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Ghuloum S, Al-Thani HAQF, Al-Amin H. Religion and mental health: an Eastern Mediterranean region perspective. Front Psychol 2024; 15:1441560. [PMID: 39171235 PMCID: PMC11335727 DOI: 10.3389/fpsyg.2024.1441560] [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: 05/31/2024] [Accepted: 07/18/2024] [Indexed: 08/23/2024] Open
Abstract
In the last decade, spirituality gained increasing recognition, with an individualized approach to the significance of symptoms and the purpose of treatment. Many psychiatrists started adopting the term "biopsychosocial-spiritual" management. Modern psychological therapies have drawn from the principles of ancient Eastern traditions. However, the spiritual beliefs within Islam and their impact on mental well-being have yet to be studied sufficiently. The Eastern Mediterranean region is largely Muslim and shares similar cultural beliefs. This paper explores some of these beliefs and their impact on perceptions of mental health and help-seeking behavior. The paper will focus primarily on the religious ideologies, the concepts of punishment and reward from Allah (God) in the context of the high stigma associated with mental illness in the region, and the knowledge, attitudes, and perceptions toward people with mental illness. We will explore cultural beliefs in possession, evil eye, and black magic and how they influence treatment adherence. Traditional and faith healers remain very popular in this part of the world and are often the first line of treatment for people presenting with mental illness. Suicide and self-harming are particularly sensitive areas due to their religious implications in life and death, as well as the afterlife. Despite the global interest in the Eastern Mediterranean region, there still is a shortage of research on the intercultural aspects of this region, especially regarding mental health assessments. In this regard, we will explore some published literature from Qatar and draw comparisons with regional findings.
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Affiliation(s)
- Suhaila Ghuloum
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
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Steiner L, Sackey J, Cohen D, Brody R. Evidence-based practice attitudes and nutrition support guideline knowledge between holders and nonholders of the Certified Nutrition Support Clinician credential. Nutr Clin Pract 2024; 39:934-944. [PMID: 38366972 DOI: 10.1002/ncp.11136] [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: 09/12/2023] [Revised: 12/26/2023] [Accepted: 01/21/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Clinical practice frequently changes, and professionals should stay abreast of evidence-based practice (EBP) guidelines. Negative attitudes towards EBP are a barrier to guideline adoption. This study explored EBP attitudes and knowledge of a complex nutrition support clinical case scenario of individuals holding or not holding the Certified Nutrition Support Clinician (CNSC) credential. METHODS This cross-sectional study used an online survey sent to American Society for Parenteral and Enteral Nutrition (ASPEN) members with and without the CNSC credential and all CNSC credential holders from the National Board of Nutrition Support Certification email list. The survey included the Evidence-Based Practice Attitude Scale Score (EBPAS-15) and eight knowledge questions using a nutrition support case scenario. An independent samples t test compared knowledge and EBPAS-15 total scores and subscores between CNSC holders and nonholders. Pearson correlation determined the correlation between knowledge and EBPAS-15 scores. RESULTS The response rate was 7.8% (N = 706). CNSC holders (n = 536) had significantly higher mean knowledge scores (4.7 ± 1.6 out of 8) than nonholders (n = 159, 4.1 ± 1.7) (P < 0.001). Total EBPAS-15 scores were not significantly different between CNSC holders (n = 542, 2.9 ± 0.4 out of 4) and nonholders (n = 164, 2.8 ± 0.7) (P = 0.434), and knowledge scores and total EBPAS-15 scores (P = 0.639) or subscores were not significantly correlated. CONCLUSIONS Regardless of holding the CNSC credential, EBPAS-15 scores indicated respondents had positive EBP attitudes. CNSC holders had significantly higher knowledge scores of recent nutrition support EBP guidelines compared with non-CNSC credential holders. Positive EBP attitudes are a precursor to clinical decision-making, but future research should determine the use of guidelines in clinical practice.
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Affiliation(s)
- Lea Steiner
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Joachim Sackey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Deborah Cohen
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Rebecca Brody
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
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Örüm MH. Letter to the editor: "Associative learning and facial expression recognition in schizophrenic patients: Effects of social presence" and "Does cannabis affect cognitive functioning in patients with schizophrenia?". Schizophr Res Cogn 2024; 36:100303. [PMID: 38414561 PMCID: PMC10897901 DOI: 10.1016/j.scog.2024.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Mehmet Hamdi Örüm
- Psychiatry, Elazig Mental Health and Diseases Hospital, Elazig, Turkey
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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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Mohamed AA, Alomair SM, Alnijadi AA, Abd Aziz F, Almulhim AS, Hammad MA, Emeka PM. Barriers to Mental Illness Treatment in Saudi Arabia: A Population-Based Cross-Sectional Study. Cureus 2024; 16:e53797. [PMID: 38465168 PMCID: PMC10924077 DOI: 10.7759/cureus.53797] [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] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Mental illness is a disorder that can cause impairment and disability, affecting mood, thinking, and behavior; therefore, early intervention will reduce morbidity. This study aims to evaluate all the personal, family, societal, and medical barriers that prevent mental health patients from seeking consultation and treatment. METHODS In Saudi Arabia, a cross-sectional study was conducted on 463 individuals aged 18 and above. Data were collected by face-to-face interviews using a validated questionnaire, which consisted of two parts. The first part included sociodemographic data, while the second part contained subsections of society/family, personal, and medical barriers. RESULTS The results showed that 379 (81.9%) indicated that society and family barriers impacted them, whereas 325 (70.3%) believed that personal barriers hindered seeking help. However, 294 (63.5%) opted for medical barriers as a hindrance. Regarding the highest barriers, 120 of the total respondents (25.9%) saw psychiatric illness as a source of shame and stigma, 166 respondents (35.9%) said that the psychiatric patient is seen as crazy, 159 of them (34.3%) believed it is tough for anyone to talk about their feelings and emotions and 183 respondent (39.5%) feared that psychiatric illness would decrease the chance of marriage to the appropriate person. Our findings also indicated a low trust in hospital treatment, hence a loss of confidence in using medications. CONCLUSION The findings of this study indicate that societal stigma is the most common barrier preventing people from seeking mental health consultation. Many barriers differ significantly between males and females.
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Affiliation(s)
- Ahmed A Mohamed
- Clinical Pharmacy, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Sufyan M Alomair
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Fatimatuzzahra Abd Aziz
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Abdulaziz S Almulhim
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Promise M Emeka
- Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
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Myers B, Regenauer KS, Rose A, Johnson K, Ndamase S, Ciya N, Brown I, Joska J, Bassett IV, Belus JM, Ma TC, Sibeko G, Magidson JF. Community health worker training to reduce mental health and substance use stigma towards patients who have disengaged from HIV/TB care in South Africa: protocol for a stepped wedge hybrid type II pilot implementation trial. Implement Sci Commun 2024; 5:1. [PMID: 38167261 PMCID: PMC10759561 DOI: 10.1186/s43058-023-00537-w] [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: 10/15/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND South Africa has deployed community health workers (CHWs) to support individuals to enter and stay in HIV/TB care. Although CHWs routinely encounter patients with mental health (particularly depression) and substance use (SU) conditions that impact their engagement in HIV/TB care, CHWs are rarely trained in how to work with these patients. This contributes to mental health and SU stigma among CHWs, a known barrier to patient engagement in care. Mental health and SU training interventions could reduce CHW stigma and potentially improve patient engagement in care, but evidence of the feasibility, acceptability, and preliminary effectiveness of these interventions is scarce. Therefore, we designed a hybrid type 2 effectiveness-implementation pilot trial to evaluate the implementation and preliminary effectiveness of a CHW training intervention for reducing depression and SU stigma in the Western Cape, South Africa. METHODS This stepped wedge pilot trial will engage CHWs from six primary care clinics offering HIV/TB care. Clinics will be block randomized into three-step cohorts that receive the intervention at varying time points. The Siyakhana intervention involves 3 days of training in depression and SU focused on psychoeducation, evidence-based skills for working with patients, and self-care strategies for promoting CHW wellness. The implementation strategy involves social contact with people with lived experience of depression/SU during training (via patient videos and a peer trainer) and clinical supervision to support CHWs to practice new skills. Both implementation outcomes (acceptability, feasibility, fidelity) and preliminary effectiveness of the intervention on CHW stigma will be assessed using mixed methods at 3- and 6-month follow-up assessments. DISCUSSION This trial will advance knowledge of the feasibility, acceptability, and preliminary effectiveness of a CHW training for reducing depression and SU stigma towards patients with HIV and/or TB. Study findings will inform a larger implementation trial to evaluate the longer-term implementation and effectiveness of this intervention for reducing CHW stigma towards patients with depression and SU and improving patient engagement in HIV/TB care. TRIAL REGISTRATION ClinicalTrials.gov NCT05282173. Registered on 7 March 2022.
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Affiliation(s)
- Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Perth, WA, Australia.
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Parow, Cape Town, South Africa.
- Department of Psychiatry and Mental Health, Division of Addiction Psychiatry, University of Cape Town, Cape Town, South Africa.
| | - Kristen S Regenauer
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
| | - Alexandra Rose
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
| | - Kim Johnson
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Parow, Cape Town, South Africa
| | - Sibabalwe Ndamase
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Parow, Cape Town, South Africa
| | - Nonceba Ciya
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Parow, Cape Town, South Africa
| | - Imani Brown
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
| | - John Joska
- Department of Psychiatry and Mental Health, Division of Neuropsychiatry, University of Cape Town, HIV Mental Health Research Unit, Cape Town, South Africa
| | - Ingrid V Bassett
- Division of Infectious Diseases, Medical Practice Evaluation Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Jennifer M Belus
- Department of Clinical Research, Division of Clinical Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Tianzhou Charles Ma
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA
| | - Goodman Sibeko
- Department of Psychiatry and Mental Health, Division of Addiction Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jessica F Magidson
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
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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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Faruk MO, Rosenbaum S. Mental illness stigma among indigenous communities in Bangladesh: a cross-sectional study. BMC Psychol 2023; 11:216. [PMID: 37525224 PMCID: PMC10391860 DOI: 10.1186/s40359-023-01257-5] [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: 08/24/2022] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Mental illnesses stigma is a universal and transcultural phenomenon. While mental illnesses stigma is pervasive in Bangladesh, very little research exists on stigma toward mental illnesses among indigenous communities. This study aimed to investigate the prevailing stigma and the risk factors among different indigenous communities in the Chattogram Hill Tracts (CHT) in Bangladesh. METHODS A cross-sectional survey was carried out and participants were recruited purposively from Rangamati, a South-Eastern district of Bangladesh in the CHT. Participants from various indigenous communities including Chakma, Marma, Rakhine, Tripura, and Pangkhua were recruited. The 28- item Bangla translated version of the Mental Illnesses Stigma Scale was used. Independent-samples t-test, ANOVA, and multiple regression were performed. RESULTS The results indicate evidence of a gender difference with females reporting more stigma than their male counterparts. Age, gender, socioeconomic status, and monthly income are associated with stigma among indigenous people. Further analyses of the subscales indicated significant differences among sociodemographic variables. CONCLUSIONS The results provide an insight into the prevailing stigma and associate risk factors among indigenous communities. The results may help inform anti-stigma interventions targeting indigenous communities in Bangladesh.
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Affiliation(s)
- Md Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh.
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Rammou A, Berry C, Fowler D, Hayward M. "Attitudes to voices": a survey exploring the factors influencing clinicians' intention to assess distressing voices and attitudes towards working with young people who hear voices. Front Psychol 2023; 14:1167869. [PMID: 37287782 PMCID: PMC10242135 DOI: 10.3389/fpsyg.2023.1167869] [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: 02/17/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction Due to the general psychopathological vulnerability of young people who hear distressing voices, research has stressed the importance for clinicians to assess this experience in youth. Nonetheless, the limited literature on the topic comes from studies with clinicians in adult health services and it primarily reports that clinicians do not feel confident in systematically assessing voice-hearing and doubt the appropriateness of doing so. We applied the Theory of Planned Behavior and identified clinicians' job attitudes, perceived behavioral control, and perceived subjective norms as putative predictors of their intent to assess voice-hearing in youth. Method Nine hundred and ninety-six clinicians from adult mental health services, 467 from Child and Adolescent Mental Health (CAMHS) and Early Intervention in Psychosis (EIP) services and 318 primary care clinicians across the UK completed an online survey. The survey gathered data on attitudes toward working with people who hear voices, stigmatizing beliefs, and self-perceived confidence in voice-related practices (screening for, discussing and providing psychoeducation material about voice-hearing). Responses from youth mental health clinicians were compared with professionals working in adult mental health and primary care settings. This study also aimed to identify what youth mental health clinicians believe about assessing distressing voices in adolescents and how beliefs predict assessment intention. Results Compared to other clinicians, EIP clinicians reported the most positive job attitudes toward working with young voice-hearers, the highest self-efficacy in voice-hearing practices, and similar levels of stigma. Job attitudes, perceived behavioral control and subjective norms explained a large part of the influences on clinician's intention to assess voice-hearing across all service groups. In both CAMHS and EIP services, specific beliefs relating to the usefulness of assessing voice-hearing, and perceived social pressure from specialist mental health professionals regarding assessment practices predicted clinician intention. Discussion Clinicians' intention to assess distressing voices in young people was moderately high, with attitudes, subjective norms and perceived behavioral control explaining a large part of its variance. Specifically in youth mental health services, promoting a working culture that encourages opening and engaging in discussions about voice-hearing between clinicians, and with young people, and introducing supportive assessment and psychoeducation material about voice-hearing could encourage conversations about voices.
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Affiliation(s)
- Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
| | - Clio Berry
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
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Ghafoori B, Salgado C, Ramos N, Murillo K, Quintana S. Utilizing a webinar to introduce an evidence-based trauma treatment in Chile: Results from a pilot study investigating clinician attitudes and needs. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2023. [DOI: 10.1080/00207411.2023.2177478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Bita Ghafoori
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
| | | | - Nadia Ramos
- Faculty of Psychology, University of Talca, Chile
| | - Karen Murillo
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
| | - Sofia Quintana
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
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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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The Assessment of Attitudes of Medical Doctors towards Psychiatric Patients-A Cross-Sectional Online Survey in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126419. [PMID: 34199325 PMCID: PMC8296253 DOI: 10.3390/ijerph18126419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022]
Abstract
(1) Introduction: Stigmatization is a multi-level process leading to depreciation of particular social groups. It is particularly visible among people suffering from mental illnesses. Patient stigmatization is a serious problem in psychiatric care; thus, a reliable assessment of its level is important in the context of effective medical interventions. The aim of this paper is to assess the level of stigmatization of psychiatric patients among doctors. (2) Methods: An online, quantitative, CAWI (Computer Assisted Web Interview) study was conducted in the form of an anonymous, voluntary survey addressed to doctors working in Poland. The questionnaire questions included a socio-geographic assessment and questions assessing the level of stigmatization. A standardized psychometric tool, the MICA-4 Scale for doctors, was also used. The results obtained were compared with the evaluation of the existing reports on stigmatization among Polish society. (3) Results: 501 doctors of various specialties and at various stages of career participated in the study. Most of the respondents were women (75%). The average score of MICA-4 obtained by the respondents was 40.26 (minimum 17; maximum 67; SD 8.93). The women’s score was lower than the men’s (p = 0.034). (4) Conclusions: Stigmatization of psychiatric patients is a common phenomenon among doctors. The type of performed work and career stage has an impact on the perception of psychiatric patients. Specialists scored highest in the MICA-4 Scale, similarly to physicians of surgical fields. Due to the prevalence of the phenomenon of stigmatization, especially among people who are meant to provide patients with help, there is an urgent need to implement anti-stigma programs.
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Vasudevan L, Stinnett S, Mizelle C, Melgar K, Makarushka C, Pieters M, Sanchez LER, Jeronimo J, Huchko MJ, Proeschold-Bell RJ. Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru. Prev Med Rep 2020; 20:101212. [PMID: 33224718 PMCID: PMC7666342 DOI: 10.1016/j.pmedr.2020.101212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/20/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022] Open
Abstract
Cervical cancer is the leading cause of mortality in women of reproductive age in Peru. Increasing knowledge and awareness may promote cervical cancer screening uptake. Mitigating financial barriers may increase treatment rates among diagnosed women. Participants reported high willingness to adopt new cervical cancer interventions.
Cervical cancer mortality is high among Peruvian women of reproductive age. Understanding barriers and facilitators of cervical cancer screening and treatment could facilitate development of contextually-relevant interventions to reduce cervical cancer incidence and mortality. From April to October 2019, we conducted a cross-sectional survey with 22 medical personnel and administrative staff from Liga Contra el Cancer, in Lima, Peru. The survey included structured and open-ended questions about participants’ roles in cervical cancer prevention and treatment, perceptions of women’s barriers and facilitators for getting screened and/or treated for cervical cancer, as well as attitudes towards adopting new cervical cancer interventions. For structured questions, the frequency of responses for each question was calculated. For responses to open-ended questions, content analysis was used to summarize common themes. Our data suggest that the relative importance and nature of barriers that Peruvian women face are different for cervical cancer screening compared to treatment. In particular, participants mentioned financial concerns as the primary barrier to treatment and a lack of knowledge or awareness of human papillomavirus and/or cervical cancer as the primary barrier to screening uptake among women. Participants reported high willingness to adopt new interventions or strategies related to cervical cancer. Building greater awareness about benefits of cervical cancer screening among women, and reducing financial and geographic barriers to treatment may help improve screening rates, decrease late-stage diagnosis and reduce mortality in women who have a pre-cancer diagnosis, respectively. Further studies are needed to generalize study findings to settings other than Lima, Peru.
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Affiliation(s)
- Lavanya Vasudevan
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA.,Duke Global Health Institute, Durham, NC, USA.,Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | - Sandra Stinnett
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | | | | | - Christina Makarushka
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | | | | | | | - Megan J Huchko
- Duke Global Health Institute, Durham, NC, USA.,Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - Rae Jean Proeschold-Bell
- Duke Global Health Institute, Durham, NC, USA.,Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
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Spagnolo J, Vasiliadis HM, Berbiche D, Champagne F, Leduc N, Melki W, Saeed K, Charfi F. The influence of primary care physicians' mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial. BJPsych Open 2020; 6:e130. [PMID: 33121559 PMCID: PMC7745245 DOI: 10.1192/bjo.2020.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists' mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown. AIMS We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia. METHOD Participants included PCPs who completed questionnaires before (n = 112), immediately after (n = 88) and 18 months after (n = 59) training. Multivariable analyses with linear mixed models accounting for the correlation among participants were performed with the SAS version 9.4 PROC MIXED procedure. The significance level was α < 0.05. RESULTS Data show a significant interaction between time and mental health attitudes on referrals to specialised mental health services per week. Higher scores on the attitude scale were associated with more referrals to specialised services before and 18 months after training, compared with immediately after training. CONCLUSION Findings indicate that, in parallel to mental health training, considering structural/organisational supports to bring about a sustainable change in the influence of PCPs' mental health attitudes on referrals is important. Our results will inform the scale-up of an initiative to further integrate mental health into primary care settings across Tunisia, and potentially other countries with similar profiles interested in further developing task-sharing initiatives.
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Affiliation(s)
- Jessica Spagnolo
- School of Public Health, University of Montreal; Department of Community Health Sciences, University of Sherbrooke; and Charles-Le-Moyne - Saguenay-Lac-St-Jean Research Centre on Health Innovations, University of Sherbrooke - Longueuil Campus, Quebec, Canada
| | - Helen-Maria Vasiliadis
- Department of Community Health Sciences, University of Sherbrooke; and Charles-Le-Moyne - Saguenay-Lac-St-Jean Research Centre on Health Innovations, University of Sherbrooke - Longueuil Campus, Quebec, Canada
| | - Djamal Berbiche
- Department of Community Health Sciences, University of Sherbrooke; and Charles-Le-Moyne - Saguenay-Lac-St-Jean Research Centre on Health Innovations, University of Sherbrooke - Longueuil Campus, Quebec, Canada
| | | | - Nicole Leduc
- School of Public Health, University of Montreal, Quebec, Canada
| | - Wahid Melki
- Department of Psychiatry D, Razi Hospital; Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia; and Technical Committee for Mental Health Promotion in Ministry of Health, Tunis, Tunisia
| | - Khalid Saeed
- Mental Health and Substance Abuse Unit, Department of Non-Communicable Diseases and Mental Health, World Health Organization Regional Office for the Eastern Mediterranean, Egypt
| | - Fatma Charfi
- Department of Child Psychiatry, Mongi Slim Hospital; and Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
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15
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Őri D, Rózsa S, Szocsics P, Simon L, Purebl G, Győrffy Z. Factor structure of The Opening Minds Stigma Scale for Health Care Providers and psychometric properties of its Hungarian version. BMC Psychiatry 2020; 20:504. [PMID: 33046048 PMCID: PMC7552521 DOI: 10.1186/s12888-020-02902-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a widely used questionnaire to measure the stigmatising attitudes of healthcare providers towards patients with mental health problems. The psychometric properties of the scale; however, have never been investigated in Hungary. We aimed to thoroughly explore the factor structure of the OMS-HC and examine the key psychometric properties of the Hungarian version. METHODS The OMS-HC is a self-report questionnaire that measures the overall stigmatising attitude by a total score, and three subscales can be calculated: Attitude, Disclosure and Help-seeking, and Social Distance. Our study population included specialists and trainees in adult and child psychiatry (n = 211). Exploratory and confirmatory factor analyses were performed, and higher-order factors were tested. We calculated the test-retest reliability on a subgroup of our sample (n = 31) with a follow-up period of 1 month. The concurrent validity of the scale was measured with the Mental Illness: Clinician's Attitudes-4 scale (MICA-4). RESULTS Three factors were extracted based on a parallel-analysis. A bifactor solution (a general factor and three specific factors) showed an excellent model-fit (root mean square error of approximation = 0.025, comparative fit index = 0.961, and Tucker-Lewis index = 0.944). The model-based reliability was low; however, the general factor showed acceptable reliability (coefficient omega hierarchical = 0.56). The scale demonstrated a good concurrent validity with the MICA-4 [intraclass correlation coefficient (ICC) = 0.77]. The test-retest reliability was excellent for the general factor (ICC = 0.95) and good for the specific factors (ICC = 0.90, 0.88, and 0.84, respectively). CONCLUSIONS The three dimensions of the OMS-HC was confirmed, and the scale was found to be an adequate measure of the stigmatising attitude in Hungary. The bifactor model is more favourable as compared to the three correlated factor model; however, despite the excellent internal structure, its model-based reliability was low.
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Affiliation(s)
- Dorottya Őri
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Sándor Rózsa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | | | - Lajos Simon
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, Budapest, H-1089, Hungary.
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Could COVID-19 improve psychiatric awareness at the heart of the Middle East? - A personal reflection on Bahrain's response. Ir J Psychol Med 2020; 39:406-408. [PMID: 32484123 PMCID: PMC7562783 DOI: 10.1017/ipm.2020.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This perspective offers a personal insight into COVID-19 in Bahrain along with the response to this unprecented pandemic. In a country where a robust health care system and economic prosperity have allowed it to cope with the medical sequelae, the mental health consequences may have been less anticipated but more problematic. An unforeseen positive emerging from the pandemic might be the nation’s recognition of the importance of mental health well-being and a new openness to discussing it.
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