Does Postgraduate Training in Community Mental Health Make a Difference to Primary Care Physicians' Attitudes to Depression and Schizophrenia?

Quality of life of higher education students with disabilities at Shaqra University

Saudi Arabia, through its Vision 2030, seeks to enhance the Quality of Life (QoL) of all individuals who live there. Therefore, this study aimed to examine the of QoL of students with disabilities in a Saudi university (Shaqra University) as a case study. Although this study was conducted in one university, many students with disabilities around the world are facing the same systematic practices in many universities (Carballo et al., 2021; Khayatzadeh-Mahani et al., 2020). Therefore, this study used qualitative research by interviewing all students with disabilities who are registered at the university for the academic year 2022-2023. In addition to these 11 students with disabilities, 2 senior university administrators who have a direct relationship with the services provided to these students were also interviewed. The overall outcomes confirm that the QoL for these students is very low due to multiple factors that were discussed in detail.

Physicians' and medical students' beliefs and attitudes toward psychotic disorders: A systematic review

OBJECTIVE

The aim of this study was to analyze physicians' and medical students' (MS) beliefs and attitudes toward people with psychotic disorders.

METHODS

This systematic review follows the PRISMA guidelines. It was conducted on 5 databases (Pubmed, PsycINFO, Pascal & Francis, Scopus and EMBASE) with a keyword string combining words for physicians' and students' professional status, attitudes toward people, and psychotic disorders. No limitations on publication dates were imposed.

RESULTS

This review includes 39 articles, among which quantitative studies are in the majority, and general practioners are mainly represented. Schizophrenia is the main condition used to illustrate psychotic disorders and measure stigmatizing attitudes. Physicians' and MS' beliefs toward people with psychotic disorders are mainly represented by dangerousness and unpredictability. They can be reinforced with socio-demographic criteria (age and female gender) or physicians' beliefs about the disease's etiology. The desire for social distance is higher toward patients with schizophrenia compared to other psychiatric disorders, and medical care could be impacted with a tendency to refer them at psychiatric specific care or to anticipate their difficulties and to modify their treatment plan. Stigma scores remain globally high during medical training. Even if specific anti-stigma trainings have a positive impact on beliefs and attitudes, these effects do not last in time.

CONCLUSION

This review highlights the importance to explore physicians' and medical students' representations about patient with psychosis to understand better their difficulties in the management of these patients.

Somatic health care professionals' stigmatization of patients with mental disorder: a scoping review

BACKGROUND

Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals' stigmatization toward patients with mental disorders.

METHODS

We conducted a scoping review using Arksey and O'Malley's framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May-June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008-2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo.

RESULTS

A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions.

CONCLUSIONS

The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.

Chinese perspectives on primary care for common mental disorders: Barriers and policy implications

BACKGROUND

The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China.

AIMS

This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings.

METHODS

A narrative literature review was conducted, focusing on literature published from mid-1990s in English or Chinese. Patient, PCP and health system factors were reviewed.

RESULTS

Although Chinese and Western findings show similar themes of barriers, the Chinese have stronger barriers in most aspects, including under-recognition of the need for treatment, stigma on mental illness, somatization, worries about taking psychiatric drugs, uncertainties in the role, competency and legitimacy of PCPs in mental health care and short consultation time.

CONCLUSION

Current policies in China emphasize enhancement of mental health facilities and workforce in the community. Our review suggests that patients' intention to seek help and PCPs' competency in mental health care are other fundamental factors to be addressed.

Five-year outcomes of western mental health training for Traditional Chinese Medicine practitioners

BACKGROUND

There are increasing expectations for primary care practitioners to deal with mental health problems. In Hong Kong, 15 % of the general public consult Traditional Chinese Medicine (TCM) practitioners regularly for their primary health care needs. This study investigated the 5-year outcomes of a western mental health training course for TCM practitioners in Hong Kong.

METHOD

Structured questionnaire surveys were conducted to compare the TCM practitioners' confidence and engagement in mental health care before and after the Course. The data collected during 2011-2015 were analyzed.

RESULTS

A total of 151 TCM practitioners returned both pre- and post-Course questionnaires, with a response rate of 95.6 %. After the course, there were significant increases in the proportions of participants being confident of recognizing patients with psychological problems (62.9 % before the course vs 89.4 % after), diagnosing common mental health problems (47.7 % vs 77.5 %), and managing them (31.2 % vs 64.3 %). Overall, 66.9 % of the participants reported some increase in their confidence in recognizing patients with psychological problems, diagnosing or/and managing patients with common mental health problems. Qualitative responses illustrated the major improvements were increased awareness of mental symptoms, better understanding of classification of mental disorders and management approaches. On the other hand, barriers included difficulties in understanding medical terms in English, consultation time constraints, and a lack of formal referral system to psychiatrists.

CONCLUSIONS

The Course has positive impact on TCM practitioners in handling mental health patients. The findings are useful for designing similar trainings on complementary and alternative medicine practitioners in other countries.