Dignity in mental health practice & research: Time to unite on innovation, outreach & education

Association Between Familiarity with Mental Disorders and Stigma Discrimination Related to Mental Disorders Among Colombian Students

Children and adolescents with mental disorders are often discriminated against by their peers in the school context. However, knowing the variables associated with stigma discrimination related to mental disorders (SDRMD) in each school community is crucial. The study aimed to estimate the relationship of familiarity with mental disorders with SDRMD among students in Santa Marta, Colombia. A cross-sectional study was conducted. Familiarity with mental disorders and SDRMD were measured with the Reported and Intended Behavior Scale. Three hundred fifty students were aged between 10 and 17 years (13.34 ± 1.78), and 188 (53.71%) were girls. Having a close friend with a mental health problem (odds ratio = 0.17, 95% CI, 0.06-0.48) was a protective factor for SDRMD. Having a close friend with a mental health problem is protective against SDRMD among Colombian school students.

Performance of the Reported and Intended Behavior Scale Among Colombian Adolescents

Background

Stigma discrimination against people who meet the criteria for mental disorders is frequent in Colombian adolescents; however, there is no valid and reliable instrument for measurement. The study aimed to establish the Reported and Intended Behavior Scale psychometric performance among Colombian adolescents.

Methods

A validation study was carried out with 350 students aged between 10 and 17, 53.7% of whom were girls. The authors estimated frequencies for reported behaviors and measured internal consistency and confirmatory factor analysis for intended behaviors. The Reported and Intended Behavior Scale has 2 sub-scales-reported and intended behaviors, with 4 items each.

Results

The reported behavior sub-scale ranged from 10.0% to 24.9%, whereas the intended behavior sub-scale presented a Cronbach's alpha of 0.88 (95% CI: 0.86-0.90) and a McDonald omega of 0.88. For the confirmatory factor analysis, Kaiser-Meyer-Olkin was 0.81, Bartlett chi-squared, was 771.1 (df = 6, P = .001), and Eigen value was 2.95 that explained 73.9% of the total variance. For the goodness-of-fit tests, chi-squared was 21.9 (df = 2, P = .001), root mean square error of approximation was 0.17 (90% CI: 0.11-0.24), Comparative Fit Index was 0.97, Tucker-Lewis Index was 0.92, and standardized root mean square residual was 0.03.

Conclusions

The Reported and Intended Behavior Scale can measure reported behaviors, and the intended behavior sub-scale shows high internal consistency. However, the dimensionality of the intended behavior sub-scale presents modest goodness-of-fit indexes. These findings need replications.

The role of Mental Health Care Act status in dignity-related complaints by psychiatric inpatients: A cross-sectional analytical study

Background

Globally interest has grown in promoting the rights of patients, especially psychiatric patients. Two core elements of patients’ rights are the rights to be treated in a dignified manner and to give feedback about services. Psychiatric patients may feel treated in an undignified manner, especially during involuntary hospital admissions.

Aim

We explored the relationship between Mental Health Care Act 17 of 2002 (MHCA) status and dignity-related complaints.

Setting

The study was conducted at a specialist state psychiatric hospital.

Methods

We reviewed 120 registered complaints by psychiatric inpatients, retrieved the clinical files, and analysed 70 complaints. Fisher’s exact tests described the relationship between patients’ MHCA status and the frequency of dignity-related or other categories of complaints. Logistic regression analyses were adjusted for potential covariates.

Results

Most complaints were from single, literate male patients, aged 30–39 years, with mood disorders. Most complainants were admitted involuntarily (60%). Dignity-related complaints (n = 41; 58%) outnumbered nondignity-related complaints (n = 29; 41%). The proportion of dignity-related complaints was higher in involuntary (64%) and assisted (60%) patients than in voluntary patients (44%). Dignity-related complaints were not significantly associated with MHCA status (χ² = 2.03 and p = 0.36). Involuntary patients were more than twice as likely as assisted and voluntary patients to complain about dignity-related matters (Odds ratio [OR]: 2.25; 95% confidence interval [CI] [0.71; 7.13]; p = 0.16).

Conclusion

Involuntary patients are more likely to complain about dignity-related matters. Qualitative research is recommended for a deeper understanding of patients’ experiences during admission.

Perception of the primary health care response capacity by patients with and without mental health problems, and health professionals: qualitative study

BACKGROUND

The objective of this study is to deepen our understanding of perceptions towards Primary Health Care Response Capacity by specifically using patients with and without mental disorders, as well as family doctors and a manager, in order to compare and endorse perspectives. For it, a qualitative study was performed. In-depth interviews were conducted with 28 patients with and without mental health disorders and focus groups were held with 21 professionals and a manager. An inductive thematic content analysis was performed in order to explore, develop and define the emergent categories of analysis.

RESULTS

The fundamental domains for patients are dignity, communication, and rapid service. People with mental health problems also highlight the domain of confidentiality as relevant, while patients who do not have a mental health problem prioritize the domain of autonomy. Patients with mental health disorders report a greater number of negative experiences in relation to the domain of dignity. Patients do not consider their negative experiences to be a structural problem of the system. These findings are also endorsed by health care professionals.

CONCLUSIONS

It is necessary to take these results into account as responsive systems can improve service uptake, ensure adherence to treatment, and ultimately enhance patient welfare.