Mental health and physical and social health are closely interwoven fibers that are vital for every individual. Mental health extends beyond diagnosed mental disorders. According to World Health Organization (WHO) (2002), it encompasses personal well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and recognition of the ability to realize one's intellectual and emotional potential [1,2,3,4].
Mental health is essential for the overall well-being of individuals, societies, and countries. Despite being imperative for human existence, in many countries, unlike the importance given to physical health, mental health has been relegated. This could partly be due to the myths and misconceptions surrounding mental illnesses in many parts of the world [5,6,7].
Negative views, fear, and stigmatization are responsible for the ostracization of mentally ill persons and lack of access to proper psychiatric treatment Therefore, mentally ill people seek professional help from hospitals after they have tried all options and the symptom has worsened. This negatively affects the prognoses of treatment [8, 9]. Mental disorders are attached to negative and stigmatizing attitudes, often due to a lack of knowledge about mental illness [10, 11]. People with mental illness are perceived as dangerous, unpredictable, and different from others, responsible for their condition, hard to talk to, and incurable in the community [12,13,14].
The concept of mental health problems and its causes vary in different communities [5, 15]. Society's knowledge regarding mental illness is often far from the scientific view, and it negatively affects treatment-seeking and adherence [9].
People's perception about mental ailments is influenced by their knowledge, encounters with people suffering from mental illnesses, media portrayal, cultural stereotypes, and their personal experiences of mental disorders [16, 17]. In many African societies, psychiatric illness is believed to be either an outcome of a familial defect or the 'handiwork of evil machinations' (demons, evil spirits). It is not uncommon to blame psychiatric patients for their illness, especially when it is an alcohol and/or substance-related problem [18, 19].
Literature shows Ethiopians, like other sub-Saharan African societies, attribute mental illnesses almost exclusively to supernatural phenomena. Mental illnesses have predominantly been attributed to possession by evil spirits, punishment from God or guardian spirits for sins, and/or curses, spells, or bewitchment by people alleged to have supernatural powers. Research also points out the limited and poorly developed infrastructure for modern mental health services [20,21,22].
Help-seeking behavior is influenced by people's knowledge of mental health problems and illness, which are based on the combinations of traditional and modern beliefs. Mental health knowledge includes the capacity to identify mental health problems, understanding of risk factors and causes, professional help available, attitudes that promote recognition, and appropriate mental health help-seeking behaviors [23,24,25,26].
Often mental illnesses are poorly understood by the general public, which threatens the effectiveness of patient care and rehabilitation [27, 28]. Beliefs about the causation and experience may influence patients' beliefs about effective treatment and may also determine the type of treatment that is sought. At times, the mentally ill are blamed for bringing on their illness. In contrast, others may see mentally ill people as victims of unfortunate fate, religious and moral transgression, or even witchcraft [29]. These misbeliefs may lead to denial of the problem by both the sufferers and their families, with subsequent delays in seeking professional treatment [28, 30,31,32].
Scientific evidence demonstrates that low rates of seeking psychiatric help are mainly due to inadequate knowledge of mental health disorders, including mental disorders symptoms, and psychiatric treatments [33]. Evidence revealed improved knowledge about mental health and illness leads to less stigma [34,35,36].
Heterogenous causation of biological, psychological, social, and cultural causes of mental illness was reported from the studies done in Nigeria [37,38,39], northern Ethiopia [13], and Denmark [40]. Whereas biological factors were reported as the main causes of mental illness in the studies conducted in Tanzania [41], Eretria [38], and Saudi Arabia [42]. Conversely, in South Africa [43], elsewhere in Ethiopia [44,45,46], Nigeria [36], and, Pakistan [47] mental illness was attributed to religious and cultural factors,
While a combination of medical, religious, and traditional treatment was favored by the respondents in the studies done in Eritrea [48], Saudi Arabia [49], Nigeria [39], and Ethiopia [5], medical management (medication and counseling) was the most preferred among the study subjects in Tanzania [41], Saudi Arabia [42], Slovak Republic, and Russia [50], New Zealand [51], South Africa [43], Ethiopia [13, 52], and India [45].
Overall, inadequate mental health knowledge of the community was described in various studies conducted in many parts of the world [9, 28, 30, 37, 38, 40, 41, 53,54,55]. The differences in the explanation of the causation and management of mental illness could be due to the difference in the literacy status, socio-cultural-economic disparities, availability, and use of media, and the difference in the availability of mental health services among the countries.
To the best of our knowledge, only a few studies were conducted regarding the rural communities' understanding of mental health problems in Ethiopia. The previous studies were done a long time ago, with fewer sample size, and conducted in different geographical-socio-cultural contexts [9, 44, 46, 56]. Hence, assessing the community's knowledge is essential in designing an appropriate mental health promotion and scaling up the public's utilization of mental health services. Therefore, the present study aimed to assess the knowledge and associated factors of the Jimma zone community towards mental health and mental health problems.