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Howard LM, Wilson CA, Reilly TJ, Moss KM, Mishra GD, Coupland-Smith E, Riecher-Rössler A, Seedat S, Smith S, Steinberg JR, van Ditzhuijzen J, Oram S. Women's reproductive mental health: currently available evidence and future directions for research, clinical practice and health policy. World Psychiatry 2025; 24:196-215. [PMID: 40371748 PMCID: PMC12079463 DOI: 10.1002/wps.21305] [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] [Indexed: 05/16/2025] Open
Abstract
Sex and gender differences in the epidemiology of mental disorders are well documented. Less well understood are the drivers of these differences. Reproductive health represents one of the gendered determinants of mental health that may affect women throughout their life course. In this paper, we review common reproductive events that may be associated with mental ill health, including menstruation (with premenstrual dysphoric disorder appearing for the first time in recent classifications of mental disorders), contraception, abortion, sexual dysfunction, hypersexuality, sexual violence, reproductive coercion, infertility and associated gynaecological conditions, and menopause. Such reproductive events may differentially affect women globally via a range of potential biological and psychosocial mechanisms. These include, for example, vulnerability to the physiological changes in hormone levels across the menstrual cycle; side effects of treatment of mental disorders; inflammation underpinning endometriosis and polycystic ovarian syndrome as well as mental disorders such as depression; intersections with gender disadvantage manifesting, for example, as structural barriers in accessing menstrual products and sanitation, contraception and abortion, underscoring the broader social determinants impacting women's mental health. Greater understanding of these mechanisms is guiding the development of effective interventions, which are also reviewed here. However, key evidence gaps remain, partly as a result of the historic gender bias in mental health research, and the neglect of reproductive health in clinical practice. Furthermore, while several women's health strategies have recently been proposed internationally, they do not usually include a focus on mental health across the life course, particularly for women with severe mental illness. Integrating co-designed reproductive health interventions into primary and secondary mental health care settings, providing tailored care, increasing the evidence base on effective interventions, and empowering women to make informed choices about their reproductive health, could improve not only reproductive health but also women's mental health across the life course.
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Affiliation(s)
- Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Katrina M Moss
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Gita D Mishra
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | | | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Shubulade Smith
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Julia R Steinberg
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jenneke van Ditzhuijzen
- Interdisciplinary Social Science, Social Policy and Public Health, Utrecht University, Utrecht, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Sian Oram
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Niederkrotenthaler T, Arensman E, Armstrong G, Keyes K, Pitman A, Till B. Suicide Prevention in Changing Environments. CRISIS 2025; 46:123-131. [PMID: 40395065 DOI: 10.1027/0227-5910/a001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2025]
Affiliation(s)
- Thomas Niederkrotenthaler
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ella Arensman
- School of Public Health, College of Medicine and Health and National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Gregory Armstrong
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexandra Pitman
- Epidemiology & Applied Clinical Research Department UCL Division of Psychiatry, University College London, London, UK
- Veterans Mental Health and Wellbeing Service, North London NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Benedikt Till
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Alataş E, Yığman F, Karaoğlan Kahiloğulları A. The effect of an in-service training programme on mental health literacy of family physicians. PSYCHOL HEALTH MED 2025:1-9. [PMID: 40272050 DOI: 10.1080/13548506.2025.2495890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 04/11/2025] [Indexed: 04/25/2025]
Abstract
Mental health literacy is defined as 'information that helps to recognise, manage or prevent mental disorders' and is of significant importance within health services. The present study aims to evaluate the effect of MHSSP (Mental Health Services Strengthening Program) training on mental health literacy in family physicians working in primary care. A total of 689 people participated in the study. Of these, 274 (39.85%) had received MHSSP training, while 415 (60.2%) had not received in-service mental health training. The Mental Health Literacy Scale and the Mental Health Knowledge Questionnaire were administered online to all participants. Scores on the mental health knowledge questionnaire and mental health literacy scales were significantly higher for physicians with MHSSP training. The findings of this study support the notion that mental health literacy should be considered a significant concept in both society and among health professionals, with the potential for any activity aimed at enhancing mental health literacy having a favourable impact on health services.
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Affiliation(s)
| | - Fatih Yığman
- Yüksek İhtisas Univercity, Faculty of Medicine, Ankara, Türkiye
| | - Akfer Karaoğlan Kahiloğulları
- Health Sciences University, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Psychiatry, Türkiye
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Lasalvia A, Benedetti L, Bodini L, Albasini F, Chiamulera C, Fabene P, Rugiu C, Bonetto C. Addressing the associative stigma of psychiatry and psychiatrists: a survey on the attitudes of medical and nursing students and doctors in Verona, Italy. BMC Psychol 2025; 13:357. [PMID: 40205491 PMCID: PMC11983888 DOI: 10.1186/s40359-025-02682-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 04/02/2025] [Indexed: 04/11/2025] Open
Abstract
BACKGROUND Negative societal attitudes toward mental health often contribute to misconceptions and stereotypes about psychiatry, a phenomenon known as "associative stigma". This stigma can hinder collaboration between psychiatrists and other specialists and deter students from pursuing psychiatry as a career. This study focused on one of the three main components of stigma by examining attitudes toward psychiatry and psychiatrists among medical and nursing students, as well as doctors, and identifying factors that influence these attitudes. METHODS A cross-sectional survey was conducted among medical and nursing students at the University of Verona and doctors affiliated to the Medical Professional Association of Verona. Attitudes toward psychiatry were assessed using the Attitude to Psychiatry Scale. Regression analysis evaluated the relationship between participants' characteristics and their attitudes toward psychiatry and psychiatrists. RESULTS A total of 511 medical students, 394 nursing students, and 638 doctors participated in the study. While students had generally positive attitudes towards psychiatry, they perceived it as lacking full respect within medial community (84% medical, 76% nursing), having low prestige (63.5% medical, 65.9% nursing), and receiving insufficient encouragement in university courses (39% medical, 41.7% nursing). Doctors also expressed positive attitudes, though to a lesser extent than students. Their primary concerns related to patient care: 81% reported feeling emotionally drained when treating psychiatric patients, and 58.2% felt that patients were not appreciative of the care received. Female students and doctors, students who had taken psychiatric courses, and doctors in non-surgical specialties exhibited more positive attitudes. CONCLUSIONS This study revealed generally positive attitudes towards psychiatry, underscoring its relevance as a medical specialty. However, concerns regarding the discipline's perceived status and respect within the medical field highlight areas for targeted interventions to enhance its image and encourage greater interest among students and professionals.
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Affiliation(s)
- Antonio Lasalvia
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Policlinico "G.B. Rossi", P.le Scuro, 10, Verona, 37134, Italy.
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy.
| | - Lorenzo Benedetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Policlinico "G.B. Rossi", P.le Scuro, 10, Verona, 37134, Italy
| | - Luca Bodini
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Policlinico "G.B. Rossi", P.le Scuro, 10, Verona, 37134, Italy
| | - Francesco Albasini
- Central Institute of Mental Health (CIMH - ZI), Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Cristiano Chiamulera
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paolo Fabene
- Department of Engineering and for Innovation Medicine, University of Verona, Verona, Italy
| | - Carlo Rugiu
- Medical Professional Association (OMCEO) of the Province of Verona, Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Policlinico "G.B. Rossi", P.le Scuro, 10, Verona, 37134, Italy
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Kemna S, Nguyen VT, Böge K, Bajbouj M, Bringmann M, Weyn-Banningh S, Eilinghoff L, Nguyen VP, Tuturea LE, Le Cong T, Le TTH, Ta TMT, Hahn E. Attitudes of Vietnamese University students on restrictions of rights and compulsory admissions in patients with severe mental illness - a cross-sectional study. Front Psychiatry 2025; 16:1542247. [PMID: 40195971 PMCID: PMC11973515 DOI: 10.3389/fpsyt.2025.1542247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Accepted: 02/24/2025] [Indexed: 04/09/2025] Open
Abstract
Introduction This cross-sectional, explorative study examines university students' attitudes (n = 610) in Hanoi, Vietnam, toward the rights of psychiatric patients. Methods Medical students responded to self-report questionnaires investigating their attitudes towards restrictions and compulsory admissions in case of severe mental illness after attending a psychiatry course. Medical students and non-medical students who did not participate in the course served as two control groups. Results In all groups, the majority of students opposed restricting the civil rights of psychiatric patients, but most supported compulsory admissions in certain situations. Medical students who had not attended a psychiatry course were generally more in favor of compulsory admissions compared to those who had attended a psychiatry course and non-medical students. However, when investigating attitudes on compulsory admission in specific scenarios, students that had attended a psychiatry course were more likely to endorse compulsory admissions, except when admission was based on the patient's family request. Discussion Medical and psychiatric training seem to encourage more differentiated opinions on the use of compulsory admissions in psychiatric care. Future research, including longitudinal designs and a broader geographical scope, is needed to better understand the impact of psychiatric education in medical studies on attitudes toward mental health.
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Affiliation(s)
- Solveig Kemna
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Van Tuan Nguyen
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Kerem Böge
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Max Bringmann
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Sebastian Weyn-Banningh
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Luisa Eilinghoff
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Van Phi Nguyen
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- Department of Mental Health, National Geriatric Hospital, Hanoi, Vietnam
| | - Laura Elisabeth Tuturea
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Thien Le Cong
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Thi Thu Ha Le
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Thi Minh Tam Ta
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Neuroscience, Charité University Medicine Berlin, Berlin, Germany
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Macfarlane H, Paton A, Bush J. A qualitative exploration of the interaction between mental illness stigma and preparedness for practice in pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2025; 17:102271. [PMID: 39729763 DOI: 10.1016/j.cptl.2024.102271] [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: 07/02/2024] [Revised: 11/11/2024] [Accepted: 12/09/2024] [Indexed: 12/29/2024]
Abstract
INTRODUCTION Mental illness stigma can result in discriminative practice in pharmacy, such as providing less pharmaceutical care to people living with mental illness (PMI) than those with physical illness. Pharmacy education should aim to reduce the impact of mental illness stigma on the pharmaceutical care of PMI. Whilst previous research has shown that some interventions can reduce stereotyping and prejudice in pharmacy students, the impact on subsequent discrimination is questionable and the reasons for successful and unsuccessful outcomes are unclear. This study aimed to explore pharmacy students' views on working with PMI and how these views might interact with mental illness stigma. METHODS Focus groups and semi-structured interviews with final year pharmacy students and recent graduates were conducted at one UK university. Question guides were developed based on the aim of the study and investigated participants' attitudes and beliefs about mental illness. Following transcription, data were analysed in line with the guiding principles of constructivist Grounded Theory. RESULTS Three major categories were developed which accounted for the data: Knowing, Doing and Valuing. Participants reported that in common with the general public, pharmacy students possess insufficient knowledge about mental illness, which limits what can be done to help and support people living with it. Finally, participants reported that mental illness is ascribed insufficient value in the pharmacy curriculum, healthcare, and in wider society. Interactions between stigma and each of these categories were identified. CONCLUSION The findings offer a novel, qualitative description and explanation of mental illness stigma among pharmacy students from one UK university. Further, the factors identified by pharmacy students as modifiers of preparedness for professional practice provide an evidence base for curriculum development with possible international relevance. This may help pharmacy educators to develop evidence-based strategies aimed at reducing the impact of mental illness stigma in future professional practice.
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Affiliation(s)
- Hannah Macfarlane
- School of Pharmacy, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
| | - Alexis Paton
- School of Social Sciences And Humanities, College Of Business And Social Sciences, Aston University, Birmingham B4 7ET, United Kingdom
| | - Joseph Bush
- School of Pharmacy, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, United Kingdom
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Li Y, Qiu D, Zhang C, Wu Q, Ni A, Tang Z, Xiao S. Experienced and anticipated discrimination among people living with schizophrenia in China: a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2025:10.1007/s00127-025-02839-x. [PMID: 39953168 DOI: 10.1007/s00127-025-02839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/05/2025] [Indexed: 02/17/2025]
Abstract
PURPOSE Understanding the experienced and anticipated discrimination of people living with schizophrenia (PLS) in China is the cornerstone of culturally informed intervention. This study aims to describe the pattern of experienced and anticipated discrimination against PLS in China and investigate which social and illness characteristics are associated with discrimination. METHODS PLS dwelling in community were randomly recruited from four cities across China and completed measures of experienced and anticipated discrimination by discrimination and stigma scale (version 12; DISC-12). Multivariable regression was used to analyses the correlates of experienced and anticipated discrimination. RESULTS A total of 787 participants (54.0% were female) were included in the analysis. 38% of participants reported experienced discrimination and 71.4% reported anticipated discrimination. The most common experienced discrimination for PLS in China were from neighborhood, making/keeping friends, finding/keeping a job, and family. 59.3% of participants had concealed their mental illness. Living in rural areas, household poverty, longer illness duration, severer symptoms and higher level of disability were associated with more experienced discrimination. Younger ages, unemployment, higher level of disability and experienced discrimination were associated with more anticipated discrimination. CONCLUSION More than a third of PLS in China have experienced discrimination in their lives. Economically disadvantage PLS and PLS living in rural setting may experience more discrimination in China. New and culturally informed intervention approaches are needed to prevent and reduce discrimination of schizophrenia.
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Affiliation(s)
- Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Chengcheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Qiuyan Wu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Anyan Ni
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Zixuan Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, China.
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Turner M, Muanido A, Cumbe V, Jala JN, Armando EE, Mambuque E, Faduque F, Xerinda ER, Sherr K, Weiner BJ, Flaherty BP, Sharma M, Wagenaar BH. Mental health care cascade performance and associated factors: longitudinal analyses of routine Ministry of Health services in Mozambique. BMJ PUBLIC HEALTH 2025; 3:e001024. [PMID: 40099137 PMCID: PMC11911670 DOI: 10.1136/bmjph-2024-001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/24/2025] [Indexed: 03/19/2025]
Abstract
ABSTRACT Introduction Mental, neurological and substance use (MNS) disorders are leading causes of disability worldwide. Nevertheless, limited research exists regarding MNS health system performance across the care cascade and associated patient characteristics in low-income and middle-income countries (LMICs) such as Mozambique. Methods We used baseline data from an ongoing randomised controlled trial, collected across 16 outpatient clinics on variables of sex, age, marital status, tuberculosis and HIV status, alcohol and drug use, suicidal ideation, pregnancy and MNS diagnosis. Mixed-effects multivariable regression was used to examine factors associated with patient functional improvement or low functional impairment measured by a standardised disability questionnaire. Results From February to September 2022, there were 4323 patient visits, of which 65.9% (n=2851) were attended on time (±5 days), 41.4% (n=1793) had medication adherence and 30.5% (n=1321) achieved a functional impairment score <10 or 50% improvement from baseline. Patients 15-18 years old had 60% lower odds of demonstrating functional improvement or low functional impairment during a follow-up visit compared with those 26-35 years old (95% CI: 0.19, 0.85). Compared with single persons, those in a domestic union had 3.3 times higher odds of demonstrating functional improvement or low functional impairment (95% CI: 1.8, 6.1). Individuals expressing suicidal ideation had 85% lower odds of demonstrating functional improvement than those without suicidal ideation (95% CI: 0.02, 0.91). For patients new to treatment, each additional visit was associated with a mean reduction in functional impairment of 0.62 points (95% CI: -0.76, -0.47). Conclusions This analysis revealed gaps in patients reaching functional improvement or low functional impairment in outpatient MNS care in Mozambique. Gaps were more pronounced for patients who are ≤18 years of age, single or expressing suicidal ideation. Implementation strategies to optimise patient outcomes are needed as nascent mental health systems are scaled-up in Mozambique and other similar LMICs. Trial registration number NCT05103033.
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Affiliation(s)
- Morgan Turner
- Global Health, University of Washington, Seattle, Washington, USA
| | | | - Vasco Cumbe
- Mental Health Department, Provincial Health Directorate, Ministry of Health, Beira, Mozambique
- Centro de Formação e Pesquisa em Saúde, Hospital Central da Beira, MISAU, Beira, Mozambique
| | | | | | | | - Flávia Faduque
- Mental Health Department, Provincial Health Directorate, Ministry of Health, Chimoio, Mozambique
| | - Ernesto Rodrigo Xerinda
- Mental Health Department, Provincial Health Directorate, Ministry of Health, Beira, Mozambique
| | - Kenneth Sherr
- Global Health, University of Washington, Seattle, Washington, USA
- Epidemiology, University of Washington, Seattle, Washington, USA
- Industrial & Systems Engineering, University of Washington, Seattle, Washington, USA
| | - Bryan J Weiner
- Global Health, University of Washington, Seattle, Washington, USA
| | - Brian P Flaherty
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Monisha Sharma
- Global Health, University of Washington, Seattle, Washington, USA
| | - Bradley H Wagenaar
- Global Health, University of Washington, Seattle, Washington, USA
- Epidemiology, University of Washington, Seattle, Washington, USA
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Lasalvia A, D'agnalo Vallan M, Bodini L, Bonetto C. Attitudes of ambulance service staff towards people with mental illness: A cross-sectional survey in the Verona province, Italy. Psychiatry Res 2025; 343:116291. [PMID: 39631101 DOI: 10.1016/j.psychres.2024.116291] [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: 07/26/2024] [Revised: 10/29/2024] [Accepted: 11/25/2024] [Indexed: 12/07/2024]
Abstract
Healthcare professionals can be sources of stigma for people with mental illness. Ambulance personnel are often the first healthcare providers that people with mental illness encounter during physical and mental health crises and their attitudes may be influenced by misconceptions and stereotyping views. This study aimed to assess the attitudes of ambulance personnel toward people with mental illness using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) and to evaluate its psychometric properties. The study involved 510 ambulance staff members from a non-profit organization. The original factor structure of the OMS-HC, comprising three subscales was confirmed. The internal consistency for the OMS-HC total score was good (α=0.75) and acceptable for the subscales (Social Distance α=0.66; Attitudes α=0.59; Disclosure/Help-Seeking α=0.61). One-third of respondents displayed stigmatizing attitudes on half of the OMS-HC items. Higher scores were associated with being male, having lower levels of education, and working as both rescuers and ambulance drivers and with feeling uncomfortable when dealing with patients with mental illness. Overall, stigmatizing attitudes towards individuals with mental illness are prevalent among ambulance staff. The Italian version of the OMS-HC for ambulance personnel demonstrated satisfactory psychometric properties and is recommended for evaluating training programs targeting this population.
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Affiliation(s)
- Antonio Lasalvia
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy.
| | - Michelle D'agnalo Vallan
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Luca Bodini
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
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Van Meter AR, Wheaton MG, Cosgrove VE, Andreadis K, Robertson RE. The Goldilocks Zone: Finding the right balance of user and institutional risk for suicide-related generative AI queries. PLOS DIGITAL HEALTH 2025; 4:e0000711. [PMID: 39774367 PMCID: PMC11709298 DOI: 10.1371/journal.pdig.0000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025]
Abstract
Generative artificial intelligence (genAI) has potential to improve healthcare by reducing clinician burden and expanding services, among other uses. There is a significant gap between the need for mental health care and available clinicians in the United States-this makes it an attractive target for improved efficiency through genAI. Among the most sensitive mental health topics is suicide, and demand for crisis intervention has grown in recent years. We aimed to evaluate the quality of genAI tool responses to suicide-related queries. We entered 10 suicide-related queries into five genAI tools-ChatGPT 3.5, GPT-4, a version of GPT-4 safe for protected health information, Gemini, and Bing Copilot. The response to each query was coded on seven metrics including presence of a suicide hotline number, content related to evidence-based suicide interventions, supportive content, harmful content. Pooling across tools, most of the responses (79%) were supportive. Only 24% of responses included a crisis hotline number and only 4% included content consistent with evidence-based suicide prevention interventions. Harmful content was rare (5%); all such instances were delivered by Bing Copilot. Our results suggest that genAI developers have taken a very conservative approach to suicide-related content and constrained their models' responses to suggest support-seeking, but little else. Finding balance between providing much needed evidence-based mental health information without introducing excessive risk is within the capabilities of genAI developers. At this nascent stage of integrating genAI tools into healthcare systems, ensuring mental health parity should be the goal of genAI developers and healthcare organizations.
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Affiliation(s)
- Anna R. Van Meter
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Michael G. Wheaton
- Department of Psychology, Barnard College, New York, New York, United States of America
| | - Victoria E. Cosgrove
- Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Katerina Andreadis
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Ronald E. Robertson
- Stanford Internet Observatory, Stanford University, Stanford, California, United States of America
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Zeng Y, Pan T, Sun M. The influencing factors of stigma towards people with mental illness among nursing students: a mixed-method systematic review. MEDICAL EDUCATION ONLINE 2024; 29:2376802. [PMID: 38970824 PMCID: PMC11229721 DOI: 10.1080/10872981.2024.2376802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
The stigma of nursing students towards people with mental illness (PMI) creates significant barriers to diagnosis, treatment, and recovery for those with PMI. It can also have a significant impact on the future career choices of nursing students in the field of psychiatry. Current research has found various influencing factors, including personal characteristics and educational influences. However, a comprehensive analysis that encompasses all aspects is lacking. The aim of the study was to conduct a convergent mixed-method systematic review to synthesize the influencing factors of the stigma of nursing students towards PMI according to Framework Integrating Normative Influences on Stigma (FINIS) at micro, meso, and macro levels. PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO were searched from 1990 to 31 December 2023. The reference lists of the included literature were further checked to identify potentially relevant articles. Two authors independently screened all titles, abstracts, and full-text articles and extracted data. Study quality was assessed by two authors using the Mixed Method Appraisal Tool (MMAT). A total of 4865 articles were initially retrieved, and 73 of these articles were included. The results suggested that the stigma towards PMI by nursing students was influenced by micro, meso and macro levels. At each FINIS level, the most frequent influencing factors are personal characteristics, the treatment system and media images. Numerous interconnected factors exert an influence on the stigma towards PMI among nursing students. Our research can be used to identify barriers and facilitators to nursing students' stigma towards PMI and to provide supporting information for interventions designed to reduce this stigma.
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Affiliation(s)
- Yi Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Changsha Medical University, Changsha, China
| | - Ting Pan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Xinjiang Medical University, Urumqi City, China
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12
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Maurus I, Wagner S, Spaeth J, Vogel A, Muenz S, Seitz V, von Philipsborn P, Solmi M, Firth J, Stubbs B, Vancampfort D, Hallgren M, Kurimay T, Gerber M, Correll CU, Gaebel W, Möller HJ, Schmitt A, Hasan A, Falkai P. EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence. Eur Psychiatry 2024; 67:e80. [PMID: 39655999 PMCID: PMC11733621 DOI: 10.1192/j.eurpsy.2024.1766] [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: 02/07/2024] [Revised: 04/26/2024] [Accepted: 05/12/2024] [Indexed: 12/18/2024] Open
Abstract
There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.
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Affiliation(s)
- Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Johanna Spaeth
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anastasia Vogel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Muenz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Valentina Seitz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter von Philipsborn
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | - Tamás Kurimay
- North-Buda Saint John Central Hospital, Buda Family Centered Mental Health Centre, Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary
| | - Markus Gerber
- Department of Sport, Exercise and Health (DSBG), University of Basel, Switzerland
| | - Christoph U. Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- German Center for Mental Health (DZPG), Berlin, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany
- WHO Collaborating Centre DEU-131, LVR-Klinikum Düsseldorf, Duesseldorf, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
- German Center for Mental Health (DZPG), Munich/Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- German Center for Mental Health (DZPG), Munich/Augsburg, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
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Harhaji S, Tomori S, Nakov V, Chihai J, Radić I, Mana T, Stoychev K, Esanu A, Pirlog MC. Stigmatising Attitudes Towards Mental Health Conditions Among Medical Students In Five South-Eastern European Countries. Zdr Varst 2024; 63:188-197. [PMID: 39319025 PMCID: PMC11417508 DOI: 10.2478/sjph-2024-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/02/2024] [Indexed: 09/26/2024] Open
Abstract
Introduction Stigmatising attitudes towards mentally ill people are present among healthcare professionals. The aim of the study was to evaluate medical students' attitudes in five medical schools from Albania, Bulgaria, Moldova, Romania and Serbia and to determine if psychiatry clerkship improves these attitudes. Methods In the first stage, the study included students from the first and final years of medical school; in the second stage, only final-year students were included; The Mental Illness Clinicians' Attitude Scale (MICA-2) and the Attribution Questionnaire (AQ-9) were used in this study. The total sample comprised 1,526 medical students in the first stage and 614 in the second stage. Results The analysis of the average AQ-9 and MICA-2 scores between countries revealed significant differences (p<0.05). Multivariable analysis showed that female students were 30% more likely to have elevated AQ-9 scores than male students (p=0.029). Final-year students had a significantly lower chance of having a higher MICA-2 score compared to first-year students (OR=0.7; p<0.05). Conclusions Psychiatry clerkship contributes to a decrease in the level of stigmatising attitudes among medical students. Further research is required to assess the curricula to achieve better results in reducing stigma among future doctors.
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Affiliation(s)
- Sanja Harhaji
- Institute of Public Health of Vojvodina, Futoška 121, 21000, Novi Sad, Serbia
| | - Sonila Tomori
- Tirana Medical University, Rruga e Dibrës 371, AL1005, Tirana, Albania
| | - Vladimir Nakov
- National Centre of Public Health and Analyses, Akad. Iv. E. Geshov Blvd 15, Sofia, Bulgaria
| | - Jana Chihai
- Nicolae Testemitanu State University of Medicine and Pharmacy, Ştefan cel Mare şi Sfant Blvd 165Chisinau, Moldova
| | - Ivana Radić
- Institute of Public Health of Vojvodina, Futoška 121, 21000, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Tedi Mana
- Tirana Medical University, Rruga e Dibrës 371, AL1005, Tirana, Albania
| | - Kaloyan Stoychev
- Faculty of Medicine, Medical University Pleven, Sv. Kliment Ohridski 1, 5800, Pleven, Bulgaria
| | - Andrei Esanu
- Nicolae Testemitanu State University of Medicine and Pharmacy, Ştefan cel Mare şi Sfant Blvd 165Chisinau, Moldova
| | - Mihail Cristian Pirlog
- Medical Sociology Department, University of Medicine and Pharmacy of Craiova, Petru Rares 2, 200349, Craiova, Romania
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Subu MA, Dias JM, Mottershead R, Ahmed FR, Narulita S, Maryuni M, Zakiyah Z, Nurbaeti I, Mohamed Al Marzouqi A, Al-Yateem N. Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2327103. [PMID: 38465669 DOI: 10.1080/17482631.2024.2327103] [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: 11/02/2023] [Accepted: 03/03/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals. AIMS This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia. METHODS This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis. RESULTS Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns. CONCLUSIONS The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.
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Affiliation(s)
- Muhammad Arsyad Subu
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Jacqueline Maria Dias
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Richard Mottershead
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Refaat Ahmed
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Sari Narulita
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Maryuni Maryuni
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Zakiyah Zakiyah
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, UIN Syarif Hidayatullah, Jakarta, Indonesia
| | - Alounoud Mohamed Al Marzouqi
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
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Manley AE, Biddle L, Savović J, Moran P. Changing Medical Student Perceptions of Mental Illness Through a Psychiatry Clinical Clerkship: A Longitudinal Qualitative Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:570-580. [PMID: 39251563 PMCID: PMC11635035 DOI: 10.1007/s40596-024-02035-0] [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: 03/28/2024] [Accepted: 08/18/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE This study sought to understand whether perceptions of mental illness change during the course of students' psychiatry clerkships, and what facilitates such change. METHODS Using a longitudinal qualitative study design, the authors followed up 14 medical students, interviewing them before, during, and after their psychiatric clerkship. RESULTS Prior to clerkships, students perceived psychiatric patients to be dangerous, fragile, hard to treat, and to exert a disproportionate emotional toll on clinicians. Stigma was reinforced by safety measures including the provision of alarms, but this improved following "real life" engagement with patients. Students experienced little emotional distress from clinical contacts, particularly those where they led the consultation. Pre-existing beliefs about mental illness being hard to "fix" showed less change over time. Although uncommon, when staff referred to patients using pejorative language, students emulated these negative attitudes. CONCLUSIONS Among medical students, direct patient contact plays an important role in counteracting pre-existing negative attitudes towards mental illness. This can be facilitated by supportive supervisors, clinical teams allocating students a clear practical role, involving patients in teaching, and roleplay to alleviate potential concerns about seeing patients.
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Affiliation(s)
- Amy E Manley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Paul Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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16
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Chen L, Chang L, Lin H, Tu J, Zhou Y, Han Y. Savior or saboteur? A nationwide study on digital economy and depression in China. J Affect Disord 2024; 365:578-586. [PMID: 39187198 DOI: 10.1016/j.jad.2024.08.147] [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: 11/09/2023] [Revised: 08/09/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
The regional boom in digital economy has provided people with remote conversations and socialization while reducing the risk of depression. This study aims to elucidate whether regional digital economy can be a savior for individual depression. The multi-source dataset collects 11,845 individuals from the China Health and Retirement Longitudinal Study 2018 (CHARLS), with the combination of corresponding regional data from China City Statistical Yearbooks. A series of regressions with integrated mediation and moderation analyses are employed to bridge the link between the digital economy and depression. The results suggest that people living in areas with a higher level of digital economy are less likely to suffer from depression. The development of the digital economy helps people find solace or air grievances more easily, thereby reducing the risk of depression. Individual information and communications technology (ICT) engagement is found to mediate the relationship between the regional digital economy and individual depression. Residence type moderates the association between the three casual pairs of digital economy, ICT engagement, and depression. Improved digitization stimulates personal engagement with ICTs, which in turn expands social connections and support. Strengthened social interactions naturally keep depression away. Moreover, the urban-rural differences further confirm the underlying mechanism. Properly embracing the new digital world can therefore benefit from the transformative potential and mitigate depressive outcomes.
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Affiliation(s)
- Lu Chen
- School of Economics and Management, Tongji University, Shanghai 200092, China
| | - Le Chang
- Department of Acoustics, School of Physics, Nanjing University, Nanjing 210093, China
| | - Han Lin
- Business School, Hohai University, Nanjing 211100, China.
| | - Juan Tu
- Department of Acoustics, School of Physics, Nanjing University, Nanjing 210093, China.
| | - Yunyun Zhou
- Fox Chase Cancer Center, Temple University Health System, Philadelphia 19111, USA.
| | - Yilong Han
- School of Economics and Management, Tongji University, Shanghai 200092, China.
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17
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Roy P, Chowdhury KUA. Exploring the stigma against people with mental illness in Bangladesh. Glob Ment Health (Camb) 2024; 11:e108. [PMID: 39776981 PMCID: PMC11704370 DOI: 10.1017/gmh.2024.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/15/2024] [Accepted: 09/05/2024] [Indexed: 01/11/2025] Open
Abstract
This study investigates the stigma against people with mental illness in Bangladesh through in-depth interviews with 14 patients and 9 healthcare professionals, and 33 focus group discussions with people without mental illness. The research has delved into the understanding of different types of stigma against mental illness in the context of Bangladesh. The findings revealed four types of stigma which were categorized into four themes namely self-stigma, public stigma, professional, and institutional stigma. Patients had internalized negative attitudes, thereby discriminated toward themselves. The public discriminated against patients because of believing in prejudices against them. Other health professionals had negative conceptions toward patients, and they devalued mental health professionals (MHPs). A culture of negative attitude and belief had emerged in institutional settings which encouraged discrimination. Policymakers and healthcare professionals can use the findings to develop a mental health service by addressing the stigma. Mental health practitioners can assess the impact of stigma to improve the mental well-being of their patients. Students and workplace staff will benefit from intentional or unintentional discrimination in educational institutions and workplace settings by addressing the effects of stigma. Importantly, other health care providers will be aware of their thoughts against patients and MHPs.
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Affiliation(s)
- Prodyut Roy
- Independent Scholar – Educational Psychology, Dhaka, Bangladesh
| | - Kamal Uddin Ahmed Chowdhury
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
- Nasirullah Psychotherapy Unit, Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
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18
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Hajizadeh A, Amini H, Heydari M, Rajabi F. How to combat stigma surrounding mental health disorders: a scoping review of the experiences of different stakeholders. BMC Psychiatry 2024; 24:782. [PMID: 39516842 PMCID: PMC11549754 DOI: 10.1186/s12888-024-06220-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 10/25/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND The stigma associated with mental health disorders (MHDs) results in delayed help-seeking, limited access to health services, suboptimal treatment, poor treatment outcomes, and an increased risk of human rights violations. This scoping review summarizes qualitative research on the lived experiences of different stakeholders regarding strategies and interventions to combat stigma for people with MHDs. METHODS This study was a six-step scoping review using the Arksey and O'Malley framework. A comprehensive search of the following electronic databases was conducted to identify relevant records: PubMed, Scopus, Web of Science (WoS) and Google Scholar, as well as a manual search of the reference lists. All steps, including screening of eligible studies, data extraction, and analysis, were performed independently by multiple reviewers, with disagreements resolved by discussion. The data were synthesized based on the for-content synthesis guidelines. RESULTS A total of 25 studies were included in this review of the 32,976 initial identified citations. The included studies were from all countries (low, middle, and high income), stigmatized disorders (e.g., schizophrenia, bipolar disorder, etc.) and target populations (e.g., people with MHDs and their families, health care providers, the general community, and students and school members). The thematic synthesis revealed six types of interventions and strategies and 17 themes related to reducing stigma in patients on MHDs. Strategies and interventions were classified by patient (self-stigma), family (family stigma), healthcare professionals' stigma, workplace stigma, public/societal stigma, and structural type of stigma (institutional stigma). CONCLUSIONS This review contributes new evidence that should be considered in future interventions and policies to reduce stigma against MHDs. Multilevel and multistakeholder strategies and interventions are needed to reduce the stigmatization of MHDs.
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Affiliation(s)
- Alireza Hajizadeh
- Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Amini
- Department of Psychiatry, School of Medicine, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdiyeh Heydari
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Rajabi
- Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Tomar N, Jensen TM, Pace N. Differences in internalized stigma of mental illness among college students based on demographic characteristics. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:2333-2337. [PMID: 36170563 DOI: 10.1080/07448481.2022.2126944] [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: 03/08/2021] [Revised: 08/17/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Objective: To assess differences in internalized stigma of mental illness based on demographic characteristics and mental healthcare utilization among college students. Participants: Students with self-reported mental illness (n = 128) were recruited via random sampling. Methods: Participants completed an online survey, including questions related to demographic characteristics and mental healthcare utilization. The survey also included the Internalized Stigma of Mental Illness (ISMI) scale. Data were analyzed using descriptive and inferential statistics. Results: Students accessing mental healthcare (pharmacological and/or psychotherapeutic) reported higher ISMI scores than students who did not access services during past year. Students with sexual minority statuses also reported higher ISMI scores than their heterosexual counterparts. Conclusions: Results highlight differences in internalized stigma based on demographics characteristics and mental healthcare utilization among college students. More research is needed to better understand intersectional stigma. Further, universities need tailored and specific interventions to address internalized stigma among students with diverse backgrounds and needs.
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Affiliation(s)
- Nikhil Tomar
- Department of Occupational Therapy, The University of New Hampshire, Durham, New Hampshire, USA
| | - Todd M Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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20
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Ung TX, O'Reilly CL, Moles RJ, Collins JC, Ng R, Pham L, Saini B, Ong JA, Chen TF, Schneider CR, El-Den S. Evaluation of Mental Health First Aid Training and Simulated Psychosis Care Role-Plays for Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:101288. [PMID: 39304009 DOI: 10.1016/j.ajpe.2024.101288] [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: 04/01/2024] [Revised: 08/23/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE This study explored the impact of Mental Health First Aid (MHFA) training and simulated psychosis care role-plays on pharmacy students' stigma, confidence, and behaviors when supporting people experiencing mental health symptoms or crises. METHODS MHFA training was delivered to final year pharmacy students. Post-MHFA training, students were invited to participate in simulated psychosis care role-plays (co-designed and content validated with mental health stakeholders) with trained actors. Role-plays were observed by peers, tutors, and mental health consumer educators (MHCEs). Students immediately engaged in self-assessment, feedback, and debrief discussions with peers, tutors, and MHCEs. Quantitative analyses (ANOVA and chi-square tests) were conducted on scores awarded by each rater (self, tutor, MHCE) and for each scenario (n = 3). Students completed a 15-item survey exploring mental health stigma and mental health confidence, at 3 timepoints (pre-MHFA training, post-MHFA training, and post-role-plays). Survey scores were analyzed using paired t tests. RESULTS Of 209 MHFA-trained students, 86 participated in role-play. The self-assessment mean score was the lowest and the MHCEs' mean score highest. Post-MHFA training, 14 survey item scores significantly improved, implying reduced stigma and increased confidence in providing psychosis care. Post-role-play scores suggested improvements in 12 survey items. CONCLUSION Psychosis care role-plays are associated with short-term improvements in pharmacy students' stigma and mental health confidence post-MHFA training; students' self-assessment scores are lower than tutors and MHCEs. It is recommended that future studies further integrate observed behaviors with self-reported data and use simulated patients in clinical practice to evaluate MHFA outcomes longitudinally.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia.
| | | | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Ricki Ng
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Lily Pham
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Bandana Saini
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Jennifer A Ong
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Carl R Schneider
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
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Grandón P, Bustos C, Fernández D, Cova F, Nazar G, Díaz-Pérez G, Monreal V, Méndez J. Stigma toward people with mental disorders in mental healthcare in Chile. Int J Soc Psychiatry 2024; 70:1289-1297. [PMID: 39108018 DOI: 10.1177/00207640241263251] [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] [Indexed: 10/27/2024]
Abstract
OBJECTIVE This research aimed to determine the stigma toward people with mental illness among mental health personnel and identify individual, professional, and contextual predictors. METHODS A descriptive, cross-sectional, and correlational design was used. The sample consisted of 218 mental health personnel working in Outpatient Psychiatric Units belonging to hospitals and Community Mental Health Centers in Chile. Stigma was evaluated using a scale of humanized treatment, a scale of social distance, and a scale of attitudes in health personnel. In addition, sociodemographic and professional information was collected from mental health personnel and contextual information, particularly the type of outpatient mental health center and the technical-administrative unit that groups all the health centers in a territory. RESULTS It was found that mental health personnel, in general terms, present low levels of stigma expressed in behaviors of comfort and support toward users, a desire for closeness and social interaction, and reduced stigmatizing beliefs and attitudes of infantilization toward individuals with MHPs. However, intimacy and trust were lower than expected.Only educational levels and health centers were related to stigma. CONCLUSIONS The low levels of stigma may be due to the evolution of this phenomenon and the country's mental health policies.
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Affiliation(s)
- Pamela Grandón
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
| | - Claudio Bustos
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
| | - Dany Fernández
- Facultad de Psicología, Universidad del Desarrollo, Concepción, Chile
| | - Félix Cova
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
| | - Gabriela Nazar
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
| | - Gabriela Díaz-Pérez
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
| | - Verónica Monreal
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Chile
| | - Jaime Méndez
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Chile
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22
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Jauch M, Occhipinti S, O’Donovan A, Clough B. A Qualitative Study Into the Relative Stigmatization of Mental Illness by Mental Health Professionals. QUALITATIVE HEALTH RESEARCH 2024; 34:1326-1338. [PMID: 38768408 PMCID: PMC11555896 DOI: 10.1177/10497323241238618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Mental health professionals stigmatize mental illness, which has significant ramifications for public health and policy. Within this domain, there is a lack of comprehensive research on relative stigma, emotions, and behaviors and an absence of literature that can guide research on these topics. The current study sought to address these limitations. Unstructured interviews were conducted with 22 mental health professionals, and data were analyzed using a grounded theory approach. The current study identified a collection of mental disorders (e.g., borderline personality disorder), stereotypes (e.g., dangerousness), emotion-related responses (e.g., fear), and behaviors (e.g., helping) as being key to the relative stigmatization of mental illness by mental health professionals. The results also suggested that professional context and familiarity with mental illness decrease the stigmatization of mental illness by mental health professionals. These variables and constructs were combined to form a grounded theory of mental health professionals stigmatizing mental illness. The current study has implications for the direction of future research on the stigmatization of mental illness by mental health professionals and interventions that strive to mitigate this type of stigmatization.
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Affiliation(s)
| | - Stefano Occhipinti
- Griffith University, Brisbane, QLD, Australia
- International Research Centre for the Advancement of Health Communication, Department of English and Communication, Hong Kong Polytechnic University, Hong Kong, China
| | | | - Bonnie Clough
- Griffith University, Brisbane, QLD, Australia
- Griffith Centre for Mental Health, Brisbane, QLD, Australia
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23
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Valentim O, Correia T, Moutinho L, Seabra P, Querido A, Laranjeira C. "This Is Me" an Awareness-Raising and Anti-Stigma Program for Undergraduate Nursing Students: A Pre-Post Intervention Study. NURSING REPORTS 2024; 14:2956-2974. [PMID: 39449453 PMCID: PMC11503353 DOI: 10.3390/nursrep14040216] [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: 07/18/2024] [Revised: 10/02/2024] [Accepted: 10/08/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND Stigma education for nursing students has focused solely on stigma reduction, with studies showing temporary improvements in attitudes. However, nursing education research should also emphasize the importance of critical reflection and self-reflection to enhance attitudes, beliefs, topic comprehension, and learning satisfaction. This study aimed to evaluate the effectiveness of the "This is me" intervention regarding knowledge, attitudes, and communication skills of senior undergraduate nursing students in responding to mental illness-related stigma. METHODS This study employed a psychoeducational intervention for reducing mental illness stigma, using a questionnaire survey to assess pre- and post-intervention effects, with 37 eligible nursing students undergoing clinical training in psychiatric services between 16 May and 15 July 2022. Instruments included sociodemographic and health questions, the MICA-4 scale to evaluate students' attitudes toward mental illness, the MAKS to measure mental health knowledge, the Empathy Scale (JSPE-S), the Intergroup Anxiety Scale (SS-12), and the Attribution Questionnaire (AQ-27). RESULTS Most students were female (73.0%) and single (70.3%), with a mean age of around 29 years. After implementing the psychoeducational program, there was a statistically significant increase in overall stigma-related knowledge (MAKS: Z = -1.99, p < 0.05), a decrease in intergroup anxiety (IAS: Z = -3.42, p < 0.05), and reductions in the perceptions of patients as dangerous (AQ27-Dangerousness: Z = -2.399, p < 0.05) and fear (AQ27-Fear: Z = -2.415, p < 0.05). Additionally, there was an improvement in empathy, specifically in Perspective Taking (JSPE: Z = -2.555, p < 0.05). CONCLUSIONS This program may contribute to mental health literacy related to stigma, positively impacting therapeutic relationships and communication with people with mental illness and resulting in more effective care practices.
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Affiliation(s)
- Olga Valentim
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal; (L.M.); (P.S.)
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Center for Health Technology and Services Research (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal; (T.C.); (A.Q.)
| | - Tânia Correia
- Center for Health Technology and Services Research (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal; (T.C.); (A.Q.)
- School of Health Sciences, Polytechnic Institute of Viseu, 3500-843 Viseu, Portugal
| | - Lídia Moutinho
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal; (L.M.); (P.S.)
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Center for Health Technology and Services Research (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal; (T.C.); (A.Q.)
| | - Paulo Seabra
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal; (L.M.); (P.S.)
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Ana Querido
- Center for Health Technology and Services Research (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal; (T.C.); (A.Q.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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24
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Doherty S, Kianian B, Dass G, Edward A, Kone A, Manolova G, Sivayokan S, Solomon M, Surenthirakumaran R, Lopes-Cardozo B. Changes in mental health stigma among healthcare professionals and community representatives in Northern Sri Lanka during an mhGAP intervention study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1871-1881. [PMID: 38713387 DOI: 10.1007/s00127-024-02684-4] [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: 01/03/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Research indicates that exposure to conflict, natural disasters, and internal displacement can increase mental health conditions. Since the end of the civil conflict within Sri Lanka, the country has worked to increase access to mental health services to meet the needs of conflict-affected populations, however, gaps remain. To address this, integration of mental health services into primary care can reduce the strain on growing specialized care. As part of a larger study primary care practitioners (doctors), public health professionals (nurses, midwives), and community representatives (teachers, social workers) were trained to deliver mental health services in primary care across the heavily impacted Northern Province. The aim was to reduce mental health stigma among enrolled healthcare workers and community representatives by 50%. METHODS Stigma was measured across all participant groups at six time points: pre- and post- initial training at baseline, pre- and post- refresher training 3-months after initial training, and pre- and post- refresher training 6-months after initial training. RESULTS Results indicate a small improvement in average stigma scores at the 6-month refresher point for primary care practitioners, and no meaningful difference in average scores across time points for public health professionals or community representatives. CONCLUSION World Health Organization mhGAP training appears to reduce stigma among primary care practitioners and could be an effective strategy to counteract mental health stigma in low resource settings. Future research should investigate underlying mechanisms of stigma reduction to improve delivery of mental health services in primary care and community settings.
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Affiliation(s)
- Shannon Doherty
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
| | - Behzad Kianian
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Giselle Dass
- THEME Institute, 50/13, Old Kesbawa Road, Boralesgamuwa, Sri Lanka
| | - Anne Edward
- THEME Institute, 50/13, Old Kesbawa Road, Boralesgamuwa, Sri Lanka
| | - Ahoua Kone
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Gergana Manolova
- World Health Organization, Av. Appia 20, 1211, Geneva, Switzerland
| | - Sambasivamoorthy Sivayokan
- Department of Community and Family Medicine, University of Jaffna, Ramanathan Road, PO Box 57, Thirunelvely, Jaffna, Sri Lanka
| | - Madonna Solomon
- THEME Institute, 50/13, Old Kesbawa Road, Boralesgamuwa, Sri Lanka
| | - Rajendra Surenthirakumaran
- Department of Community and Family Medicine, University of Jaffna, Ramanathan Road, PO Box 57, Thirunelvely, Jaffna, Sri Lanka
| | - Barbara Lopes-Cardozo
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
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25
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McGhie-Fraser B, Ballering A, Lucassen P, McLoughlin C, Brouwers E, Stone J, Olde Hartman T, van Dulmen S. Validation of the Persistent Somatic Symptom Stigma Scale for Healthcare Professionals. J Clin Epidemiol 2024; 174:111505. [PMID: 39159771 DOI: 10.1016/j.jclinepi.2024.111505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/14/2024] [Accepted: 08/13/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVES Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While many studies have explored stigmatisation by healthcare professionals toward people with PSS, there is a lack of validated measurement instruments. We recently developed a stigma scale, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). The aim of this study is to evaluate the measurement properties (validity and reliability) and factor structure of the PSSS-HCP. STUDY DESIGN AND SETTING The PSSS-HCP was tested with 121 healthcare professionals across the United Kingdom to evaluate its measurement properties. Analysis of the factor structure was conducted using principal component analysis. We calculated Cronbach's alpha to determine the internal consistency of each (sub)scale. Test-retest reliability was conducted with a subsample of participants with a 2-week interval. We evaluated convergent validity by testing the association between the PSSS-HCP and the Medical Condition Regard Scale (MCRS) and the influence of social desirability using the short form of the Marlowe-Crowne Social Desirability Scale (MCSDS). RESULTS The PSSS-HCP showed sufficient internal consistency (Cronbach's alpha = 0.84) and sufficient test-retest reliability, intraclass correlation = 0.97 (95% CI 0.94-0.99, P < .001). Convergent validity was sufficient between the PSSS-HCP and the MCRS, and no relationship was found between the PSSS-HCP and the MCSDS. A three factor structure was identified (othering, uneasiness in interaction, non-disclosure) which accounted for 60.5% of the variance using 13 of the 19 tested items. CONCLUSION The PSSS-HCP can be used to measure PSS stigmatisation by healthcare professionals. The PSSS-HCP has demonstrated sufficient internal consistency, test-retest reliability, convergent validity and no evidence of social desirability bias. The PSSS-HCP has demonstrated potential to measure important aspects of stigma and provide a foundation for stigma reduction intervention evaluation.
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Affiliation(s)
- Brodie McGhie-Fraser
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Aranka Ballering
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Lucassen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caoimhe McLoughlin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Evelien Brouwers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Tim Olde Hartman
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra van Dulmen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands; Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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26
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Zamorano S, González-Sanguino C, Fernández-Jiménez E, Muñoz M. A Burnt-Out Health: Stigma towards Mental Health Problems as a Predictor of Burnout in a Sample of Community Social Healthcare Professionals. Behav Sci (Basel) 2024; 14:812. [PMID: 39336027 PMCID: PMC11429299 DOI: 10.3390/bs14090812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 09/09/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Burnout is a primary psychosocial risk factor in the workplace. Mental health stigma, which includes negative cognitions, emotions, and behaviors, also undermines the performance of social healthcare professionals. This study aimed to explore the levels of burnout in a sample of community social healthcare workers as well as its relationships with variables such as stigma towards mental health problems, professional skills, and job characteristics. An online assessment was conducted with 184 social healthcare professionals (75.5% female, mean age = 40.82 years, SD = 9.9). Medium levels of burnout and stigma and high levels of professional skills were observed. Multiple linear regression analyses revealed that stigma towards mental health problems and professional skills predicted emotional exhaustion (R2 = 0.153, F(4, 179) = 9.245, p < 0.001), depersonalization (R2 = 0.213, F(3, 180) = 17.540, p < 0.001), and personal accomplishment (R2 = 0.289, F(5, 178) = 15.87, p < 0.001). These findings suggest that social healthcare systems could benefit from taking care of the mental health of their workers by addressing burnout, tackling negative attitudes towards mental health problems, and providing professional skills training. This would help to make social healthcare systems more inclusive and of higher quality, thereby reducing health costs.
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Affiliation(s)
- Sara Zamorano
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
| | - Clara González-Sanguino
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
- Department of Psychology, School of Education and Social Work, University of Valladolid, 47011 Valladolid, Spain
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, 28046 Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
- Faculty of Social Sciences and Communication, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Manuel Muñoz
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
- Chair Against Stigma Grupo 5, Complutense University of Madrid, 28223 Madrid, Spain
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27
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Moro MF, Gyimah L, Susser E, Ansong J, Kane J, Amissah C, Gureje O, Osei A, Norcini Pala A, Taylor D, Drew N, Kofie H, Baingana F, Ohene SA, Addico NL, Fatawu A, Atzeni M, D’Oca S, Carta MG, Funk M. Evaluating the psychometric properties of three WHO instruments to assess knowledge about human rights, attitudes toward persons with mental health conditions and psychosocial disabilities, and practices related to substitute decision-making and coercion in mental health. Front Psychiatry 2024; 15:1435608. [PMID: 39310660 PMCID: PMC11413867 DOI: 10.3389/fpsyt.2024.1435608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/01/2024] [Indexed: 09/25/2024] Open
Abstract
Background Instruments to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion are either missing or lack evaluation of their validity and reliability. Aim The aim of this study is to evaluate the validity and reliability of three instruments developed to fill this gap in the literature, the World Health Organization's QualityRights (WHO QR) Knowledge questionnaire, the WHO QR Attitudes questionnaire, and the WHO QR Practices questionnaire. Methods A sample of participants was recruited and completed an online survey. Content validity and face validity were assessed for the three questionnaires. Based on the characteristics of the questionnaires, different approaches were used to assess their construct validity (confirmatory factor analysis, known group validity, and convergent and divergent validity). Internal consistency was evaluated using Cronbach's alpha and test re-test reliability using Pearson's and Spearman's r coefficients. Results The analyses conducted indicate that the three questionnaires are valid and reliable instruments to evaluate the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion. Conclusion This finding lends support to the use of these instruments both within mental health services and in the general population for a better understanding of current knowledge, attitudes, and practices related to a human rights-based approach to mental health in mental health services and the community.
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Affiliation(s)
- Maria Francesca Moro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Leveana Gyimah
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- New York State Psychiatric Institute, New York, NY, United States
| | - Joana Ansong
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | - Jeremy Kane
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | | | - Oye Gureje
- World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akwasi Osei
- Mental Health Authority, Ghana Ministry of Health, Accra, Ghana
| | - Andrea Norcini Pala
- Department of Community Health Sciences, State University of New York (SUNY) Downstate, Brooklyn, NY, United States
| | | | - Nathalie Drew
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Florence Baingana
- Mental Health and Substance Abuse, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo
| | - Sally-ann Ohene
- World Health Organization (WHO) Country Office for Ghana, Accra, Ghana
| | | | | | - Michela Atzeni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michelle Funk
- Policy, Law and Human Rights, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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28
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Moraleda Ruano A, Galán-Casado D. Stigma toward individuals with intellectual disabilities and severe mental disorders: analysis of postgraduate university students’ perceptions. Adv Ment Health Intellect Disabil 2024; 18:125-139. [DOI: 10.1108/amhid-04-2024-0012] [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: 01/06/2025]
Abstract
Purpose
The purpose of this study is to delve into societal stigma surrounding severe mental disorders and intellectual disabilities, emphasizing gender differences and students’ proximity influence.
Design/methodology/approach
Involving 572 Spanish master’s students, this nonexperimental study categorizes participants based on contact frequency, using Goratu and CAEE questionnaires to measure stigma.
Findings
Gender-based stigma differences are absent; however, increased contact correlates with lower stigma levels. Notably, greater closeness is associated with more positive attitudes toward intellectual disability, resulting in diminished stigma toward severe mental disorders.
Practical implications
This research sheds light on the pervasive stigma faced by individuals with intellectual disabilities and severe mental disorders among postgraduate university students. Notably, the recognition of widespread stigma among individuals with higher education highlights a more significant societal problem. The findings underscore the urgent need for targeted interventions, especially in higher education contexts, to enhance understanding and reduce societal bias.
Social implications
By identifying factors influencing stigma and emphasizing the importance of contact in fostering empathy, the study lays the groundwork for informed socioeducational strategies. These strategies have the potential to promote inclusivity, challenge stereotypes and contribute to the well-being and social integration of those affected by intellectual disabilities and severe mental disorders.
Originality/value
The findings highlight the efficacy of direct contact in reducing stigma and underscore the necessity for nuanced understanding. The study suggests fostering positive attitudes through increased contact can combat prejudice and promote social inclusion. Nevertheless, further research is crucial to explore factors influencing stigma reduction and design comprehensive socioeducational interventions addressing diverse cultural proficiencies. This study contributes valuable insights for mitigating stigma, fostering inclusivity and informing future interventions.
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29
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Halliday S, Rao D, Augusto O, Poongothai S, Sosale A, Sridhar GR, Tandon N, Sagar R, Patel SA, Narayan KMV, Johnson LCM, Wagenaar BH, Huh D, Flaherty BP, Chwastiak LA, Ali MK, Mohan V. A mediation analysis evaluating change in self-stigma on diabetes outcomes among people with depression in urban India: A secondary analysis from the INDEPENDENT trial of the collaborative care model. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003624. [PMID: 39231130 PMCID: PMC11373850 DOI: 10.1371/journal.pgph.0003624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/30/2024] [Indexed: 09/06/2024]
Abstract
Self-stigma-the internalization of negative community attitudes and beliefs about a disease or condition-represents an important barrier to improving patient care outcomes for people living with common mental disorders and diabetes. Integrated behavioral healthcare interventions are recognized as evidence-based approaches to improve access to behavioral healthcare and for improving patient outcomes, including for those with comorbid diabetes, yet their impact on addressing self-stigma remains unclear. Using secondary data from the Integrating Depression and Diabetes Treatment (INDEPENDENT) study-a trial that aimed to improve diabetes outcomes for people with undertreated and comorbid depression in four urban Indian cities via the Collaborative Care Model-we longitudinally analyzed self-stigma scores and evaluated whether change in total self-stigma scores on diabetes outcomes is mediated by depressive symptom severity. Self-stigma scores did not differ longitudinally comparing Collaborative Care Model participants to enhanced standard-of-care participants (mean monthly rate of change in Self-Stigma Scale for Chronic Illness-4 Item scores; B = 0.0087; 95% CI: -0.0018, 0.019, P = .10). Decreases in total self-stigma scores over 12 months predicted diabetes outcomes at 12 months (HbA1c, total effect; B = 0.070 95%CI: 0.0032, 0.14; P < .05), however depressive symptoms did not mediate this relationship (average direct effect; B = 0.064; 95% CI: -0.0043, 0.13, P = .069). Considering the local and plural notions of stigma in India, further research is needed on culturally grounded approaches to measure and address stigma in India, and on the role of integrated care delivery models alongside multi-level stigma reduction interventions. Trial registration : ClinicalTrials.gov, NCT02022111. https://clinicaltrials.gov/study/NCT02022111.
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Affiliation(s)
- Scott Halliday
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Deepa Rao
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Orvalho Augusto
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
- Manhiça Health Research Centre (CISM), Maputo, Mozambique
| | - Subramani Poongothai
- Madras Diabetes Research Foundation, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Aravind Sosale
- Diabetes Care and Research Center, Diacon Hospital, Bangalore, India
| | | | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Shivani A Patel
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, Georgia, United States of America
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, Georgia, United States of America
| | - Leslie C M Johnson
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, Georgia, United States of America
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Bradley H Wagenaar
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - David Huh
- School of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Brian P Flaherty
- Department of Psychology, University of Washington, Seattle, Washington, United States of America
| | - Lydia A Chwastiak
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Mohammed K Ali
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, Georgia, United States of America
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai, India
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Wang J, Pasyk SP, Slavin-Stewart C, Olagunju AT. Barriers to Mental Health care in Canada Identified by Healthcare Providers: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:826-838. [PMID: 38512557 DOI: 10.1007/s10488-024-01366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
The mental health treatment gap remains wide across the world despite mental illness being a significant cause of disability globally. Both end-user and healthcare provider perspectives are critical to understanding barriers to mental healthcare and developing interventions. However, the views of providers are relatively understudied. In this review, we synthesized findings from current literature regarding providers' perspectives on barriers to mental healthcare in Canada. We searched Medline, PsycINFO, Embase, and CINAHL for eligible Canadian studies published since 2000. Analysis and quality assessment were conducted on the included studies. Of 4,773 reports screened, 29 moderate-high quality studies were reviewed. Five themes of barriers emerged: health systems availability and complexity (reported in 72% of the studies), work conditions (55%), training/education (52%), patient accessibility (41%), and identity-based sensitivity (17%). Common barriers included lack of resources, fragmented services, and gaps in continuing education. Interestingly, clinicians often cited confusion in determining the ideal service for patients due to an overwhelming number of potential services without clear descriptions. These five domains of barriers present a synthesized review of areas of improvement for mental healthcare spanning both patients and clinicians. Canadian mental health systems face a need to improve capacity, clinician training, and in particular service navigability and collaboration.
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Affiliation(s)
- Jeffrey Wang
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Stanislav P Pasyk
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Claire Slavin-Stewart
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
- Discipline of Psychiatry, The University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
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Noonan M, Brown M, Gibbons M, Tuohy T, Johnson K, Bradshaw C, Tighe SM, Atkinson S, Murphy L, Mohamad M, Imcha M, O'Dwyer N, Grealish A. Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study. Midwifery 2024; 136:104089. [PMID: 38968682 DOI: 10.1016/j.midw.2024.104089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Healthcare professionals have a role to play in reducing perinatal mental health related stigma. AIM To assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies. DESIGN A single group pre-test-post-test pilot study with no control group. SETTING(S) A university affiliated maternity hospital in Ireland PARTICIPANTS: A convenience sample of registered midwives, nurses and doctors (n = 60) recruited from October 2020-January 2021. INTERVENTION A twenty-minute video-based educational intervention. METHODS Respondents (n = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (n = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores. RESULTS The difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (z = 3.27, df=36, P = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (z= -3.368, df=59, P = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions. CONCLUSIONS Further research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention. TWEETABLEABSTRACT A video-based intervention can increase healthcare professionals' knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article.
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Affiliation(s)
- Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Melissa Brown
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Maria Gibbons
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Teresa Tuohy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Kevin Johnson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sylvia Murphy Tighe
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sandra Atkinson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Louise Murphy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mas Mohamad
- University Maternity Hospital Limerick, Limerick, Ireland
| | | | - Niamh O'Dwyer
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland; Kings Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK.
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Adams ET, Nyblade L, Madson G, Wallhagen M, Smith SL, Stelmach RD, Francis HW. Development and Preliminary Validation of Scales to Measure Enacted, Perceived, and Experienced Hearing Loss Stigma in Health Care Settings. Ear Hear 2024; 45:42S-52S. [PMID: 39294880 DOI: 10.1097/aud.0000000000001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
OBJECTIVES Qualitative evidence suggests that stigma experienced by people who are d/Deaf and hard of hearing (d/DHH) can reduce willingness to engage with health services. Quantitative evidence remains lacking, however, about how health care providers (HCPs) perceive societal stigma toward people who are d/DHH, how HCPs might enact d/DHH stigma within provider-patient encounters, and what patients who are d/DHH share with providers about those patients' perceptions and experiences of stigma. Such quantitative evidence would allow HCPs to understand if and how stigma influences hearing health decisions made by people who are d/DHH. It could also shape practices to reduce d/DHH stigma within clinical encounters and guide providers in considering stigma as a driving force in their patients' hearing health care decisions. Building that evidence base requires validated quantitative measures. In response, the present study initiated an iterative process toward developing and preliminarily validating HCP self-report measures for different forms of d/DHH stigma. These measures draw upon HCPs' own perspectives, as well as their reports of secondhand information about stigma shared during clinical conversations. We developed and preliminary validated four measures: (1) provider-perceived stigma (HCPs' perceptions of the existence of negative attitudes and stereotypes toward d/DHH individuals in society), (2) provider-enacted stigma (self-reported subtle or indirect acts of stigma HCPs might commit during clinical encounters), (3) secondhand patient-experienced stigma (external acts of stigma reported to HCPs by patients who are d/DHH during clinical encounters), and (4) secondhand patient-perceived stigma (perceptions of negative attitudes and stereotypes reported to HCPs by patients who are d/DHH during clinical encounters). DESIGN Scale items were extracted from a comprehensive literature review of stigma measures. Question stems and individual items were adapted for HCPs, cognitively tested on 5 HCPs, and pretested with 30 HCPs. The 4 scales were then validated on a sample of primary care providers and hearing care specialists (N = 204) recruited through an online survey. All data were collected in the United States. RESULTS We conducted an exploratory factor analysis of the four proposed d/DHH stigma HCP stigma scales. Scale items loaded satisfactorily with ordinal alphas ranging between 0.854 and 0.944. CONCLUSIONS The four measures developed and preliminarily validated in this study can provide opportunities for HCPs to develop a more nuanced understanding of stigma experienced and perceived by their patients who are d/DHH and how that stigma manifests across social contexts, including health care settings. Further, the ability to assess forms of d/DHH stigma in clinical encounters, as well as their association with patient disengagement and resistance to advanced hearing care, could lead to innovative stigma-reduction interventions. Such interventions could then be evaluated using the measures from this article and then applied to clinical practice. We envision these measures being further refined, adapted, and tested for a variety of health care contexts, including primary care settings where hearing difficulties may first be identified and in hearing health care settings where audiologic rehabilitation is initiated.
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Affiliation(s)
- Elizabeth Troutman Adams
- Social, Statistical, and Environmental Sciences Business Unit, RTI International, Research Triangle Park, North Carolina, USA
| | - Laura Nyblade
- Social, Statistical, and Environmental Sciences Business Unit, RTI International, Research Triangle Park, North Carolina, USA
| | - Gabriel Madson
- Social, Statistical, and Environmental Sciences Business Unit, RTI International, Research Triangle Park, North Carolina, USA
| | - Margaret Wallhagen
- Department of Physiological Nursing, School of Nursing, University of California - San Francisco, San Francisco, California, USA
| | - Sherri L Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, USA
| | - Rachel D Stelmach
- International Development Group, RTI International, Research Triangle Park, North Carolina, USA
| | - Howard W Francis
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, USA
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McLeod KE, Butler A, Martin RE, Buxton JA. "Just clearly the right thing to do": perspectives of correctional services leaders on moving governance of health-care in custody. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:299-312. [PMID: 39183588 PMCID: PMC11345676 DOI: 10.1108/ijoph-08-2023-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 04/05/2024] [Accepted: 05/05/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE Governance models are a defining characteristic of health-care systems, yet little research is available about the governance of health-care delivered in correctional facilities. This study aims to explore the perspectives of correctional services leaders in British Columbia, Canada, on the motivations for transferring responsibility for health-care services in provincial correctional facilities to the Ministry of Health, as well as key lessons learned. DESIGN/METHODOLOGY/APPROACH Eight correctional services leaders participated in one-on-one interviews between September 2019 and February 2020. The authors used inductive thematic analysis to explore key themes. To triangulate early effects of the transfer identified by participants the authors used complaints data from Prisoners' Legal Services to examine changes over time. FINDINGS The authors identified four major themes related to the rationale for this transfer: 1) quality and equivalence of care, 2) integration and throughcare, 3) values and expertise and 4) funding and resources. Facilitators included changes in the external environment, having the right people in the right places, a strong sense of alignment and shared goals and a changing culture in corrections. Participants also highlighted challenges, including ongoing human resourcing issues, having to navigate and define shared responsibilities and adapting a large bureaucracy to the environment in corrections. Consistent with outcomes described by participants, data showed that a lower proportion of complaints received after the transfer were related to health-care. ORIGINALITY/VALUE The perspectives of correctional leaders on the transfer of governance for health-care services in custody to the community health-care system provide novel insights into the processes and potential of this change.
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Affiliation(s)
| | - Amanda Butler
- School of Criminology, Simon Fraser
University, Burnaby, Canada
| | - Ruth Elwood Martin
- School of Population and Public Health, The University
of British Columbia, Vancouver, Canada
| | - Jane A. Buxton
- School of Population and Public Health, The University
of British Columbia, Vancouver, Canada
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Olivo MLO, Oluwakemi RA, Lakner Z, Farkas T. Gender differences in research fields of bioeconomy and rural development-based on sustainable systems in Latin America and Africa regions. PLoS One 2024; 19:e0308713. [PMID: 39172914 PMCID: PMC11340968 DOI: 10.1371/journal.pone.0308713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 07/30/2024] [Indexed: 08/24/2024] Open
Abstract
Using bibliometric analysis of large-scale publication data is a simple approach to exploring gender-related trends, especially gender equality in academic publishing. The aim of this study is to investigate gender trends in the fields of bio-economy and rural development sciences in two under develop regions as Latin America and Africa. This study examines gender differences in these fields in order to: (1) recognize the contribution of female researchers in bioeconomy and rural development, (2) explore the relational structure of gender aspects in academic publications, (3) identify trends in female authorship in these scientific research fields over time, and finally (4) identify gender potentials for women to become more visible in these fields of study. To achieve these objectives, we used bibliometric tools to analyses 1891 publication records in bioeconomy and rural development. After cleaning the database of full names of authors of academic publications relevant to the field studies, we performed a series of statistical analyses in R and SPSS software, such as Lotkas distribution, network analysis, co-authorship analysis and spatial distribution of authors in the study. The results show that the number of male authors is almost three times higher than the number of female authors, suggesting that women are under-represented in the fields studied. Men occupy the most important position of authorship in scientific articles; publications with corresponding male authors were found in 1389 out of 1891 publications related to the bio-economy and rural development. In terms of geographical regions, publications with female authors were more prevalent in European and North American areas, with a small exception in some developing countries such as Argentina and South Africa. In terms of research networks, from the total number of authors evaluated, only 23% are female authors on the map of research influence. This indicates that there is a significant gap to be filled in the promotion of scholarly impact through the sharing of knowledge and expertise among authors.
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Affiliation(s)
- M. Lourdes Ordoñez Olivo
- Faculty of Economics and Social Sciences, Hungarian University of Agricultural and Life Science, Gödöllo, Hungary
| | - Rachael Adeleye Oluwakemi
- Institute of Rural Development and Sustainable Economy, Hungarian University of Agricultural and Life Science, Gödöllo, Hungary
| | - Zoltán Lakner
- Faculty of Economics and Social Sciences, Hungarian University of Agricultural and Life Science, Gödöllo, Hungary
| | - Tibor Farkas
- Institute of Rural Development and Sustainable Economy, Hungarian University of Agricultural and Life Science, Gödöllo, Hungary
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Thi LM, Manzano A, Ha BTT, Vui LT, Quynh-Chi NT, Duong DTT, Lakin K, Kane S, Mirzoev T, Trang DTH. Mental health stigma and health-seeking behaviors amongst pregnant women in Vietnam: a mixed-method realist study. Int J Equity Health 2024; 23:163. [PMID: 39152438 PMCID: PMC11328496 DOI: 10.1186/s12939-024-02250-z] [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: 04/20/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Approximately 15% of women in low-and middle-income countries experience common perinatal mental disorders. Yet, many women, even if diagnosed with mental health conditions, are untreated due to poor quality care, limited accessibility, limited knowledge, and stigma. This paper describes how mental health-related stigma influences pregnant women's decisions not to disclose their conditions and to seek treatment in Vietnam, all of which exacerbate inequitable access to maternal mental healthcare. METHODS A mixed-method realist study was conducted, comprising 22 in-depth interviews, four focus group discussions (total participants n = 44), and a self-administered questionnaire completed by 639 pregnant women. A parallel convergent model for mixed methods analysis was employed. Data were analyzed using the realist logic of analysis, an iterative process aimed at refining identified theories. Survey data underwent analysis using SPSS 22 and descriptive analysis. Qualitative data were analyzed using configurations of context, mechanisms, and outcomes to elucidate causal links and provide explanations for complexity. RESULTS Nearly half of pregnant women (43.5%) would try to hide their mental health issues and 38.3% avoid having help from a mental health professional, highlighting the substantial extent of stigma affecting health-seeking and accessing care. Four key areas highlight the role of stigma in maternal mental health: fear and stigmatizing language contribute to the concealment of mental illness, rendering it unnoticed; unconsciousness, normalization, and low literacy of maternal mental health; shame, household structure and gender roles during pregnancy; and the interplay of regulations, referral pathways, and access to mental health support services further compounds the challenges. CONCLUSION Addressing mental health-related stigma could influence the decision of disclosure and health-seeking behaviors, which could in turn improve responsiveness of the local health system to the needs of pregnant women with mental health needs, by offering prompt attention, a wide range of choices, and improved communication. Potential interventions to decrease stigma and improve access to mental healthcare for pregnant women in Vietnam should target structural and organizational levels and may include improvements in screening and referrals for perinatal mental care screening, thus preventing complications.
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Affiliation(s)
- Le Minh Thi
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Hanoi, 10000, Vietnam.
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, LS29JT, UK
| | - Bui Thi Thu Ha
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Hanoi, 10000, Vietnam
| | - Le Thi Vui
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Hanoi, 10000, Vietnam
| | | | | | - Kimberly Lakin
- Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Sumit Kane
- Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Tolib Mirzoev
- London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E7HT, UK
| | - Do Thi Hanh Trang
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Hanoi, 10000, Vietnam
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Li W, Li Q. Psychometric properties of the chinese version of the value-based stigma inventory (VASI): a translation and validation study. BMC Psychiatry 2024; 24:550. [PMID: 39112959 PMCID: PMC11308479 DOI: 10.1186/s12888-024-05998-4] [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: 11/04/2023] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVE This study aimed to develop a culturally adapted Chinese version of the Value-based Stigma Inventory (VASI) and to evaluate its psychometric properties, including reliability and validity, among the general Chinese population. METHODS This study is a cross-sectional study. Convenience sampling was used to recruit 708 general citizens from Shenyang City, Liaoning Province, China. The VASI's internal consistency, split-half reliability, and test-retest reliability were tested to assess the translated scale's reliability. Several validity tests were performed, including expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States). RESULTS The Chinese version of the VASI showed good reliability, with a Cronbach's α value of 0.808, and the dimensions ranged from 0.812 to 0.850. Test-retest reliability showed good temporal stability with a value of 0.855, and the split-half reliability value was 0.845, indicating a high degree of consistency. The scale also demonstrated good content validity with a content validity index of 0.952. After conducting exploratory factor analysis, a five-factor structure was identified, including factors of self-realization, personal enrichment, reputation, meritocratic values, and security. In the confirmatory factor analysis, all recommended fit indicators were found to be within the acceptable range, including χ2/DF = 1.338, GFI = 0.960, AGFI = 0.940, RMSEA = 0.031, TLI = 0.985, CFI = 0.989, IFI = 0.989, PGFI = 0.640, and PNFI = 0.729. CONCLUSION The Chinese version of the VASI is valid and reliable among the Chinese general public. The five-factor structured scale effectively assessed public stigma against mental illness, including the value orientations associated with personal stigma. Given the harsh and widespread public stigma against mental illness, the findings from the questionnaire may inform the development of future public health education programs. Public health education is needed to reduce the stigma of mental illness, increase public awareness of mental health issues, and mitigate the continued stigmatization of mental illness.
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Affiliation(s)
- Wenbo Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Qiujie Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
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Grewal J, Kennedy CJ, Mamman R, Biagioni JB, Garcia-Barrera MA, Schmidt J. Understanding the barriers and facilitators of healthcare services for brain injury and concurrent mental health and substance use issues: a qualitative study. BMC Health Serv Res 2024; 24:881. [PMID: 39095800 PMCID: PMC11295555 DOI: 10.1186/s12913-024-11316-1] [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: 03/23/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND People with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues. METHODS Semi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data. RESULTS 90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services. CONCLUSIONS These findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services.
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Affiliation(s)
- Jasleen Grewal
- University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, BC, Canada
| | - Cole J Kennedy
- Department of Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Rinni Mamman
- University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, BC, Canada
| | | | - Mauricio A Garcia-Barrera
- Department of Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Julia Schmidt
- University of British Columbia, Vancouver, BC, Canada.
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, BC, Canada.
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.
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Braun D, Lascelles K. Involving and supporting families, friends, and carers during a mental health crisis. Lancet Psychiatry 2024; 11:586-587. [PMID: 38876131 DOI: 10.1016/s2215-0366(24)00165-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Dorit Braun
- Life Beyond the Cubicle Project, Making Families Count, Banbury, OX17 1QL, UK.
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Mickelberg AJ, Walker B, Ecker UKH, Fay N. Helpful or harmful? The effect of a diagnostic label and its later retraction on person impressions. Acta Psychol (Amst) 2024; 248:104420. [PMID: 39088996 DOI: 10.1016/j.actpsy.2024.104420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
Diagnostic labels for mental health conditions can inadvertently reinforce harmful stereotypes and exacerbate stigma. If a diagnosis is incorrect and a label is wrongly applied, this may negatively impact person impressions even if the inaccurate label is later corrected. This registered report examined this issue. Participants (N = 560) read a vignette about a hospital patient who was either diagnosed with schizophrenia, diagnosed with major depressive disorder, or not diagnosed with a mental health condition. The diagnostic labels were later retracted strongly, retracted weakly, or not retracted. Participants completed several stigma measures (desire for social distance, perceived dangerousness, and unpredictability), plus several inferential-reasoning measures that tested their reliance on the diagnostic label. As predicted, each mental health diagnosis elicited stigma, and influenced inferential reasoning. This effect was stronger for the schizophrenia diagnosis compared to the major depressive disorder diagnosis. Importantly, the diagnostic label continued to influence person judgments after a clear retraction (strong or weak), highlighting the limitations of corrections in reducing reliance on person-related misinformation and mental health stigma.
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Affiliation(s)
- Amy J Mickelberg
- School of Psychological Science, University of Western Australia, Australia.
| | - Bradley Walker
- School of Psychological Science, University of Western Australia, Australia
| | - Ullrich K H Ecker
- School of Psychological Science, University of Western Australia, Australia; Public Policy Institute, University of Western Australia, Australia
| | - Nicolas Fay
- School of Psychological Science, University of Western Australia, Australia.
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Ravaldi C, Mosconi L, Crescioli G, Lombardo G, Russo I, Morese A, Ricca V, Vannacci A. Are midwives trained to recognise perinatal depression symptoms? Results of MAMA (MAternal Mood Assessment) cross-sectional survey in Italy. Arch Womens Ment Health 2024; 27:567-576. [PMID: 38308142 PMCID: PMC11230996 DOI: 10.1007/s00737-024-01439-z] [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: 09/06/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. METHODS We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. RESULTS A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. CONCLUSION This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment.
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Affiliation(s)
- Claudia Ravaldi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Laura Mosconi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giada Crescioli
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giulia Lombardo
- Unit of Obstetrics and Gynecology, Parma University Hospital, Parma, Italy
| | - Ilenia Russo
- Unit of Obstetrics and Gynecology, "S. Marta E S. Verera" Hospital, ASP Catania, Acireale, Italy
| | - Angelo Morese
- Section of Pediatrics, Obstetrics and Gynecology and Nursing, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Section of Psychiatry, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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Alhefdhi H, Alshehri N, Al Zomia A, Lahiq L, Hussain A, Alaskari A, Alasiri W, Alqarni A, Asiri F, Alqahtani A, Asiri M, Alhifthy E. Exploring quality of life, discrimination, and knowledge of parents of ADHD children in Saudi Arabia: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38102. [PMID: 38875372 PMCID: PMC11175895 DOI: 10.1097/md.0000000000038102] [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: 10/16/2023] [Revised: 03/05/2024] [Accepted: 04/11/2024] [Indexed: 06/16/2024] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. This study investigates the quality of life (QoL) of parents of children with ADHD, the discrimination they encounter, and their sources of information about the disorder. This cross-sectional study was conducted using an online questionnaire through Google Forms from March to April 2023. Study participants were recruited using a convenient sampling technique from patient records in 4 regions of Saudi Arabia. The questionnaire was sent through commonly used social media. QoL was assessed through the validated Arabic version of the World Health Organization Quality of Life Instrument, Short Form questionnaire. A total of 100 participants were recruited for this study. Most of the participants were from the southern region (80%, n = 80), 66.0% (n = 66) were mothers, 66.0% (n = 66) were married and 64% (n = 64) had a college degree. The mean scores of the physical, psychological, mental, environmental, total scales, and general QoL were (57.18 ± 13.67, 62.58 ± 17.49, 63.33 ± 23.12, 23.07 ± 12.87, 51.54 ± 14.34, 3.69 ± 1.06, respectively). Half of the population studied experienced discrimination with no significant differences between mothers and fathers (64% vs 68%, P = .833). The main source of information on ADHD was the Internet (49%) followed by schools (11%), and relatives (10%). Fifty-four percent of the participants have participated in workshops or seminars on neurodevelopmental disorders and 39.0% believed that schools and institutions are sufficiently equipped to support children with ADHD. ADHD had a profound impact on the QoL of parents, with a substantial portion facing discrimination due to their child condition. Additionally, parents showed a strong desire to acquire more information about ADHD, highlighting the need for a comprehensive understanding and support surrounding this condition.
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Affiliation(s)
- Hayfa Alhefdhi
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Nawaf Alshehri
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Al Zomia
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Lama Lahiq
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Waheed Alasiri
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abdulrhman Alqarni
- College of Medicine, Umm Al-Qura University, Makkah Almukarramah, Saudi Arabia
| | - Fahad Asiri
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ali Alqahtani
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Muzun Asiri
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Elham Alhifthy
- Department of Pediatrics, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Elliot V, Kosteniuk J, O'Connell ME, Cameron C, Morgan D. Services for older adults in rural primary care memory clinic communities and surrounding areas: a qualitative descriptive study. BMC Health Serv Res 2024; 24:725. [PMID: 38872136 PMCID: PMC11170901 DOI: 10.1186/s12913-024-11167-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND/OBJECTIVES As part of a larger study, and in collaboration with rural primary health care teams, RaDAR (Rural Dementia Action Research) primary care memory clinics have evolved and continue to spread in communities across southeast Saskatchewan, Canada. This study focuses on the geographical areas of the four communities where RaDAR memory clinics were first developed and implemented and describes the services and supports available to older adults including memory clinic patients and families living in these areas. Our goal was to identify and describe existing programs and gaps, create inventories and maps, and explore the service experiences of family caregivers of people living with dementia in these rural areas. METHODS Using a qualitative descriptive design, an environmental scan of services was conducted from December 2020 to April 2021 using focus groups (n = 4) with health care providers/managers (n = 12), a secondary source (e.g., program brochures) review, and a systematic internet search targeting four RaDAR memory clinic communities and surrounding areas via community websites, online resources, and the 211 Saskatchewan service database. Data were analyzed using content analysis; findings informed semi-structured interviews with caregivers (n = 5) conducted from March to July 2022, which were analyzed thematically. Geographic areas explored in this study covered an area of approximately 5666 km2. RESULTS From the scan, 43 services were identified, categorized into 7 service types, and mapped by location. Seventeen services were dementia-related. Services included social/leisure activities (n = 14), general support/referrals (n = 13), transportation (n = 7), information/education (n = 4), respite (n = 2), in-home care (n = 2), and safety (n = 1). Service levels included local (n = 24), provincial (n = 17), and national (n = 2), and were offered in-person, remotely (or both) with 20 services across 4 service types offered remotely. In general, most services had no fees, involved self-referral, and providers had a range of education/training. Key interview themes reflected the need for locally available, accessible services that offer (i) individualized, flexible, needs-based approaches, (ii) in-home care and continuity of care, and (iii) both formal and informal supports. Key gaps were identified, including (i) locally accessible, available services and resources in general, (ii) dementia-related training and education for service providers, and (iii) awareness of available services. Benefits of services, consequences of gaps, and recommendations to address gaps were reported. In general, service providers and program participants were an even mix of females and males, and program content was gender neutral. CONCLUSIONS Findings highlight a range of available services, and a number of varied service-user experiences and perspectives, in these rural areas. Key service gaps were identified, and caregivers made some specific recommendations to address these gaps. Findings underscore multiple opportunities to inform service delivery and program participation for rural and remote people living with dementia and their families.
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Affiliation(s)
- Valerie Elliot
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan (SK), SK S7N 2Z4, Canada.
| | - Julie Kosteniuk
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan (SK), SK S7N 2Z4, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Chelsie Cameron
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan (SK), SK S7N 2Z4, Canada
| | - Debra Morgan
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan (SK), SK S7N 2Z4, Canada
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Paterson C, Leduc C, Maxwell M, Aust B, Strachan H, O'Connor A, Tsantila F, Cresswell-Smith J, Purebl G, Winter L, Fanaj N, Doukani A, Hogg B, Corcoran P, D'Alessandro L, Mathieu S, Hegerl U, Arensman E, Greiner BA. Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis. Syst Rev 2024; 13:152. [PMID: 38849924 PMCID: PMC11157821 DOI: 10.1186/s13643-024-02569-2] [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: 11/08/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors. METHODS A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models. RESULTS We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible. CONCLUSIONS There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
- Charlotte Paterson
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | - Caleb Leduc
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | | | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Louvain, 3000, Belgium
| | - Johanna Cresswell-Smith
- Finnish Institute for Health and Welfare (THL) Equality Unit-Mental Health Team, Helsinki, Finland
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Lars Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | - Naim Fanaj
- Mental Health Center Prizren, Prizren, Kosovo
- Almae Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Asmae Doukani
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, SpainHospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Paul Corcoran
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), 5221 Wisconsin Avenue NW, Washington, DC, 20015, USA
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Brisbane, Australia
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, QLD, 4122, Australia
| | - Ulrich Hegerl
- European Alliance Against Depression E.V., Leipzig, 04109, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, 60528, Germany
| | - Ella Arensman
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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Chukwuma OV, Ezeani EI, Fatoye EO, Benjamin J, Okobi OE, Nwume CG, Egberuare EN. A Systematic Review of the Effect of Stigmatization on Psychiatric Illness Outcomes. Cureus 2024; 16:e62642. [PMID: 39036187 PMCID: PMC11258934 DOI: 10.7759/cureus.62642] [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: 06/17/2024] [Indexed: 07/23/2024] Open
Abstract
A significant proportion of individuals with psychiatric disorders face dual challenges such as managing the symptoms and disabilities of their conditions and enduring stigma arising from misconceptions about mental illness. This stigma denies them quality-of-life opportunities, such as access to satisfactory healthcare services, better employment, safer housing, and social affiliations. This systematic review aims to evaluate the effect of stigmatization on psychiatric illness outcomes, particularly its influence on treatment adherence, treatment-seeking behavior, and care outcomes. We conducted a systematic review of 39 studies published between 2010 and 2024, focusing on the effects of stigmatization on psychiatric illness outcomes. The review utilized robust methodology following Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies from 2010 to 2024 obtained from databases such as PubMed, Embase, Google Scholar, Web of Science, and SCOPUS. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies, with most studies rated as moderate to high quality. The findings indicate that stigma in psychiatric illness is closely associated with several factors, including illness duration (mean effect size = 0.42, p < 0.05), frequency of clinic visits (mean reduction = 2.3 visits/year), and diagnosis of psychotic disorders (OR = 1.78, 95% CI: 1.20-2.65). Stigma manifests through misinformation, prejudice, and discrimination, leading to significant barriers to accessing and adhering to psychiatric treatment, thereby worsening health outcomes. It leads to delays in accessing healthcare, poor adherence to medication and follow-up, and negative psychiatric health outcomes, including disempowerment, reduced self-efficacy, increased psychiatric symptoms, and decreased quality of life. Also, stigma extends to caregivers and healthcare professionals, complicating care delivery. This review highlights the need for effective interventions and strategies to address stigma, emphasizing the importance of educational interventions to mitigate the adverse effects of public stigma. Understanding the multifaceted nature of stigma is crucial for developing targeted approaches to improve psychiatric care outcomes and ensure better mental health services for individuals with mental illnesses.
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Affiliation(s)
| | - Esther I Ezeani
- Family Medicine, Indiana Regional Medical Center (IRMC), Indiana, USA
- Primary Care, Lifebridge Health, Baltimore, USA
| | | | - Janet Benjamin
- Internal Medicine, Ross University School of Medicine, Miramar, USA
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Chuka G Nwume
- Family Medicine, University of Port Harcourt, Port Harcourt, NGA
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Guerrero Z, Iruretagoyena B, Parry S, Henderson C. Anti-stigma advocacy for health professionals: a systematic review. J Ment Health 2024; 33:394-414. [PMID: 36919957 PMCID: PMC10173949 DOI: 10.1080/09638237.2023.2182421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/21/2022] [Accepted: 11/14/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Many anti-stigma programs for healthcare workers already exist however there is less research on the effectiveness of training in skills for health professionals to counter stigma and its impacts on patients. AIMS The objective of this study was to examine the theory base, content, delivery, and outcomes of interventions for healthcare professionals which aim to equip them with knowledge and skills to aid patients to mitigate stigma and discrimination and their health impacts. METHODS Five electronic databases and grey literature were searched. Data were screened by two independent reviewers, conflicts were discussed. Quality appraisal was realized using the ICROMS tool. A narrative synthesis was carried out. RESULTS The final number of studies was 41. In terms of theory base, there are three strands - responsibility as part of the professional role, correction of wrongful practices, and collaboration with local communities. Content focusses either on specific groups experiencing health-related stigma or health advocacy in general. CONCLUSIONS Findings suggest programs should link definitions of stigma to the role of the professional. They should be developed following a situational analysis and include people with lived experience. Training should use interactive delivery methods. Evaluation should include follow-up times that allow examination of behavioural change. PROSPERO, ID: CRD42020212527.
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Affiliation(s)
- Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Barbara Iruretagoyena
- Department of Neurology and Psychiatry, Clínica Alemana Universidad del Desarrollo, Las Condes, Chile
| | - Sarah Parry
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Claire Henderson
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Health Service and Population Research, King’s College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Özbıçakçı Ş, Salkim ÖÖ. The predictors of mental health literacy among adolescents students. Arch Psychiatr Nurs 2024; 50:1-4. [PMID: 38789220 DOI: 10.1016/j.apnu.2024.03.002] [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: 10/17/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 05/26/2024]
Abstract
AIM This study aimed to examine levels of mental health literacy (MHL) and associated factors among adolescents. METHODS A descriptive, cross-sectional, analytical study was conducted with a total of 650 students aged 11-18 years in three middle and three high schools. Data were collected using the Child and Adolescent Mental Health Literacy Scale and evaluated using descriptive statistics and regression analysis to determine whether age, gender, and grade are predictive factors of MHL. RESULTS The mean age of the participants in the study was 16.8 ± 1.35 years, 55 % of the students were girls, and the mean MHL score was 3.96 ± 1.2, indicating moderate MHL. Multiple regression analysis indicated that the variables of age, gender, and grade explained 5.5 % of the variance in MHL score. When these variables were examined individually, gender and grade had no significant effect (p > 0.05), while older age was associated with higher MHL score (p < 0.05). CONCLUSION The results of this study showed that MHL improved with age. MHL promotion is important in mental health resilience. Collaboration between school nurses, school counselors, and psychiatric nurses to provide mental health educational interventions may help reduce stigma and increase help-seeking behaviors.
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Affiliation(s)
- Şeyda Özbıçakçı
- Dokuz Eylul Universitesi (University of Dokuz Eylül), Nursing Faculty, Public Health Nursing Department, Inciralti, 35340 Izmir, Turkiye.
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Gupta S, Kumar A, Kathiresan P, Pakhre A, Pal A, Singh V. Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications. Indian J Psychiatry 2024; 66:336-346. [PMID: 38778855 PMCID: PMC11107930 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_412_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: 06/02/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.
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Affiliation(s)
- Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Preethy Kathiresan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Pakhre
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Jønsson ABR, Brodersen JB, Reventlow S, Svanholm C, Møller A, Kousgaard MB. General practitioners' experiences of providing somatic care for patients with severe mental illness: a qualitative study. BMC PRIMARY CARE 2024; 25:96. [PMID: 38519880 PMCID: PMC10958876 DOI: 10.1186/s12875-024-02338-z] [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: 08/30/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Patients dealing with severe mental illnesses (SMI) often face suboptimal clinical outcomes and higher mortality rates due to a range of factors, including undetected physical health conditions. The provision of care for individuals with SMI is frequently disjointed, as they engage with diverse healthcare providers. Despite this fragmentation, primary care, particularly general practitioners (GPs), assumes a pivotal role in the care of SMI patients. Our study aimed to delve into the first-hand experiences of GPs in delivering somatic care to SMI patients, concentrating on the challenges they encounter and the strategies they employ to navigate these difficulties. METHODS We conducted in-depth interviews with fifteen GPs, utilizing a semi-structured interview guide, supplemented by ethnographic observations during clinical consultations in general practice. Through inductive coding, interview transcripts and observational field notes were systematically analysed using interpretative phenomenological analysis (IPA). The findings were then deliberated upon within the author group. RESULTS GPs revealed that managing the chronic somatic care of SMI patients posed significant challenges. These challenges encompassed the multifaceted needs of patients, their behavior tied to symptoms, a lack of care continuity, and overarching time constraints. To tackle these challenges, the GPs had devised various strategies. However, all participants underscored the critical importance of having adequate time to properly prepare for, conduct, and follow up on consultations. CONCLUSION The GPs' interactions with SMI patients brought numerous challenges, although treating these patients were concurrently acknowledged as vital and fulfilling. The findings suggest that increased allocated time in general practice consultations for patients with SMI is important to support the somatic treatment requirements of this patient group.
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Affiliation(s)
- Alexandra Brandt Ryborg Jønsson
- Center for General Practice, University of Copenhagen, Copenhagen, Denmark.
- Department of People and Technology, Roskilde University, Roskilde, Denmark.
- Department of Community Health, The Arctic University of Norway, Tromsø, Norway.
| | - John Brandt Brodersen
- Center for General Practice, University of Copenhagen, Copenhagen, Denmark
- Department of Community Health, The Arctic University of Norway, Tromsø, Norway
- Research Unit for General Practice, Region Zealand, Denmark
| | - Susanne Reventlow
- Center for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Christina Svanholm
- Center for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Center for General Practice, University of Copenhagen, Copenhagen, Denmark
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Eilinghoff L, Nguyên VT, Hahn E, Nguyên VP, Lê CT, Lê TTH, Böge K, Mavituna S, Zierhut MM, Schomerus G, Kuehl LK, Ta TMT. Changes in attitudes toward persons with mental disorders after attendance of a psychiatric curriculum among medical students in Vietnam: A cross-sectional study. Asian J Psychiatr 2024; 93:103949. [PMID: 38335892 DOI: 10.1016/j.ajp.2024.103949] [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: 11/06/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024]
Abstract
This study aimed to determine the influence of psychiatric training and hands-on learning with individuals with mental illness on increasing medical students' benevolent attitudes towards psychiatry and psychiatric patients. The cross-sectional study compares medical students' attitudes before and after a compulsory psychiatry curriculum and psychiatric bedside training at Hanoi Medical University with those of non-medical students who have yet to undergo similar training. Two validated scales regarding the attitudes toward psychiatry and psychiatric patients were evaluated. Analysis of the Medical Conditions Regard Scale[1] revealed a significant difference, indicating that medical students displayed more accepting and benevolent attitudes towards psychiatry and psychiatric patients after completing the curriculum and bedside training than medical students before participation. Most stigmatising and rejecting attitudes were found among non-medical students. This study is the first to examine medical students' attitudes toward psychiatry and psychiatric patients compared to non-medical students in Vietnam. It can guide the development of the medical curriculum to increase benevolence towards psychiatric patients and interest in the psychiatric field of work in Vietnam and Southeast Asia, aiming to improve the mental health care sector.
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Affiliation(s)
- Luisa Eilinghoff
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Văn Tuân Nguyên
- Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, Viet Nam
| | - Eric Hahn
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam
| | - Văn Phi Nguyên
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, Viet Nam
| | - Công Thiên Lê
- Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, Viet Nam
| | - Thi Thu Há Lê
- Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, Viet Nam
| | - Kerem Böge
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Selin Mavituna
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Marco Matthaeus Zierhut
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Thi Minh Tam Ta
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Department of Psychiatry, Hanoi Medical University, Hanoi, Viet Nam
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Glassman LH, Otis NP, Kobayashi Elliott KT, Michalewicz-Kragh B, Walter KH. Gender Differences in Psychological Outcomes Following Surf versus Hike Therapy among U.S. Service Members. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:241. [PMID: 38397730 PMCID: PMC10888301 DOI: 10.3390/ijerph21020241] [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: 12/01/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Surf and hike therapies have demonstrated effectiveness as adjunct interventions for service members with major depressive disorder (MDD). This study explores gender differences in intervention outcomes following a pragmatic, randomized controlled trial of Surf and Hike Therapy for service members with MDD (N = 96; men, n = 46; women, n = 50). METHODS Clinician-administered and self-report measures (depression, anxiety, positive affect, negative affect, resilience, and pain) were completed at preprogram, postprogram, and 3-month follow-up; brief measures (depression/anxiety and positive affect) were completed before and after each session. RESULTS Multilevel modeling results showed that anxiety decreased from pre- to postprogram and significantly differed by gender (B = -2.26, p = 0.029), with women reporting greater reductions. The remaining outcomes from pre- to postprogram demonstrated significant improvements that did not differ by gender (ps = 0.218-0.733). There were no gender differences through follow-up (ps = 0.119-0.780). However, within sessions, women reported greater improvements in depression/anxiety (B = -0.93, p = 0.005) and positive affect (B = 3.73, p = 0.001). The change in positive affect scores within sessions was greater for women in Hike Therapy compared to men (p = 0.016). CONCLUSIONS Overall, results demonstrate that both genders benefit from adjunctive Surf and Hike Therapies, but women exhibit a better response in terms of longer-term anxiety and immediate psychological outcomes.
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Affiliation(s)
- Lisa H. Glassman
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA; (N.P.O.); (K.H.W.)
- Leidos, Inc., San Diego, CA 92121, USA
| | - Nicholas P. Otis
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA; (N.P.O.); (K.H.W.)
- Leidos, Inc., San Diego, CA 92121, USA
| | | | | | - Kristen H. Walter
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA 92106, USA; (N.P.O.); (K.H.W.)
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