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Ngo VK, Vu TT, Levine D, Punter MA, Beane SJ, Weiss MR, Wyka K, Florez-Arango JF, Zhou X. A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program). BMC Public Health 2024; 24:2554. [PMID: 39300414 DOI: 10.1186/s12889-024-20026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation. METHODS In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers' needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization. DISCUSSION We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide. TRIAL REGISTRATION NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023.
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Affiliation(s)
- Victoria K Ngo
- Center for Innovation in Mental Health, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA
| | - Thinh T Vu
- Center for Innovation in Mental Health, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA.
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA.
| | - Deborah Levine
- Harlem Health Initiative, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Malcolm A Punter
- Harlem Congregations for Community Improvement, Inc., New York, USA
| | | | - Marina R Weiss
- Center for Innovation in Mental Health, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, NY, New York, USA
| | | | - Xin Zhou
- Department of Biostatistics, Yale School of Public Health, Connecticut, USA
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Zamorano S, González-Sanguino C, Fernández-Jiménez E, Muñoz M. A Burnt-Out Health: Stigma towards Mental Health Problems as a Predictor of Burnout in a Sample of Community Social Healthcare Professionals. Behav Sci (Basel) 2024; 14:812. [PMID: 39336027 PMCID: PMC11429299 DOI: 10.3390/bs14090812] [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: 07/19/2024] [Revised: 09/09/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Burnout is a primary psychosocial risk factor in the workplace. Mental health stigma, which includes negative cognitions, emotions, and behaviors, also undermines the performance of social healthcare professionals. This study aimed to explore the levels of burnout in a sample of community social healthcare workers as well as its relationships with variables such as stigma towards mental health problems, professional skills, and job characteristics. An online assessment was conducted with 184 social healthcare professionals (75.5% female, mean age = 40.82 years, SD = 9.9). Medium levels of burnout and stigma and high levels of professional skills were observed. Multiple linear regression analyses revealed that stigma towards mental health problems and professional skills predicted emotional exhaustion (R2 = 0.153, F(4, 179) = 9.245, p < 0.001), depersonalization (R2 = 0.213, F(3, 180) = 17.540, p < 0.001), and personal accomplishment (R2 = 0.289, F(5, 178) = 15.87, p < 0.001). These findings suggest that social healthcare systems could benefit from taking care of the mental health of their workers by addressing burnout, tackling negative attitudes towards mental health problems, and providing professional skills training. This would help to make social healthcare systems more inclusive and of higher quality, thereby reducing health costs.
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Affiliation(s)
- Sara Zamorano
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
| | - Clara González-Sanguino
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
- Department of Psychology, School of Education and Social Work, University of Valladolid, 47011 Valladolid, Spain
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, 28046 Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
- Faculty of Social Sciences and Communication, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Manuel Muñoz
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
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Witte TH, Oldenburg B. Substance Use Disorder Stigma and Professional Decision Making Among Pre-Professional Healthcare Trainees. JOURNAL OF DRUG EDUCATION 2024:472379241278326. [PMID: 39169754 DOI: 10.1177/00472379241278326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Provider stigma toward people who have substance use disorders (SUDs) may be a barrier to effective treatment delivery. The purpose of this study was to measure provider stigma among healthcare professionals-in-training and determine whether stigma levels were associated with professional decision making. A sample of 240 participants were recruited from the following academic programs at a large university in the southeastern United States: Nursing, Social Work, Counseling, Marriage and Family Therapy, and Psychology. Through an online, anonymous survey, provider stigma and other constructs were measured. The participants were also asked to make two hypothetical professional decisions: one regarding their choice to provide treatment for an SUD patient and the other regarding their likelihood of attending a professional development event (i.e., conference session) on the topic of SUDs. Results showed that self-reported stigma toward patients with SUDs was associated with a reduced likelihood of choosing to provide treatment for a patient with SUD (compared to patients with other conditions) and a reduced likelihood of attending SUD training at an upcoming conference (compared to other conference topics). Results have potential implications for the development of training programs for pre-professional healthcare trainees.
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Affiliation(s)
- Tricia H Witte
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Brantley Oldenburg
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Alabama, USA
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McGhie-Fraser B, Ballering A, Lucassen P, McLoughlin C, Brouwers E, Stone J, Olde Hartman T, van Dulmen S. Validation of the Persistent Somatic Symptom Stigma Scale for Healthcare Professionals. J Clin Epidemiol 2024; 174:111505. [PMID: 39159771 DOI: 10.1016/j.jclinepi.2024.111505] [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: 02/21/2024] [Revised: 06/14/2024] [Accepted: 08/13/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVES Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While many studies have explored stigmatisation by healthcare professionals toward people with PSS, there is a lack of validated measurement instruments. We recently developed a stigma scale, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). The aim of this study is to evaluate the measurement properties (validity and reliability) and factor structure of the PSSS-HCP. STUDY DESIGN AND SETTING The PSSS-HCP was tested with 121 healthcare professionals across the United Kingdom to evaluate its measurement properties. Analysis of the factor structure was conducted using principal component analysis. We calculated Cronbach's alpha to determine the internal consistency of each (sub)scale. Test-retest reliability was conducted with a subsample of participants with a 2-week interval. We evaluated convergent validity by testing the association between the PSSS-HCP and the Medical Condition Regard Scale (MCRS) and the influence of social desirability using the short form of the Marlowe-Crowne Social Desirability Scale (MCSDS). RESULTS The PSSS-HCP showed sufficient internal consistency (Cronbach's alpha = 0.84) and sufficient test-retest reliability, intraclass correlation = 0.97 (95% CI 0.94-0.99, P < .001). Convergent validity was sufficient between the PSSS-HCP and the MCRS, and no relationship was found between the PSSS-HCP and the MCSDS. A three factor structure was identified (othering, uneasiness in interaction, non-disclosure) which accounted for 60.5% of the variance using 13 of the 19 tested items. CONCLUSION The PSSS-HCP can be used to measure PSS stigmatisation by healthcare professionals. The PSSS-HCP has demonstrated sufficient internal consistency, test-retest reliability, convergent validity and no evidence of social desirability bias. The PSSS-HCP has demonstrated potential to measure important aspects of stigma and provide a foundation for stigma reduction intervention evaluation.
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Affiliation(s)
- Brodie McGhie-Fraser
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Aranka Ballering
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Lucassen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caoimhe McLoughlin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Evelien Brouwers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Tim Olde Hartman
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra van Dulmen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands; Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Torres IN, Pereira HP, Moreira MBP, Marina S, Ricou M. Prevalence of stigma towards mental illness among Portuguese healthcare professionals: a descriptive and comparative study. Front Psychiatry 2024; 15:1425301. [PMID: 39149153 PMCID: PMC11324421 DOI: 10.3389/fpsyt.2024.1425301] [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: 04/29/2024] [Accepted: 07/17/2024] [Indexed: 08/17/2024] Open
Abstract
Background Stigmatising attitudes among healthcare professionals can hinder access to healthcare, making it important to address this issue. This study aimed to investigate the prevalence of stigma related to mental illness among Portuguese healthcare professionals and to compare the results among mental health professionals, General Practitioners (GPs) and other health professionals. Methods An online cross-sectional observational study was conducted in Portugal using Google Forms® to collect data. The data collection process lasted five months, from September 2023 to January 2024. Participants were recruited from various professional associations and Health Centre Groups, through a purposive sampling. The study used the Portuguese version of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) to measure stigma which assesses three dimensions: attitudes towards disclosure and help-seeking, attitudes towards people with mental illness, and attitudes towards social distance. Results A total of 292 healthcare professionals participated in the study. In Portugal, healthcare professionals displayed low to moderate levels of stigma towards mental illness (M = 22.17, SD = 5.41). Mental health professionals demonstrated significantly lower levels of stigma (M=20.37, SD=5.37) compared to other healthcare professionals (M=24.15, SD=4.71), including GPs (M=23.97, SD=5.03). Additionally, having a close friend or relative with mental illness seemed to be related with lower levels of stigma for the dimension attitudes towards social distance (M=6.93, SD=2.50), compared to not having one (M=7.60, SD=2.56). On the other hand, a personal history of mental illness indicated higher levels of stigma for the dimension disclosure and help-seeking (M=8.95, SD=3.07), compared to having no history of mental illness (M=8.16, SD=2.67). Conclusion This study indicates that Portuguese healthcare professionals have stigmatising attitudes towards mental illness, although at low to moderate levels. Training and frequent interaction with people with mental illness seem to be associated with lower levels of stigma. Personal experience of mental illness seems to follow the opposite path regarding disclosure and seeking help. Thus, further research is necessary to evaluate the effectiveness of anti-stigma measures and deepen the study of the concept of self-stigma in healthcare professionals.
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Affiliation(s)
- Inês N Torres
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Helena P Pereira
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Sílvia Marina
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel Ricou
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
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Cid A, Patten A, Beazely MA, Grindrod K. Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma. PHARMACY 2024; 12:105. [PMID: 39051389 PMCID: PMC11270195 DOI: 10.3390/pharmacy12040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach's α co-efficient were calculated for each version. The term "opioid addiction" was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions.
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Affiliation(s)
- Ashley Cid
- School of Pharmacy, University of Waterloo, 10A Victoria St. S, Kitchener, ON N2G 1C5, Canada; (A.P.); (K.G.)
| | | | - Michael A. Beazely
- School of Pharmacy, University of Waterloo, 10A Victoria St. S, Kitchener, ON N2G 1C5, Canada; (A.P.); (K.G.)
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Rehl D, Mangapora M, Love M, Love C, Shaw K, McCarthy J, Beverly EA. Feasibility of a cinematic-virtual reality training program about opioid use disorder for osteopathic medical students: a single-arm pre-post study. J Osteopath Med 2024; 0:jom-2023-0188. [PMID: 38965036 DOI: 10.1515/jom-2023-0188] [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: 08/09/2023] [Accepted: 05/16/2024] [Indexed: 07/06/2024]
Abstract
CONTEXT Opioid use disorder (OUD) has a considerable morbidity and mortality in the United States. Healthcare providers are key points of contact for those with OUD; however, some providers may hold stigma toward OUD. Stigma toward OUD can lead to lower quality of care and more negative health outcomes. Thus, new trainings designed to reduce stigma toward OUD while increasing empathy are critical. We created a web-based cinematic virtual reality (cine-VR) training program on OUD for osteopathic medical students. OBJECTIVES The aim of this pilot study was to assess changes in stigma toward OUD and empathy before and after the online cine-VR training program on OUD. METHODS We employed a single-arm, pre- and posttest pilot study to assess changes in stigma toward OUD and empathy. Osteopathic medical students from one large medical school in the Midwest with three campuses were invited to participate in the online cine-VR training. Participants completed two surveys before and after the cine-VR training. We performed paired t tests to examine changes in stigma toward OUD and empathy scores before and after the cine-VR OUD training program. RESULTS A total of 48 participants completed the training. We observed a decrease in stigma toward OUD posttraining (t=4.402, p<0.001); this change had a Cohen's d of 0.64, indicating a medium effect. We also observed an increase in participants' empathy scores posttraining (t=-2.376, p=0.023), with a Cohen's d of 0.40 signifying a small effect. CONCLUSIONS Findings from this pilot study suggest that the online cine-VR training may reduce stigma toward OUD while increasing empathy. Future research employing a randomized controlled trial design with a larger, more diverse sample and a proper attention control condition is needed to confirm the effectiveness of the online cine-VR training. If confirmed, this cine-VR training may be an accessible approach to educating osteopathic medical students about OUD.
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Affiliation(s)
- Dominique Rehl
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Mason Mangapora
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Matthew Love
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
| | - Carrie Love
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
| | - Kerri Shaw
- Ohio Alliance for Population Health, Ohio University, Athens, OH, USA
| | - John McCarthy
- College of Health Sciences Professions, Ohio University, Athens, OH, USA
| | - Elizabeth A Beverly
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
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Briand C, Giguère CÉ, Macario de Medeiros J, Vallée C, Luconi F, Vachon B, Drolet MJ, Monthuy-Blanc J, Mahroug A, Hakin R. The effectiveness of an online short-format Recovery College model: a co-learning model to support mental health. Int J Ment Health Syst 2024; 18:17. [PMID: 38698411 PMCID: PMC11065681 DOI: 10.1186/s13033-024-00637-7] [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: 11/08/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Our societies are facing mental health challenges, which have been compounded by the Covid-19. This event led people to isolate themselves and to stop seeking the help they needed. In response to this situation, the Health and Recovery Learning Center, applying the Recovery College (RC) model, modified its training program to a shorter online format. This study examines the effectiveness of a single RC training course delivered in a shortened online format to a diverse population at risk of mental health deterioration in the context of Covid-19. METHODS This quasi-experimental study used a one-group pretest-posttest design with repeated measures. Three hundred and fifteen (n = 315) learners agreed to take part in the study and completed questionnaires on wellbeing, anxiety, resilience, self-management, empowerment and stigmatizing attitudes and behaviors. RESULTS Analyses of variance using a linear mixed models revealed that attending a RC training course had, over time, a statistically significant effect on wellbeing (p = 0.004), anxiety (p < 0.001), self-esteem/self-efficacy (p = 0.005), disclosure/help-seeking (p < 0.001) and a slight effect on resilience (p = 0.019) and optimism/control over the future (p = 0.01). CONCLUSIONS This study is the first to measure participation in a single online short-format RC training course, with a diversity of learners and a large sample. These results support the hypothesis that an online short-format training course can reduce psychological distress and increase self-efficacy and help-seeking. TRIAL REGISTRATION This study was previously approved by two certified ethics committees: Comité d'éthique de la recherche du CIUSSS EMTL, which acted as the committee responsible for the multicenter study, reference number MP-12-2021-2421, and Comité d'éthique avec les êtres humains de l'UQTR, reference number CER-20-270-07.01.
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Affiliation(s)
- Catherine Briand
- Department of Occupational Therapy, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada.
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada.
| | - Charles-Édouard Giguère
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | | | - Catherine Vallée
- School of Rehabilitation Sciences, Université Laval, Québec City, Québec, Canada
| | - Francesca Luconi
- Office for Continuing Professional Development, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Brigitte Vachon
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Josée Drolet
- Department of Occupational Therapy, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Johana Monthuy-Blanc
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
- Department of Education, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Amani Mahroug
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Régis Hakin
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
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Kyzar EJ, Arbuckle MR, Abba-Aji A, Balachandra K, Cooper J, Dela Cruz A, Edens E, Heward B, Jibson M, Jordan A, Moreno-De-Luca D, Pazderka H, Singh M, Weleff JJ, Yau B, Young J, Ross DA. Leveraging neuroscience education to address stigma related to opioid use disorder in the community: a pilot study. Front Psychiatry 2024; 15:1360356. [PMID: 38563031 PMCID: PMC10982477 DOI: 10.3389/fpsyt.2024.1360356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Opioid use disorder (OUD) and overdose deaths are a public health crisis. One contributing factor is stigma towards people who use opioids. We developed and conducted a public-facing, half-day educational event designed to challenge misperceptions about OUD from a contemporary neuroscience perspective. Participants engaged with three different resources on the neurobiology of addiction, and, at the end of the event, they rated its effectiveness. We also collected and compared pre- and post-event composite OUD stigma scales. Participants rated our approach and the overall event as highly effective. Additionally, OUD stigma scores were lower immediately following the event, and this decrease was primarily driven by decreased internalized stigma. Here, we demonstrate an effective proof-of-concept that an accessible, public-facing, neuroscience education event may reduce OUD stigma in the community.
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Affiliation(s)
- Evan J Kyzar
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Adam Abba-Aji
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Krishna Balachandra
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Joseph Cooper
- Department of Psychiatry, University of Illinois, Chicago, IL, United States
| | - Adriane Dela Cruz
- Department of Psychiatry, University of Texas, Dallas, TX, United States
| | - Ellen Edens
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brady Heward
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington, VT, United States
| | - Michael Jibson
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan MI, United States
| | - Ayana Jordan
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Daniel Moreno-De-Luca
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
- CASA Mental Health, Edmonton, AB, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Mohit Singh
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Jeremy J Weleff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Bernice Yau
- Department of Psychiatry, University of Texas, Dallas, TX, United States
| | - Justin Young
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - David A Ross
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
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Moreira MBP, Pereira HP, Torres IN, Marina S, Ricou M. The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC). Front Psychol 2024; 15:1359483. [PMID: 38515965 PMCID: PMC10955081 DOI: 10.3389/fpsyg.2024.1359483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals. Methods A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72). Conclusion The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.
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Affiliation(s)
| | - Helena P. Pereira
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês N. Torres
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sílvia Marina
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel Ricou
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
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Tran AR, Patel SA, Loera LJ, Smith T, Catanzano S. The impact of early direct-contact experiences on reducing mental health stigma among student pharmacists: A pilot study. Ment Health Clin 2024; 14:73-78. [PMID: 38312437 PMCID: PMC10836568 DOI: 10.9740/mhc.2024.02.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/14/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Mental health-related stigma is a barrier to treatment and recovery for serious mental illnesses (SMIs). Educational training programs demonstrate positive changes in health professional students' attitudes and stigma toward SMI; however, student pharmacists have minimal opportunity to directly engage with the SMI population. This study aims to assess and compare student pharmacists' stigma related to SMI before and after participating in a pilot series of direct-contact workshop experiences. Methods The 15-item Opening Minds Scale for Healthcare Providers survey was administered to student pharmacists before and after the workshop experiences to measure stigma toward SMI. Five 2-hour workshops were provided to members of a local nonprofit organization serving people with SMI by student pharmacist volunteers detailing a health and wellness topic. The postworkshop survey included free text responses to obtain student feedback. Results Twenty-four complete preworkshop surveys were obtained, and most of them had positive attitudes and beliefs at baseline. Thirteen postworkshop surveys were obtained from student pharmacists who participated in a workshop event, and 9 were completed by student pharmacists who did not participate in a workshop event, which were used as a comparator group. Stigma decreased after participating in a workshop event, and those who participated demonstrated a lower degree of stigma versus the comparator group. Discussion Direct-contact experiences allow student pharmacists to interact with people with SMI earlier in their training and help reduce stigma toward those with psychiatric disorders. Future research is needed to identify large-scale changes in pharmacy student stigma.
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Affiliation(s)
- Amber R Tran
- PharmD Candidate 2024, College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Saumyaa A Patel
- PharmD Candidate 2025, College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Lindsey J Loera
- Assistant Professor of Practice, College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Tawny Smith
- Associate Professor of Psychiatry, The University of Texas at Austin Dell Medical School, Austin, Texas
| | - Samantha Catanzano
- PharmD Candidate 2024, College of Pharmacy, The University of Texas at Austin, Austin, Texas
- PharmD Candidate 2025, College of Pharmacy, The University of Texas at Austin, Austin, Texas
- Assistant Professor of Practice, College of Pharmacy, The University of Texas at Austin, Austin, Texas
- Associate Professor of Psychiatry, The University of Texas at Austin Dell Medical School, Austin, Texas
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12
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PhengPhal M, Knight M. The Impact of an Online Educational Intervention on Attitudes of Primary Care Clinicians Toward Managing Patients With Substance Use Disorders. J Addict Nurs 2024; 35:22-27. [PMID: 38574105 DOI: 10.1097/jan.0000000000000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Negative attitudes of primary care clinicians toward patients with substance use disorders affect the quality and delivery of care in this highly marginalized patient population. PURPOSE This project aimed to improve negative attitudes of primary care clinicians toward managing patients with substance use disorders. METHODS A pretest-and-posttest design, employing multidimensional online educational interventions, was implemented from June to August 2020. The participants (n = 18) were recruited from a pool of 70 primary care clinicians at two community primary care agencies. The Affect Scale for Substance Users and 15-item Opening Minds Scale for Health Care Providers were administered before, immediately after, and 30 days after the intervention. RESULTS There were statistically significant reductions in the immediate postintervention and 30-day postintervention mean scores in the Affect Scale for Substance Users and the disclosure and help-seeking subscale when compared with those of preintervention. The change in attitudes was maintained at 30-day postintervention. CONCLUSIONS The project findings support conducting and evaluating future educational programs for substance use disorder management among primary care clinicians. Because of the heterogeneity of the participants and the small sample size, the project results have limited generalizability. Overall, this project is among one of the few aimed at substance use disorder management among primary care clinicians.
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Affiliation(s)
- Miadette PhengPhal
- Miadette PhengPhal, MSN, AGPCNP-BC, and Margaret Knight, PhD, PMHCNS-BC, Solomont School of Nursing, University of Massachusetts Lowell, Lowell
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Rees A, Cuthbert C, Shah V, Rong L, Peh D, Baptista A, Smith S. Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools. BMC MEDICAL EDUCATION 2023; 23:981. [PMID: 38124141 PMCID: PMC10731839 DOI: 10.1186/s12909-023-04962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors' training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical education to prevent such attitudes propagating into clinical practice. Thus, this study explores whether stigmatising attitudes are detectable amongst medical students in London and Singapore and examines whether they are ameliorated by specific curricular and welfare features of formal medical education, utilising the Mental Illness Stigma Framework (MISF). METHODS A mixed-methods approach was adopted. Medical students at Imperial College London (UK; n = 211) and Nanyang Technological University (Singapore; n = 141) completed a validated scale (the OMS-HC-15) to assess attitudes towards mental illness. Semi-structured interviews were conducted (Imperial: n = 12, NTU: n = 8) until theoretical saturation was reached. Quantitative data were analysed descriptively and comparatively using SPSS and interview data subjected to inductive thematic analysis. RESULTS Total OMS-HC-15 scores ranged from 19-51 for Imperial (n = 211) and 16-53 for NTU (n = 141). No significant differences in overall stigma scores were found between the two schools (p = 0.24), nor when comparing year groups within each school. Four themes were identified across interview data: student perceptions, impacts of medical school culture, university support, and curricular impacts on mental illness perceptions. Themes allowed identification of aspects of medical school that were well-received and warranted further emphasis by students, alongside areas for improvement. CONCLUSION Mental health stigma was identified in two medical schools, with differing cultures. Mean stigma scores obtained were comparable between both UK and Singaporean medical students. Nuanced differences were identified via subgroup analysis, and the MISF identified both shared and country-specific drivers for this stigma across the qualitative data. Actionable recommendations to mitigate this were hypothesised. Curricular improvements such as earlier psychiatric teaching and sharing of personal stories may improve future stigma scores as students' progress through the course. Specific welfare-based changes to formal support systems were also deemed to be beneficial by students. The impacts of welfare and curricular redesign in relation to societal influence on students' attitudes warrants further investigation, as does medical students' self-stigma.
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Affiliation(s)
- Annie Rees
- School of Medicine, Imperial College London, London, UK.
| | | | - Viraj Shah
- School of Medicine, Imperial College London, London, UK
| | - Lim Rong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Daniel Peh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ana Baptista
- School of Medicine, Imperial College London, London, UK
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
| | - Susan Smith
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Kyzar EJ, Arbuckle M, Abba-Aji A, Balachandra K, Cooper J, Dela Cruz A, Edens E, Heward B, Jibson M, Jordan A, Moreno-De-Luca D, Pazderka H, Singh M, Weleff J, Yau B, Young J, Ross DA. Leveraging neuroscience education to address stigma related to opioid use disorder (OUD) in the community: A pilot study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.11.23299824. [PMID: 38168432 PMCID: PMC10760253 DOI: 10.1101/2023.12.11.23299824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Opioid use disorder (OUD) and overdose deaths are a public health crisis. One contributing factor is stigma towards people who use opioids. We developed and conducted a public-facing, half-day educational event designed to challenge misperceptions about OUD from a contemporary neuroscience perspective. Participants engaged with three different resources on the neurobiology of addiction; at the end of the event, they rated its effectiveness. We also collected and compared pre- and post-event composite OUD stigma scales. Participants rated our approach and the overall event as highly effective. Additionally, OUD stigma scores were lower immediately following the event, and this decrease was primarily driven by decreased internalized stigma. Here, we demonstrate an effective proof-of-concept that an accessible, public-facing, neuroscience education event may reduce OUD stigma in the community.
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Őri D, Szocsics P, Molnár T, Motlova LB, Kazakova O, Mörkl S, Wallies M, Abdulhakim M, Boivin S, Bruna K, Cabaços C, Carbone EA, Dashi E, Grech G, Greguras S, Ivanovic I, Guevara K, Kakar S, Kotsis K, Ingeholm Klinkby IM, Maslak J, Matheiken S, Mirkovic A, Nechepurenko N, Panayi A, Pereira AT, Pomarol-Clotet E, Raaj S, Prelog PR, Soler-Vidal J, Strumila R, Schuster F, Kisand H, Reim A, Ahmadova G, Vircik M, Kafali HY, Grinko N, Győrffy Z, Rózsa S. Attitudes of psychiatrists towards people with mental illness: a cross-sectional, multicentre study of stigma in 32 European countries. EClinicalMedicine 2023; 66:102342. [PMID: 38149261 PMCID: PMC10749877 DOI: 10.1016/j.eclinm.2023.102342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 12/28/2023] Open
Abstract
Background Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce. Methods A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978). Findings A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d = -0.92, 95% confidence interval (CI) = -1.68 to -0.15, p = 0.019), receiving medical treatment for a mental illness (d = -0.88, 95% CI = -1.71 to -0.04, p = 0.040), as well as having a friend or a family member similarly affected (d = -0.68, 95% CI = -1.14 to -0.22, p = 0.004)), being surrounded by colleagues who are less stigmatising (d = -0.98, 95% CI = -1.26 to -0.70, p < 0.001), providing psychotherapy to patients (d = -1.14, 95% CI = -1.63 to -0.65 p < 0.001), and being open to (d = -1.69, 95% CI = -2.53 to -0.85, p < 0.001) and actively participating in (d = -0.94, 95% CI = -1.45 to -0.42, p < 0.001) case discussion, supervision, or Balint groups. Interpretation Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross-national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration. Funding National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134). All authors received no funding for their contribution.
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Affiliation(s)
- Dorottya Őri
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Szocsics
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Molnár
- Department of Psychiatry, Aladar Petz County Teaching Hospital, Győr, Hungary
| | - Lucie Bankovska Motlova
- Division of Medical Psychology, 3rd Faculty of Medicine, Charles University, Prague, The Czech Republic
| | - Olga Kazakova
- Inpatient Psychiatric Department #2, Psychiatric Clinic of Minsk City, Minsk, Belarus
| | - Sabrina Mörkl
- Division of Medical Psychology, Psychosomatics and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | | | - Sylvie Boivin
- Department of Child and Adolescent Psychiatry, EPSM du Finistère Sud, Quimper, France
| | - Krista Bruna
- Admission Ward, State Psychiatric Hospital Gintermuiza, Jelgava, Latvia
| | - Carolina Cabaços
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, Coimbra University, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Elona Dashi
- Department of Neuroscience, University Hospital Center “Mother Theresa”, Tirane, Albania
| | - Giovanni Grech
- Mental Health Services, Mount Carmel Hospital, Attard, Malta
| | - Stjepan Greguras
- Division of Child and Adolescent Psychiatry and Psychotherapy, Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Iva Ivanovic
- Department for Child Psychiatry, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro
| | - Kaloyan Guevara
- Acute Detoxification Ward, State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism, Sofia, Bulgaria
| | - Selay Kakar
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | - Ana Mirkovic
- Child Psychiatry Unit, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nikita Nechepurenko
- The Serbsky State Scientific Center for Social and Forensic Psychiatry, Moscow, Russian Federation
| | | | - Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, Coimbra University, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Shaeraine Raaj
- Department of General Adult Psychiatry, South Meath Mental Health Service, Co.Meath, Ireland
| | - Polona Rus Prelog
- Centre for Clinical Psychiatry, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
- Hospital Benito Menni, Complex Assistencial Salut Mental, Sant Boi de Llobregat, Spain
| | - Robertas Strumila
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Psychiatric Clinic, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Florian Schuster
- Klinikum Rechts der Isar der Technischen Universität München: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Munich, Germany
| | | | - Ann Reim
- University of Tartu, Tartu, Estonia
| | - Gumru Ahmadova
- Department of Psychiatry, United City Hospital N15, Baku, Azerbaijan
| | - Matus Vircik
- Acute Psychiatric Department 1, Psychiatric Hospital Michalovce, Michalovce, Slovak Republic
| | - Helin Yilmaz Kafali
- Department of Psychology, Fevziye School Fundatitions, Işık University, Istanbul, Turkey
| | - Natalia Grinko
- Department of Clinical Psychology, Ukrainian Catholic University, Lviv, Ukraine
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Sándor Rózsa
- Department of Personality and Health Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
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Van Liew JR, Jie C, Tucker JR, Streyffeler L. Reducing stigma and increasing competence working with mental illness: Adaptation of a contact-based program for osteopathic medical students to a virtual, active learning format. MEDICAL EDUCATION ONLINE 2023; 28:2151069. [PMID: 36420940 PMCID: PMC9704085 DOI: 10.1080/10872981.2022.2151069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/18/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Contact-based education, offering meaningful contact with individuals living in recovery with mental illness, reduces stigma. This study evaluated the effectiveness of the National Alliance on Mental Illness Provider Education Program (NAMI PEP) when implemented as a curricular requirement across two cohorts of third-year osteopathic medical students, comparing traditional, passive learning and active, online delivery formats. MATERIALS AND METHODS Participants were two cohorts of third-year medical students (Cohort 1 n = 186; Cohort 2 n = 139; overall N = 325) who completed questionnaires measuring affect, beliefs, and behaviors toward patients with mental illness at pre-program, 1-week follow-up, and 6-month follow-up. For Cohort 1, the existing community-based NAMI PEP was implemented. For Cohort 2, the program was adapted to an online, active learning format tailored to medical students, and an additional 3-month follow-up assessment was added to better identify intermediate-term effects. RESULTS The NAMI PEP was associated with longitudinal improvements in target outcomes, with enhanced effects with the adapted curriculum in Cohort 2. At 6-month follow-up, students reported less stigma, fewer stereotyping negative attitudes, and lower anxiety treating patients with mental illness. They also reported increased confidence integrating psychiatry into routine care and increased competence in principles of collaborative mental health treatment. CONCLUSIONS This study demonstrates the longitudinal effectiveness of the NAMI PEP across two cohorts of medical students, with strengthened effects observed when the program is tailored to contemporary medical education.
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Affiliation(s)
- Julia R. Van Liew
- Department of Behavioral Medicine, Medical Humanities, and Bioethics, Des Moines University, Des Moines, IA, USA
| | - Chunfa Jie
- Department of Biochemistry and Nutrition, Des Moines University, Des Moines, IA, USA
| | - Jeritt R. Tucker
- Department of Behavioral Medicine, Medical Humanities, and Bioethics, Des Moines University, Des Moines, IA, USA
| | - Lisa Streyffeler
- Department of Behavioral Medicine, Medical Humanities, and Bioethics, Des Moines University, Des Moines, IA, USA
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Valdivia Ramos HN, Mora-Rios J, Natera G, Mondragón L. Psychometric properties of the Mexican version of the opening minds stigma scale for health care providers (OMS-HC). PeerJ 2023; 11:e16375. [PMID: 38025693 PMCID: PMC10655721 DOI: 10.7717/peerj.16375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Healthcare providers are one of the main groups that contribute to the stigmatization of people with mental disorders. Apathy, accusation, fatalism, and morbid curiosity are the most common forms of stigmatization encountered, and these are associated with inadequate treatment, reduced treatment adherence, decreased help-seeking behavior, an increased risk of relapse, and complications with other medical conditions. The aim of this study was to examine the psychometric properties of an adapted Spanish version of the Opening Minds Stigma Scale (OMS-HC) for healthcare providers in Mexico and identify certain stigmatizing attitudes within this group. Methods An ex-post facto cross-sectional observational study was conducted with 556 healthcare providers in Mexico, with an average age of 29.7 years, who were mostly women (80.4%). Validity was examined through confirmatory factor analysis. Differences according to gender, discipline, occupation, and educational level were analyzed using multivariate methods. Results The factor structure of the OMS-HC, consisting of three subscales identified by the original authors of the instrument (attitudes of healthcare providers towards people with mental illness, secrecy/help-seeking, and social distance), was confirmed. The model demonstrated good fit (x2/df = 2.36, RMSEA = 0.050, CFI = 0.970, TLI = 0.962, SRMR = 0.054, NFI = 0.950, PNFI = 0.742). Internal consistency was found to be adequate (α = 0.73, ω = 0.76) for the scale itself and slightly lower than acceptable for the subscales. Significant differences were found by discipline, educational level, and, for student providers, by academic semester. Higher scores were observed on the OMS-HC scale among nursing and medical professionals, undergraduate students, and those in early semesters. Conclusions The Spanish version of the OMS-HC has demonstrated adequate psychometric properties and could be a useful tool to facilitate research on this topic in Mexico, and to carry out comparative studies with healthcare personnel in other Spanish-speaking countries.
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Affiliation(s)
- Hugo Noel Valdivia Ramos
- Programa de Maestría y Doctorado de Ciencias Médicas, Ontológicas y de la Salud, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Jazmín Mora-Rios
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Guillermina Natera
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Liliana Mondragón
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
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Sheehan KA, Chaput J, Bond V, Alloo J, Bonta M, Soklaridis S, Zhang M, Sockalingam S. Exploring the Impact of ECHO Ontario Integrated Mental and Physical Health on Participants' Approach and Attitude Toward the Care of Patients With Complex Needs. J Acad Consult Liaison Psychiatry 2023; 64:512-520. [PMID: 37536441 DOI: 10.1016/j.jaclp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To examine how project Extension for Community Healthcare Outcomes-Integrated Mental and Physical Health (ECHO-IMPH) influences the attitudes and approaches of primary care providers and other participants towards patients. METHODS An exploratory qualitative approach was undertaken using semistructured interviews conducted between August 2020 and March 2021. One hundred and sixty-four individuals from two cycles of ECHO-IMPH were invited to participate, and 22 (n = 22) agreed to participate. Data were analyzed using the Braun and Clarke method for thematic analysis. RESULTS Three major themes were identified: 1) enhanced knowledge and skills; 2) changes in attitude and approach; 3) space for reflection and exploration. When participants were asked about areas for improvement, suggestions were focused on the structure of the sessions. Participants identified that ECHO-IMPH helped them to view patients more holistically, which led to greater patient-centered care in their practice. Additionally, skills gained in ECHO-IMPH gave participants the concrete tools needed to have more empathetic interactions with patients with complex needs. CONCLUSIONS ECHO-IMPH created a safe space for participants to reflect on their practice with patients with complex needs. Participants applied newly acquired knowledge and skills to provide more empathetic and patient-centered care for patients with complex needs. Based on the shift in perspectives described by participants, transformative learning theory was proposed as a model for how ECHO-IMPH created change in participants' practice.
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Affiliation(s)
- Kathleen A Sheehan
- University Health Network (UHN), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Jake Chaput
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Victoria Bond
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Javed Alloo
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Ontario College of Family Physicians, Toronto, ON, Canada
| | - Mark Bonta
- University Health Network (UHN), Toronto, ON, Canada
| | | | - Maria Zhang
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Bazzari AH, Bazzari FH. Assessing Stigma towards Mental Illness in Relation to Demographics Attitudes and Past Experiences among Pharmacy Students in a Jordanian University Sample. Behav Sci (Basel) 2023; 13:884. [PMID: 37998631 PMCID: PMC10669770 DOI: 10.3390/bs13110884] [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: 10/02/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
Stigma towards mental illness poses a significant risk for negative mental health outcomes. Efforts have been undertaken to mitigate self-stigma and stigmatizing behaviors among the public; however, few have considered stigma among healthcare providers, including pharmacists. This study aimed to assess the level of stigma towards mental illness, using the 15-item version of the Opening Minds Scale for Health Care Providers (OMS-HC), and associated factors among pharmacy students and was conducted via a printed questionnaire. A total of 125 students participated and the mean total stigma score was 47.9 with 58.4% of the participants scoring above 45, the midpoint of the possible range of scores. The stigma score was independent of participant demographics, except for grade point average. Higher total stigma scores were observed among subjects who have been prescribed a neuropsychiatric drug before, those who believe that pharmacists should have a role in mental healthcare, those who believe that pharmacists are qualified enough to provide mental health support, and those who are willing to seek help from a pharmacist. The results indicate an overall high stigma score among pharmacy students, which highlights the importance of enhancing pharmacy students' awareness and knowledge regarding mental healthcare through incorporating additional courses and/or training programs in pharmacy education curricula.
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Affiliation(s)
- Amjad H. Bazzari
- Department of Basic Scientific Sciences, Faculty of Arts & Sciences, Applied Science Private University, Amman 11931, Jordan
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Parish CL, Feaster DJ, Pollack HA, Horigian VE, Wang X, Jacobs P, Pereyra MR, Drymon C, Allen E, Gooden LK, Del Rio C, Metsch LR. Health Care Provider Stigma Toward Patients With Substance Use Disorders: Protocol for a Nationally Representative Survey. JMIR Res Protoc 2023; 12:e47548. [PMID: 37751236 PMCID: PMC10565625 DOI: 10.2196/47548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The US overdose epidemic is an escalating public health emergency, accounting for over 100,000 deaths annually. Despite the availability of medications for opioid use disorders, provider-level barriers, such as negative attitudes, exacerbate the treatment gap in clinical care settings. Assessing the prevalence and intensity of provider stigma, defined as the negative perceptions and behaviors that providers embody and enact toward patients with substance use disorders, across providers with different specialties, is critical to expanding the delivery of substance use treatment. OBJECTIVE To thoroughly understand provider stigma toward patients with substance use disorders, we conducted a nationwide survey of emergency medicine and primary care physicians and dentists using a questionnaire designed to reveal how widely and intensely provider attitudes and stigma can impact these providers' clinical practices in caring for their patients. The survey also queried providers' stigma and clinical practices toward other chronic conditions, which can then be compared with their stigma and practices related to substance use disorders. METHODS Our cross-sectional survey was mailed to a nationally representative sample of primary care physicians, emergency medicine physicians, and dentists (N=3011), obtained by American Medical Association and American Dental Association licensees based on specified selection criteria. We oversampled nonmetropolitan practice areas, given the potential differences in provider stigma and available resources in these regions compared with metropolitan areas. Data collection followed a recommended series of contacts with participants per the Dillman Total Design Method, with mixed-modality options offered (email, mail, fax, and phone). A gradually increasing compensation scale (maximum US$250) was implemented to recruit chronic nonresponders and assess the association between requiring higher incentives to participate and providers stigma. The primary outcome, provider stigma, was measured using the Medical Condition Regard Scale, which inquired about participants' views on substance use and other chronic conditions. Additional survey measures included familiarity and social engagement with people with substance use disorders; clinical practices (screening, treating, and referring for a range of chronic conditions); subjective norms and social desirability; knowledge and prior education; and descriptions of their patient populations. RESULTS Data collection was facilitated through collaboration with the National Opinion Research Center between October 2020 and October 2022. The overall Council of American Survey Research Organizations completion rate was 53.62% (1240/2312.7; physicians overall: 855/1681.9, 50.83% [primary care physicians: 506/1081.3, 46.79%; emergency medicine physicians: 349/599.8, 58.2%]; dentists: 385/627.1, 61.4%). The ineligibility rate among those screened is applied to those not screened, causing denominators to include fractional numbers. CONCLUSIONS Using systematically quantified data on the prevalence and intensity of provider stigma toward substance use disorders in health care, we can provide evidence-based improvement strategies and policies to inform the development and implementation of stigma-reduction interventions for providers to address their perceptions and treatment of substance use. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47548.
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Affiliation(s)
- Carrigan Leigh Parish
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, Miami, FL, United States
| | - Daniel J Feaster
- Department of Biostatistics, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, United States
| | - Viviana E Horigian
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Xiaoming Wang
- Office of Behavioral and Social Clinical Trials, Division of Behavioral and Social Research, National Institute on Aging/National Institute of Health, Bethesda, MD, United States
| | - Petra Jacobs
- Office of Behavioral and Social Clinical Trials, Division of Behavioral and Social Research, National Institute on Aging/National Institute of Health, Bethesda, MD, United States
| | - Margaret R Pereyra
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, Miami, FL, United States
| | | | - Elizabeth Allen
- National Opinion Research Center, Chicago, IL, United States
| | - Lauren K Gooden
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, Miami, FL, United States
| | - Carlos Del Rio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
- School of General Studies, Columbia University, New York, NY, United States
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Sevak RJ, Chandler C, Lui MC, Kaye AM, Halliwell RF, Rogan EL. Impact of a Neuropsychiatric Therapeutics Course and a Case-Based Course on Pharmacy Students' Mental Health Stigma. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100125. [PMID: 37714654 DOI: 10.1016/j.ajpe.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Mental health education can reduce the stigma held by medical and nursing students; however, findings in this regard are limited in pharmacy academia. This study investigated the impact of a neuropsychiatric therapeutics course followed by a case-based course on the mental health stigma held by pharmacy students. METHODS A survey was conducted of second-year pharmacy students (n = 202) on the first and last day of a neuropsychiatric therapeutics course and 4 months later, at the end of a case-based course. The questionnaires included the Opening Minds Stigma Scale for HealthCare Providers (OMS-HC) scale, Recovery scale, Empowerment scale, and Attribution Questionnaire (AQ-9). Omnibus Friedman tests evaluated the main effect of time, followed by Wilcoxon signed-rank post hoc tests to compare baseline and postcourse scores. RESULTS Friedman test outcomes showed significant main effects of Time for OMS-HC, Recovery, Empowerment, and AQ-9 scales. Post hoc analysis indicated that compared to the baseline scores, the scores on Recovery and Empowerment scales significantly increased, OMS-HC scores decreased, but AQ-9 scores did not change after the therapeutics course. Compared to the baseline, OMS-HC and AQ-9 scores decreased, Recovery scale score increased, but the Empowerment scale score did not change after the case-based course. The scores did not decrease further after the case-based course compared to those after the therapeutics course. CONCLUSION The decreases in OMS-HC and AQ-9 scores and increases in Recovery and Empowerment scores indicate reductions in mental health stigma. Stigma among students was overall reduced after the therapeutics course and this reduction was maintained after the case-based course.
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Affiliation(s)
- Rajkumar J Sevak
- Department of Pharmacy Practice, University of the Pacific School of Pharmacy, Stockton, CA, USA.
| | - Celine Chandler
- Department of Pharmacy Practice, University of the Pacific School of Pharmacy, Stockton, CA, USA
| | - May C Lui
- Department of Pharmacy Practice, University of the Pacific School of Pharmacy, Stockton, CA, USA
| | - Adam M Kaye
- Department of Pharmacy Practice, University of the Pacific School of Pharmacy, Stockton, CA, USA
| | - Robert F Halliwell
- Department of Physiology and Pharmacology, University of the Pacific School of Pharmacy, Stockton, CA, USA
| | - Edward L Rogan
- Department of Pharmacy Practice, University of the Pacific School of Pharmacy, Stockton, CA, USA
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McKeirnan KC, MacCamy KL, Robinson JD, Ebinger M, Willson MN. Implementing Mental Health First Aid Training in a Doctor of Pharmacy Program. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100006. [PMID: 37597905 DOI: 10.1016/j.ajpe.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE In this study, we aimed to describe the implementation of Mental Health First Aid (MHFA) training as a required curricular component in a Doctor of Pharmacy (PharmD) program; and analyze the impact of MHFA training on student pharmacist's perceptions of stigma, comfort, confidence, and willingness to intervene when someone is experiencing a mental health issue. METHODS Student pharmacists completed an all-day MHFA training as a required element of the PharmD curriculum during the spring of 2022. Pre- and post-survey was completed by students during the in-person training. Questions included items from the Opening Minds to Stigma Scale for Healthcare Providers; question, persuade, refer gatekeeper training for suicide prevention; and questions developed by the authors to assess the impact of the training on participant-reported stigma, confidence, and willingness to provide care to those potentially experiencing a mental issue. RESULTS A total of 235 student pharmacists completed the MHFA training. A statistically significant reduction of stigma was seen for 9 of the 15 statements from Opening Minds to Stigma Scale for Healthcare Providers. Additionally, all responses related to comfort and willingness to provide care and confidence improved significantly after completing MHFA. CONCLUSION MHFA training was implemented as a mandatory requirement for all student pharmacists in the didactic portion of a PharmD program. This training led to reduced stigma around mental illness and improved confidence, comfort, and willingness to intervene among student pharmacists.
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Affiliation(s)
- Kimberly C McKeirnan
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Kathryn L MacCamy
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Jennifer D Robinson
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Michael Ebinger
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Megan N Willson
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA.
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23
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Sheppard H, Bizumic B, Calear A. Prejudice toward people with borderline personality disorder: Application of the prejudice toward people with mental illness framework. Int J Soc Psychiatry 2023; 69:1213-1222. [PMID: 36794515 PMCID: PMC10338706 DOI: 10.1177/00207640231155056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND People living with borderline personality disorder (BPD) face high levels of prejudice and discrimination from both the community and medical professionals, but no measure of prejudice toward people living with BPD exists. AIMS The current study aimed to adapt an existing Prejudice toward People with Mental Illness (PPMI) scale and investigate the structure and nomological network of prejudice toward people with BPD. METHODS The original 28-item PPMI scale was adapted to create the Prejudice toward People with Borderline Personality Disorder (PPBPD) scale. The scale and related measures were completed by three samples: 217 medical or clinical psychology students, 303 psychology undergraduate students, and 314 adults from the general population. RESULTS The original four-factor structure of the PPMI was supported in the PPBPD scale. Reported prejudice toward people with BPD was more negative than prejudice toward people with mental illness in general. The association of the PPBPD scale with antecedents and consequences was assessed, including social dominance orientation, right-wing authoritarianism, ethnocentrism, personality traits, empathy, prior contact, and feelings toward other stigmatized groups and mental illnesses. CONCLUSIONS This study provided evidence for the validity and psychometric properties of the PPBPD scale across three samples and investigated anticipated relationships with theoretically related antecedents and consequences. This research will help improve understanding of the expressions underlying prejudice toward people with BPD.
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Affiliation(s)
- Hannah Sheppard
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
| | - Boris Bizumic
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
| | - Alison Calear
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
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Lauria-Horner B, Knaak S, Cayetano C, Vernon A, Pietrus M. An initiative to improve mental health practice in primary care in Caribbean countries. Rev Panam Salud Publica 2023; 47:e89. [PMID: 37363624 PMCID: PMC10289476 DOI: 10.26633/rpsp.2023.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/12/2023] [Indexed: 06/28/2023] Open
Abstract
Objectives The aim of this initiative was to assess whether a novel training program - Understanding Stigma and Strengthening Cognitive Behavioral Interpersonal Skills - could improve primary health care providers' confidence in the quality of mental health care they provide in the Caribbean setting by using the Plan-Do-Study-Act rapid cycle for learning improvement. Methods We conducted a prospective observational study of the impact of this training program. The training was refined during three cycles: first, the relevance of the program for practice improvement in the Caribbean was assessed. Second, pilot training of 15 local providers was conducted to adapt the program to the culture and context. Third, the course was launched in fall 2021 with 96 primary care providers. Pre- and post-program outcomes were assessed by surveys, including providers' confidence in the quality of the mental health care they provided, changes in stigma among the providers and their use of and comfort with the tools. This paper describes an evaluation of the results of cycle 3, the official launch. Results A total of 81 participants completed the program. The program improved primary care providers' confidence in the quality of mental health care that they provided to people with lived experience of mental health disorders, and it reduced providers' stigmatization of people with mental health disorders. Conclusions The program's quality improvement model achieved its goals in enhancing health care providers' confidence in the quality of the mental health care they provided in the Caribbean context; the program provides effective tools to support the work and it helped to empower and engage clients.
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Affiliation(s)
- Bianca Lauria-Horner
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanadaDepartment of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephanie Knaak
- Mental Health Commission of Canada (MHCC)OttawaCanadaMental Health Commission of Canada (MHCC), Ottawa, Ottawa, Canada
| | - Claudina Cayetano
- Department of Noncommunicable Diseases and Mental HealthMental Health UnitPan American Health OrganizationWashington, DCUnited States of AmericaDepartment of Noncommunicable Diseases and Mental Health, Mental Health Unit, Pan American Health Organization, Washington, DC, United States of America
| | - Andrew Vernon
- Department of Noncommunicable Diseases and Mental HealthMental Health UnitPan American Health OrganizationWashington, DCUnited States of AmericaDepartment of Noncommunicable Diseases and Mental Health, Mental Health Unit, Pan American Health Organization, Washington, DC, United States of America
| | - Michael Pietrus
- Mental Health Commission of Canada (MHCC)OttawaCanadaMental Health Commission of Canada (MHCC), Ottawa, Ottawa, Canada
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Fiedler DV, Rosenstiel S, Zeibig JM, Seiffer B, Welkerling J, Frei AK, Studnitz T, Baur J, Helmhold F, Ray A, Herzog E, Takano K, Nakagawa T, Kropp S, Franke S, Peters S, Flagmeier AL, Zwanzleitner L, Sundmacher L, Ramos-Murguialday A, Hautzinger M, Ehring T, Sudeck G, Wolf S. Concept and study protocol of the process evaluation of a pragmatic randomized controlled trial to promote physical activity in outpatients with heterogeneous mental disorders-the ImPuls study. Trials 2023; 24:330. [PMID: 37189210 PMCID: PMC10186678 DOI: 10.1186/s13063-023-07331-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Evidence suggests that patients suffering from different mental disorders benefit from exercise programs combined with behavior change techniques. Based on this evidence, we have developed an exercise program (ImPuls) specifically designed to provide an additional treatment option in the outpatient mental health care system. The implementation of such complex programs into the outpatient context requires research that goes beyond the evaluation of effectiveness, and includes process evaluation. So far, process evaluation related to exercise interventions has rarely been conducted. As part of a current pragmatic randomized controlled trial evaluating ImPuls treatment effects, we are therefore carrying out comprehensive process evaluation according to the Medical Research Council (MRC) framework. The central aim of our process evaluation is to support the findings of the ongoing randomized controlled trial. METHODS The process evaluation follows a mixed-methods approach. We collect quantitative data via online-questionnaires from patients, exercise therapists, referring healthcare professionals and managers of outpatient rehabilitative and medical care facilities before, during, and after the intervention. In addition, documentation data as well as data from the ImPuls smartphone application are collected. Quantitative data is complemented by qualitative interviews with exercise therapists as well as a focus-group interview with managers. Treatment fidelity will be assessed through the rating of video-recorded sessions. Quantitative data analysis includes descriptive as well as mediation and moderation analyses. Qualitative data will be analyzed via qualitative content analysis. DISCUSSION The results of our process evaluation will complement the evaluation of effectiveness and cost-effectiveness and will, for example, provide important information about mechanisms of impact, structural prerequisites, or provider qualification that may support the decision-making process of health policy stakeholders. It might contribute to paving the way for exercise programs like ImPuls to be made successively available for patients with heterogeneous mental disorders in the German outpatient mental health care system. TRIAL REGISTRATION The parent clinical study was registered in the German Clinical Trials Register (ID: DRKS00024152, registered 05/02/2021, https://drks.de/search/en/trial/DRKS00024152 ).
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Affiliation(s)
- David Victor Fiedler
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany.
| | - Stephanie Rosenstiel
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Johanna-Marie Zeibig
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Britta Seiffer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Jana Welkerling
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Anna Katharina Frei
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Thomas Studnitz
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Julia Baur
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Florian Helmhold
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Andreas Ray
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Eva Herzog
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Tristan Nakagawa
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Saskia Kropp
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Sebastian Franke
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Stefan Peters
- German Association for health-related Fitness and Exercise Therapy (German: DVGS), Hürth-Efferen, Germany
| | | | | | - Leonie Sundmacher
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Ander Ramos-Murguialday
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Martin Hautzinger
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Thomas Ehring
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Gorden Sudeck
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Sebastian Wolf
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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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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Őri D, Szocsics P, Molnár T, Bankovska Motlova L, Kazakova O, Mörkl S, Wallies M, Abdulhakim M, Boivin S, Bruna K, Cabacos C, Carbone EA, Dashi E, Grech G, Greguras S, Ivanovic I, Guevara K, Kakar S, Kotsis K, Klinkby IMI, Maslak J, Matheiken S, Mirkovic A, Nechepurenko N, Panayi A, Pereira AT, Pomarol-Clotet E, Raaj S, Rus Prelog P, Soler-Vidal J, Strumila R, Schuster F, Kisand H, Hargi A, Ahmadova G, Vircik M, Yilmaz Kafali H, Grinko N, Győrffy Z, Rózsa S. Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries - A bifactor ESEM representation. Front Public Health 2023; 11:1168929. [PMID: 37361150 PMCID: PMC10285467 DOI: 10.3389/fpubh.2023.1168929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/17/2023] [Indexed: 06/28/2023] Open
Abstract
Aims To measure the stigma of healthcare providers toward people suffering from mental illness, the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a commonly applied instrument. However, this scale has not been thoroughly validated in many European countries, its psychometric properties are still unknown and data on practicing psychiatrists is lacking. Therefore, this multicenter study aimed to assess the psychometric characteristics of the 15-item OMS-HC in trainees and specialists in adult and child psychiatry in 32 countries across Europe. Materials and methods The OMS-HC was conducted as an anonymous online survey and sent via Email to European adult and child psychiatrists. Parallel analysis was used to estimate the number of OMS-HC dimensions. Separate for each country, the bifactor ESEM, a bifactor exploratory structural equation modeling approach, was applied to investigate the factor structure of the scale. Cross-cultural validation was done based on multigroup confirmatory factor analyses and reliability measures. Results A total of 4,245 practitioners were included, 2,826 (67%) female, 1,389 (33%) male. The majority (66%) of participants were specialists, with 78% working in adult psychiatry. When country data were analyzed separately, the bifactor model (higher-order factor solution with a general factor and three specific factors) showed the best model fit (for the total sample χ2/df = 9.760, RMSEA = 0.045 (0.042-0.049), CFI = 0.981; TLI = 0.960, WRMR = 1.200). The average proportion of variance explained by the general factor was high (ECV = 0.682). This suggests that the aspects of 'attitude,' 'disclosure and help-seeking,' and 'social distance' could be treated as a single dimension of stigma. Among the specific factors, the 'disclosure and help-seeking' factor explained a considerable unique proportion of variance in the observed scores. Conclusion This international study has led to cross-cultural analysis of the OMS-HC on a large sample of practicing psychiatrists. The bifactor structure displayed the best overall model fit in each country. Rather than using the subscales, we recommend the total score to quantify the overall stigmatizing attitudes. Further studies are required to strengthen our findings in countries where the proposed model was found to be weak.
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Affiliation(s)
- Dorottya Őri
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, United States
| | - Péter Szocsics
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Molnár
- Department of Psychiatry, Aladar Petz County Teaching Hospital, Győr, Hungary
| | - Lucie Bankovska Motlova
- Division of Medical Psychology, 3rd Faculty of Medicine, Charles University, Prague, Czechia
| | - Olga Kazakova
- Inpatient Psychiatric Department #2, Psychiatric Clinic of Minsk City, Minsk, Belarus
| | - Sabrina Mörkl
- Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, Graz, Austria
| | | | | | - Sylvie Boivin
- Department of Child and Adolescent Psychiatry, EPSM du Finistère Sud, Quimper, France
| | - Krista Bruna
- Admission Ward, State Psychiatric Hospital Gintermuiza, Jelgava, Latvia
| | - Carolina Cabacos
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Elona Dashi
- Department of Neuroscience, University Hospital Center “Mother Theresa”, Tirana, Albania
| | - Giovanni Grech
- Mental Health Services, Mount Carmel Hospital, Attard, Malta
| | - Stjepan Greguras
- Department of Psychiatry and Psychological Medicine, Division of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Iva Ivanovic
- Department for Child Psychiatry, Clinical Centre of Montenegro, Institute for Children’s Diseases, Podgorica, Montenegro
| | - Kaloyan Guevara
- Acute Detoxification Ward, State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism, Sofia, Bulgaria
| | - Selay Kakar
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | | | | | - Ana Mirkovic
- Child Psychiatry Unit, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nikita Nechepurenko
- The Serbsky State Scientific Center for Social and Forensic Psychiatry, Moscow, Russia
| | | | - Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Shaeraine Raaj
- Department of General Adult Psychiatry, South Meath Mental Health Service, Meath, Ireland
| | - Polona Rus Prelog
- Centre for Clinical Psychiatry, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
- Hospital Benito Menni, Complex Assistencial Salut Mental, Sant Boi de Llobregat, Spain
| | - Robertas Strumila
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Psychiatric Clinic, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Florian Schuster
- Klinikum rechts der Isar der Technischen Universität München: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Munich, Germany
| | | | | | - Gumru Ahmadova
- Department of Psychiatry, United City Hospital N15, Baku, Azerbaijan
| | - Matus Vircik
- Acute Psychiatric Department 1, Psychiatric Hospital Michalovce, Michalovce, Slovakia
| | - Helin Yilmaz Kafali
- Child and Adolescent Psychiatry, Sultanbeyli State Hospital, Istanbul, Türkiye
| | - Natalia Grinko
- Department of Clinical Psychology, Ukrainian Catholic University, Lviv, Ukraine
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Sandor Rózsa
- Department of Personality and Health Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
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Carrara BS, Sanches M, Bobbili SJ, de Godoy Costa S, de Sousa ÁFL, de Souza J, Ventura CAA. Validation of the Opening Minds Scale for Health Care Providers (OMS-HC): Factor Structure and Psychometric Properties of the Brazilian Version. Healthcare (Basel) 2023; 11:healthcare11071049. [PMID: 37046976 PMCID: PMC10094058 DOI: 10.3390/healthcare11071049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 04/14/2023] Open
Abstract
Stigma towards people with mental illness is also present among health professionals. The study validated and estimated the reliability, dimensionality and structure of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) scale in Brazil. In this methodological study, health professionals (n = 199) from Family Health Units in Brazil were recruited by convenience sampling. The EFA conducted with 16 items resulted in four factors. The Cronbach's Alpha for the OMS scale was 0.74, which is considered to reflect reasonable reliability. The data presented contribute to the use of the scale in studies that investigate the level of stigma among health professionals towards people with mental illness, as well as in the development of anti-stigma interventions in this context.
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Affiliation(s)
- Bruna Sordi Carrara
- PAHO/WHO Collaborating Centre for Nursing Research Development-Brazil, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, Brazil
| | - Marcos Sanches
- Centre for Addiction & Mental Health, Toronto, ON M6J 1H4, Canada
| | | | - Simone de Godoy Costa
- PAHO/WHO Collaborating Centre for Nursing Research Development-Brazil, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, Brazil
| | | | - Jacqueline de Souza
- PAHO/WHO Collaborating Centre for Nursing Research Development-Brazil, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, Brazil
| | - Carla Aparecida Arena Ventura
- PAHO/WHO Collaborating Centre for Nursing Research Development-Brazil, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto 14040-902, Brazil
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29
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Adamus C, Alpiger J, Jäger M, Richter D, Mötteli S. Independent Supported Housing Versus Institutionalised Residential Rehabilitation for Individuals with Severe Mental Illness: A Survey of Attitudes and Working Conditions Among Mental Healthcare Professionals. Community Ment Health J 2023; 59:531-539. [PMID: 36227518 PMCID: PMC9981490 DOI: 10.1007/s10597-022-01037-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/29/2022] [Indexed: 11/03/2022]
Abstract
Despite widespread support for Independent Supported Housing (ISH) interventions, psychiatric housing rehabilitation still commonly takes place in residential care facilities (RCFs). This study compares preferences, attitudes and working conditions of mental healthcare professionals (MHCPs) in ISH and RCFs using an online survey. The survey included setting preferences, stress and strain at work, recovery attitudes, stigmatisation, and factors experienced as particularly important or obstructive in housing rehabilitation. Data were analysed using quantitative and qualitative approaches. Of the 112 participating MHCPs, 37% worked in ISH and 63% in RCFs. Professionals' education, work-related demands and influence at work were higher in ISH, stigmatising attitudes were higher in RCFs. MHCPs in both settings endorsed ISH. The support process was seen as particularly important whereas stigmatisation, regulatory and political requirements were seen as obstructive for successful housing rehabilitation. Results indicate that social inclusion of individuals with severe mental illness is seldom feasible without professional support.
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Affiliation(s)
- Christine Adamus
- Centre for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland. .,University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. .,Centre for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Sägestrasse 75, 3098, Köniz, Switzerland.
| | - Jovin Alpiger
- School of Applied Psychology, ZHAW Zurich University of Applied Sciences, Zurich, Switzerland
| | - Matthias Jäger
- Psychiatrie Baselland, Liestal, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Dirk Richter
- Centre for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland.,University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Sonja Mötteli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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30
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Hennen R, Phillips KE. Emergency Nurses' Care of Psychiatric Patients. J Am Psychiatr Nurses Assoc 2023; 29:96-102. [PMID: 36916646 DOI: 10.1177/10783903231153418] [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] [Indexed: 03/16/2023]
Abstract
OBJECTIVE The volume of patients with mental illness presenting to the emergency department (ED) has been increasing in recent years, yet many ED nurses hold stigmatized attitudes and behaviors about patients with mental illness, creating barriers to therapeutic care. At the same time, there has been an increase in workplace violence (WPV) against nurses. Fortunately, resilience helps nurses manage their response to WPV and continue to provide therapeutic care. Although research has considered many barriers to the therapeutic care of patients with mental illness in the ED, the variables of stigma, resilience, and the experience of WPV have not been considered in relation to behavioral care competence and work performance, which is the purpose of this study. METHODS A survey consisting of the Brief Resilience Scale, the Individual Work Performance Questionnaire, the Behavioral Healthcare Competency (BHCC) survey, the Opening Minds Scale for Healthcare Providers, and open-ended questions about WPV were used to collect data. Independent t-tests were run between scale scores and categorical descriptive data. Correlations were run between scale scores and continuous descriptive data. RESULTS Over half (60%) had experienced a personal injury from WPV. Higher behavioral competence scores were associated with lower stigma and higher contextual work performance. Nurses who experienced a WPV injury had higher mean BHCC and higher contextual work performance scores. CONCLUSIONS WPV may be an impetus for nurses to improve their practice in behavioral health and working as part of a team.
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Affiliation(s)
- Rebecca Hennen
- Rebecca Hennen, DNP, PMHNP-BC, Psychiatric Nurse Practitioner, UW Health, Consultation Liaison Psychiatry, Madison, WI, USA
| | - Kathryn E Phillips
- Kathryn E. Phillips, PhD, APRN, Associate Professor, Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT, USA
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31
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Examining the impact of experiencing auditory verbal hallucinations from a first-person perspective on the degree of empathy and stigmatization in a group of psychology students: A study using 360° immersive videos. Compr Psychiatry 2023; 123:152379. [PMID: 36870090 DOI: 10.1016/j.comppsych.2023.152379] [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: 10/14/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Stigmatization toward psychosis is persistent among mental health professionals (MHPs) and negatively impacts the patients' outcomes. One suggested way of reducing stigmatization is to expose MHPs to simulations of psychotic symptoms. This approach has been associated with an increase in empathy, but also with an increase in the desire of social distance. The addition of an empathic task (ET) has been suggested to neutralize this effect on social distance. The present study aims to (1) examine the effect of a remotely administered 360° immersive video (360IV) simulation on empathy and stigma among psychology students and (2) replicate the neutralizing effect of an ET on social distance. Finally, the potential role of immersive properties on changes will also be explored. METHODS A 360IV simulating auditory hallucinations was constructed in collaboration with patient partners. 121 psychology students were allocated to one of three conditions: (i) exposure to the 360IV, (ii) exposure to the 360IV and to an ET (360IV + ET), and (iii) no exposure (control). Measures of empathy and stigma (stereotypes and social distance) were collected before and after the interventions. RESULTS An increase of empathy was observed in the 360IV and 360IV + ET conditions compared to the control condition. There was an increase of stereotypes in all conditions and no effect on social distance. CONCLUSIONS This study confirms the effectiveness of a 360IV simulation intervention in increasing empathy in psychology students but questions its efficacy in reducing stigma.
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Stigma Toward Mental Illness Among Saudi Medical Students: Pre and Post Psychiatry Course Comparison. J Nerv Ment Dis 2023; 211:157-162. [PMID: 36108280 DOI: 10.1097/nmd.0000000000001582] [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: 02/02/2023]
Abstract
This cross-sectional study aims to compare pre- versus post-psychiatry course stigma levels toward mental illnesses among King Saud University medical students and identify which factors could affect stigma degree. The sample included 384 randomly chosen students. The overall scores of the used scale, the 15-item Opening Minds Scale for Healthcare Providers (OMS-HC-15), indicated no statistically significant difference between the before- and the after-psychiatry-course groups. The univariate analysis for differences in OMS-HC-15 score according to the sociodemographic characteristics of the pre psychiatry course group indicated that the factors associated with the total OMS-HC-15 score were sex ( p < 0.001), being diagnosed with mental illness ( p < 0.001), and having a relative diagnosed with mental illness ( p = 0.005). Among the post psychiatry course group, the univariate analysis indicated that the same factors, namely, sex ( p = 0.001), being diagnosed with mental illness ( p = 0.006), and having a relative diagnosed with mental illness ( p = 0.007), were associated with the total OMS-HC-15 score. Further studies at a larger scale to confirm generalizability of the results are warranted.
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Kolb K, Liu J, Jackman K. Stigma towards patients with mental illness: An online survey of United States nurses. Int J Ment Health Nurs 2023; 32:323-336. [PMID: 36285570 DOI: 10.1111/inm.13084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 01/14/2023]
Abstract
People with mental illness experience significant health disparities, including morbidity and premature mortality. Evidence suggests that stigma is a contributing factor to these observed inequities. The tripartite conceptualization of stigma proposes that three problems underlie stigma: problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). There is limited prior research concerning stigma towards mental illness among nurses in the United States (US). The aims of this study were to assess stigma among US nurses towards patients with mental illness, compare the stigma expressed by nurses working in medical/surgical settings with mental health settings, and identify factors associated with stigma. Participants were recruited online from national professional nursing organizations in the US. We collected demographic data and administered measures of mental health stigma and stigma-related mental health knowledge. Mental health nurses demonstrated comparatively lower levels of stigma and higher levels of knowledge than the medical/surgical nurses. Nursing speciality and personal contact with mental illness were the most significant predictors of stigma and knowledge. Knowledge was found to partially mediate the relationship between nursing speciality and stigma. We found support for the 'contact hypothesis', that is, having a personal experience of mental illness or a friend or family member who has a mental illness is associated with lower stigma towards mental illness. These findings support the development of contact-based and educational anti-stigma interventions for nurses in order to reduce stigma towards mental illness.
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Affiliation(s)
- Kristen Kolb
- New York-Presbyterian Hospital, New York, NY, USA
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, USA
| | - Kasey Jackman
- New York-Presbyterian Hospital, Columbia University School of Nursing, New York, NY, USA
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34
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Hsia SL, Brooks J, Yao E, Gruenberg K, Finley P. Impact of an auditory hallucination simulation coupled with a speaker diagnosed with schizophrenia on mental illness stigma in pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1397-1403. [PMID: 36117122 DOI: 10.1016/j.cptl.2022.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/05/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Hallucination simulations improve student empathy but increase desired social distance from individuals with schizophrenia, while direct contact reduces social distance. This study describes the implementation of combining an auditory hallucination simulation with a speaker diagnosed with schizophrenia and its impact on mental illness stigma. METHODS Pharmacy students in their last year of didactic instruction (N = 346) attended a presentation by a speaker diagnosed with schizophrenia then participated in a hallucination simulation. Mental illness stigma was measured before and after the intervention using the Opening Minds Survey for Health Care Professionals (OMS-HC). Related-samples Wilcoxon-signed rank tests were used to evaluate changes in OMS-HC scores. An inductive qualitative analysis was conducted on student perceptions of patients with psychosis. RESULTS OMS-HC total scores were reduced by an average of 2.0 ± 5.6 (P = .005) for the first-year pilot and 2.3 ± 7.0 (P < .001) for the subsequent year. OMS-HC attitudes (P = .005) and disclosure/help-seeking (P < .005) subscales decreased both years. There was no significant change in the social distance subscale (P = .205) the first year and a significant decrease (P = .015) the second year. The themes identified from the open-ended comments were increased awareness, sympathy, empathy, inspiration/admiration, discomfort, and change to patient care. CONCLUSIONS The combination of a speaker with schizophrenia and auditory hallucination simulation effectively reduced mental illness stigma. The combination is likely effective for reducing stigmatizing attitudes and willingness to disclose mental illness with variable reduction in desired social distance.
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Affiliation(s)
- Stephanie L Hsia
- Clinical Pharmacy, University of California, San Francisco School of Pharmacy, 505 Parnassus Ave, San Francisco, CA 94143, United States.
| | - Jordan Brooks
- Clinical Pharmacology and Therapeutics Fellow, University of California, San Francisco School of Pharmacy, 505 Parnassus Ave, San Francisco, CA 94143, United States.
| | - Emily Yao
- PGY-2 Pharmacy Resident, San Francisco Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121, United States.
| | - Katherine Gruenberg
- Clinical Pharmacy, University of California, San Francisco School of Pharmacy, 505 Parnassus Ave, San Francisco, CA 94143, United States.
| | - Patrick Finley
- Clinical Pharmacy, University of California, San Francisco School of Pharmacy, 505 Parnassus Ave, San Francisco, CA 94143, United States.
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Abstract
The opioid epidemic has greatly increased the number of pregnant women with opioid use and newborns exposed to opioids in utero. Mothers with opioid use disorder can face stigma by nurses in perinatal care settings, contributing to negative care experiences. A survey was distributed to nurses caring for mothers and newborns exposed to opioids in a large urban hospital in the Pacific Northwest United States (n = 89) from March to July 2019. Survey measures included participant characteristics, attitude toward substance use in pregnancy and postpartum (stigma, compassion satisfaction, comfort, and knowledge), and open-ended questions. Relationships among variables and questionnaire items were examined using Pearson's correlations, 2-sample t tests, and simultaneous multiple linear regression. Qualitative description was used to analyze open-ended questions. Nurses' stigma was negatively correlated with compassion satisfaction (r = -0.63), feeling knowledgeable (r = -0.36), and comfortable in providing care to this population (r = -0.44). Nurses identified defensiveness, lack of trust, and inadequate social support as key challenges in this patient population. Nurses suggested more support for mothers and nurses, increased nursing education, and clinical guidelines to improve clinical practice and foster therapeutic relationships. Findings highlight potential strategies to improve nursing care for chemically dependent mothers and their infants. These strategies may offer practical approaches to reduce stigma, develop therapeutic relationships, and improve patient outcomes.
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36
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Raj CT. The effectiveness of mental health disorder stigma-reducing interventions in the healthcare setting: An integrative review. Arch Psychiatr Nurs 2022; 39:73-83. [PMID: 35688548 DOI: 10.1016/j.apnu.2022.03.005] [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: 05/11/2021] [Revised: 03/12/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022]
Abstract
Individuals with mental health disorders frequently seek medical treatment in health care settings other than a mental health facility. However, mental health disorder stigmatization is prevalent in the healthcare setting across the globe. Stigmatizing attitudes remain widespread among healthcare professionals who are responsible for delivering patient-centered, quality care. Stigma in the healthcare setting can undermine effective diagnosis, therapy, and optimum health outcomes. Addressing stigma is critical to delivering quality health care in both developed and developing countries. Therefore, it is important to deliver successful anti-stigma education, along with practical strategies, to reduce the stigma of mental health disorders among healthcare professionals. An integrative review was conducted to identify the effectiveness of various interventions used in 10 different countries globally to reduce the stigma of mental health disorders in the healthcare setting.
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Affiliation(s)
- Catherine T Raj
- Department of Nursing, Liberty University, United States of America.
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37
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Movahedi S, Shariat SV, Shalbafan M. Attitude of Iranian medical specialty trainees toward providing health care services to patients with mental disorders. Front Psychiatry 2022; 13:961538. [PMID: 35966498 PMCID: PMC9366058 DOI: 10.3389/fpsyt.2022.961538] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/01/2022] [Indexed: 02/03/2023] Open
Abstract
Introduction The stigma of mental illness has a negative impact on the diagnosis and treatment of these disorders. Considering the high prevalence of mental illness, the attitude of medical specialists toward mental disorders, who are front liners in diagnosing and treating these patients, is critical. Therefore, we examined the attitude of Iranian medical specialty trainees toward providing health care services for patients with mental illness. Methods We included 143 residents in the fields that have the most interactions with patients with mental disorders, including internal medicine, surgery, neurology, cardiovascular diseases, and psychiatry. A demographic checklist, as well as the opening minds scale for health care providers stigma assessment questionnaire, was provided, which measures five dimensions of improvement, social responsibility, social distance, exposure, and other (such as risk) in health care providers toward delivering the healthcare services to patients with mental disorders. Results The mean score of stigma for mental illness in medical specialty trainees was 61.36 ± 4.83 out of 100. Psychiatric residents have the least stigmatizing attitude (58.38 ± 3.54), and internal medicine and cardiology residents have the highest score, respectively, (62.96 ± 6.05, 62.45 ± 3.80). As for comparing subscales between specialties, only the social responsibility subscale showed a significant difference, with psychiatry having less stigma toward social responsibility (12.93 ± 2.01) than cardiology (15.09 ± 1.50) trainees. Conclusion The attitude of medical specialty trainees toward providing health care services for patients with mental illness is not uniform; internal medicine and cardiology residents have more stigmatizing attitude, while psychiatric residents have less stigmatizing attitude. It seems that not every contact could be useful in making a better attitude toward mental illness, but it needs preconditions, like a structured contact that leads to positive outcomes. Anti-stigma interventions are needed to improve the attitude of medical specialty trainees toward providing health care services to patients with mental illness.
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Affiliation(s)
| | | | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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38
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Parra Videla C, Sapag JC, Klabunde R, Velasco PR, Anríquez S, Aracena Álvarez M, Mascayano F, Bravo P, Sena BF, Jofré Escalona A, Bobbili SJ, Corrigan PW, Bustamante I, Poblete F, Alvarado R. Cross-cultural adaptation of four instruments to measure stigma towards people with mental illness and substance use problems among primary care professionals in Chile. Transcult Psychiatry 2022; 60:286-301. [PMID: 35821607 DOI: 10.1177/13634615221100377] [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] [Indexed: 11/15/2022]
Abstract
Stigma toward people with mental illness and substance use problems is a significant global concern, and prevents people with these conditions from accessing treatment, particularly in primary health care (PHC) settings. Stigma is a cultural phenomenon that is influenced by particular contexts and can differ by country and region. The majority of stigma research focuses on Europe or North America leading to a lack of culturally relevant stigma research instruments for the Latin American context. The present study describes and discusses the methodology for cross-culturally adapting four stigma measurement scales to the Chilean context. The cross-cultural adaptation process included nine phases: (1) preparation; (2) independent translations; (3) synthesis 1 with expert committee; (4) focus groups and interviews with researchers, PHC professionals, and PHC users; (5) synthesis 2 with expert committee; (6) independent back translations; (7) synthesis 3 with expert committee; (8) pilot with PHC professionals; and (9) final revisions. The adaptation process included an array of diverse voices from the PHC context, and met three adaptation objectives defined prior to beginning the process (Understandability, Relevance, and Acceptability and Answer Options). The resulting, culturally adapted questionnaire is being validated and implemented within PHC settings across Chile to provide in-depth insight into stigma among PHC professionals in the country. The authors hope it will be useful for future research on mental illness and substance use stigma in similar settings across Latin America.
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Affiliation(s)
- Claudia Parra Videla
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, 28033Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime C Sapag
- Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Division of Clinical Public Health, Dalla Lana School of Public Health, 274071University of Toronto, Toronto, Ontario, Canada.,Collaborator Scientist WHO/PAHO Collaborating Centre, Institute for Mental Health Policy Research, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Klabunde
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola R Velasco
- Collaborator Scientist WHO/PAHO Collaborating Centre, Institute for Mental Health Policy Research, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Samanta Anríquez
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Franco Mascayano
- Department of Epidemiology, Mailman School of Public Health, 33638Columbia University, New York, NY, USA.,Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, NY, USA
| | - Paulina Bravo
- Escuela de Enfermería, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,School of Social Sciences, Cardiff University, Cardiff, UK
| | - Brena F Sena
- Center for Innovation in Social Work and Health, Boston University School of Social Work, Boston, MA, USA
| | - Ana Jofré Escalona
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sireesha J Bobbili
- WHO/PAHO Collaborating Centre for Addiction & Mental Health, Institute for Mental Health Policy Research, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Inés Bustamante
- Facultad de Salud Pública y Administración, 33216Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fernando Poblete
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rubén Alvarado
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile/Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Rapisarda F, Macario de Medeiros J, Briand C, Boivin A, Monthuy-Blanc J, Vallée C, Drolet MJ, Vachon B, Luconi F. Assessing Changes in Anxiety, Empowerment, Stigma and Wellbeing in Participants Attending an Online-Based Recovery College in Quebec During the Covid-19 Pandemic: A Pre-Experimental Study. Int J Public Health 2022; 67:1604735. [PMID: 35814737 PMCID: PMC9263090 DOI: 10.3389/ijph.2022.1604735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: The present study aims to evaluate the effect of an online Recovery College (RC) program implemented in Quebec (Canada) during the COVID-19 pandemic. From October 2020 to June 2021, 27 training groups were conducted with a total of 362 attendees. Methods: Outcome was evaluated using a single group repeated measure design, assessing participants prior the training (T0), after the training (T1) and at follow up (T2). 107 learners of the Quebec RC program attended three two-hour sessions agreed to participate to the research. Results: Overall findings show at T1 a small but statistically significant reduction of anxiety and increase in empowerment, and below threshold reduction of stigmatizing attitudes and increase of wellbeing. Conversely, the medium-term changes at follow up were non-significant for all the outcome dimension except for anxiety. Conclusion: Findings suggest that the RC online program can be considered as a potential effective strategy to support self-regulation and empowerment of individuals and to reduce anxiety in the context of crisis for the general population.
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Affiliation(s)
- Filippo Rapisarda
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | | | - Catherine Briand
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Département d’Ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- *Correspondence: Catherine Briand,
| | - Antoine Boivin
- Departement of Family Medicine, Centre de Recherche du CHUM, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - Johana Monthuy-Blanc
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Catherine Vallée
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, QC, Canada
- VITAM Research Centre on Sustainable Health, Laval University, Québec, QC, Canada
- Cervo Brain Research Centre, Laval University, Laval, QC, Canada
| | - Marie-Josée Drolet
- Département d’Ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Brigitte Vachon
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Francesca Luconi
- Office for Continuing Professional Development, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
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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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Kitay BM, Walde T, Robertson D, Cohen T, Duvivier R, Martin A. Addressing Electroconvulsive Therapy Knowledge Gaps and Stigmatized Views Among Nursing Students Through a Psychiatrist-APRN Didactic Partnership. J Am Psychiatr Nurses Assoc 2022; 28:225-234. [PMID: 32727255 DOI: 10.1177/1078390320945778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Knowledge gaps and stigmatized perceptions regarding electroconvulsive therapy (ECT) among patients and health providers contribute to the underutilization of an important therapeutic modality. The proactive education of future advanced practice registered nurses (APRNs) provides an opportunity to optimize the use of this evidence-based clinical practice. AIMS: As part of a general course in psychiatry during the first year of nursing school, we dedicated 1 hour to treatment-refractory depression, including ECT, and a second hour to a summary discussion of mood disorders. We evaluated the efficacy of this didactic offering, which was co-taught by a psychiatrist and a psychiatric APRN. METHOD: At baseline, consenting students (n = 94) provided three words they associated with ECT and then completed three validated instruments: (a) Questionnaire on Attitudes and Knowledge of ECT, (b) Opening Minds Stigma Scale for Health Care Providers, and (c) Self-Stigma of Seeking Help. Among the 67 students who repeated the assessment at endpoint, 39 attended the ECT didactic (Intervention group, 58%) and 28 did not (Control, 42%). RESULTS: After completion of the 3-month course, students showed improvement across all measures (p < .001). The only outcomes that improved differentially between the Intervention and Control groups were the Questionnaire on Attitudes and Knowledge of ECT Attitudes and Knowledge scales (p = .01). Word choice valence associated with ECT shifted favorably by endpoint (p < .001). CONCLUSIONS: An educational intervention co-led by a psychiatric-mental health APRN had a significant impact on nursing students' knowledge and perceptions of ECT. This approach can be readily implemented at other institutions. Future refinements will include the videotaped depiction of a simulated patient undergoing the consent, treatment, and recovery phases of ECT.
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Affiliation(s)
- Brandon M Kitay
- Brandon M. Kitay, MD, PhD, Yale University, New Haven, CT, USA
| | - Tina Walde
- Tina Walde, DNP, APRN, PMHNP, Yale University, Orange, CT, USA
| | - Dilice Robertson
- Dilice Robertson, DNP, APRN, PMHNP, Yale University, Orange, CT, USA
| | - Tammy Cohen
- Tammy Cohen, APRN, Yale Psychiatric Hospital, New Haven, CT, USA
| | - Robbert Duvivier
- Robbert Duvivier, MD, PhD, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrés Martin
- Andrés Martin, MD, MPH, Yale University, New Haven, CT, USA
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Neikrug AB, Stehli A, Xiong GL, Suo S, Le-Bucklin KV, Cant W, McCarron RM. Train New Trainers Primary Care Psychiatry Fellowship-Optimizing Delivery of Behavioral Health Care Through Training for Primary Care Providers. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:105-114. [PMID: 35439771 DOI: 10.1097/ceh.0000000000000432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To expand and optimize the behavioral health workforce, it is necessary to improve primary care providers' (PCPs) overall knowledge and clinical skills in primary care-based psychiatry. Studies on the effects of postgraduate psychiatric education programs for PCPs on psychiatric knowledge are limited. METHODS A total of 251 PCPs completed a 1-year fellowship. Data from program development and evaluation were analyzed for 4 fellowship years (2016-2019). Fellows were surveyed at baseline, midpoint, and postfellowship about mental health stigma, perceived competency, attitudes about psychiatry, satisfaction with current psychiatric knowledge, confidence and comfort to treat psychiatric illnesses, and program satisfaction. Psychiatric knowledge was evaluated at baseline, midpoint, and postfellowship. RESULTS Large effects were noted on perceived competency/self-efficacy and confidence in the treatment of common psychiatric disorders encountered in primary care settings. Positive effects were observed on attitudes of mental health stigma, and even more robust effects were found with improvement in psychiatry clinical knowledge. Knowledge improved by 12% at postfellowship (P < .0001). Correlations of the degree of change in attitude with improved psychiatric literacy demonstrated significant relationships with reduction of stigma total score (r = -0.2133, P = .0043), increased willingness (r = 0.1941, P = .0096), and increased positive attitudes (r = 0.1894, P = .0111). CONCLUSION Innovative initiatives to improve and expand psychiatric knowledge and clinical skills among those who provide the most behavioral health care (PCPs) can have marked impacts on attitudes toward mental health care delivery, stigma, and competency/self-efficacy. Future studies are necessary to consider the impact of this program on clinical practice pattern outcomes on a larger scale.
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Affiliation(s)
- Ariel B Neikrug
- Neikrug: Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA. Stehli: Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA. Xiong: Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA. Suo: Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA. Le-Bucklin: Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA. Cant: Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA. McCarron: Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA
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Neary S, Ruggeri M, Roman C, Kamauf R, Chilton J, Martin A. Attitudes Towards Mental Health Among Physician Assistant Students with Shared Living Experiences Through Synchronous Videoconferencing. J Physician Assist Educ 2022; 33:9-16. [PMID: 35067586 PMCID: PMC9037761 DOI: 10.1097/jpa.0000000000000410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We tested the hypothesis that physician assistant (PA) students can benefit from exposure to senior PAs who share their living experiences with mental illness. METHODS First-year students from 5 PA programs were asked to participate in this mixed methods study. After completing a pre-activity survey, students from 3 programs participated in an intervention consisting of senior PA faculty sharing their mental health experiences, including treatment and recovery. A facilitated discussion followed, and students not exposed to the intervention served as controls. The qualitative component of the study was based on transcripts from 3 focus groups of students in the exposed group. RESULTS We recruited 167 students from 5 PA training programs, 112 of whom (67%) completed baseline and endpoint assessments (37 in the exposed group, 75 in the control). The intervention resulted in significant improvements on the Opening Minds to Stigma (OMS-HC, p = 0.002, Cohen's d = 0.38) and Self-Stigma of Seeking Help (SSOSH, p = 0.006, d = 0.31) scales. Change in the OMS-HC was driven by its social distance (p = 0.003) and disclosure (p = 0.02) subscales. No comparable changes were found in the control group. We identified 3 overarching themes: 1) active elements of the intervention; 2) mutuality; and 3) peer relationships. CONCLUSIONS Senior PAs sharing their lived experiences with mental illness proved to be an effective anti-stigma intervention for PA students. A candid, intimate, and confidential virtual learning space was feasible through synchronized videoconferencing. Our findings can inform programmatic interventions to address stigma, self-stigma, help-seeking behaviors, and the overall mental health of PA students.
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Affiliation(s)
- Stephanie Neary
- Physician Assistant Online Program, Yale School of Medicine, New Haven, CT
| | - Mary Ruggeri
- Physician Assistant Online Program, Yale School of Medicine, New Haven, CT
| | | | - Renée Kamauf
- Physician Assistant Online Program, Yale School of Medicine, New Haven, CT
| | - Julie Chilton
- Child Study Center, Yale School of Medicine, New Haven, CT
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT
- Standardized Patient Program, Teaching and Learning Center, Yale School of Medicine, New Haven, CT
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Groningen, The Netherlands
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Cid A, Patten A, Beazely M, Grindrod K, Yessis J, Chang F. Protocol for the Optimizing Naloxone Dispensing in Pharmacies (ONDP) Online Continuing Education Program: A Randomized Controlled Trial. PHARMACY 2022; 10:pharmacy10010024. [PMID: 35202073 PMCID: PMC8875968 DOI: 10.3390/pharmacy10010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/10/2022] Open
Abstract
The number of opioid-related deaths in Canada has steadily increased since 2016 and the COVID-19 pandemic has worsened this trend. Naloxone has been pivotal for reducing opioid-related harms and death, and pharmacists play a crucial role in ensuring the supply of naloxone to Canadians through community pharmacies. However, naloxone dispensing by pharmacists is not optimal; in fact, in Ontario, only 50% of pharmacists offer naloxone, despite national guidelines that pharmacists should offer naloxone to everyone with an opioid prescription. When asked why pharmacists do not proactively offer naloxone, recent research has identified that pharmacists need continuing education to boost confidence and knowledge on how to start conversations with patients. The study involves a delayed start, double-blind randomized controlled trial, for Canadian licensed pharmacists and pharmacy technicians. The goals of the program are to increase Canadian pharmacy professional’s knowledge, confidence, and motivation to proactively offer naloxone, as well as to decrease stigma associated with naloxone. The program incorporates behaviour change techniques from the Theoretical Domains Framework and the Theory of Planned Behaviour. The intervention program includes three modules that focus on improving pharmacists’ communication skills by teaching them how to proactively offer naloxone, while the control group will complete a reading assignment on the naloxone consensus guidelines. The program will involve a process and outcome evaluation in addition to a contribution analysis. This program is important for breaking down previously identified barriers and knowledge gaps for why pharmacists currently do not proactively offer naloxone. This study will provide important new information about what behaviour change techniques are successful in improving confidence and motivation in the pharmacy profession and in an online environment. Findings from this study can be used to produce a national naloxone education program that can also be implemented into current pharmacy school curriculum.
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Affiliation(s)
- Ashley Cid
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Alec Patten
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Michael Beazely
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
- Correspondence:
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W, Waterloo, ON N2L 3G1, Canada;
| | - Feng Chang
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
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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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Sapag JC, Traub C, Velasco PR, Arratia T, Alvarado R, Aracena M, Poblete FC, Villarroel L, Bravo P, Álvarez-Huenchulaf C, Jofré Escalona A, Vargas-Malebrán N, Bobbili S, Bustamante I, Khenti A, Corrigan PW. Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study. Front Psychiatry 2022; 13:1083042. [PMID: 36606131 PMCID: PMC9808783 DOI: 10.3389/fpsyt.2022.1083042] [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: 10/28/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chile is implementing a Community Mental Health Model with a strong role of primary health care (PHC). PHC has great potential to early detection and provision of accessible and coordinated services to people who present mental illness and/or substance use issues (MISUI). However, stigma toward people with MISUI among PHC professionals is a significant barrier to accessing good quality of care. A wealth of literature supports the importance of reducing stigma for this population. The main goal of this research project is to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviors among PHC providers toward individuals with MISUI in the Chilean context, using Centros de Salud Familiar (CESFAMs) as the point of intervention. METHODS The intervention is based on an initiative that was previously developed in Canada and then also pilot-tested in Lima, Peru, with the Center for Addiction and Mental Health (Ontario, Canada). The model will be culturally adapted with CESFAM PHC provider and user inputs to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community. The expected intervention outcomes are the following: Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUI compared with the control group as measured by the Chilean version of the Opening Minds Scale for Health Care Providers Scale (OMS-HC); Participation in the experimental group will result in a significant decrease of PHC users experiences of stigma conveyed by PHC providers compared with the control group as measured by the Internalized Stigma of Mental Illness (ISMI) scale, validated for the Chilean population. The changes in attitudes and behaviors within the experimental group will be sustained over time as measured at 6 months-follow-up. To evaluate the effectiveness of this 18-month intervention, a 4-year, two-arm, cluster-randomized controlled trial is proposed, with CESFAMs being the unit of randomization (or "cluster"). Implementation Science approach will be taken to measure relevant implementation outcomes for each component of the intervention, and through qualitative data collection with CESFAM providers and authorities. Data analysis will be carried out using SAS 9.4 (specifically, using POC MIXED and PROC GENMOD) and R 3.5. Mixed-effect modeling will used for both PHC provider and user data, which will include individuals and CESFAMs as random effects and group (intervention/control) as fixed effects. DISCUSSION This study represents a new stage of relevant and innovative research in mental health and stigma in Chile that will contribute to improving access and quality of care for people with MISUI. Evaluating the impact of the intervention model and its implementation will provide the necessary tools to scale the intervention up to other CESFAMs across Chile. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NCT05578066].
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Affiliation(s)
- Jaime C Sapag
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Medicina Familiar, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Carolina Traub
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola R Velasco
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tamara Arratia
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rubén Alvarado
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile.,Programa de Salud Mental, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marcela Aracena
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Fernando C Poblete
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Villarroel
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paulina Bravo
- Escuela de Enfermería, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cinthia Álvarez-Huenchulaf
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana Jofré Escalona
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nelson Vargas-Malebrán
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sireesha Bobbili
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Inés Bustamante
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Akwatu Khenti
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
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Gajardo J, Espinosa F, Goycolea R, Oyarzún M, Muñoz I, Valdebenito A, Pezoa C. Estigma hacia personas con enfermedad mental en estudiantes y profesores de terapia ocupacional,. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctoao24103145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Introducción Las personas con enfermedad mental experimentan actitudes estigmatizadoras desde la población general, incluyendo profesionales y estudiantes de la salud. Estudios internacionales han estimado el estigma en estudiantes de terapia ocupacional hacia personas con enfermedad mental como moderado. Objetivo Describir el estigma hacia personas con enfermedad mental en estudiantes y profesores de terapia ocupacional en una universidad chilena. Método Estudio descriptivo transversal con docentes y estudiantes en 1er y 4° año de terapia ocupacional en una universidad en Santiago de Chile, año 2020. Se aplicó formato online de cuestionario Opening Minds Stigma Scale for Health Care Providers (OMS-HC), versión adaptada a Chile, y formulario de datos sociodemográficos. Se calculó puntajes promedio para cuestionario de 20 ítems y ajustado a tres dimensiones con 15 ítems. Se usó pruebas de UMann-Whitney y t student para diferencias entre grupos. Los datos sociodemográficos fueron analizados mediante estadística descriptiva. Resultados Muestra de 87 personas, edad promedio 27 años (18-58), 81 (93%) mujeres, 41 (47%) estudiantes de 4to año, 28 (24%) estudiantes de 1er año, y 22 (25%) docentes. Puntaje promedio OMS-HC para muestra total fue 42,2 puntos (28-57), indicando nivel moderado-bajo de actitudes estigmatizadoras. Estudiantes de 1er año obtuvieron mayores puntajes, pero diferencias no fueron significativas. Conclusión Los resultados son consistentes con literatura previa refiriendo nivel moderado-bajo de actitudes estigmatizadoras hacia personas con enfermedades mentales. Las diferencias incipientes entre estudiantes de 1er y 4to año hacen pertinentes nuevos estudios con mayor tamaño muestral y en otros contextos.
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Affiliation(s)
- Jean Gajardo
- Universidad San Sebastián, Chile; Universidad de Chile, Chile
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Aziz MM, Badahdah AM, Mohammed HM. Cross-Cultural Adaptation and Psychometric Assessment of an Arabic Version of the Health Care Provider HIV/AIDS Stigma Scale. J Int Assoc Provid AIDS Care 2021; 20:23259582211066402. [PMID: 34913384 PMCID: PMC8689598 DOI: 10.1177/23259582211066402] [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] Open
Abstract
HIV stigma among health care providers in the Arab world is understudied due to a lack of valid and reliable measures. Data from 352 Egyptian physicians was used to validate an Arabic version of the Health Care Provider HIV/AIDS Stigma Scale (HPASS). Exploratory factor analysis (n = 1 9 4) suggested a 3 -factor structure. Confirmatory factor analysis (n = 1 5 8) validated the three-factor solution with 18 items, which explained 5 3 .3 6% of the variance. All items loaded on their designated constructs, which ranged from 0 .58 to 0 .82 (prejudice) to 0 .58 to 0 .66 (stereotypes) and 0 .52 to 0 .91 (discrimination). The prejudice, stereotypes, and discrimination subscales consisted of seven, five, and six items, respectively. The internal consistency (α = 0 .9 0) and the test-retest reliability demonstrated (r = 0 .9 5) were excellent. The cultural adaptation of the Arabic version of HPASS suggests that it is a suitable scale for assessing HIV stigma among Arab health care providers.
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Affiliation(s)
- Mirette M Aziz
- Department of Public Health & Community Medicine, 68796Assiut University, Egypt
| | - Abdallah M Badahdah
- School of Psychology, Sociology and Rural Studies, 2019South Dakota State University, Brookings, SD
| | - Heba M Mohammed
- Department of Public Health & Community Medicine, 68796Assiut University, Egypt
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Newton-Howes G, Senior J, Beaglehole B, Purdie GL, Gordon SE. Does a comprehensive service user-led education programme effect more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress in medical students? A comparative cohort study. Aust N Z J Psychiatry 2021; 55:903-910. [PMID: 33459033 DOI: 10.1177/0004867420987886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study sought to investigate the impact of a service user-led anti-stigma and discrimination education programme, encompassing numerous interventions focused on facilitating multiple forms of social contact, the promotion of recovery, and respect for human rights, on medical student attitudes. METHOD A comparison cohort study was used to compare the attitudes of two cohorts of medical students who received this programme as part of their fifth (the fifth-year cohort) or sixth (the sixth-year cohort) year psychological medical education attachment (programme cohorts) with two cohorts of equivalent students who received a standard psychological medical attachment (control cohorts). Attitudes to recovery (using the Recovery Attitudes Questionnaire) and stigma (using the Opening Minds Scale for Healthcare Providers) were measured at the beginning and end of the attachments for each year and compared both within and between the cohorts using Wilcoxon signed-rank or Wilcoxon rank-sum tests. RESULTS With sample sizes ranging from 46 to 70 across all cohorts, after their psychological medicine attachment both the programme and control cohorts showed more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress. Significant differences between the programme cohorts and the control cohorts were found for recovery attitudes (median difference of 2, p < 0.05 in both fifth and sixth year), with particularly large differences being found for the 'recovery is possible and needs faith' subdomain of the Recovery Attitudes Questionnaire. There were no significant between cohort differences in terms of stigmatising attitudes as measured by the Opening Minds Scale for Healthcare Providers. CONCLUSION The introduction of a comprehensive service user-led anti-stigma and education programme resulted in significant improvements in recovery attitudes compared to a control cohort. However, it was not found to be similarly superior in facilitating less stigmatising attitudes. Various possible reasons for this are discussed.
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Affiliation(s)
- Giles Newton-Howes
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Jessica Senior
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Gordon L Purdie
- Dean's Department, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Sarah E Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
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Sandhu HS, Arora A, Brasch J. Correlates of explicit and implicit stigmatizing attitudes of Canadian undergraduate university students toward mental illness: A cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:567-571. [PMID: 31702960 DOI: 10.1080/07448481.2019.1682002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/09/2019] [Accepted: 10/12/2019] [Indexed: 06/10/2023]
Abstract
To assess explicit and implicit attitudes toward mental illness of undergraduate students and explore associated variables. Participants: Year 1-4 undergraduate students from a large Canadian university (n = 382). Methods: Participants completed demographics, the Opening Minds Scale for Healthcare Providers, and an Implicit Association Test. Two-tailed independent and paired-samples t-tests, and ANOVA were performed with significance level at p < .05. Results: About 67.5% self-reported having experienced a mental illness and 31.2% had been diagnosed. Lower explicit stigma was associated with females, those with a history of mental illness diagnosis, and those who have had a close relationship with someone experiencing a mental illness. Faculty of Social Sciences students had significantly lower explicit stigma scores than Faculty of Engineering students. Implicit stigma did not show significant associations with any factors. Conclusions: A high proportion of undergraduate students experience mental illness. Increased exposure and experience were associated with reduced explicit stigma.
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Affiliation(s)
- Harman S Sandhu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Anish Arora
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Jennifer Brasch
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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