How Mental Illness is Perceived by Iranian Medical Students: A Preliminary Study

Attitude towards patients with psychiatric illness among undergraduate medical students at Government Medical College: A cross-sectional study

Background

People with mental illnesses commonly experience stigma, discrimination, and prejudice from the general public and medical professionals around the world. Numerous research has looked into the unfavourable perceptions that medical students have of those who suffer from mental illness.

Objective

The objective was to study the attitude of undergraduate medical students towards patients with psychiatric illnesses.

Materials and Methods

A cross-sectional study was carried out among undergraduate medical students who were exposed (n = 69) to 2-week psychiatry posting and attended lectures and those who were not exposed (n = 163) to psychiatry training using self-reported Attitude Scale for Mental Illness (ASMI) questionnaire via Google form distributed among medical students.

Results

The findings indicate there is no change in attitude toward the patient with psychiatric illness after exposure to psychiatry training among medical students. However, urban residence and female gender were the factors found to be influencing students' attitudes towards patients with psychiatric illnesses.

Conclusions

There was no change in attitude towards patients with psychiatric illness after psychiatry exposure. Students belonging to urban domicile and female students showed more sympathetic attitudes toward those with mental illnesses.

Stigma Toward Mental Illness Among Saudi Medical Students: Pre and Post Psychiatry Course Comparison

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.

Persian translation and validation of community attitudes toward the mentally ill scale: a tool for assessing social stigma about mental illness

No study, best of our knowledge, has been conducted on assessing the validity and reliability of community attitudes toward the mentally ill (CAMI) inventory in Iran. The questionnaire was translated into Persian and then returned to English. Content validity ratio (CVR), content validity index (CVI), impact score (IS) to assess content validity, Cronbach's alpha, and test-retest reliability was used to prove the internal and external reliabilities, respectively. The questionnaires were distributed to 130 people from different levels of society. Some were in contact with at least one patient with mental illness and some others had no connection. After 2 weeks, the questionnaires were resent to 50 participants to evaluate the reliability using the test-retest method. All questions had CVI (>0.79) and CVR (>0.49) except for three questions (Q 10, 24, and 30), which were excluded from the questionnaire. The questions were relevant, clear, simple, and valid. The IS was more than 1.5. The Cronbach's alpha values of four subscales including authoritarianism, benevolence, social restrictiveness, and community mental health ideology were recorded as 0.61, 0.49, 0.64, and 0.76, respectively. The CAMI scale is a valid and sustainable tool over time to assess the negative attitude toward mental illness.

Developing an Educational Package to Improve Attitude of Medical Students Toward People With Mental Illness: A Delphi Expert Panel, Based on a Scoping Review

INTRODUCTION

The importance of stigma toward patients with mental illness in medical students as future physicians cannot be overemphasized. There is currently no formal training to reduce stigma toward mental illness in medical students in their educational curriculums in Iran like most other low and middle income countries. Therefore, aiming to provide a practical and effective training package focused on reducing stigma toward patients with mental illness in medical students, the current study conducted, as an expert panel with Delphi method, based on a scoping review, to develop an education package to improve attitude of medical students toward patients with mental illness.

MATERIALS AND METHODS

We surveyed the available international databases including PubMed, Google Scholar, Scopus, PsycINFO, Tripdatabase, Web of Science, Cochrane Database of Systematic Reviews as well as Persian databases including Iranmedex, SID, Irandoc and Magiran in February and March 2020. After an extensive review of related resources, 13 articles met our inclusion criteria. Then, we extracted the related data including type and duration of the interventions, sample size, mean and standard deviation of stigma scores before and after interventions. To develop the package among the included interventions, we asked 16 experts in psychology, psychiatry, and social medicine to rate the interventions based on a number of variables such as effectiveness, feasibility and applicability in a Delphi process.

RESULTS

The selected intervention in Delphi method with consensus of experts included a set of four sequential interactive interventions: showing a movie and discussing it, psychiatric training including contact with people who affected psychiatric disorders, social communication with people who affected psychiatric disorders, and group discussion on defining stigma and personal experiences.

CONCLUSION

In the present study, we recommend a set of interventions to reduce stigma toward patients with mental illness among medical students in the form of a package of combined, interactive and sequential interventions that have been previously been shown to be effective in reducing stigma related to mental illness. We expect that implementation of these interventions would reduce mental illness stigma in medical students; which needs further verification.

The level of the stigma of medical students at King Saud bin Abdulaziz University for Health Sciences, towards mentally ill patients

Aim:

The study aimed to measure the level of the stigma of medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus, towards mentally ill patients.

Material and Methods:

A cross-sectional survey was conducted in King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh. The data collection was started in July 2017 till March 2018. The students completed a self-administered questionnaire consisting of sociodemographic data and the Community Attitudes toward the Mentally Ill (CAMI) Scale.

Results:

The sample size was realized as 274 participants. There were no significant differences in all CAMI subscales for the different academic years except for Authoritarianism which showed a significant increase in the level of stigma (P-value = 0.04). Male gender, previous psychiatric treatment, and having a relative with psychiatric illness were associated with higher Authoritarianism and Social Restrictiveness scores and lower Benevolence and CMHI scores.

Discussion:

More stigma was observed among the 4^th year students and it might be due to insufficient academic preparation as well as more exposure to psychiatric rotations.

Conclusion:

The results support the importance of implementing anti-stigma programs throughout the medical program to improve the healthcare provided to mentally ill patients.

Stigmatization Toward Patients with Mental Health Diagnoses: Tehran’s Stakeholders’ Perspectives

Background: The stigma associated with mental health disorders has an enormous impact on decisions concerning receiving mental health services. Objectives: The current qualitative study aimed to describe the stigma toward mental disorders in Tehran, Iran. Methods: The current grounded theory study conducted from 2013 to 2016 in Tehran (Iran). Fourteen participants were sampled using purposive and theoretical sampling techniques. Data were collected through face-to-face interviews, focused groups, and written narratives. The Corbin and Strauss coding paradigm (2008) was used to analyze data. Results: Three main categories of stigmatization toward patients with mental health diagnoses were extracted: (1) barriers to stigma reduction; (2) strategies to reduce stigma; and (3) outcomes of stigma reduction such as negative consequences of stigma toward mental disorders and positive impacts of stigma reduction toward mental disorders. Conclusions: To improve mental health services for patients in Tehran (Iran), it is imperative to reduce the stigma toward mental disorders, educate the community, including the general population and healthcare professionals, and remove existing barriers to receive mental health services.

The Effect of Clinical Exposure to Patients on Medical Students' Attitude Towards Mental Illness

BACKGROUND

Stigma of mental disorders causes a reduction in seeking help from the health care professionals and is evident across the world.

OBJECTIVES

The current study aimed to compare medical students' attitude towards mental illness after two different psychiatry clerkships in terms of the level of clinical exposure to patients with mental illness.

PATIENTS AND METHODS

Through a quasi-experimental study, all of the 4^th-year medical students were invited to enroll this study conducted in Tehran University of Medical Sciences (TUMS). They were non-randomly assigned into two different psychiatry clerkships from January 2009 to January 2010. One group was enrolled in the traditional lecture-based course (low-exposure) while the second group participated in a novel method with increased hours of patient exposure (high-exposure). Attitude towards mental illness (AMI) was measured by a 22-item questionnaire before and after the clerkship and data were compared between the two groups in terms of changing attitude towards mental illness in five different categories.

RESULTS

A total of 211 participants were enrolled in the study (115 female) of which 115 students (54.5%) were in low-exposure group and 96 students (45.5%) in the high-exposure group. Generally, AMI scores did not differ between the two groups and did not show any significant changes before and after the psychiatry clerkship. The only exceptions to this were AMI4 category (the concept of etiology of the mental illness), which significantly improved after the clerkship in the low-exposure (P = 0.011) and the high-exposure groups (P = 0.024), respectively.

CONCLUSIONS

Exposure of medical students to patients with mental illness did not improve attitude towards mental illness and psychiatric conditions.

Attitudes toward people with mental illness among medical students

Background:

Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’ attitudes toward people with mental illness is limited from India.

Aim:

The aim was to assess and compare the attitudes toward people with mental illness among medical students’.

Materials and Methods:

A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire.

Results:

Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013) and stigmatization (t = 2.656, P < 0.009) domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students’ attitudes toward mental illness.

Conclusion:

The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.