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Kataoka M, Ohira T, Tsuboi S, Miura I, Yabe H. Comparison of attitudes toward schizophrenia among medical students and health professionals in Japan and their associated factorsamong medical students:a cross-sectional study. Fukushima J Med Sci 2024:23-00012. [PMID: 39370276 DOI: 10.5387/fms.23-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2024] Open
Abstract
Changing perceptions of schizophrenia is crucial for both medical professionals and students. This study examined negative attitudes toward schizophrenia among medical students, psychiatrists, psychiatric staff, physicians, and non-medical workers. We created an 18-item survey using a web-based tool to assess attitudes toward schizophrenia, focusing on three factors:stigma, underestimation of patients' abilities, and skepticism about treatment. To compare scores among the five participants' groups, we used analysis of covariance, adjusting for age and sex. The study included 237 medical students, 10 psychiatrists, 16 psychiatric staff, 26 physicians, and 98 non-medical workers. After adjusting for age and sex, the overall discrimination score for psychiatrists was significantly lower than those of medical students, physicians, and non-medical workers. Among medical students, a comparison of each score by grade revealed that underestimation of patients' abilities scores was significantly higher in the fourth year than in the third year. Furthermore, those aspiring to become psychiatrists had significantly lower adjusted mean and stigma scores than students with different career goals (p<0.05). In conclusion, medical students, as well as physicians and non-medical workers, displayed higher levels of stigma towards schizophrenia than psychiatrists. It is essential to explore modifying factors to improve medical students' attitudes towards schizophrenia.
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Affiliation(s)
- Mariko Kataoka
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Satoshi Tsuboi
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Hirooki Yabe
- Department of Mind & Brain Medicine, Fukushima Medical University School of Medicine
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Moro MF, Gyimah L, Susser E, Ansong J, Kane J, Amissah C, Gureje O, Osei A, Norcini Pala A, Taylor D, Drew N, Kofie H, Baingana F, Ohene SA, Addico NL, Fatawu A, Atzeni M, D’Oca S, Carta MG, Funk M. Evaluating the psychometric properties of three WHO instruments to assess knowledge about human rights, attitudes toward persons with mental health conditions and psychosocial disabilities, and practices related to substitute decision-making and coercion in mental health. Front Psychiatry 2024; 15:1435608. [PMID: 39310660 PMCID: PMC11413867 DOI: 10.3389/fpsyt.2024.1435608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/01/2024] [Indexed: 09/25/2024] Open
Abstract
Background Instruments to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion are either missing or lack evaluation of their validity and reliability. Aim The aim of this study is to evaluate the validity and reliability of three instruments developed to fill this gap in the literature, the World Health Organization's QualityRights (WHO QR) Knowledge questionnaire, the WHO QR Attitudes questionnaire, and the WHO QR Practices questionnaire. Methods A sample of participants was recruited and completed an online survey. Content validity and face validity were assessed for the three questionnaires. Based on the characteristics of the questionnaires, different approaches were used to assess their construct validity (confirmatory factor analysis, known group validity, and convergent and divergent validity). Internal consistency was evaluated using Cronbach's alpha and test re-test reliability using Pearson's and Spearman's r coefficients. Results The analyses conducted indicate that the three questionnaires are valid and reliable instruments to evaluate the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion. Conclusion This finding lends support to the use of these instruments both within mental health services and in the general population for a better understanding of current knowledge, attitudes, and practices related to a human rights-based approach to mental health in mental health services and the community.
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Affiliation(s)
- Maria Francesca Moro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Leveana Gyimah
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- New York State Psychiatric Institute, New York, NY, United States
| | - Joana Ansong
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | - Jeremy Kane
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | | | - Oye Gureje
- World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akwasi Osei
- Mental Health Authority, Ghana Ministry of Health, Accra, Ghana
| | - Andrea Norcini Pala
- Department of Community Health Sciences, State University of New York (SUNY) Downstate, Brooklyn, NY, United States
| | | | - Nathalie Drew
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Florence Baingana
- Mental Health and Substance Abuse, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo
| | - Sally-ann Ohene
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | | | | | - Michela Atzeni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michelle Funk
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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Alliende LM, Sands BR, Mittal VA. Chatbots and Stigma in Schizophrenia: The Need for Transparency. Schizophr Bull 2024; 50:957-960. [PMID: 38917476 PMCID: PMC11348995 DOI: 10.1093/schbul/sbae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Affiliation(s)
| | - Beckett Ryden Sands
- Weinberg College, Department of Psychology, Northwestern University, Evanston, IL, USA
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Mickelberg AJ, Walker B, Ecker UKH, Fay N. Helpful or harmful? The effect of a diagnostic label and its later retraction on person impressions. Acta Psychol (Amst) 2024; 248:104420. [PMID: 39088996 DOI: 10.1016/j.actpsy.2024.104420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
Diagnostic labels for mental health conditions can inadvertently reinforce harmful stereotypes and exacerbate stigma. If a diagnosis is incorrect and a label is wrongly applied, this may negatively impact person impressions even if the inaccurate label is later corrected. This registered report examined this issue. Participants (N = 560) read a vignette about a hospital patient who was either diagnosed with schizophrenia, diagnosed with major depressive disorder, or not diagnosed with a mental health condition. The diagnostic labels were later retracted strongly, retracted weakly, or not retracted. Participants completed several stigma measures (desire for social distance, perceived dangerousness, and unpredictability), plus several inferential-reasoning measures that tested their reliance on the diagnostic label. As predicted, each mental health diagnosis elicited stigma, and influenced inferential reasoning. This effect was stronger for the schizophrenia diagnosis compared to the major depressive disorder diagnosis. Importantly, the diagnostic label continued to influence person judgments after a clear retraction (strong or weak), highlighting the limitations of corrections in reducing reliance on person-related misinformation and mental health stigma.
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Affiliation(s)
- Amy J Mickelberg
- School of Psychological Science, University of Western Australia, Australia.
| | - Bradley Walker
- School of Psychological Science, University of Western Australia, Australia
| | - Ullrich K H Ecker
- School of Psychological Science, University of Western Australia, Australia; Public Policy Institute, University of Western Australia, Australia
| | - Nicolas Fay
- School of Psychological Science, University of Western Australia, Australia.
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5
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Ho GWK, Mui JHC, Wong R, Chien WT, Wong KH, Bressington D. Visitor characteristics and changes in mental health stigma after attending the Mind Space mental health experience exhibition. Front Psychiatry 2024; 15:1302799. [PMID: 38742134 PMCID: PMC11089183 DOI: 10.3389/fpsyt.2024.1302799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Mind Space is an experiential mental health exhibition in Hong Kong, aiming to raise public awareness and provide education regarding mental health. This prepost study aimed to 1) examine the relationships between visitors' characteristics and their mental health stigma at baseline, and 2) provide a preliminary evaluation of the effectiveness of Mind Space in reducing stigma and promoting help-seeking attitudes toward mental health conditions. Methods We analyzed data from all consenting visitors who attended Mind Space between September 2019 and December 2021. Visitors' attitudes toward mental health conditions and their willingness to seek professional psychological help were measured through online questionnaires before and after visits. Multiple linear regression was used to identify the demographic predictors of outcome variables at baseline. Changes in outcome variables after attending Mind Space were assessed using paired sample t-tests. Results A total of 382 visitors completed the baseline questionnaires, among which 146 also completed the post-test. At baseline, higher socioeconomic levels and personal contact with people with mental health conditions predicted more positive attitudes and understanding toward mental disorders. Tentatively, the results also showed that after attending Mind Space, a significant reduction in negative attitudes about mental illness (t=4.36, p=<.001; d=.361) and improvements in the propensity to seek professional help (t=-5.20, p<.001; d=-.430) were observed, along with decreases in negative attitudes toward stereotypes (t=4.71, p=<.001; d=.421) and restrictions (t=2.29, p=.024; d=.205) among healthcare professionals. Discussion Our findings highlight the need for mental health education for people with lower socioeconomic status and the importance of direct contact in public mental health education initiatives. The present study also suggests that Mind Space may be a useful model for public mental health education, but the exhibition requires further evaluation to ascertain if any reductions in stigma are maintained over time.
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Affiliation(s)
- Grace W. K. Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Jolene Hang Chun Mui
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Raymond Wong
- Castle Peak Hospital, Hong Kong, Hong Kong SAR, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kwan Ho Wong
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin, NT, Australia
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Gupta S, Kumar A, Kathiresan P, Pakhre A, Pal A, Singh V. Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications. Indian J Psychiatry 2024; 66:336-346. [PMID: 38778855 PMCID: PMC11107930 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_412_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.
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Affiliation(s)
- Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Preethy Kathiresan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Pakhre
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Stacchini L, Fonzo M, Catalini A, Di Martino G, Santangelo OE, Menegon T, Cedrone F, Gianfredi V. An Italian Validation of the 5-Item Attitudes to Mental Illness Questionnaire (AMIQ): A Useful Tool for Rapid Assessment of Stigma, Acceptance, and Tolerance. Healthcare (Basel) 2024; 12:395. [PMID: 38338280 PMCID: PMC10855529 DOI: 10.3390/healthcare12030395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Stigma negatively impacts individuals, families, and communities, affecting relationships, education, and employment and leading to an additional burden on mental health. Assessing public attitudes towards people with mental health conditions is crucial, especially in terms of public health. Therefore, the Attitudes to Mental Illness Questionnaire (AMIQ) was validated and adapted to the Italian cultural context. Translation followed four phases, involving bilingual speakers, comparison, back-translation, and expert review. In the pre-test phase, the questionnaire was administered to 21 participants anonymously. The validation test involved 213 subjects. Statistical analyses included exploratory and confirmatory factor analysis, and McDonald's Omega and Cronbach's alpha to assess the internal consistency. The results indicate good internal consistency (Omega = 0.71; Alpha = 0.72), and confirmatory factor analysis (CFI = 0.971) validated the questionnaire's construct. The study's findings align with the original validation, underscoring the questionnaire's robustness. Overall, understanding public attitudes is crucial for public health interventions combating stigma and fostering positive attitudes.
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Affiliation(s)
- Lorenzo Stacchini
- Department of Health Science, University of Florence, 50134 Florence, Italy;
| | - Marco Fonzo
- Hygiene and Public Health Unit, Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy;
| | - Alessandro Catalini
- Food Safety and Nutrition Unit, Local Health Authority of Macerata, 62100 Macerata, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
- Unit of Hygiene, Epidemiology and Preventive Medicine, ASL Pescara, 65100 Pescara, Italy
| | | | - Tiziana Menegon
- Health Promotion Unit, Azienda ULSS Marca Trevigiana, 31100 Treviso, Italy;
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
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8
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von Peter S, Stuetzle S, Brieger A, Ponew A, Lust C, Bermpohl F, Bechdolf A, Hardt O, Schomerus G, Speerforck S. Leaving the stigma to the patients? Frequency of crisis experiences among mental health professionals in Berlin and Brandenburg and how they cope with it. J Ment Health 2024; 33:66-74. [PMID: 36880330 DOI: 10.1080/09638237.2023.2182415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 11/16/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND Although mental health professionals' mental health problems are gaining increased attention, there is little systematic research on this topic. AIMS This study investigated the frequency of crisis experiences among mental health professionals and examined how they approach these experiences in terms of their personal and social identities. METHODS An online survey was conducted among mental health professionals in 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg (N = 215), containing questions about personal crisis experiences, help sought, service use, meaningfulness of lived experiences, causal beliefs of mental illness and psychotherapeutic orientation. Social identification was assessed via semantic differential scales derived from preliminary interview studies. To investigate relationships between the variables, explorative correlation analyses were calculated. RESULTS Results showed a high frequency rate of crisis experiences, substantial rates of suicidal ideation and incapacity to work and high service use. Most participants regarded their experiences as meaningful for their personal identity. Meaningfulness was positively related to a psychosocial causation model of mental illness, to psychodynamic psychotherapeutic orientation and to a high degree of disidentification with users and crisis experienced colleagues. CONCLUSION The (paradoxical) disintegration of personal and social identity of may be understood as a strategy to avoid stigmatization. A more challenging coping style among professionals is discussed.
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Affiliation(s)
| | - Stefan Stuetzle
- Medical University Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Anna Brieger
- Medical University Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Angel Ponew
- Medical University Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Christian Lust
- Medical University Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Center (FRITZ), Vivantes Klinikum Am Urban, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Olaf Hardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Akanni OO, Eboreime-Oikeh IO, Oyeyemi OK, Olashore AA. Impact of Psychiatry Posting on Attitudes Toward Mental Illness: A Prospective Cohort Study of Medical Students From Three Universities. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241275420. [PMID: 39161642 PMCID: PMC11331473 DOI: 10.1177/23821205241275420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/29/2024] [Indexed: 08/21/2024]
Abstract
INTRODUCTION Negative attitudes towards mental illness are known to exist among medical students in Nigeria. However, the effect of undergoing a rotation in psychiatry on their attitudes is uncertain. OBJECTIVES It aimed to determine the effect of psychiatry posting during medical training on medical students' attitudes toward mental illness and examine the association of posting-related and demographic factors with their attitudes. METHODS It is a prospective cohort study in which 187 medical students from three different universities were followed up during their psychiatry postings in two different posting sites. Questionnaires containing basic demography, posting-related variables, and the Community Attitude to Mental Illness (CAMI) scale were administered to all available students before and after the rotation in psychiatry. A paired t-test was applied to test the differences in the CAMI scores before and after posting, while ANOVA and hierarchical regression were utilized to determine the association of variables with the CAMI scores. RESULTS There were significant differences between the pre-and post-rotation CAMI scores in CAMI's social restrictiveness (SR) and community mental health ideology (CMHI) domains, indicating improved attitudes. Demographic factors had no significant influence on the students' attitudes, but the length of posting, university of the students, and posting sites had varying impacts. CONCLUSION Psychiatry rotation has a positive impact on students' attitudes toward mental illness in both posting sites, particularly in the domains of SR and CMHI. This underscores the importance of psychiatry training in medical education in changing the attitudes of future healthcare professionals.
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Affiliation(s)
- Oluyemi O Akanni
- Clinical Services, Federal Neuropsychiatric Hospital, Benin City, Edo State, Nigeria
| | | | - Oderinde K Oyeyemi
- Department of Mental Health, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Abstract
This article investigates the content and the consequences of the prototypes of people with depression in a multimethod fashion. Fourteen preregistered studies (total N = 5,023, with U.S. American, British, and French adult participants) show that laypeople consider people with depression as having specific psychological, social, and physical features (e.g., unattractive, overweight, unsuccessful, introverted). Target prototypicality influences how much laypeople believe others have depression, how much observers believe that depression-like symptoms cause someone to experience psychological pain, and how much professional mental health care is appropriate for others. This effect was not reduced by instructing people to focus on the symptoms and ignore the target features yet was weakly reduced by informing them of the effect. We discuss theoretical implications for the understanding of prototypes of people with depression and practical implications for alleviating the impact of prototypes.
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Affiliation(s)
- Ignazio Ziano
- Geneva School of Economics and Management, University of Geneva
| | - Yasin Koc
- Faculty of Behavioural and Social Sciences, University of Groningen
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Napoli G, Autuori S, Ephraim KS. Attitudes of Italian mental health nurses towards mental illness and recovery: a cross-sectional study. AIMS Public Health 2023; 10:333-347. [PMID: 37304595 PMCID: PMC10251057 DOI: 10.3934/publichealth.2023025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 06/13/2023] Open
Abstract
Background Mental health nurses' (MHNs) stigma and discrimination against people with mental illnesses are obstacles to recovery and the development of effective care and treatment. Although many authors have been interested in exploring stigma among general health professionals, paradoxically, less and non-generalizable evidence is available on this phenomenon among MHNs. Understanding the factors associated with stigma and its relationship to recovery attitudes among MHNs could allow for more accurate interventions and improve patient care outcomes. Objective This study conducted on a sample of Italian psychiatric nurses had the objective of analyzing the aptitude for recovery and the tendency towards stigma of these professionals towards mental illness. Methodology A cross-sectional web survey was conducted on a sample of Italian MHNs, who were administered two validated tools, the RAQ-7 (assessment of recovery aptitude) and the WHO-HC-15 (assessment of stigma) respectively. Results A total of 204 MHNs were interviewed. The analysis showed positive overall scores (high recovery aptitude and low stigma levels) among participating MHNs. The attitude to recovery appeared to be directly related to a lower tendency to stigma towards mental illness. It has been observed that MHNs with advanced levels of education appear to be more predisposed to recovery, as well as generally less stigmatizing. There is evidence that the setting in which care is provided, marital status and age can play a significant role in the tendency to stigmatization. Conclusion Our manuscript could assist nursing executives, leaders or educators in making decisions about managing and preventing stigma among MHNs.
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Affiliation(s)
- Giovanni Napoli
- Dipartimento di Salute Mentale, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Simone Autuori
- UOC Psichiatria 2, Azienda Ospedale-Università Padova (AOUP), Padova, Italy
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12
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Jenkins TA, Robison M, Joiner TE. Dehumanization and mental health: clinical implications and future directions. Curr Opin Behav Sci 2023. [DOI: 10.1016/j.cobeha.2023.101257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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13
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Steiger S, Moeller J, Sowislo JF, Lieb R, Lang UE, Huber CG. General and Case-Specific Approval of Coercion in Psychiatry in the Public Opinion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2081. [PMID: 36767450 PMCID: PMC9916390 DOI: 10.3390/ijerph20032081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Psychiatric patients are subjected to considerable stigmatization, in particular, because they are considered aggressive, uncontrollable, and dangerous. This stigmatization might influence the approval of coercive measures in psychiatry by the public and healthcare professionals and might have an influence on the clinical practice of coercive measures. We examined whether the general approval of coercive measures for psychiatric patients with dangerous behaviors differs from case-specific approval. METHOD We conducted a representative survey of the general population (n = 2207) in the canton of Basel-Stadt, Switzerland. In total, 1107 participants assessed a case vignette depicting a fictitious character with a mental illness and indicated whether they would accept coercive measures (involuntary hospitalization, involuntary medication, and seclusion) for the person in the vignette. It was explicitly stated that within the last month, the fictitious character displayed no dangerous behavior (Vignette ND) or dangerous behavior (Vignette D). Another 1100 participants were asked whether they would approve coercive measures (involuntary hospitalization, involuntary medication, and seclusion) for psychiatric patients with dangerous behavior in general (General D), i.e., without having received or referring to a specific case vignette. FINDINGS The logistic regression model containing all variables explained 45% of the variance in approval of any type of coercive measures. Assessment of case vignettes without dangerous behavior (Vignette ND) was associated with significantly reduced approval of coercive measures compared to assessment of a case vignette with dangerousness (Vignette D), while approval for coercive measures in a person with mental health disorder with dangerous behavior in general (General D) was significantly higher than for the case vignette with dangerousness. CONCLUSIONS The general approval of coercive measures for people with mental disorders seems to differ depending on if the respondents are asked to give a general assessment or to examine a specific and detailed clinical case vignette, indicating an increased role of stigmatization when asking about generalized assessments. This may contribute to diverging findings on the acceptance of coercive measures in the literature and should be considered when designing future studies.
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Affiliation(s)
- Sahar Steiger
- University Psychiatric Clinics Basel, Wilhelm Klein-Str. 27, CH-4012 Basel, Switzerland
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, CH-4055 Basel, Switzerland
| | - Julian Moeller
- University Psychiatric Clinics Basel, Wilhelm Klein-Str. 27, CH-4012 Basel, Switzerland
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, CH-4055 Basel, Switzerland
| | - Julia F. Sowislo
- University Psychiatric Clinics Basel, Wilhelm Klein-Str. 27, CH-4012 Basel, Switzerland
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, CH-4055 Basel, Switzerland
| | - Undine E. Lang
- University Psychiatric Clinics Basel, Wilhelm Klein-Str. 27, CH-4012 Basel, Switzerland
| | - Christian G. Huber
- University Psychiatric Clinics Basel, Wilhelm Klein-Str. 27, CH-4012 Basel, Switzerland
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14
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Jauch M, Occhipinti S, O’Donovan A. The stigmatization of mental illness by mental health professionals: Scoping review and bibliometric analysis. PLoS One 2023; 18:e0280739. [PMID: 36662889 PMCID: PMC9858369 DOI: 10.1371/journal.pone.0280739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
Although research suggests that mental health professionals stigmatize mental illness, studies on this topic are relativity new. Little is known about the state of this research and existing literature reviews exhibit multiple limitations. Accordingly, a scoping review was performed on the endorsed stigmatization of mental illness by mental health professionals, with the aim of exploring how research is conducted and whether there are gaps in the literature. Studies were included from any time period if they supplied findings on the endorsed stigmatization of mental illness by mental health professionals. Research was identified through electronic databases (i.e., PsycINFO, Embase, Medline, Scopus) and other sources (i.e., the Griffith University library, Google Scholar, literature reviews). It was found that the research is characterized by a number of limitations, and little progress has been made in this important domain. Among other limitations, there was a lack of comprehensive studies on the relative stigma of mental illness and how the components of stigmatization relate to each other. A bibliometric analysis also found that a large proportion of the research is not connected by references. Recommendations were made with respect to future research in this area.
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Affiliation(s)
- Michael Jauch
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Stefano Occhipinti
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
- Department of English and Communication, International Research Centre for the Advancement of Health Communication, Hong Kong Polytechnic University, Hong Kong, China
| | - Analise O’Donovan
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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15
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Predicting different dimensions of schizophrenia-related stigma in Israel: Exploring the applicability of the common sense model of illness. Arch Psychiatr Nurs 2023; 43:9-14. [PMID: 37032022 DOI: 10.1016/j.apnu.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/08/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
The common sense model of illness is a promising conceptual framework that can promote our understanding of the predictors of schizophrenia-related public stigma. Because stigma is a multidimensional phenomenon, studies on schizophrenia-related stigma need to account for the origins of the various aspects of this phenomenon. This study explored which common sense model of illness components (cognitive and emotional) predicted three distinct indicators of stigma (stereotypes and discrimination on the individual and structural levels). A nonprobability sample of 149 students from one of the largest universities in Israel was drawn. Data were collected via a self-reported questionnaire. We found that five of the nine common sense model of illness variables predicted schizophrenia stereotypes, whereas very few predicted discrimination. Additionally, we found that greater belief in the effectiveness of schizophrenia treatment was associated with lower stereotypes and social-level discrimination. The less the perceived consequences of schizophrenia (the extent to which the illness is perceived to affect one's life), the lower the stereotypes and discrimination (individual and social). The perceived cause of schizophrenia and attribution of personal control over the illness did not predict any stigma dimension. The findings suggest that the common sense model of illness is more suitable for predicting stereotypes than discrimination. More research is needed to understand the unique drivers of different dimensions of stigma. The findings also imply the need to design separate programs to address different aspects of schizophrenia-related stigma.
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16
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Le Glaz A, Lemey C, Berrouiguet S, Walter M, Lemogne C, Flahault C. Physicians' and medical students' beliefs and attitudes toward psychotic disorders: A systematic review. J Psychosom Res 2022; 163:111054. [PMID: 36272378 DOI: 10.1016/j.jpsychores.2022.111054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- A Le Glaz
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France.
| | - C Lemey
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - S Berrouiguet
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France; TIM, INSERM, UMR 1101, Brest, France.
| | - M Walter
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - C Lemogne
- Department of Psychiatry and Addictology, AP-HP.Centre-Université de Paris, Paris, Île-de-France, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.
| | - C Flahault
- Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France; U.F. de Psychologie et Psychiatrie de Liaison et d'Urgences DMU Psychiatrie et Addictologie, AP-HP Centre Université de Paris, France.
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17
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Bizumic B, Gunningham B, Christensen BK. Prejudice towards people with mental illness, schizophrenia, and depression among mental health professionals and the general population. Psychiatry Res 2022; 317:114817. [PMID: 36122536 DOI: 10.1016/j.psychres.2022.114817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
The aim of the study was to measure and compare prejudice towards people with specific mental illnesses between mental health professionals and the general population, and examine personality, ideological, and attitudinal antecedents of prejudice. To do so, we also aimed to validate three shortened scales of prejudice. A sample of mental health professionals (N = 299) and a sample from the general population (N = 427) completed shortened versions of the Prejudice towards People with Mental Illness, Prejudice towards People with Schizophrenia, and Prejudice towards People with Depression scales. They also completed measures of validity criteria and demographics. The scales demonstrated construct validity in both samples. Although prejudice was highest towards people with schizophrenia and lowest towards people with depression, mental health professionals demonstrated significantly less prejudice overall than the general population. Prejudice was associated with higher social dominance orientation, right wing authoritarianism, ethnocentrism, conservatism, and generalized prejudice, and lower agreeableness, openness to experience, and contact. These antecedents of prejudice were better predictors than any demographic or profession-related variables examined. This study contributes increased knowledge of the structure and correlates of prejudice towards people with mental disorders. This knowledge should inform more nuanced and effective interventions, therapy, and training.
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Affiliation(s)
- Boris Bizumic
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia.
| | - Beth Gunningham
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia
| | - Bruce K Christensen
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia
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18
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Giralt Palou R, Prat Vigué G, Torà Suarez N, Romeu-Labayen M, Tort-Nasarre G. The development of positive attitudes toward mental health among university nursing students: Countering the role of social desirability. Perspect Psychiatr Care 2022; 58:1680-1690. [PMID: 34873707 DOI: 10.1111/ppc.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study analyses the evolution of attitudes of nursing students towards mental health, paying particular attention to the influence of social desirability. DESIGN AND METHODS Prospective longitudinal repeated-measures study in a sample of nursing students who completed the Community Attitudes toward Mental Illness scale and The Social Desirability Scale. FINDINGS After their training, and after adjusting for social desirability, students of female gender recognized attitudes that foster humanistic values than their male counterparts. However, attitudes of restrictiveness and authoritarianism continued to be manifested significantly when the students themselves had mental health problems (MHPs), had had previous training, or were older. PRACTICE IMPLICATIONS University courses should continue to foster attitudes of acceptance and destigmatization of people with MHPs, through responses that value authenticity.
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Affiliation(s)
- Rosa Giralt Palou
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Barcelona, Spain.,SaMIS Group, Division of Mental Health, Althaia Foundation, Manresa, Barcelona, Spain
| | - Gemma Prat Vigué
- SaMIS Group, Division of Mental Health, Althaia Foundation, Manresa, Barcelona, Spain
| | - Núria Torà Suarez
- Research & Innovation Unit, Althaia Foundation, Manresa, Barcelona, Spain
| | - Maria Romeu-Labayen
- Mental health department, Adult Mental Health Center Horta Guinardo, Barcelona, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain
| | - Glòria Tort-Nasarre
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Barcelona, Spain.,GREpS, Health Education Research Group, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
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19
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Lettieri A, Soto-Pérez F, Díez E, Bernate-Navarro M, Franco-Martín M. The attitudes of mental health professionals on the employability of people with mental illness: A different view limiting employment rehabilitation. Brain Behav 2022; 12:e2767. [PMID: 36101902 PMCID: PMC9575599 DOI: 10.1002/brb3.2767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Mental health professionals are becoming increasingly involved in the process of employment rehabilitation of persons with psychiatric disabilities. However, few studies address the attitudes of these professionals toward the employability of those with mental illness. The aim of this research was to identify differences in the attitudes of medical and non-medical mental health professionals, as well as to detect any association between attitude scores and the type of professional. METHODS A sample of 140 employees from public and third sector mental health organizations answered a questionnaire using a scale measuring their attitudes and views on the employability of people with psychiatric disabilities. The psychometric characteristics of the scale are provided together with the variations detected in the professionals' attitudes. RESULTS This research shows that significant differences in the attitudes between medical and non-medical mental health employees exist and that there is a need for the implementation of educational programs that may help to improve the attitudes of medical professionals toward the employability of people with mental illness. CONCLUSION This research indicates the importance of improving the professionals' attitudes to support people attempting to return to work.
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Affiliation(s)
- Andrea Lettieri
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,INTRAS Foundation, Zamora, Spain
| | - Felipe Soto-Pérez
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,INICO: University Institute for Community Integration, Salamanca, Spain.,IBSAL: Institute of Biomedical Research of Salamanca, Salamanca, Spain
| | - Emiliano Díez
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,INICO: University Institute for Community Integration, Salamanca, Spain
| | | | - Manuel Franco-Martín
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,IBSAL: Institute of Biomedical Research of Salamanca, Salamanca, Spain.,Department of Psychiatry, Hospital Provincial Rodríguez Chamorro, Zamora, Spain
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20
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Mengual-Pujante M, Morán-Sánchez I, Luna-Ruiz Cabello A, Pérez-Cárceles MD. Attitudes of the police towards individuals with a known psychiatric diagnosis. BMC Psychiatry 2022; 22:614. [PMID: 36123659 PMCID: PMC9484251 DOI: 10.1186/s12888-022-04234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Police officers are increasingly required to respond to incidents involving psychiatric patients. However, few studies have assessed whether the attitude of police officers depends on prior knowledge of their specific psychiatric diagnosis. Our aim was to analyze the effects of psychiatric diagnosis on the behavior of police officers. METHODS We utilized the Attribution Questionnaire adapted to the police context to examine the attitudes of 927 officers of the Spanish National Police Force towards persons diagnosed with either schizophrenia or depressive disorder playing the role of somebody in need of assistance, a victim of a crime, a witness, or a suspect in a criminal case. Different socio-demographic variables were also collected. RESULTS Compared to attitudes to individuals with a known psychiatric diagnosis, police officers expressed increased willingness to help psychiatric patients and increased sympathy and attributing to them less responsibility for their actions. They also showed increased feelings of avoidance, reported a greater perception of danger and a greater need for isolation and involuntary treatment. This was especially so in the case of schizophrenia. Stigmatizing attitudes were less apparent when the person was a woman, a veteran officer, or someone with a history of work experience. CONCLUSIONS Police officers may hold certain stigmatizing attitudes towards persons with mental illness, particularly schizophrenia, that require special attention, as they may negatively affect police action. We found several factors associated with the persistence of these stigmatizing attitudes among police officers that may guide us when implementing training programs for promoting attitude change, especially at the beginning of an officer's professional career.
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Affiliation(s)
- M. Mengual-Pujante
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - I. Morán-Sánchez
- Cartagena Mental Health Centre, Real St 8, E-30201, Cartagena, Murcia, Spain ,grid.411967.c0000 0001 2288 3068Department of Forensic Psychiatry, Law Faculty, Catholic University of Murcia, Murcia, Spain
| | - A. Luna-Ruiz Cabello
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - M. D. Pérez-Cárceles
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
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21
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Vorstenbosch E, Masoliver-Gallach R, Escuder-Romeva G. Measuring professional stigma towards patients with a forensic mental health status: protocol for a Delphi consensus study on the design of a questionnaire. BMJ Open 2022; 12:e061160. [PMID: 36581980 PMCID: PMC9438202 DOI: 10.1136/bmjopen-2022-061160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Negative attitudes towards individuals with a mental illness and/or criminal background are widely studied, but empirical interest in the attitudes towards patients with a forensic mental health status is lacking. Negative attitudes among mental healthcare (MHC) professionals can have a significant impact on treatment outcomes and hence, affect patients' rehabilitation. This study will elaborate an instrument to assess stigmatising attitudes among community MHC professionals towards patients with a forensic mental health status. METHODS AND ANALYSIS The instrument will be developed by means of a Delphi study and depart from pre-existing instruments that assess public and professional stigma towards individuals with a mental illness and/or criminal background. Relevant instruments were identified through a targeted literature review. A longlist of items has been selected for the Delphi survey. Five expert panels (ie, academic experience in stigma or forensic MHC, clinical experience in community or forensic MHC or patient experience in forensic and community MHC) will be asked to score the relevance of each item on a 7-point Likert scale and to agree on the wording (yes/no). Participants will be provided with the option to suggest additional items or alternative wording. Adapted Delphi methodology will be applied with an expectation of at least three rounds to achieve consensus: ≥60% of the participants of at least four of five expert panels rank the item in the top three (inclusion) or bottom three (exclusion). Items will be reworded for a consecutive round based on a 'yes minus no' score and participants' suggestions. ETHICS AND DISSEMINATION This study has been approved by the ethics committee of Fundación Sant Joan de Déu. Dissemination of results will be through peer-reviewed publications, presentations and (inter-)national academic conferences. A summary of the results will be shared with the participants and key persons in community and forensic MHC.
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Affiliation(s)
- Ellen Vorstenbosch
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
- Department of Medicine and Translational Research, University of Barcelona, Barcelona, Spain
- Sant Joan de Déu Research Institute, Barcelona, Spain
| | - Ruth Masoliver-Gallach
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Gemma Escuder-Romeva
- Sant Joan de Déu Research Institute, Barcelona, Spain
- Penitentiary Psychiatric Hospitalization Unit of Catalonia, Parc Sanitari Sant Joan de Déu, Sant Esteve Sesrovires, Barcelona, Spain
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22
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Lin CH, Lai TY, Chen YJ, Lin SK. Social distance towards schizophrenia in health professionals. Asia Pac Psychiatry 2022; 14:e12506. [PMID: 34915596 DOI: 10.1111/appy.12506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/06/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The stigma and prejudice of the public regarding psychiatric disorders are a long-standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self-rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan. METHOD This study used a cross-sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18-item Social Distance Scale for schizophrenia, and the 19-item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self-rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia. RESULT In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (n = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (β ± SE = -0.26 ± 0.14, p = .057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance. CONCLUSION High levels of self-rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and training are imperative to increase familiarity and knowledge of schizophrenia. Appropriate education could be implemented from different perspectives, including communication skills, resources of social support, and topics to reduce stigma and prejudice.
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Affiliation(s)
- Chen-Hua Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tzu-Yu Lai
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Jen Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shun-Ku Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC.,Center of the General Education, University of Taipei, Taipei, Taiwan, ROC
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23
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Blease C. Sharing online clinical notes with patients: implications for nocebo effects and health equity. JOURNAL OF MEDICAL ETHICS 2022; 49:medethics-2022-108413. [PMID: 35918134 DOI: 10.1136/jme-2022-108413] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called 'open notes'). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes-the potential to increase 'nocebo effects'. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify 'closed notes', and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route.
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Affiliation(s)
- Charlotte Blease
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA
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24
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Lagunes-Cordoba E, Lagunes-Cordoba R, Fresan-Orellana A, Gonzalez-Olvera J, Jarrett M, Thornicroft G, Henderson C. Mexican Psychiatric Trainees' Attitudes Towards People with Mental Illness: A Qualitative Study. Community Ment Health J 2022; 58:982-991. [PMID: 34716830 PMCID: PMC9187538 DOI: 10.1007/s10597-021-00907-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
Despite their training, psychiatrists have been found to have negative attitudes towards people with mental illness, including the patients they treat. Similarly, studies focused on service users have identified psychiatrists as a source of stigma. Even though negative attitudes in psychiatrists have been identified in different countries and settings, in Mexico the attitudes of these professionals have never been assessed. Because of this, we invited psychiatric trainees from a hospital in Mexico to participate in individual interviews to describe their opinions regarding mental health-related stigma, to evaluate their attitudes towards people with mental illness and to identify factors that could be influencing their attitudes. Interviews were audio recorded, transcribed and analysed using thematic analysis. A total of 29 trainees participated in the study. The results suggested that trainees recognised psychiatrists can have negative attitudes towards people with mental illness, such as poor empathy, judgement and labelling, and mainly towards patients considered difficult and with borderline personality disorder. Participants recognised these attitudes can influence their relationship with patients, and considered it is necessary to develop interventions to improve their own attitudes and reduce mental health stigma. From this study we concluded Mexican psychiatrists are not free from stigma towards people with mental illness. However, Mexican psychiatric trainees are interested in improving their attitudes and reactions towards their patients.
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Affiliation(s)
- Emmeline Lagunes-Cordoba
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Roberto Lagunes-Cordoba
- Instituto de Investigaciones Psicológicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Ana Fresan-Orellana
- Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Mexico City, Mexico
| | - Jorge Gonzalez-Olvera
- Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Mexico City, Mexico.,Comisión Nacional Para la Prevención de Adicciones, Mexico City, Mexico
| | - Manuela Jarrett
- School of Health Sciences, City, University of London, London, UK
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Claire Henderson
- Centre for Global Mental Health and Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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25
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Steiger S, Sowislo JF, Moeller J, Lieb R, Lang UE, Huber CG. Personality, self-esteem, familiarity, and mental health stigmatization: a cross-sectional vignette-based study. Sci Rep 2022; 12:10347. [PMID: 35725744 PMCID: PMC9209478 DOI: 10.1038/s41598-022-14017-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/22/2022] [Indexed: 12/04/2022] Open
Abstract
There has been little research exploring the relationship between personality traits, self-esteem, and stigmatizing attitudes toward those with mental disorders. Furthermore, the mechanisms through which the beholder's personality influence mental illness stigma have not been tested. The aim of this study is to examine the relationship between Big Five personality traits, self-esteem, familiarity, being a healthcare professional, and stigmatization. Moreover, this study aims to explore the mediating effect of perceived dangerousness on the relationship between personality traits and desire for social distance. We conducted a vignette-based representative population survey (N = 2207) in the canton of Basel-Stadt, Switzerland. Multiple regression analyses were employed to examine the associations between personality traits, self-esteem, familiarity, and being a healthcare professional with the desire for social distance and perceived dangerousness. The mediation analyses were performed using the PROCESS macro by Hayes. Analyses showed associations between personality traits and stigmatization towards mental illness. Those who scored higher on openness to experience (β = - 0.13, p < 0.001), (β = - 0.14, p < 0.001), and those who scored higher on agreeableness (β = - 0.15, p < 0.001), (β = - 0.12, p < 0.001) showed a lower desire for social distance and lower perceived dangerousness, respectively. Neuroticism (β = - 0.06, p = 0.012) was inversely associated with perceived dangerousness. Additionally, high self-esteem was associated with increased stigmatization. Personal contact or familiarity with people having mental disorders was associated with decreased stigmatization. Contrarily, healthcare professionals showed higher perceived dangerousness (β = 0.04, p = 0.040). Finally, perceived dangerousness partially mediated the association between openness to experience (indirect effect = - .57, 95% CI [- .71, - 0.43]) as well as agreeableness (indirect effect = - 0.57, 95% CI [- 0.74, - 0.39]) and desire for social distance. Although the explained variance in all analyses is < 10%, the current findings highlight the role of personality traits and self-esteem in areas of stigma. Therefore, future stigma research and anti-stigma campaigns should take individual differences into consideration. Moreover, the current study suggests that perceived dangerousness mediates the relationship between personality traits and desire for social distance. Further studies are needed to explore the underlying mechanisms of such relationship. Finally, our results once more underline the necessity of increasing familiarity with mentally ill people and of improving the attitude of healthcare professionals towards persons with mental disorders.
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Affiliation(s)
- Sahar Steiger
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, 4055, Basel, Switzerland
| | - Julia F Sowislo
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland
| | - Julian Moeller
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, 4055, Basel, Switzerland
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, 4055, Basel, Switzerland
| | - Undine E Lang
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland
| | - Christian G Huber
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland.
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Őri D, Szocsics P, Molnár T, Ralovich FV, Huszár Z, Bene Á, Rózsa S, Győrffy Z, Purebl G. Stigma towards mental illness and help-seeking behaviors among adult and child psychiatrists in Hungary: A cross-sectional study. PLoS One 2022; 17:e0269802. [PMID: 35687584 PMCID: PMC9187077 DOI: 10.1371/journal.pone.0269802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists’ attitudes towards their patients and link them to psychosocial and professional factors. Methods An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits. Results Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168–0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038–0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188–1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248–1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178–5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188–1.843), p = 0.016]. Conclusions The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues’ attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.
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Affiliation(s)
- Dorottya Őri
- Department of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- * E-mail:
| | - Péter Szocsics
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Molnár
- University of Pécs Medical School, County Hospital Győr, Petz Aladár Hospital, Győr, Hungary
| | - Fanni Virág Ralovich
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Zsolt Huszár
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Ágnes Bene
- Department of Psychiatry and Psychiatric Rehabilitation, Saint John Hospital, Budapest, Hungary
| | - Sándor Rózsa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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Almeida B, Samouco A, Grilo F, Pimenta S, Moreira AM. Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners. Int J Soc Psychiatry 2022; 68:708-717. [PMID: 33730898 DOI: 10.1177/00207640211002558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. AIMS This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. METHOD A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions (Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. RESULTS GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician's interest in mental health topics. CONCLUSIONS Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.
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Affiliation(s)
| | - Ana Samouco
- Unidade Local de Saúde do Norte Alentejano EPE, Portalegre, Portugal
| | - Filipe Grilo
- Departamento de Economia, Faculdade de Economia da Universidade do Porto, Portugal
| | - Sónia Pimenta
- Electroconvulsive Therapy Unit, Hospital de Magalhães Lemos EPE, Porto, Portugal
| | - Ana Maria Moreira
- Community Mental Health Service, Hospital de Magalhães Lemos EPE, Porto, Portugal
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Piat M, Sofouli E, Wainwright M, Albert H, Rivest MP, Casey R, LeBlanc S, Labonté L, O'Rourke JJ, Kasdorf S. Translating mental health recovery guidelines into recovery-oriented innovations: A strategy combining implementation teams and a facilitated planning process. EVALUATION AND PROGRAM PLANNING 2022; 91:102054. [PMID: 35219017 DOI: 10.1016/j.evalprogplan.2022.102054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/18/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Recovery is the focus of mental health strategies internationally. However, little translation of recovery knowledge has occurred in mental health services. The purpose of this research is to bridge the gap between recovery guidelines and practice by developing a new implementation strategy involving the formation of implementation teams made up of different stakeholders (service users, service providers, managers, knowledge users) and facilitating a 12-meeting implementation planning process. Sevenmental health organizations across Canada successfully completed the process of translating the guidelines into a recovery-oriented innovation that was implemented. Fifty-five implementation team members were interviewed upon completion of the 12-meeting process. Findings indicate that implementation team members perceived the structured planning process as positive. Nevertheless, the language of implementation science remains difficult to understand for a non-academic audience. Key elements of the 12-meeting process included the value of consensus building among implementation team members and the subsequent shifting power relationships. While working with diverse stakeholders came with certain challenges, the process in itself was a form of system transformation. This type of engaged planning process was a significant departure from the more top-down approaches to organizational change that staff were used to.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University, Quebec, Canada; Douglas Mental Health University Institute, Quebec, Canada.
| | - Eleni Sofouli
- Department of Psychiatry, McGill University, Quebec, Canada; Douglas Mental Health University Institute, Quebec, Canada.
| | - Megan Wainwright
- Department of Psychiatry, McGill University, Quebec, Canada; Douglas Mental Health University Institute, Quebec, Canada.
| | - Hélene Albert
- Université de Moncton, École de travail social, Moncton, New Brunswick, Canada.
| | - Marie-Pier Rivest
- Université de Moncton, École de travail social, Moncton, New Brunswick, Canada.
| | - Regina Casey
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Canada.
| | - Sébastien LeBlanc
- Université de Moncton, École de travail social, Moncton, New Brunswick, Canada.
| | - Lise Labonté
- Douglas Mental Health University Institute, Quebec, Canada.
| | - Joseph J O'Rourke
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Canada.
| | - Sarah Kasdorf
- Douglas Mental Health University Institute, Quebec, Canada.
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Al-Yateem N, Rossiter R, Subu MA, Slewa-Younan S, Azizur Rahman S, Dias JM, Al-Marzouqi A. A qualitative exploration of mental health knowledge among pediatric health professionals in the United Arab Emirates. PLoS One 2022; 17:e0266224. [PMID: 35349585 PMCID: PMC8963574 DOI: 10.1371/journal.pone.0266224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mental health literacy (MHL) is an essential competency for all healthcare professionals. In the United Arab Emirates, previous studies reported a low level of MHL among healthcare professionals working with vulnerable populations such as children and adolescents with chronic illnesses. Further in-depth exploration is necessary to build understanding of beliefs and knowledge about mental illness among pediatric health professionals. METHODS Written narratives exploring mental health knowledge were collected from pediatric nurses and analyzed using content analysis. These written narratives were extracted from responses to open-ended questions embedded in a questionnaire completed as part of previous studies. The Standards for Reporting Qualitative Research were followed in reporting this study. RESULTS The overarching theme that emerged from the data was that nurses struggled to negotiate the complexities of psychological distress and mental illness. Two overlapping sub-themes were identified: (1) professional knowledge was incomplete, confused, and lacking in clarity and (2) professional knowledge was impacted by cultural beliefs and stigma. A third sub-theme reflected how participants identified with others' suffering and felt powerless to help themselves or others. Participants described stress and mental exhaustion. CONCLUSIONS Participants' narratives were characterized by struggles arising from insufficient knowledge, confusion, and deeply-held cultural and religious beliefs. Therefore, they were unable to resolve the conflict between professional knowledge, attitudes, and beliefs about mental illness and stigma arising from cultural and religious beliefs/attitudes. Culturally-specific education is needed for healthcare professionals that addresses contextual, cultural, and religious factors impacting on stigma while actively supporting the healthcare workforce and enabling access to mental health services.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, UAE
- School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University, Bathurst, NSW, Australia
| | - Rachel Rossiter
- School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University, Bathurst, NSW, Australia
| | - Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | | | - Syed Azizur Rahman
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Jacqueline Maria Dias
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Amina Al-Marzouqi
- Department of Health Services Administration, University of Sharjah, Sharjah, UAE
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Tippin GK, Maranzan KA. Photovoice as a Method to Reduce the Stigma of Mental Illness Among Health Care Students. Health Promot Pract 2022; 23:331-337. [PMID: 35285317 PMCID: PMC8921880 DOI: 10.1177/15248399211057152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Photovoice is theorized to influence those who interact with the photos and captions, and so it is important to examine and further understand this mechanism. This article seeks to further our understanding of this critical process—that is, what is the impact of the Photovoice Artist’s stories on the viewing audience? Herein we demonstrate how an incarnation of photovoice, digital storytelling, and photo elicitation impacted mental illness stigma among health sciences students. By focusing on application beyond the original exhibition, this article highlights how photovoice methods and aims overlap with best practices in stigma reduction, and its fit with multimodal anti-stigma interventions. Overall, this study contributes to addressing the question of how photovoice can be applied to achieve action for social change.
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Loganathan K, Leroy P, Elbaz P, Grimfeld A, Mouaffak F. Incidence and outcomes of COVID-19 first wave pandemic in a French nursing home with residents suffering from severe mental illnesses. Psychiatry Res 2022; 309:114398. [PMID: 35066309 PMCID: PMC8762817 DOI: 10.1016/j.psychres.2022.114398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/22/2022]
Abstract
During the first wave of COVID-19, nearly 50% of France's fatalities occurred in nursing homes. Older people with mental health disorders are considered to be more prone to infections when epidemics arise. To test this hypothesis, we conducted a retrospective descriptive and comparative study of the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a cohort of elderly residents with or without severe mental illness (SMI) living in a French nursing home facility. This was done during the first lockdown from March 17th until May 11th, 2020. Our study included 72 participants of 75 residents, of whom 58 contracted COVID-19, 14 developed a severe form requiring hospitalisation, and 14 died. The disease was significantly less frequent in residents with SMI 15(62%) than those without SMI 43 (89.6%). In regression analysis, a higher level of autonomy was significantly associated with a lower disease incidence. Once contracted, residents with or without SMI differed significantly neither on morbidity nor mortality. The period of survival did not either significantly differ between the two groups. As a potential explanation, we suggested that pathological social withdrawal added to stigmatisation could have protected SMI residents from contracting the disease.
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Affiliation(s)
| | - Pascale Leroy
- ADEF Résidences, 2 rue Romain Rolland, 93200 Saint Denis, France
| | - Pierre Elbaz
- ADEF Résidences, 2 rue Romain Rolland, 93200 Saint Denis, France
| | - Alain Grimfeld
- ADEF Résidences, 2 rue Romain Rolland, 93200 Saint Denis, France
| | - Fayçal Mouaffak
- ADEF Résidences, 2 rue Romain Rolland, 93200 Saint Denis, France; Pôle 93G04, EPS Ville EVRARD, 5 rue du Docteur DELAFONTAINE, 93200 Saint Denis, France.
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McKenzie K, Gregory J, Hogg L. Mental Health Workers' Attitudes Towards Individuals With a Diagnosis of Borderline Personality Disorder: A Systematic Literature Review. J Pers Disord 2022; 36:70-98. [PMID: 34124949 DOI: 10.1521/pedi_2021_35_528] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.
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Affiliation(s)
| | | | - Lorna Hogg
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, U.K
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Lagunes-Cordoba E, Alcala-Lozano R, Lagunes-Cordoba R, Fresan-Orellana A, Jarrett M, Gonzalez-Olvera J, Thornicroft G, Henderson C. Evaluation of an anti-stigma intervention for Mexican psychiatric trainees. Pilot Feasibility Stud 2022; 8:5. [PMID: 35031066 PMCID: PMC8759153 DOI: 10.1186/s40814-021-00958-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/03/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. AIMS To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. METHODS This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. RESULTS Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees' own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one's own negative attitudes and recognition of one's ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees' work overload and lack of support from the host organisation were identified as barriers to implement the intervention. CONCLUSIONS A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people's lives.
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Affiliation(s)
- Emmeline Lagunes-Cordoba
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Ruth Alcala-Lozano
- Laboratorio de Neuromodulación, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Mexico City, Mexico
| | - Roberto Lagunes-Cordoba
- Instituto de Investigaciones Psicológicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Ana Fresan-Orellana
- Laboratorio de Neuromodulación, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Mexico City, Mexico
| | - Manuela Jarrett
- School of Health Science at City, University of London, London, UK
| | | | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Claire Henderson
- Centre for Implementation Science, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Bizumic B, Gunningham B. Prejudice Toward People With Mental Illness, Schizophrenia, and Depression: Measurement, Structure, and Antecedents. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac060. [PMID: 39144795 PMCID: PMC11206083 DOI: 10.1093/schizbullopen/sgac060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Objectives Many existing measures of prejudiced attitudes toward people with mental illness have conceptual, theoretical, and psychometric problems. The recently created Prejudice toward People with Mental Illness (PPMI) scale has addressed many of these limitations, but prejudice toward people with different mental disorders may be unique and require further exploration. This study aimed to facilitate this exploration by adapting the PPMI to focus on schizophrenia and depression, and investigate the structure, distinctiveness, and the nomological network of prejudice toward people with these mental disorders. Study Design We adapted the original 28-item PPMI scale to create the Prejudice toward People with Schizophrenia (PPS) and Prejudice toward People with Depression (PPD) scales. There were 406 participants from the general population, who completed these scales and related measures. Study Results The original 4-factor structure (fear/avoidance, unpredictability, authoritarianism, and malevolence) was supported for each scale. Participants expressed the highest levels of prejudice toward people with schizophrenia, followed by prejudice toward people with mental illness, and lastly by prejudice toward people with depression. Analyses supported the proposed nomological network of prejudice, which involves theoretical antecedents of social dominance orientation, right-wing authoritarianism, empathy, personality traits, disgust sensitivity, and prior contact. Conclusions This research provides evidence for the validity and psychometric properties of the PPMI, PPS, and PPD scales, expanding our understanding of antecedents to prejudice toward people with different mental disorders. This research also shows that we gain more insight into prejudice when we use measures targeting specific disorders rather than mental illness in general.
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Affiliation(s)
- Boris Bizumic
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Beth Gunningham
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
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Girod R, Thompson P, Davis C. Genetic counseling students' and recent graduates' attitudes toward psychiatric illness. J Genet Couns 2021; 31:713-721. [PMID: 34846769 DOI: 10.1002/jgc4.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 11/08/2022]
Abstract
Due to the high prevalence of mental illness in the general population, genetic counselors are likely to encounter patients with mental illness in practice, regardless of specialty. However, previous studies have shown that recent graduates of genetic counseling programs do not feel comfortable discussing mental illness in clinical encounters. One possible explanation for this discomfort is stigma toward mental illness, a well-documented phenomenon both in society and in the healthcare field. Previous studies of this phenomenon in genetic counselors and trainees have relied on self-report measures and are vulnerable to social desirability bias. We sought to gain a holistic understanding of attitudes toward mental illness held by genetic counseling trainees by measuring implicit and explicit biases. This study assessed 141 responses from genetic counseling students and recent graduates from master's graduate programs across North America. They were asked to complete a survey, which included a demographic questionnaire, a scale that has been validated for use for a variety of healthcare professionals (Nordt et al. 2006, Schizophrenia Bulletin, 32, 709), measuring explicit attitudes toward those with depression and schizophrenia (i.e., social distance and stereotype endorsement), and an implicit association test. Mean scores on the social distance and stereotype endorsement scales were higher for schizophrenia than depression, indicating higher levels of explicit bias toward the former than the latter. Participants held slightly significant implicit bias toward individuals with either physical or mental illness. These data suggest that unconscious or implicit bias may not contribute to unpreparedness to address psychiatric disorders in clinical practice that has been previously reported by new graduates. Therefore, genetic counseling trainees may be receptive to clinically relevant education pertaining to mental illness. These results could inform the curriculum of genetic counseling programs and facilitate provision of services to this population.
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Affiliation(s)
- Rebecca Girod
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
| | - Patricia Thompson
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
| | - Claire Davis
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
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Carrara BS, Fernandes RHH, Bobbili SJ, Ventura CAA. Health care providers and people with mental illness: An integrative review on anti-stigma interventions. Int J Soc Psychiatry 2021; 67:840-853. [PMID: 33380251 DOI: 10.1177/0020764020985891] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Health care providers are an important target group for anti-stigma interventions because they have the potential to convey stigmatizing attitudes towards people with mental illness. This can have a detrimental impact on the quality and effectiveness of care provided to those affected by mental illness. AIMS AND METHODS Whittemore & Knafl's integrative review method (2005) was used to analyze 16 studies investigating anti-stigma interventions targeting health care providers. RESULTS The interventions predominantly involved contact-based educational approaches which ranged from training on mental health (typically short-term), showing videos or films (indirect social contact) to involving people with lived experiences of mental illness (direct social contact). A few studies focused on interventions involving educational strategies without social contact, such as mental health training (courses/modules), distance learning via the Internet, lectures, discussion groups, and simulations. One study investigated an online anti-stigma awareness-raising campaign that aimed to reduce stigmatizing attitudes among health care providers. CONCLUSION Anti-stigma interventions that involve social contact between health care providers and people with mental illness, target specific mental illnesses and include long-term follow-up strategies seem to be the most promising at reducing stigma towards mental illness among health care providers.
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Affiliation(s)
- Bruna Sordi Carrara
- PAHO/WHO Collaborating Center for Nursing Research Development, University of Sao Paulo at Ribeirao Preto College Nursing, Brazil
| | | | - Sireesha Jennifer Bobbili
- University of Toronto, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Carla Aparecida Arena Ventura
- PAHO/WHO Collaborating Center for Nursing Research Development, University of Sao Paulo at Ribeirao Preto College Nursing, Brazil
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Weiste E, Stevanovic M, Valkeapää T, Valkiaranta K, Lindholm C. Discussing mental health difficulties in a "diagnosis free zone". Soc Sci Med 2021; 289:114364. [PMID: 34649178 DOI: 10.1016/j.socscimed.2021.114364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Being identified as "mentally ill" is a complicated social process that may be stigmatizing and socially problematic, as a mental illness diagnosis determines the criteria for what is considered normal. This has given rise to a number of anti-stigma campaigns designed to create awareness of the way stigmas affect people with mental health difficulties and to normalize those difficulties in society. One such campaign is the "diagnosis-free zone", which declares that those with mental health difficulties should not be categorized on the basis of their diagnosis; rather, they should be encountered as full individuals. In this paper, we investigate how mental health difficulties are discussed in Clubhouse communities, which adhere to the "diagnosis free zone" programme. The findings are based on conversation analysis of 29 video-recorded rehabilitation group meetings, in one Finnish Clubhouse, intended to advance clients' return to the labour market. The analysis demonstrated that members referred to their mental health difficulties to explain the misfortunes in their lives, especially interruptions and stoppages in their careers. By contrast, staff members disattended members' explanations and normalized their situations as typical of all humans and thus unrelated to their mental health difficulties as such. In this way, the discussion of mental health difficulties at the Clubhouse meetings was implicitly discouraged. We propose that the standards of normality expected of a person not suffering from a mental health difficulty may well be different from the expectations levelled at participants with a history of mental problems. Therefore, instead of considering cultural expectations of normality to be a unified domain, effective anti-stigma work might sometimes benefit from referring to mental-health diagnoses as a means of explicitly tailoring expectations of normality.
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Affiliation(s)
- Elina Weiste
- University of Helsinki, Faculty of Humanities, P.O. Box 24, 00014, University of Helsinki, Finland.
| | - Melisa Stevanovic
- Tampere University, Faculty of Social Sciences, 33014, Tampere University, Finland.
| | - Taina Valkeapää
- University of Helsinki, Faculty of Social Sciences, P.O. Box 24, 00014, University of Helsinki, Finland.
| | - Kaisa Valkiaranta
- University of Helsinki, Faculty of Social Sciences, P.O. Box 24, 00014, University of Helsinki, Finland.
| | - Camilla Lindholm
- Tampere University, Faculty of Information Technology and Communication Sciences, 33014, Tampere University, Finland.
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Piat M, Wainwright M, Cherkas D, Leblanc S, Sofouli E, Rivest MP, Albert H, Casey R, O'Rourke JJ, Labonté L. Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services. Implement Sci Commun 2021; 2:101. [PMID: 34526136 PMCID: PMC8441235 DOI: 10.1186/s43058-021-00206-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/25/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic. METHODS Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct's impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes. RESULTS Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives-renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed "engaging implementation teams during the COVID-19 pandemic" for this study). CONCLUSIONS The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University and Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.
| | - Megan Wainwright
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, UK
| | - Danielle Cherkas
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, Ontario, M5S 1V4, Canada
| | - Sébastien Leblanc
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Eleni Sofouli
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Avenue des Pins, Montréal, QC, H3A 1A1, Canada
| | - Marie-Pier Rivest
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Hélène Albert
- École de travail social, Université de Moncton, 18, avenue Antonine-Maillet, Moncton, Nouveau-Brunswick, E1A 3E9, Canada
| | - Regina Casey
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, T-325, 2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5I, Canada
| | - Joseph J O'Rourke
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, T-325, 2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5I, Canada
| | - Lise Labonté
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada
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Lagunes-Cordoba E, Davalos A, Fresan-Orellana A, Jarrett M, Gonzalez-Olvera J, Thornicroft G, Henderson C. Mental Health Service Users' Perceptions of Stigma, From the General Population and From Mental Health Professionals in Mexico: A Qualitative Study. Community Ment Health J 2021; 57:985-993. [PMID: 32892303 PMCID: PMC8131298 DOI: 10.1007/s10597-020-00706-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/26/2020] [Indexed: 11/28/2022]
Abstract
Negative attitudes towards people with mental health disorders have been widely studied and identified in the general population, and even within health care professionals. Moreover, studies focused on service users have also identified mental health professionals, including psychiatrists, as a source of stigma. However, in Mexico and Latin America few studies have been conducted addressing this issue. To explore mental health service users' perceptions of stigma by members of the general population and by psychiatrists in Mexico, service users at a psychiatric hospital in Mexico were invited to participate in either focus groups or individual interviews, which were audio recorded, transcribed and analysed using thematic analysis. A total of 47 service users participated in this study. The results suggested that participants were not only aware of the possible consequences of mental health related stigma, but they have also experienced stigmatisation for having a mental illness. Participants also considered psychiatrists can hold negative attitudes towards people with mental illness, something that can represent a barrier for them to have optimal quality of care. Therefore, participants agreed that these attitudes should be addressed to improve the care they received from these professionals. This study suggests that, like members of the general population, psychiatrists are also considered as a source of stigma by people with mental illness in Mexico. These findings not only add to previous work conducted in Mexico and other countries, they also confirm the importance of addressing negative attitudes in this group of health professionals.
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Affiliation(s)
- Emmeline Lagunes-Cordoba
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Alan Davalos
- Instituto Nacional de Psiquiatría "Ramón de La Fuente Muñíz", Mexico City, Mexico
| | - Ana Fresan-Orellana
- Instituto Nacional de Psiquiatría "Ramón de La Fuente Muñíz", Mexico City, Mexico
| | | | | | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.,Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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40
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Markham S. The omnipresence of risk and associated harms in secure and forensic mental health services in England and Wales. SOCIAL THEORY & HEALTH 2021; 21:1-17. [PMID: 34149319 PMCID: PMC8207492 DOI: 10.1057/s41285-021-00167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2021] [Indexed: 11/30/2022]
Abstract
Current legislation and policy frameworks regulating the detention and treatment of mentally disordered offenders in England and Wales are predicated on the assumption that a minority of patients have enduring violent tendencies and pose a serious long-term risk to the safety of others. This paper seeks to consider the manner in which notions of risk and the imperative to contain and minimise the potential for harm, present and impact patients in secure and forensic mental health settings. Within this, we consider how mental health stigma and Beck's concept of the Risk Society can affect the thoughts and actions of those who may be held accountable for rare but potentially serious harmful events. We consider what changes may need to be enacted within secure and forensic mental health services to reduce the incidence and severity of consequent risks of harm to patients and their mental health recovery.
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Affiliation(s)
- Sarah Markham
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO72 De Crespigny Park, Denmark Hill, London, SE5 8AF UK
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The Assessment of Attitudes of Medical Doctors towards Psychiatric Patients-A Cross-Sectional Online Survey in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126419. [PMID: 34199325 PMCID: PMC8296253 DOI: 10.3390/ijerph18126419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022]
Abstract
(1) Introduction: Stigmatization is a multi-level process leading to depreciation of particular social groups. It is particularly visible among people suffering from mental illnesses. Patient stigmatization is a serious problem in psychiatric care; thus, a reliable assessment of its level is important in the context of effective medical interventions. The aim of this paper is to assess the level of stigmatization of psychiatric patients among doctors. (2) Methods: An online, quantitative, CAWI (Computer Assisted Web Interview) study was conducted in the form of an anonymous, voluntary survey addressed to doctors working in Poland. The questionnaire questions included a socio-geographic assessment and questions assessing the level of stigmatization. A standardized psychometric tool, the MICA-4 Scale for doctors, was also used. The results obtained were compared with the evaluation of the existing reports on stigmatization among Polish society. (3) Results: 501 doctors of various specialties and at various stages of career participated in the study. Most of the respondents were women (75%). The average score of MICA-4 obtained by the respondents was 40.26 (minimum 17; maximum 67; SD 8.93). The women’s score was lower than the men’s (p = 0.034). (4) Conclusions: Stigmatization of psychiatric patients is a common phenomenon among doctors. The type of performed work and career stage has an impact on the perception of psychiatric patients. Specialists scored highest in the MICA-4 Scale, similarly to physicians of surgical fields. Due to the prevalence of the phenomenon of stigmatization, especially among people who are meant to provide patients with help, there is an urgent need to implement anti-stigma programs.
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42
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Kay-Lambkin F, Searl A, Johnson MP, Baker A. Working with people experiencing psychotic disorders and co-occurring nicotine dependence: Attitudes and reflections from psychologists on the Healthy Lifestyles research trial. Bull Menninger Clin 2021; 85:204-230. [PMID: 34032459 DOI: 10.1521/bumc.2021.85.2.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The combination of psychotic and substance use disorders compounds the well-documented challenges of treatment engagement, retention, and outcome for these single conditions. This study focuses on the formation of alliance among this important clinical group. Psychologists working on a research trial participated in qualitative interviews focused on their impression of delivering treatment to people with psychotic disorders and concurrent nicotine dependence. Utilizing Interpretive Phenomenological Analysis, the authors highlighted the complex and unusual experience of working with people with psychotic disorders and concurrent nicotine dependence, the importance of considering each client as an individual, and the many layers of interaction between therapist and client. The authors found that meaningful therapeutic relationships over the longer term are possible, even when active symptoms are present. There is also potential for telephone-based treatments to work well. Clinical supervision and support, tailored to the unique experience of therapists working with psychotic populations, is pivotal.
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Affiliation(s)
- Frances Kay-Lambkin
- Professor/Senior Research Fellow in the School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Amanda Searl
- Clinical Psychologist in the School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Martin P Johnson
- Senior Lecturer in the School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Amanda Baker
- Professor/Senior Clinical Psychologist in the School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
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Time Waits for No One: Longitudinal Study on the Effects of an Anti-Stigma Seminar on the Psychology Student Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105441. [PMID: 34069628 PMCID: PMC8161382 DOI: 10.3390/ijerph18105441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022]
Abstract
The primary aim is to describe the changes in the knowledge of mental health conditions, the attitudes toward the mentally ill, and the intended behaviour towards people with mental illness among the entire student population of the third year of a degree course in Psychology. A total of 570 students attended a seminar on stigma towards mental illness and were invited to complete an online survey which collected data on sociodemographic characteristics and three validated questionnaires evaluating different aspects of stigma at three different time points (pre-intervention, post-intervention, and at one year follow up). A total of 253 students (44.39%) completed the questionnaires at t0, t1, and t2. The mean age of the sample was 23.7 (SD = ±5.89), and 86.96% (n = 220) were females. Between t0 and t1, a statistically significant improvement was observed for all three outcomes, while the intended behaviour outcome was no longer significant between t1 and t2 (Z = −0.70; p = 0.48). Females and who participated live at the seminar maintained a significant knowledge of mental illness and a better attitude toward community mental health care. The effects of the seminar focused on reducing stigma tended to diminish over time at one year follow-up, particular in relation to intended behaviour.
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44
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Kluemper A, Heath L, Loeb D, Kroehl M, Trinkley K. Depression-related stigma among primary care providers. Ment Health Clin 2021; 11:175-180. [PMID: 34026392 PMCID: PMC8120988 DOI: 10.9740/mhc.2021.05.175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Depression is one of the most common mental illnesses in the United States and is often treated in primary care settings. Despite its prevalence, depression remains underdiagnosed and undertreated for a variety of reasons, including stigma. This may result in suboptimal management of depression. Studies evaluating stigma in US primary care providers (PCP) are scarce. The main objective of this study was to describe stigma in a cohort of PCPs. Methods We utilized a validated questionnaire to measure stigma (score range 15 to 75 with lower scores indicating lower stigma levels). PCPs in 2 academic internal medicine clinics were sent an electronic questionnaire and received a small monetary incentive for responding. In addition to the stigma survey, we collected demographic data, including age, provider type, gender, and other data related to social proximity to mental illness. To describe stigma, differences in stigma between provider characteristics were evaluated using t tests and ANOVA tests as appropriate. Results Of 107 PCPs, 71 responded (66.4% response rate). Male responders displayed higher stigma scores than females (31.8 vs 27.4, P = .0021). Medical residents displayed higher stigma scores than nonresidents (31.3 vs 27.2, P = .0045). Providers with personal exposure to mental illness and those who reported they frequently treated depression had less stigma. Discussion Overall, a range of stigma was present among PCPs surveyed. Higher levels of stigma were found in men, medical residents, those without personal exposure to mental illness, younger PCPs, and those who reported treating depression less frequently. Future studies should utilize larger sample sizes and focus on the impact of stigma on quality of care.
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Affiliation(s)
- Andrew Kluemper
- Assistant Professor, University of Utah College of Pharmacy, Salt Lake City, Utah.,Associate Professor-Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado.,Biostatistician, Charter Communications Corporation, Greenwood Village, Colorado.,Associate Professor, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
| | - Lauren Heath
- Assistant Professor, University of Utah College of Pharmacy, Salt Lake City, Utah
| | - Danielle Loeb
- Associate Professor-Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Miranda Kroehl
- Biostatistician, Charter Communications Corporation, Greenwood Village, Colorado
| | - Katy Trinkley
- Associate Professor, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
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Scale development and an educational program to reduce the stigma of schizophrenia among community pharmacists: a randomized controlled trial. BMC Psychiatry 2021; 21:211. [PMID: 33902519 PMCID: PMC8077925 DOI: 10.1186/s12888-021-03208-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/11/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. We developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with patients diagnosed with schizophrenia (PDS) using the newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP). METHODS SSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with PDS. Participants were individually allocated to two groups: educational lecture group (56; only attending a lecture on schizophrenia) or contact-based intervention group (59; communicating with PDS and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention. RESULTS A total of 4 factors and 27 items were extracted from the exploratory factor analysis to comprise the SSCP. Cronbach's α of SSCP, social distance at professional pharmacy service (factor I), attitudes towards PDS (factor II), self-disclosure (factor III), and social distance in personal (factor IV) were 0.89, 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were - 9.0 (- 16.0 - - 5.0) in the contact-based intervention group and - 3.0 (- 7.0-1.0) in the educational lecture group, reflecting a significant reduction of stigma levels in the contact-based intervention group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20-39 years or with negligible experience of communicating with PDS at work and/or in private life. CONCLUSIONS SSCP and the educational program for community pharmacists that focuses on communication with PDS were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia. TRIAL REGISTRATION UMIN Clinical Trials Registry ( UMIN000043189 , registered on January 30, 2021), Retrospectively registered.
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Jacq KD, Norful AA, Larson E. Nurses' and Mental Health Technicians' Attitudes and Social Acceptance of People with Mental Illness. Issues Ment Health Nurs 2021; 42:365-375. [PMID: 32822233 DOI: 10.1080/01612840.2020.1799272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Over 43 million Americans are diagnosed with a mental illness. Various factors, including health professionals' attitudes, prevent patients from seeking care. Previous evidence fails to identify nursing staff attitudes toward patients with mental illness. This cross-sectional study investigated attitudes toward mental illness of 146 registered nurses and mental health technicians in a psychiatric hospital. The study was guided by the Modified Labeling Theory. Respondents expressed stereotyping beliefs that people with mental illness would be devaluated and discriminated, and endorsed stigmatizing attitudes expressing stronger desire for social distance from a person with schizophrenia than depression or diabetes. Implications for future research, nursing education and practice are discussed.
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Affiliation(s)
- Krystyna de Jacq
- Lienhard School of Nursing, Pace University, New York, New York, USA
| | | | - Elaine Larson
- School of Nursing, Columbia University, New York, New York, USA
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O'Connor LK, Yanos PT. Where are all the psychologists? A review of factors impacting the underrepresentation of psychology in work with serious mental illness. Clin Psychol Rev 2021; 86:102026. [PMID: 33813162 DOI: 10.1016/j.cpr.2021.102026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/18/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
Over the last few decades, clinical psychologists have played a key role in the development of empirically-validated psychosocial interventions for those with serious mental illness (SMI). However, in contrast to these substantial contributions, clinical psychologists in the United States are grossly underrepresented in treatment provision with this population (Roe, Yanos, & Lysaker, 2006; Rollins & Bond, 2001). This review aims to highlight various factors contributing to the establishment and perpetuation of this underrepresentation. First, we highlight systemic factors (e.g., the emergence of managed care) through an examination of the evolving role of the clinical psychologist. Next, we review training-based factors (e.g., limitations to SMI specific training) through a review of training in clinical psychology. Through an examination of training factors, the role of mental health stigma amongst clinicians toward individuals with SMI is identified as a potential perpetuating factor of this underrepresentation. Factors associated with clinician stigma are then reviewed and the relationship between clinical training and clinician stigma is considered. Lastly, important future directions to further investigate and address this underrepresentation are suggested - namely, investigating factors (training and individual) that may impact clinical psychology doctoral students' attitudes toward those with SMI.
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Affiliation(s)
- Lauren K O'Connor
- John Jay College of Criminal Justice, USA; CUNY Graduate Center, USA.
| | - Philip T Yanos
- John Jay College of Criminal Justice, USA; CUNY Graduate Center, USA
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Gal G, Shadmi E, Hoter-Ishay G, Gelkopf M, Roe D. Comparing outcome measures of persons with severe mental illness in vocational rehabilitation programs: a dual perspective of consumers and providers. Int J Qual Health Care 2021; 34:ii105–ii111. [PMID: 32232319 DOI: 10.1093/intqhc/mzaa030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/18/2020] [Accepted: 03/05/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Vocational rehabilitation for people with severe mental illness (SMI) has many benefits. Among the existing models, supported employment has consistently shown to have better impact on vocational outcomes while the findings on non-vocational outcomes are inconsistent. One source of variation with regard to non-vocational outcomes could be related to differences between consumers' self-reports and the providers' point of view. DESIGN A cross-sectional study of people with SMI consuming three different vocational services and their service providers. SETTING Data were collected as part of the Israeli Psychiatric Rehabilitation Patient Reported Outcome Measurement project. PARTICIPANTS The current data is based on 3666 pairs of people with SMI consuming vocational services and their service providers. INTERVENTIONS Vocational services included supported employment, sheltered workshops and vocational support centers. MAIN OUTCOME MEASURES The consumers-filled self-report questionnaires, which consisted of the following patient-reported outcome measurements (PROMs): quality of life, functioning and illness management. Primary professional providers were given instruments that mirrored the ones designed for self-report. RESULTS According to providers' ratings, supported employment was associated with higher functioning (F = 78.6, P < 0.001) and illness management (F = 33.0, P < 0.001) compared to other vocational services. PROMs revealed that supported employment was associated with higher functioning only (F = 31.5, P < 0.001). Consumers rated themselves higher compared to providers on all measures. CONCLUSIONS This study provides a deeper insight into non-vocational outcomes of people with SMI participating in vocational services and suggests differences in perspectives between consumers and providers with regard to outcome measures.
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Affiliation(s)
- Gilad Gal
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Rabenu Yerucham st, Yaffo, 6818211, Israel
| | - Efrat Shadmi
- The Cheryl Spencer Nursing Department of Nursing, Faculty of Social Welfare and Health Sciences, Haifa University, Abba Khoushy Ave 199, Haifa, 3498838, Israel
| | - Gili Hoter-Ishay
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, Haifa University, Israel
| | - Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, Haifa University, Israel
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, Haifa University, Israel.,Department of Clinical Medicine, Psychiatry, Aalborg University, Nybrogade 12, 9000 Aalborg, Denmark
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Nohr L, Lorenzo Ruiz A, Sandoval Ferrer JE, Buhlmann U. Mental health stigma and professional help-seeking attitudes a comparison between Cuba and Germany. PLoS One 2021; 16:e0246501. [PMID: 33571232 PMCID: PMC7877775 DOI: 10.1371/journal.pone.0246501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/21/2021] [Indexed: 11/04/2022] Open
Abstract
Globally the burden due to mental disorders is continuously increasing. Still, professional help-seeking behavior is not fully understood. To conceive cultural determinants of help-seeking is crucial to reduce personal and social costs of (untreated) mental disorders. The current study investigates mental health stigma and help-seeking attitudes in a Cuban (n = 195) and a German (n = 165) sample. In a questionnaire survey we asked for attitudes towards mental illness and professional help-seeking in the general Cuban and German populations. The cultural context was associated with mental health stigma and professional help-seeking attitudes. Interestingly, Cuban participants reported stronger mental health stigma and more willingness to seek help. In multiple hierarchical regression analyses, community attitudes towards the mentally ill significantly predicted help-seeking attitudes, especially in the Cuban sample. Only in the German sample, more negative individual beliefs about mental illness predicted more self-stigma on help-seeking. Beyond that, cultural context moderated the association between mental health stigma and help-seeking attitudes with a stronger association between the measures in the German sample. However, gender did not predict help-seeking attitudes and self-stigma on help-seeking and no interactions between community attitudes, cultural context, and gender were found in the prediction of help-seeking attitudes. Similarities and differences between the samples are discussed in the light of the cultural contexts and peculiarities of the current samples. Concluding, implications of the current findings are reviewed.
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Affiliation(s)
- Laura Nohr
- Division of Clinical Psychology and Psychotherapy, Department of Psychology and Sport Science, University of Münster, Münster, North Rhine-Westphalia, Germany
- * E-mail:
| | - Alexis Lorenzo Ruiz
- Division of Clinical Psychology, Department of Psychology, University of Havana, Ciudad de La Habana, La Habana, Cuba
| | - Juan E. Sandoval Ferrer
- Division of Psychiatry and Psychology, Outpatient Clinic of Mental Health Service, University Hospital General Calixto García Iñiguez, Ciudad de La Habana, La Habana, Cuba
| | - Ulrike Buhlmann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology and Sport Science, University of Münster, Münster, North Rhine-Westphalia, Germany
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Detecting changes in attitudes toward depression on Chinese social media: A text analysis. J Affect Disord 2021; 280:354-363. [PMID: 33221722 DOI: 10.1016/j.jad.2020.11.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/16/2020] [Accepted: 11/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Depression is a common and sometimes severe form of mental illness, and public attitudes towards depression can impact the psychological and social functioning of depressed patients. The purpose of the present study was to investigate public attitudes toward depression and three-year trends in these attitudes using big data analysis of social media posts in China. METHODS A search of publically available Sina Weibo posts from January 2014 to July 2017 identified 20,129 hot posts with the keyword term "depression". We first used a Chinese Linguistic Psychological Text Analysis System (TextMind) to analyze linguistic features of the posts. And, then we used topic models to conduct semantic content analysis to identify specific themes in Weibo users' attitudes toward depression. RESULTS Linguistic features analysis showed a significant increase over time in the frequency of terms related to affect, positive emotion, anger, cognition (including the subcategory of insight), and conjunctions. Semantic content analysis identified five common themes: severe effects of depression, stigma, combating stigma, appeals for understanding, and providing support. There was a significant increase over time in references to social (as opposed to professional) support, and a significant decrease over time in references to the severe consequences of depression. CONCLUSIONS Big data analysis of Weibo posts is likely to provide less biased information than other methods about the public's attitudes toward depression. The results suggest that although there is ongoing stigma about depression, there is also an upward trend in mentions of social support for depressed persons. A supervised learning statistical model can be developed in future research to provide an even more precise analysis of specific attitudes.
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