Mean\u0026thinsp;=\u0026thinsp;1.73, F\u0026thinsp;=\u0026thinsp;3.780, p = .010), and higher education was associated with greater awareness (Mean\u0026thinsp;=\u0026thinsp;3.19, F\u0026thinsp;=\u0026thinsp;8.347, p \u0026lt; .001). No other demographic factors showed significant differences.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eDifferences between demographic variable of the subjects in terms of awareness sum score (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStatistical values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20 years old\u003c/p\u003e \u003cp\u003e20\u0026ndash;29 years old\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;6.104\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003et\u0026thinsp;=\u0026thinsp;1.935\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHebron\u003c/p\u003e \u003cp\u003eRamallah\u003c/p\u003e \u003cp\u003eJerusalem\u003c/p\u003e \u003cp\u003eBethlehem\u003c/p\u003e \u003cp\u003eNablus\u003c/p\u003e \u003cp\u003eTulkarem\u003c/p\u003e \u003cp\u003eJericho\u003c/p\u003e \u003cp\u003eJenin\u003c/p\u003e \u003cp\u003eQalqilya\u003c/p\u003e \u003cp\u003eTubas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF=.862\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.559\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003cp\u003eVillage\u003c/p\u003e \u003cp\u003eCamp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.973\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;3.780\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.010*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2000 NIS\u003c/p\u003e \u003cp\u003e2000\u0026ndash;2999 NIS\u003c/p\u003e \u003cp\u003e3000\u0026ndash;3999 NIS\u003c/p\u003e \u003cp\u003e4000\u0026ndash;4999 NIS\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5000 NIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.528\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e386\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;8.347\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e*Significant at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Independent sample and One Way ANOVA tests\u003c/h2\u003e \u003cdiv id=\"Sec22\" class=\"Section3\"\u003e \u003ch2\u003eDifferences between demographic variable of the subjects in terms of perception mean score\u003c/h2\u003e \u003cp\u003eThe analysis shows that perceptions of mental health vary by age, gender, residence, and education. Older adults (\u0026ge;\u0026thinsp;30 years) and females had higher perception scores (Mean\u0026thinsp;=\u0026thinsp;3.34), indicating more positive views (F\u0026thinsp;=\u0026thinsp;3.631, p = .027; T\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;3.571, p \u0026lt; .001). Geographic differences were noted, with Nablus residents scoring highest (3.43) and Jericho lowest (3.11, F\u0026thinsp;=\u0026thinsp;2.546, p = .007). Higher education also correlated with better perceptions (Mean\u0026thinsp;=\u0026thinsp;3.34, F\u0026thinsp;=\u0026thinsp;5.314, p \u0026lt; .001), highlighting these factors\u0026rsquo; influence on mental health perceptions.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eDifferences between demographic variable of the subjects in terms of perception mean score (n\u0026thinsp;=\u0026thinsp;1360).\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStatistical values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20 years old\u003c/p\u003e \u003cp\u003e20\u0026ndash;29 years old\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e1056\u003c/p\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003cp\u003e3.31\u003c/p\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;3.631\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.027*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e551\u003c/p\u003e \u003cp\u003e809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.26\u003c/p\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eT=-3.571\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHebron\u003c/p\u003e \u003cp\u003eRamallah\u003c/p\u003e \u003cp\u003eJerusalem\u003c/p\u003e \u003cp\u003eBethlehem\u003c/p\u003e \u003cp\u003eNablus\u003c/p\u003e \u003cp\u003eTulkarem\u003c/p\u003e \u003cp\u003eJericho\u003c/p\u003e \u003cp\u003eJenin\u003c/p\u003e \u003cp\u003eQalqilya\u003c/p\u003e \u003cp\u003eTubas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e426\u003c/p\u003e \u003cp\u003e386\u003c/p\u003e \u003cp\u003e145\u003c/p\u003e \u003cp\u003e58\u003c/p\u003e \u003cp\u003e97\u003c/p\u003e \u003cp\u003e37\u003c/p\u003e \u003cp\u003e24\u003c/p\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e50\u003c/p\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003cp\u003e3.29\u003c/p\u003e \u003cp\u003e3.36\u003c/p\u003e \u003cp\u003e3.25\u003c/p\u003e \u003cp\u003e3.43\u003c/p\u003e \u003cp\u003e3.37\u003c/p\u003e \u003cp\u003e3.11\u003c/p\u003e \u003cp\u003e3.32\u003c/p\u003e \u003cp\u003e3.35\u003c/p\u003e \u003cp\u003e3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.40\u003c/p\u003e \u003cp\u003e0.46\u003c/p\u003e \u003cp\u003e0.37\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.52\u003c/p\u003e \u003cp\u003e0.40\u003c/p\u003e \u003cp\u003e0.47\u003c/p\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.546\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.007*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003cp\u003eVillage\u003c/p\u003e \u003cp\u003eCamp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e624\u003c/p\u003e \u003cp\u003e650\u003c/p\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.30\u003c/p\u003e \u003cp\u003e3.31\u003c/p\u003e \u003cp\u003e3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF=.367\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.693\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e889\u003c/p\u003e \u003cp\u003e445\u003c/p\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.31\u003c/p\u003e \u003cp\u003e3.30\u003c/p\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.43\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.312\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.269\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2000 NIS\u003c/p\u003e \u003cp\u003e2000\u0026ndash;2999 NIS\u003c/p\u003e \u003cp\u003e3000\u0026ndash;3999 NIS\u003c/p\u003e \u003cp\u003e4000\u0026ndash;4999 NIS\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5000 NIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e544\u003c/p\u003e \u003cp\u003e305\u003c/p\u003e \u003cp\u003e198\u003c/p\u003e \u003cp\u003e129\u003c/p\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.31\u003c/p\u003e \u003cp\u003e3.25\u003c/p\u003e \u003cp\u003e3.30\u003c/p\u003e \u003cp\u003e3.37\u003c/p\u003e \u003cp\u003e3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.40\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.304\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e291\u003c/p\u003e \u003cp\u003e798\u003c/p\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003cp\u003e3.25\u003c/p\u003e \u003cp\u003e3.33\u003c/p\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;5.314\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003e*Significant at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Independent sample and One Way ANOVA test\u003c/h2\u003e \u003cdiv id=\"Sec24\" class=\"Section4\"\u003e \u003ch2\u003eDifferences Between Demographic Variable of the Subjects in Terms of Attitude Mean Score\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e: the analysis shows that attitudes toward mental health vary by gender, income, and education. Males had slightly higher scores than females (Mean\u0026thinsp;=\u0026thinsp;3.17 vs. 3.12, T\u0026thinsp;=\u0026thinsp;2.905, p = .004). Participants earning 3,000\u0026ndash;4,999 NIS had the most positive attitudes (Mean\u0026thinsp;=\u0026thinsp;3.19, F\u0026thinsp;=\u0026thinsp;2.537, p = .038), and those with primary or diploma education scored highest (Mean\u0026thinsp;=\u0026thinsp;3.19 and 3.17, F\u0026thinsp;=\u0026thinsp;3.586, p = .013), indicating these factors influence attitudes toward mental health.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eDifferences between demographic variable of the subjects in terms of attitude mean score (n\u0026thinsp;=\u0026thinsp;1360)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStatistical values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20 years old\u003c/p\u003e \u003cp\u003e20\u0026ndash;29 years old\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e1056\u003c/p\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.19\u003c/p\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.904\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.149\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e551\u003c/p\u003e \u003cp\u003e809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.17\u003c/p\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eT\u0026thinsp;=\u0026thinsp;2.905\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.004*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHebron\u003c/p\u003e \u003cp\u003eRamallah\u003c/p\u003e \u003cp\u003eJerusalem\u003c/p\u003e \u003cp\u003eBethlehem\u003c/p\u003e \u003cp\u003eNablus\u003c/p\u003e \u003cp\u003eTulkarem\u003c/p\u003e \u003cp\u003eJericho\u003c/p\u003e \u003cp\u003eJenin\u003c/p\u003e \u003cp\u003eQalqilya\u003c/p\u003e \u003cp\u003eTubas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e426\u003c/p\u003e \u003cp\u003e386\u003c/p\u003e \u003cp\u003e145\u003c/p\u003e \u003cp\u003e58\u003c/p\u003e \u003cp\u003e97\u003c/p\u003e \u003cp\u003e37\u003c/p\u003e \u003cp\u003e24\u003c/p\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e50\u003c/p\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.15\u003c/p\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.13\u003c/p\u003e \u003cp\u003e3.19\u003c/p\u003e \u003cp\u003e3.11\u003c/p\u003e \u003cp\u003e3.07\u003c/p\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.11\u003c/p\u003e \u003cp\u003e3.23\u003c/p\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003cp\u003e0.29\u003c/p\u003e \u003cp\u003e0.35\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.30\u003c/p\u003e \u003cp\u003e0.21\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.482\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.149\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003cp\u003eVillage\u003c/p\u003e \u003cp\u003eCamp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e624\u003c/p\u003e \u003cp\u003e650\u003c/p\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF=.189\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.828\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e889\u003c/p\u003e \u003cp\u003e445\u003c/p\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.14\u003c/p\u003e \u003cp\u003e3.17\u003c/p\u003e \u003cp\u003e2.98\u003c/p\u003e \u003cp\u003e3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.38\u003c/p\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.574\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2000 NIS\u003c/p\u003e \u003cp\u003e2000\u0026ndash;2999 NIS\u003c/p\u003e \u003cp\u003e3000\u0026ndash;3999 NIS\u003c/p\u003e \u003cp\u003e4000\u0026ndash;4999 NIS\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5000 NIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e544\u003c/p\u003e \u003cp\u003e305\u003c/p\u003e \u003cp\u003e198\u003c/p\u003e \u003cp\u003e129\u003c/p\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.13\u003c/p\u003e \u003cp\u003e3.12\u003c/p\u003e \u003cp\u003e3.19\u003c/p\u003e \u003cp\u003e3.19\u003c/p\u003e \u003cp\u003e3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.33\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.537\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.038*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003cp\u003e291\u003c/p\u003e \u003cp\u003e798\u003c/p\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.19\u003c/p\u003e \u003cp\u003e3.17\u003c/p\u003e \u003cp\u003e3.12\u003c/p\u003e \u003cp\u003e3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003cp\u003e0.34\u003c/p\u003e \u003cp\u003e0.31\u003c/p\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;3.586\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.013*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003e*Significant at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Independent sample and One Way ANOVA tests\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe majority were women aged between 20 and 29 years, mostly from Hebron, Ramallah, and Jerusalem, with fewer from the camps; they were mostly single, had a bachelor's degree, and earned less than 2,000 NIS. Stigma remains widespread in Palestine; the majority of the people, at 83.5%, had little personal experience with mental illness. Prejudice, marginalization, and avoidance of treatment are all driven by negative stereotypes.\u003c/p\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003eAwareness toward mental illness etiology\u003c/h2\u003e \u003cp\u003eHowever, awareness of mental illness causes differs, with 46.4% in Iraq and more than half in Palestine being aware of substance abuse, although not all in these countries are aware of it. Moreover, in China, a study done in 2020 revealed low awareness of the causes, treatments, and prevention of mental illness. (Yin et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Lack of knowledge of the genetic basis of mental illness is also low in both regions, but more in Palestine (67.6%) than in Iraq (28.6%), though more people in Palestine are aware of its hereditary role (32.4%) than in Iraq (27.8%) (Sadik et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Belief that mental illness is divine punishment is low in both countries, with 14.1% in Palestine and 16.8% in Iraq endorsing it. Rejection is higher in Palestine (85.9%) than Iraq (42.8%), indicating stronger dismissal of this belief in Palestine. (Sadik et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Public understanding of mental health has improved over time due to awareness campaigns, education, and reduced stigma. Younger generations are more exposed to scientific information, while cultural shifts and a declining influence of traditional beliefs also shape changing attitudes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003ePerceptions of People with Mental Illness\u003c/h2\u003e \u003cp\u003eThe study found generally positive perceptions of people with mental illness, with 84.3% of participants expressing positive views, including beliefs in their ability to work and that anyone can develop mental illness. In Palestine, this may relate to widespread exposure to psychological stressors such as conflict and displacement, increasing awareness. Similar findings were reported in Japan, where most participants recognized treatability, though some stigma persists. (Kasahara-Kiritani et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Contrary to our findings in Palestine (84.3% positive perception), studies in Gimbie and Oman report more negative attitudes. In Ethiopia, lower education was linked to poorer perceptions, while in Oman, stigma persists with a preference for traditional or religious treatments due to misconceptions about mental illness. (Benti et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). In addition, the second study conducted in Oman revealed that mental illness is stigmatized in Omani society and that there is a lack of accurate knowledge and understanding of it. The results showed that many people prefer traditional or religious treatment over medical treatment because they believe that mental illness is caused by a lack of moral character or religious belief (Al-Alawi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Amro N et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Palestine, growing awareness of mental illness is supported by research institutions and international efforts, including the World Health Organization. Despite generally positive perceptions, some negative beliefs persist (e.g., inability to form friendships or self-blame), and 15.7% still show poor perceptions. Stigma remains a barrier, especially in rural areas, where limited awareness programs hinder understanding and help-seeking.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003eAttitude Toward People with Mental Illness\u003c/h2\u003e \u003cp\u003eIn our study, the positive attitude toward mentally ill people in Palestine was at 80.2%, similar to the Chinese sample. However, negative attitudes toward mentally ill people in personal relationships and trust were evident in that 55.3% believed that people would take the mentally ill person less seriously in personal relationships, 70.6% believed that women would be reluctant to date them, and 68.2% believed that mentally ill people were inappropriate caregivers. However, the ability of the sample to accept the mentally ill person as a close friend was at 43.3%. (Yin et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In Palestine, negative stereotypes of mentally ill persons are common, such as the belief that mental illness is caused by lack of will, or supernatural powers such as the evil eye or spirits, and can only be cured by traditional healers. There is also the belief that mentally ill persons are unfit for parenting due to hereditary concerns. However, due to political conflicts in Palestine, especially in Gaza, mental health problems are becoming common and accepted, creating empathy among Palestinians towards mentally ill persons.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAttitudes Towards Care and Treatment of People with Mental Illness\u003c/h3\u003e\n\u003cp\u003eIn terms of attitude toward care and treatment, the majority of participants (66.4%) expressed a negative attitude toward the care and treatment of individuals with mental illnesses. This is consistent with the public perception of mental health in Iraq (Sadik et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), In Iraq, 66% of people believed that people with mental illness should be hospitalized and controlled, as stereotypes portray that people with mental illness are incapable. Furthermore, only 15% believed that primary healthcare provided sufficient care for people with mental illness, and only 14% believed that primary healthcare provided people with mental illness with sufficient information. These beliefs are due to cultural beliefs that mental illness is shameful and affects family prestige, as seen in East Asian, Latino, and African American communities (Chiu, vet al., 2015). Tanaka et al. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found that individuals concerned about their appearance may hide their mental illness due to fear of self-stigma, hindering help-seeking. Mak et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) noted that Austrians may experience lower self-stigma than Palestinians because of community-based rehabilitation and public health education. Media can play a key role in reducing stigma, and stigma toward mental health professionals should also be addressed, as it affects occupational stress and patient outcomes.\u003c/p\u003e \u003cp\u003eDomingo et al. (2023) suggest that mental health practitioners may stigmatize their patients due to perceived challenges in connecting with them and limited societal acceptance of those with mental illnesses. Physicians working in mental health may face misunderstanding and skepticism from their families and the wider public. (Luo, et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found that, worse still, evidence indicated that professional stigma was negatively associated with job satisfaction and the quality of treatment (Do, M et al. 2024, Walsh et al. 2024). Therefore, there is a need to create a more inclusive and supportive environment for people with mental illness and advocate for policies that promote access to mental health care and support services. It is critical to fight these negative views and promote a more optimistic and understanding perspective on mental illness. Public education about mental illness and efforts to eliminate misunderstandings should be maintained, while establishing a more welcoming and supportive atmosphere for those with mental illnesses.\u003c/p\u003e \u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003eConclusion and Recommendations\u003c/h2\u003e \u003cp\u003eThis study demonstrates a gradual improvement in public knowledge and attitudes toward mental illness in Palestine, influenced by mental health education, global awareness initiatives, and the psychological impact of ongoing political conflicts. Despite this progress, stigma, misconceptions about mental health causes, and limited access to care\u0026mdash;especially in rural areas\u0026mdash;remain significant challenges. Negative attitudes toward treatment highlight the need for continued public education, stigma reduction, and the expansion of mental health services. To address these issues, efforts should focus on raising awareness through education and media campaigns, conducting further research to identify factors influencing perceptions, and improving access to counseling and treatment facilities, while fostering supportive environments that ensure respect and care for individuals with mental illness.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col style=\"list-style-type:lower-roman;\"\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThis study had no significant restrictions, except for financial and time constraints.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe political environment forced the researcher to collect data via an online survey.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSome people refused to fill out the questionnaire due to fear, the political atmosphere in their community, or a lack of education that prevented them from recognizing the importance of the research.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":" \u003ch2\u003eCorresponding Author\u003c/h2\u003e \u003cp\u003eRebhi Bsharat, [email protected]\u003c/p\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no known competing financial, personal, or professional interests that could have appeared to influence the work reported in this\u003c/p\u003e \u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eEvery author contributed significantly to the work reported, whether it was in the conception, study design, execution, data acquisition, analysis, and interpretation. all of these areas, developed the research questions and conceptualized the work, acquired the data. analyzed the data and interpreted the findings and drafted the manuscript, contributed to the interpretation of the findings and critically reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbi Doumit C, Haddad C, Sacre H, Salameh P, Akel M, Obeid S, Hallit SJP. o. 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Understanding the public stigma of mental illness: a mixed-methods, multi-level. exploratory triangulation study. 2024;12(1):403.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. (2024). Mental disorders. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/mental-disorders\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/mental-disorders\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. (1992).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYin H, Wardenaar KJ, Xu G, Tian H, Schoevers RAJB. p. (2020). Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study. \u003cem\u003e20\u003c/em\u003e, 1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mental Health, Mental Illness, Perception, Attitude, Awareness, Stigma","lastPublishedDoi":"10.21203/rs.3.rs-9325935/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9325935/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGlobally, mental health conditions, services, and professionals tend to be viewed in a negative light. Mental health conditions, which the World Health Organization describes as significant disturbances in behavior, emotion, or thinking, are a public health issue across all age groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to assess public perceptions, attitudes, and awareness toward mental illness in the Palestine.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA cross-sectional design was utilized between October and November of 2025. The study population consisted of all Palestinians in the West Bank. The total sample size was 1,360 participants. Convenience sampling was used to collect the data. An online self-administered questionnaire, adopted from a similar study conducted in Iraq, was distributed in public places and on social media platforms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe respondents' awareness of the etiology of mental illness is nearly evenly split, with 48.75% being aware and 51.25% not aware. The majority of participants (84.3%) have a positive perception of people with mental illness. While 80.2% of the respondents hold a positive attitude toward people with mental illness, their attitudes toward the care and treatment of people with mental illness were negative, with 66.4% expressing negative views.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study's results demonstrate how attitudes, awareness, and perceptions of mental illness have changed in Palestine over time, indicating an increase in public knowledge and understanding. This change can be attributed to factors such as increased mental health education, global awareness campaigns, and the psychological effects of the region's ongoing political conflicts.\u003c/p\u003e","manuscriptTitle":"Public Perception, Attitude and Awareness Toward Mental Illness in Palestine","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-26 17:13:33","doi":"10.21203/rs.3.rs-9325935/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"15027938932348071094417296585416416015","date":"2026-05-14T05:51:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180638516171207755290306016002056065790","date":"2026-05-10T16:24:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T11:15:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"320381020579249178933980406070574545921","date":"2026-05-10T10:08:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T14:03:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"152746884317698171223526913980411587814","date":"2026-04-19T13:01:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-17T12:40:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-17T12:31:40+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-09T06:18:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-08T12:07:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-04-08T11:49:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f03477cb-19f7-42f1-86a7-f32637a8aa63","owner":[],"postedDate":"April 26th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"15027938932348071094417296585416416015","date":"2026-05-14T05:51:28+00:00","index":59,"fulltext":""},{"type":"reviewerAgreed","content":"180638516171207755290306016002056065790","date":"2026-05-10T16:24:46+00:00","index":58,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T11:15:58+00:00","index":57,"fulltext":""},{"type":"reviewerAgreed","content":"320381020579249178933980406070574545921","date":"2026-05-10T10:08:34+00:00","index":56,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-26T17:13:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-26 17:13:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9325935","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9325935","identity":"rs-9325935","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}