The Relationship between Individual-Level and Context-Level Factors and Social Distancing from Patients with Depression in Taiwan: A Multilevel Analysis of National Surveys

Background: Research on social distancing from patients with depression has primarily focused on individual-level factors rather than context-level factors. This study aimed to investigate the relationship between individual-level and context-level factors and social distancing from depressive patients. Methods: Sample data were collected via computer-assisted telephone interviews with 800 Taiwanese adults aged 20 to 65 years in 2016. All effects were tested using multilevel analysis. Results: With regard to individual-level variables, male sex, older age, people with more perceived dangerousness and those with more emotional reaction of fear were associated with greater social distancing from depressive patients. After controlling for individual-level variables, a positive association was found between the degree of urbanization and social distancing. We also found the interaction between the density of psychiatric rehabilitation services and perceived dangerousness to be associated with social distance. This finding revealed that persons with more perceived dangerousness and living in a region with higher density of psychiatric rehabilitation services were associated with greater social distance. Conclusions: We found that social distancing from depressive patients is not only determined by individual-level factors but influenced by the surroundings. This study provides useful directions for the implementation of optimal anti-stigma interventions for patients with depression.