1
|
Wimbarti S, Kairupan BHR, Tallei TE. Critical review of self-diagnosis of mental health conditions using artificial intelligence. Int J Ment Health Nurs 2024; 33:344-358. [PMID: 38345132 DOI: 10.1111/inm.13303] [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: 09/20/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 03/10/2024]
Abstract
The advent of artificial intelligence (AI) has revolutionised various aspects of our lives, including mental health nursing. AI-driven tools and applications have provided a convenient and accessible means for individuals to assess their mental well-being within the confines of their homes. Nonetheless, the widespread trend of self-diagnosing mental health conditions through AI poses considerable risks. This review article examines the perils associated with relying on AI for self-diagnosis in mental health, highlighting the constraints and possible adverse outcomes that can arise from such practices. It delves into the ethical, psychological, and social implications, underscoring the vital role of mental health professionals, including psychologists, psychiatrists, and nursing specialists, in providing professional assistance and guidance. This article aims to highlight the importance of seeking professional assistance and guidance in addressing mental health concerns, especially in the era of AI-driven self-diagnosis.
Collapse
Affiliation(s)
- Supra Wimbarti
- Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - B H Ralph Kairupan
- Department of Psychiatry, Faculty of Medicine, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
- Department of Biology, Faculty of Medicine, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
| |
Collapse
|
2
|
Benau EM, Zavodnick JH, Jaffe RC. Initial evidence of reliability and validity of an implicit association test assessing attitudes toward individuals who use substances. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:64-74. [PMID: 38295383 DOI: 10.1080/00952990.2023.2300398] [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: 06/15/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
Background: Substance use disorders (SUDs) are stigmatized conditions, with individual biases driving poor health outcomes. There are surprisingly few validated measures of bias or stigma toward individuals who use substances. Bias can be classified as explicit (self-report) or implicit (behaviorally based).Objectives: The goal of the present study was to establish preliminary indices of reliability and validity of an implicit association test (IAT) designed to measure implicit bias toward individuals who use substances.Methods: A large United States-based, crowd-sourced sample (n = 394, 51.5% male, 45.4% female, 2.5% nonbinary) completed the IAT and a small battery of survey instruments that assessed social distance to mental illness (including heroin use), attitude toward and perceived controllability of injection drug use, perception of public stigma, and social desirability.Results: Nearly all (92%; n = 363) scores on the IAT indicated greater negative than positive attitudes toward those who use substances. Spearman-Brown corrected split-half reliability on the IAT scores was excellent, r = .953. Controlling for social desirability, IAT scores positively correlated with all included measures pertaining to substance use as well as social distance for heroin and schizophrenia (but not diabetes). A principal component analysis resulted in two interpretable components representing disapproval (perceived controllability and negative attitudes) and perceived stigma (social stigma and social distance). Scores on the IAT positively correlated to scores on both components, again, controlling for social desirability.Conclusion: These results provide compelling preliminary evidence of validity of an IAT designed to measure bias toward individuals who use substances.
Collapse
Affiliation(s)
- Erik M Benau
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
| | | | - Rebecca C Jaffe
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Zavorotnyy M, Klatte S, Yang Y, Liu W, Wagner U, Kircher T. The effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders as held by German medical students. Front Psychiatry 2023; 14:1306403. [PMID: 38144478 PMCID: PMC10748402 DOI: 10.3389/fpsyt.2023.1306403] [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: 10/03/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background According to the United Nations, access to medical care is a fundamental human right. However, there is widespread stigmatization of severe mental illnesses and this appears to seriously hamper the quality of healthcare in people with psychiatric co-morbidity. Thus, interventions that help reduce stigma among healthcare providers are urgently needed. Purpose The objective of the current study was to investigate the effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders held by medical students. Methods Between 2018 and 2019, a total of 256 third- and fourth-year students from Marburg University Medical School (Germany) completed two surveys-one before and one after a 2 week clerkship program that was designed to prioritize direct interaction with the patients. For measuring stigma, the questionnaires contained questions about students' attitudes toward psychiatry (ATP), including the Opening Minds Scale for Healthcare Providers (OMS-HC), Community Attitudes Toward the Mentally Ill (CAMI), and measurements according to the Stereotype-Content Model (SCM). We conducted pre-vs.-post comparisons using the Wilcoxon signed rank test with continuity correction or paired t-test and employed the Spearman method for correlational analysis. We considered p < 0.05 significant and adjusted all p-values reported here using the Benjamini-Hochberg procedure to account for family-wise error. Results After the clerkship, a significantly reduced stigma was found, as assessed with ATP (mean p < 0.001), OMS-HC (sum and subscale "attitudes" p < 0.001; subscale "disclosure" p = 0.002), and both SCM subscales (p < 0.001). Moreover, we observed significant associations between stigma expression (e.g., OMS-HC sum) and the willingness of students to choose psychiatric residency after finishing medical school (before clerkship: p < 0.001; ρ = -0.35; change after clerkship: p = 0.004; ρ = -0.2). Conclusion Our findings indicate that a psychiatric clerkship that involves students in direct interaction with patients may effectively reduce stigma. Therefore, we advocate the incorporation of components of direct interaction in medical education to combat stigma and unequal treatment, as this could improve outcomes in patients with severe mental illnesses.
Collapse
Affiliation(s)
- Maxim Zavorotnyy
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Academic Hospital of the University of Zurich, Windisch, Switzerland
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Simon Klatte
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Yunbo Yang
- Department of Experimental Psychopathology, Institute of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Wei Liu
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Ulrich Wagner
- Department of Social Psychology, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| |
Collapse
|
5
|
Saini R, Das RC, Chatterjee K, Srivastava K, Khera A, Agrawal S. Augmenting mental health literacy of troops in a large military station: A novel approach. Ind Psychiatry J 2023; 32:S166-S173. [PMID: 38370959 PMCID: PMC10871393 DOI: 10.4103/ipj.ipj_233_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/14/2023] [Accepted: 08/29/2023] [Indexed: 02/20/2024] Open
Abstract
Background Mental health literacy (MHL) helps in acknowledging the symptoms at an early stage, thus promoting prompt management of negative stress behaviors. Despite the central thrust towards augmentation of MHL of troops, there is a paucity of available literature on the subject matter, especially in the Indian context. Current research explores the efficacy of a standardized Information Education and Communication (IEC) module for the promotion of MHL among troops. Materials and Methods 1200 soldiers posted in a large military station underwent a psycho-educational module about stress and related mental health conditions in an open-label experimental study. Data was collected using a simple demographic tool and a specially constructed Armed Forces Medical College (AFMC) mental health awareness questionnaire. The same sample was studied before the IEC activity, immediately after the IEC activity, and again after six months. Results Community-based psycho-educational module helped in improvement in MHL and the gains were stable at six months. Conclusions Well-standardized and structured module was found to be an effective strategy for improving MHL. The authors consider this study as seminal for bringing objectivity to mental health promotional programs in the Armed Forces.
Collapse
Affiliation(s)
- Rajiv Saini
- Department of Psychiatry, Command Hospital (Western Command), Panchkhula, Haryana, India
| | - R. C. Das
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Kaushik Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Anurag Khera
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Sunil Agrawal
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| |
Collapse
|
6
|
Li L, Lu S, Xie C, Li Y. Stigmatizing attitudes toward mental disorders among non-mental health nurses in general hospitals of China: a national survey. Front Psychiatry 2023; 14:1180034. [PMID: 37599894 PMCID: PMC10433212 DOI: 10.3389/fpsyt.2023.1180034] [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: 03/05/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Negative attitudes of nurses toward mental disorders have been reported in various countries. Nurses' stigmatizing attitudes can harm patients with mental disorders (PWMD), thereby delaying the provision of help to patients and leading to decreased quality of care. In this study, we aimed to assess Chinese nurses' stigmatizing attitudes toward patients with mental illness and provide a basis for future development and testing of appropriate and culturally adapted interventions to reduce it. Objective This study aimed to assess the attitudes of Non-mental Health Nurses (NMHNs) in general hospitals in China toward the stigma of PWMD and determine the factors influencing them. Methods A cross-sectional survey of NMHNs in general hospitals were conducted. A self-designed WeChat-based questionnaire was used that included demographic information about the need for training on mental health issues. Participants were provided with a vignette of a depression case with suicidal thoughts. The Depression Stigma Scale (DSS) and Social Distance Scale (SDS) were used to assess attitudes toward mental disorders. Nine questions on the adequacy of knowledge about anxiety and depression and the current status of scale use were used to assess the current status of training needs for mental disorders. Descriptive analysis, chi-square test, and multivariate logistic regression were used for the table. Results A total of 8,254 nurses in non-mental health professions participated in this study. The mean DSS score of NMHNs was (17.24 ± 6.700), and the SDS score was (10.34 ± 3.154). The total detection rate of stigma among the survey respondents was 13.40% (1,107/8254). Multivariate logistic regression showed that age between 30 and 39 years [p = 0.001, OR = 1.427 (1.154-1.764)], 4 years of work experience and above [p = 0.018, OR = 1.377 (1.056-1.796)], having a bachelor's degree [p < 0.001, OR = 0.742 (0.647-0.851)], adequate psychological knowledge [p < 0.001, OR = 1.567 (1.364-1.799)], full knowledge of communication with patients with anxiety and depression [p < 0.001, OR = 1.848 (1.389-2.459)], and the need to acquire skills to identify anxiety and depression were the influencing factors associated with stigma [p < 0.001, OR = 0.343 (0.236-0.499)]. Conclusion Stigmatizing attitudes toward PWMD exist among NMHNs in general hospitals in China. Thus, more mental health education programs for NMHNs are needed. Factors associated with higher morbidity stigma can be used to develop appropriate interventions to improve NMHNs' stigmatizing attitudes and provide better quality care to PWMD.
Collapse
Affiliation(s)
- Li Li
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
- Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shurong Lu
- Centre for Mental Health | Melbourne School of Population and Global Health The University of Melbourne, Melbourne, VIC, Australia
| | - Chunyan Xie
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
7
|
Zhang N, Ye X, Xu J. The Mediating Role of Psychological Well-being Between Social Media Use and Academic Performance Among University Students: What is the Importance of Student Mental Health? Am J Health Behav 2023; 47:605-617. [PMID: 37596758 DOI: 10.5993/ajhb.47.3.18] [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: 08/20/2023]
Abstract
Objectives: Students at higher education institutes are facing the issue of mental health and psychological well-being highlighting the importance of health behavior. Therefore, the aim of this research was to investigate the relationship among social media use, self-regulation, and career development goals of university students on their psychological well-being and academic performance along with the direct effect of mental health on academic performance. Moreover, we also examined the mediating role of psychological well-being. Methods: We collected data through questionnaires from 250 students enrolled in universities using random sampling technique. The usable response rate was 70.19%. We examined the data using PLS-SEM through PLS-3.3.9. Results: Psychological well-being was significantly affected by social media use, self-regulation, and career development goals. Also, psychological well-being had a positive significant effect on students' academic performance. Conclusions: These findings also confirm the mediating role of psychological well-being as well. We present the implications and limitations of the study.
Collapse
Affiliation(s)
- Nan Zhang
- Collage of Physical Education, Anhui Normal University, Wuhu, China
| | - Xuxin Ye
- Office of Hospital Admission and Discharge, The First Affiliated Hospital of Wannan Medical Collage, Wuhu, China
| | - Jie Xu
- Office of Hospital Admission and Discharge, The First Affiliated Hospital of Wannan Medical Collage, Wuhu, China
| |
Collapse
|
8
|
Askari MS, Mauro PM, Kaur N, Keyes KM. Age, Period, and Cohort Trends in Perceived Mental Health Treatment Need and Differences by Mental Health Severity in the United States, 2008-2019. Community Ment Health J 2023; 59:631-640. [PMID: 36305995 PMCID: PMC9613449 DOI: 10.1007/s10597-022-01044-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/13/2022] [Indexed: 02/08/2023]
Abstract
Identifying age, period, and cohort trends in perceived mental health treatment need over time by mental illness severity is important to identify where to focus early intervention efforts. We included adults who did not report receiving past-year mental health treatment in the 2008-2019 National Survey on Drug Use and Health (N = 364,676). Hierarchical age-period-cohort models were used to assess perceived mental health treatment need, adjusting for demographics stratified by mental illness severity (none, any but not severe [AMI], severe [SMI]). Median odds ratios estimated cohort and period variance. Cohort effects explained a significant portion of the variance over time; period effects were minimal. Perceived mental health treatment need was highest among adults with AMI from recent birth cohorts (2000-2002: β = 1.12; 95% CI = 0.96, 1.28). Efforts are needed to address increases in perceived mental health treatment need in younger birth cohorts, such as removing structural barriers (e.g., healthcare system barriers).
Collapse
Affiliation(s)
- Melanie S Askari
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168Th St, New York, NY, 10032, USA.
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168Th St, New York, NY, 10032, USA
| | - Navdep Kaur
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168Th St, New York, NY, 10032, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168Th St, New York, NY, 10032, USA
| |
Collapse
|
9
|
Peart T, Kerr D, Searby A. Novice nurses' experiences in provision of mental ill health care within a regional emergency department: A descriptive qualitative study. Int J Ment Health Nurs 2023; 32:458-468. [PMID: 36562518 DOI: 10.1111/inm.13108] [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] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
Emergency departments are often the first point of contact for individuals presenting to healthcare services for assistance and treatment for mental ill health. Emergency departments, particularly those in regional areas, can experience high staff turnover and rely on novice nurses for workforce sustainability. The aim of this paper is to explore the experiences of novice nurses (nurses with <3 years of experience) in providing care to individuals presenting with mental ill health in the emergency department. Semi-structured interviews were conducted with novice nurses (N = 13) in a regional emergency department, using qualitative description as the guiding framework. The following three main themes were identified: (i) confidence in providing quality and safe nursing care, (ii) perceived barriers to providing quality and safe nursing care, and (iii) factors that increase confidence. Our findings indicate that proving safe and appropriate nursing care is affected in novice nurses by factors that lead to a perceived lack of confidence, such as how individuals present to the emergency department (e.g. intoxicated or violent), an inability to conduct conversations to assess accurately and perceived shortfalls in the emergency department environment itself. Future research should examine the curriculum for relevance of undergraduate education regarding acute mental health presentations and develop training strategies that enhance communication with individuals who present to the emergency department with mental ill health.
Collapse
Affiliation(s)
- Talitha Peart
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia.,Ballarat Health Services, Ballarat, Victoria, Australia
| | - Debra Kerr
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
10
|
Happell B, Gordon S, Sharrock J, Donovan AO, Kenny N, Warner T. There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience. Int J Ment Health Nurs 2023; 32:744-754. [PMID: 36645058 DOI: 10.1111/inm.13117] [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: 12/28/2022] [Indexed: 01/17/2023]
Abstract
The genuine and meaningful involvement of Experts by Experience in the education of health professionals has consistently demonstrated positive attitudinal change in students. These changes are essential if policy goals for recovery-oriented services and service user participation in mental health services are to be realized. To date academic roles for Experts by Experience have often relied on the support of allies. Despite the important role allies play, research investigating their experiences is limited. The aim of this research was to explore allies' views on supporting implementation of the academic positions for Experts by Experience. A qualitative exploratory study was undertaken involving in-depth interviews with 16 allies. Data were analysed thematically. Challenges that can exist between allies and Experts by Experience was one theme identified from the data. Allies described occasional difficulties in their relationships with Experts by Experience where they felt they were perceived as representative of members of their broader profession with whom Experts by Experience had negative experiences. The perspectives of allies are presented in four subthemes: relationships imbedded in history; consequences of interpersonal stigma; supportive, protective or paternalistic?; and the passion remains, which describes allies' ongoing commitment to supporting Expert by Experience involvement. Understanding the challenges can assist allies to respond appropriately in a non-judgemental and supportive manner. Trauma informed practice may provide a useful framework to address conflicts and facilitate more positive relationships between allies and Experts by Experience. These positive relationships are essential to maximize the positive benefits of Experts by Experience on future clinicians.
Collapse
Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia.,Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Julie Sharrock
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Aine O' Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Nuala Kenny
- Health Service Executive Bantry, Cork, Ireland.,Expert by Experience, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Terri Warner
- ANU Medical School, Australian National University, Acton, Australian Capital Territory, Australia.,ACT Mental Health Consumer Network, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
11
|
Rodríguez-Ferrer JM, Manzano-León A, Fernández-Jiménez C, Aguilar-Parra JM, Cangas AJ, Luque de la Rosa A. The use of digital escape rooms in nursing education. BMC MEDICAL EDUCATION 2022; 22:901. [PMID: 36581837 PMCID: PMC9798354 DOI: 10.1186/s12909-022-03879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/09/2022] [Indexed: 06/17/2023]
Abstract
Negative attitudes and prejudices towards people with a mental disorder are common across cultures and societies. The stigma associated with mental illness leads to a lower quality of life, given the discrimination and social exclusion suffered by people with this type of disorder. In the field of health, research has shown that doctors and nurses also manifest these types of stigmatizing behaviors and attitudes. The present study aims to create and apply an educational escape room for the purpose of training nursing students in mental health, promoting positive attitudes towards people who have a mental disorder. To do so, a pre-post study was conducted with an experimental group and a control group to determine whether the escape room was effective for the modification of stigmatizing behaviors compared to transmissive lecture class, and a third measurement was made at 6 months only to the experimental group to evaluate whether the changes produced by the escape room were maintained in the long term. The results indicate that the students participating in the study obtained better scores in sensitization and these remain better over time. It is concluded that the escape room used is suitable for the training and sensitization of future nursing professionals in the field of mental health, facilitating the learning of knowledge and positive attitudes towards severe mental disorder.
Collapse
Affiliation(s)
- J M Rodríguez-Ferrer
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
| | - A Manzano-León
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain.
| | | | - J M Aguilar-Parra
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
| | - A J Cangas
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
| | | |
Collapse
|
12
|
Happell B, Gordon S, Sharrock J, Warner T, O'Donovan A. "Making It Happen": Supporting the Implementation of Positions for Experts by Experience in Mental Health Education. Issues Ment Health Nurs 2022; 43:1022-1029. [PMID: 35913791 DOI: 10.1080/01612840.2022.2095472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Significant changes to mental health policy have positioned consumers of mental health services as active participants in all aspects of service design and delivery, leading to the development and expansion of consumer workforce roles (Experts by Experience [EBE]). Negative attitudes of health professions pose a major limitation to the success of these positions. EBE involvement in mental health education has shown favourable outcomes, particularly enhancing more positive attitudes. Unfortunately, these positions remain limited in number and scope and have largely been supported by individual clinical academic champions (allies). This article presents findings from a qualitative study, involving individual interviews that explored the experiences and perceptions of allies who supported the implementation of academic positions for EBE. Data were analysed thematically. "Making it happen" was the overarching theme identified. It comprised the sub-themes: strategic or opportunistic?; developing an argument; using evidence; showing what EBE bring; getting buy-in and utilising existing relationships. The articulation of these processes provides a useful guide to other allies interested in supporting the implementation of these positions. The implementation of further positions will ultimately improve the attitudes of other health professionals towards Expert by Experience roles.
Collapse
Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.,Faculty of Health, Southern Cross University, East Lismore, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Julie Sharrock
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Terri Warner
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
13
|
Staab EM, Wan W, Campbell A, Gedeon S, Schaefer C, Quinn MT, Laiteerapong N. Elements of Integrated Behavioral Health Associated with Primary Care Provider Confidence in Managing Depression at Community Health Centers. J Gen Intern Med 2022; 37:2931-2940. [PMID: 34981360 PMCID: PMC9485335 DOI: 10.1007/s11606-021-07294-3] [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] [Received: 04/05/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is most often treated by primary care providers (PCPs), but low self-efficacy in caring for depression may impede adequate management. We aimed to identify which elements of integrated behavioral health (BH) were associated with greater confidence among PCPs in identifying and managing depression. DESIGN Mailed cross-sectional surveys in 2016. PARTICIPANTS BH leaders and PCPs caring for adult patients at community health centers (CHCs) in 10 midwestern states. MAIN MEASURES Survey items asked about depression screening, systems to support care, availability and integration of BH, and PCP attitudes and experiences. PCPs rated their confidence in diagnosing, assessing severity, providing counseling, and prescribing medication for depression on a 5-point scale. An overall confidence score was calculated (range 4 (low) to 20 (high)). Multilevel linear mixed models were used to identify factors associated with confidence. KEY RESULTS Response rates were 60% (N=77/128) and 52% (N=538/1039) for BH leaders and PCPs, respectively. Mean overall confidence score was 15.25±2.36. Confidence was higher among PCPs who were satisfied with the accuracy of depression screening (0.38, p=0.01), worked at CHCs with depression tracking systems (0.48, p=0.045), had access to patients' BH treatment plans (1.59, p=0.002), and cared for more patients with depression (0.29, p=0.003). PCPs who reported their CHC had a sufficient number of psychiatrists were more confident diagnosing depression (0.20, p=0.02) and assessing severity (0.24, p=0.03). Confidence in prescribing was lower at CHCs with more patients living below poverty (-0.66, p<0.001). Confidence in diagnosing was lower at CHCs with more Black/African American patients (-0.20, p=0.03). CONCLUSIONS PCPs who had access to BH treatment plans, a system for tracking patients with depression, screening protocols, and a sufficient number of psychiatrists were more confident identifying and managing depression. Efforts are needed to address disparities and support PCPs caring for vulnerable patients with depression.
Collapse
Affiliation(s)
| | - Wen Wan
- University of Chicago, Chicago, IL, USA
| | | | - Stacey Gedeon
- Mid-Michigan Community Health Services, Houghton Lake, MI, USA
| | | | | | | |
Collapse
|
14
|
Valverde-Bolivar E, García-Arenas JJ, Pelegrin IL, Pérez-Gómez L, Muñoz-López M, Simonelli-Muñoz AJ. The stigma of mental health professionals towards users with a mental disorder. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:178-186. [PMID: 35867484 PMCID: PMC10803850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Individuals with mental disorders are labeled in such a way that it leads to stigmatization. This generates a disadvantage as regards to the rest of the members of the society, limiting their participation as active members within it and at the same time being deleterious to their way of life. Mental health professionals are not safe from internalizing these stereotypes and prejudices assumed from their environment, thereby showing stigmatizing attitudes and behaviors towards the users in the different mental health resources.
Collapse
Affiliation(s)
- Efrén Valverde-Bolivar
- Hospital Psiquiátrico Román Alberca, Servicio Murciano de Salud, Murcia, España
- Universidad Católica San Antonio de Murcia (UCAM), Murcia, España
| | | | - Ilda López Pelegrin
- Hospital Psiquiátrico Román Alberca, Servicio Murciano de Salud, Murcia, España
| | - Laura Pérez-Gómez
- Hospital Psiquiátrico Román Alberca, Servicio Murciano de Salud, Murcia, España
| | | | - Agustín J. Simonelli-Muñoz
- Universidad Católica San Antonio de Murcia (UCAM), Murcia, España
- Facultad de Ciencias de la Salud. Universidad de Almería, Almería, España
| |
Collapse
|
15
|
An evaluation of mental health capacity building among Community Rehabilitation Officers in Malawi: A mixed-methods case study. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
16
|
Werremeyer A, Strand MA, Eukel H, Skoy E, Steig J, Frenzel O. Longitudinal evaluation of pharmacists’ social distance preference and attitudes toward patients with opioid misuse following an educational training program. Subst Abuse 2022; 43:1051-1056. [DOI: 10.1080/08897077.2022.2060449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Amy Werremeyer
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Mark A. Strand
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Heidi Eukel
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Elizabeth Skoy
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Jayme Steig
- Quality Health Associates of North Dakota, Minot, ND, USA
| | - Oliver Frenzel
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| |
Collapse
|
17
|
Fernandes JB, Família C, Castro C, Simões A. Stigma towards People with Mental Illness among Portuguese Nursing Students. J Pers Med 2022; 12:jpm12030326. [PMID: 35330326 PMCID: PMC8955632 DOI: 10.3390/jpm12030326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/17/2022] [Indexed: 12/31/2022] Open
Abstract
Stigma is a substantial obstacle when caring for people with mental illness. Nursing students’ negative attitudes towards people with mental illness may impact the quality of care delivered and consequentially patient outcomes. In this study, we assessed the stigmatising attitudes and beliefs of nursing students towards people with mental illness and examined its relationship with several psycho-socio-demographic variables. This was a quantitative, cross-sectional descriptive correlational study, which was developed with a non-probabilistic convenience sample of 110 nursing students. Stigmatising attitudes and beliefs were assessed using the Portuguese version of the Attribution Questionnaire AQ-27. Results show that the dimensions of stigma with higher scores were help, pity, coercion and avoidance. However, significant differences were only observed depending on the year of study (fourth-year students, who already had clinical placements in this area, are less likely to show stigma), the relationship (family is less prone to show coercion), the history of mental health treatment (students with a history of mental health treatment have more tendency to help) and whether they considered working in the mental health field (students who have considered working in this field are less prone to show anger, avoidance and think of patients as dangerous). Therefore, we conclude that education in a classroom setting alone is not enough to reduce stigma in nursing students, clinical placement in the area is required to achieve such results. It is thus essential to improve nursing curricula worldwide so that students are exposed to both psychiatric nursing theory and clinical practice in the first years of the nursing degree.
Collapse
Affiliation(s)
- Júlio Belo Fernandes
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Correspondence:
| | - Carlos Família
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Molecular Pathology and Forensic Biochemistry Laboratory (MPFBL), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, 2829-511 Caparica, Portugal
| | - Cidália Castro
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
| | - Aida Simões
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
| |
Collapse
|
18
|
Ghuloum S, Mahfoud ZR, Al-Amin H, Marji T, Kehyayan V. Healthcare Professionals' Attitudes Toward Patients With Mental Illness: A Cross-Sectional Study in Qatar. Front Psychiatry 2022; 13:884947. [PMID: 35651821 PMCID: PMC9148967 DOI: 10.3389/fpsyt.2022.884947] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Negative attitudes toward mental illness by Health Care Professionals (HCP) have been reported in many countries across the world. Stigmatizing attitudes by HCP can have adverse consequences on people with mental illness from delays in seeking help to decreased quality of care provided. Assessing such attitudes is an essential step in understanding such stigma and, if needed, developing and testing appropriate and culturally adapted interventions to reduce it. AIMS To assess physicians and nurses attitudes toward mental illness and to determine associated factors with different levels of stigma. METHODS A cross-sectional survey was conducted among Physicians and Nurses. The Mental Illness Clinician's Attitudes (MICA) scale was used to assess attitudes toward mental illness. MICA scores range between 1 and 6 with higher values indicating higher stigmatizing attitudes. Demographic and work related information were also gathered. Descriptive statistics along with multivariate linear and multivariate logistic regression models were used. RESULTS A total of 406 nurses and 92 doctors participated in the study. The nurses' mean MICA score was significantly higher than that of the physicians. Among nurses, being Asian and working in a geriatric, rehabilitation and long-term care facility were associated with lower MICA scores. Among physicians, being female or graduating more than 1 year ago were also associated with lower MICA scores. CONCLUSION Stigmatizing attitudes toward people with mental illness by healthcare workers are present in Qatar. They are higher among nurses as compared to physicians. Factors associated with higher stigmatizing attitudes could be used in creating appropriate intervention to reduce the magnitude of the problem.
Collapse
Affiliation(s)
| | - Ziyad R Mahfoud
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States.,Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
| | - Hassen Al-Amin
- Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
| | - Tamara Marji
- Primary Health Care Corporation, Doha, Qatar.,Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Vahe Kehyayan
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| |
Collapse
|
19
|
Bock PE, Pham V, Puzantian T. Pharmacy students' perceptions of the effectiveness of a film-based mental health elective course. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:38-45. [PMID: 35125193 DOI: 10.1016/j.cptl.2021.11.001] [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: 12/11/2020] [Revised: 07/06/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Stigmatizing attitudes of pharmacists can contribute to poor outcomes in individuals with mental illness. Direct contact with patients during pharmacy experiential education helps establish positive attitudes toward people with mental illness yet may not be available to all students. The use of film in pharmacy education has the potential to facilitate learning and improve attitudes. METHODS We evaluated students' perceptions regarding the impact of an elective course for pharmacy students which incorporated feature films about mental illnesses. Students completed surveys addressing their perceptions of each film's role in facilitation of learning, attitudes about mental illness, and comfort level for interacting with patients with mental illness. RESULTS A total of 125 students completed a course featuring 17 films over the four-year study period. The films with the highest weighted positive rankings were Temple Grandin, Helen, As Good As It Gets, Born on the Fourth of July, Iris, A Beautiful Mind, and Silver Linings Playbook. Less favored films included One Flew Over the Cuckoo's Nest, Prozac Nation, and My Own Private Idaho. CONCLUSIONS Direct contact with patients may best prepare future pharmacists to serve the needs of people with mental illness. This study suggests that students perceive feature films used in an elective course may have a positive impact on facilitating learning and improving attitudes of pharmacy students toward individuals with mental illness. Further well-designed studies are warranted, including in other health professions students, to substantiate and define the role of film as a tool to teach and address stigma.
Collapse
Affiliation(s)
- Payton E Bock
- The George Washington University, Columbian College of Arts and Sciences, Forensic Psychology, 1925 Ballenger Avenue, Suite 250, Alexandria, VA 22314, United States.
| | - Venie Pham
- Keck Graduate Institute, School of Pharmacy and Health Sciences, 535 Watson Drive, Claremont, CA 91711., United States.
| | - Talia Puzantian
- Keck Graduate Institute, School of Pharmacy and Health Sciences, 535 Watson Drive, Claremont, CA 91711., United States.
| |
Collapse
|
20
|
Nardella N, Hooper S, Lau R, Hutchinson A. Developing acute care-based mental health nurses' knowledge and skills in providing recovery-orientated care: A mixed methods study. Int J Ment Health Nurs 2021; 30:1170-1182. [PMID: 33848046 DOI: 10.1111/inm.12868] [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: 09/15/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Recovery-oriented principles have progressively been accepted as a standard of mental health practice in many countries, including Australia. A private mental health Clinic in Melbourne, Australia, is dedicated to embedding the principles of recovery-oriented practice into care by (i) providing recovery education and training for their staff and (ii) co-designing resources with consumers to promote active consumer engagement and participation. The purpose of this study was to evaluate the impact of these initiatives on staff knowledge and provision of recovery-oriented care in acute care. Two groups of study participants were recruited: the first group completed the staff training programme introducing the concept of recovery-oriented practice, and the second group was a convenience sample of nurses recruited 12 months later working on the acute inpatient wards at the study site. Nurses completed Recovery Knowledge Inventory (RKI) and Recovery Self-Assessment (RSA-Provider) surveys and participated in a focus group discussion. The three major themes identified from the focus group discussion were as follows: (i) nurses' understanding of personal recovery-orientated practice, (ii) how to embed personal recovery-oriented care into practice, and (iii) barriers to consumer participation in recovery-oriented activities in acute care. There were significant differences between the two groups on the RKI subscale scores of 'Expectations regarding recovery' and the 'Roles of self-definition and peers in recovery' and 'Life goals' and 'Choice' factors on the RSA subscale scores. There were some gaps in the nurses' knowledge and implementation of personal recovery-oriented concepts, highlighting the need for further training and cultural change.
Collapse
Affiliation(s)
- Natalie Nardella
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia
| | - Suzie Hooper
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia
| | - Rosalind Lau
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anastasia Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
21
|
Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, Ng B, Ramy H, Saha G, Arifeen S, Elorza PM, Ratnasingham P, Azeem MW. Reducing the stigma of mental health disorders with a focus on low- and middle-income countries. Asian J Psychiatr 2021; 58:102601. [PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 01/12/2023]
Abstract
Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.
Collapse
Affiliation(s)
- Afzal Javed
- Pakistan Psychiatric Research Centre, Lahore, Pakistan; World Psychiatric Association (WPA), UK.
| | - Cheng Lee
- Institute of Mental Health, Singapore
| | - Hazli Zakaria
- Malaysian Psychiatric Association (MPA), Kuala Lumpur, Malaysia
| | - Robert D Buenaventura
- Department of Neurosciences, Manila Theological College - College of Medicine, Manila, Philippines
| | - Marcelo Cetkovich-Bakmas
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Kalil Duailibi
- Department of Psychiatry, Santo Amaro University, São Paulo, Brazil
| | - Bernardo Ng
- Asociación Psiquiátrica Mexicana, Mexico; University of California, San Diego, CA, USA
| | - Hisham Ramy
- NeuroPsychiatry Department, Ain Shams University, Cairo, Egypt; Egyptian Psychiatric Association (EPA), Cairo, Egypt; Egyptian Association of Cognitive Behavioral Therapy (EACBT), Cairo, Egypt
| | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Kolkata, India; Indian Psychiatric Society, Kolkata, India
| | | | - Paola M Elorza
- Research, Development & Medical, Upjohn - A Pfizer Division, Buenos Aires, Argentina
| | | | - Muhammad Waqar Azeem
- Department of Psychiatry, Sidra Medicine, Weill Cornell Medical College, Doha, Qatar
| |
Collapse
|
22
|
Werremeyer A, Mosher S, Eukel H, Skoy E, Steig J, Frenzel O, Strand MA. Pharmacists' stigma toward patients engaged in opioid misuse: When "social distance" does not mean disease prevention. Subst Abus 2021; 42:919-926. [PMID: 33750283 DOI: 10.1080/08897077.2021.1900988] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Health professionals may stigmatize and prefer social distance from patients with opioid misuse, leading to poorer quality of care provided. The degree to which pharmacists prefer social distance from patients with opioid misuse and opioid use disorder (OUD) is not known. Methods: Pharmacists (n = 187) completed a survey comprised of demographics, attitudinal, and Social Distance Scale (SDS) questions based on a vignette patient who displayed opioid misuse. SDS question responses and total scores (maximum of 30; higher scores representing great preference for social distance) were tallied and associations with attitudes and demographics were examined. Results: Mean SDS total score was 16.32 (range 9-23). More than 59% of respondents had an SDS score >15, indicating overall lack of willingness to interact with the vignette patient. Females had a higher mean SDS score vs male pharmacists (16.58 vs. 15.36, respectively; p = 0.023). Pharmacists were more likely to prefer social distance from the vignette patient in personal situations (i.e. renting a room) than work-related interactions (i.e. providing patient education). Pharmacists with >10 years of experience, those without personal experience with a substance use disorder, those who strongly agreed that patients with OUD require excessive time and effort, and those who agreed that some people lack self-discipline to use prescription pain medication without becoming addicted had significantly higher SDS scores than pharmacists without these characteristics. Conclusions: Pharmacists expressed significant preference for social distance indicating stigmatization of patients with opioid misuse. Pharmacists were comfortable performing pharmacy tasks with patients with opioid misuse, but were less comfortable forming therapeutic relationships, an important tenet of patient-centered care. Efforts are needed to examine contributions to social distance preferences and implement measures to reduce them. Targeting of pharmacists with >10 years' experience and without personal experience with OUD may also be most beneficial.
Collapse
Affiliation(s)
- Amy Werremeyer
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| | - Sydney Mosher
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| | - Heidi Eukel
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| | - Elizabeth Skoy
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| | - Jayme Steig
- Quality Health Associates of North Dakota, Minot, North Dakota, USA
| | - Oliver Frenzel
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| | - Mark A Strand
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA
| |
Collapse
|
23
|
Eiroa-Orosa FJ, Lomascolo M, Tosas-Fernández A. Efficacy of an Intervention to Reduce Stigma Beliefs and Attitudes among Primary Care and Mental Health Professionals: Two Cluster Randomised-Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031214. [PMID: 33572955 PMCID: PMC7908111 DOI: 10.3390/ijerph18031214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness-raising interventions respectively tailored to reduce stigmatising beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. Activists from this organisation with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The Targeted, Local, Credible, Continuous Contact (TLC3) methodology was adapted to the Catalan healthcare context. The efficacy of these interventions was evaluated using two prospective double-blind cluster-randomised-controlled trials. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in PC centres and with the Beliefs and Attitudes towards Mental Health Service users’ rights in MH centres. Reductions in both PC and MH professionals’ stigmatising beliefs and attitudes were found in the 1-month follow-up, although a ‘rebound effect’ at the 3-month follow up was detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates were high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals using assessment systems that include the measurement of knowledge acquired and actual behavioural change.
Collapse
Affiliation(s)
- Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
- First-Person Research Group, Veus, Catalan Federation of 1st Person Mental Health Organisations, 08035 Barcelona, Spain
- Correspondence:
| | - María Lomascolo
- Obertament, Catalan Alliance against Stigma and Discrimination in Mental Health, 08010 Barcelona, Spain; (M.L.); (A.T.-F.)
| | - Anaïs Tosas-Fernández
- Obertament, Catalan Alliance against Stigma and Discrimination in Mental Health, 08010 Barcelona, Spain; (M.L.); (A.T.-F.)
| |
Collapse
|
24
|
Rodríguez-Rivas ME, Cangas AJ, Fuentes-Olavarría D. Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders. Front Psychiatry 2021; 12:632252. [PMID: 33633613 PMCID: PMC7900522 DOI: 10.3389/fpsyt.2021.632252] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/20/2021] [Indexed: 01/28/2023] Open
Abstract
Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p < 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p < 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.
Collapse
Affiliation(s)
| | - Adolfo J Cangas
- Department of Psychology, University of Almería, Almería, Spain
| | | |
Collapse
|