Attitudes towards mental illness: testing the contact hypothesis among Chinese student nurses in Hong Kong

This study investigated whether previous contact with mental illness affected the attitudes to mental illness (AMI) of general student nurses in Hong Kong — the contact hypothesis. We employed a quasi-experimental design. We compared the attitudes to mental illness of students who had previous contact with mental illness through having taken a psychiatric secondment with those who had not taken a psychiatric secondment. Also, we compared the AMI of: students who had taken other courses related to mental illness with those who had not; those who had a family history of mental illness with those who had not; and those who lived with a mentally ill relative with those who did not. We found that previous contact with mental illness had no significant effect on the attitudes to mental illness of the students. In other words our findings do not support the contact hypothesis. Our sample expressed positive general attitudes to mental illness when presented with general issues about mental illness. However, their attitudes were less positive when presented with specific issues about mental illness that might impinge upon their daily lives. We discuss the implications of these findings for mental health nursing practice, education and research.     

Mental health nurses' attitudes towards severe perinatal mental illness

Title.  Mental health nurses' attitudes towards severe perinatal mental illness.
Aim.  This paper reports on a study exploring the experiences and attitudes of generic mental health nurses towards care of women with severe mental illness during the perinatal period.
Background.  Severe mental disorder in the perinatal period is a global public health concern. However, there are concerns that mental health nurses other than dedicated perinatal mental health teams may lack knowledge, skills and experience in caring for such disorders, because of their low prevalence.
Methods.  Sixteen generic Registered Mental Nurses working in public adult mental health services participated in three focus groups during 2007.
Findings.  Participants did not perceive any difference between symptoms during perinatal and non-perinatal periods. There were mixed attitudes towards caring for women with severe mental illness in the perinatal period. Fear and anxiety was expressed by the nurses when caring or feeling responsible for the babies of clients. Lack of communication between professional groups and decreased clinical decision-making following the introduction of the Edinburgh Post Natal Depression Scale caused frustration. Confidence was displayed when working with known and trusted colleagues.
Conclusion.  Generic mental health nurses would benefit from more education on perinatal mental health and there may be a need for them to be supported by specialist perinatal mental health practitioners.     

Undiagnosed mental illness in the emergency department

Background

Mental illness affects 8% of the population. The early identification and treatment of mental illness can reduce the progression and complications of the illness.

Objective

The objective of this study was to identify unsuspected psychiatric illness in patients presenting to the emergency department (ED) with non-psychiatric-related complaints. A comparison of the test results and the emergency physician assessments were then compared.

Methods

All consenting and stable patients who presented to the ED with non-psychiatric complaints were given the Mini-International Neuropsychiatric Interview (MINI). It was administered to the patient by a trained research fellow before the patient was seen by the physician. Before the patient's departure from the ED, the research fellow notified the emergency physician of the results of the MINI interview. After the emergency physician was notified of the diagnosis of the MINI, any change in the treatment was reviewed.

Results

A total of 211 patients were enrolled in the study. The majority of patients (55%) tested negative for all undiagnosed mental illnesses. The top diagnoses were as follows: major depression (24%), general anxiety (9%), and drug abuse (8%). Of all those patients who tested positive for an undiagnosed mental illness, only 2% were diagnosed by the ED attending.

Conclusions

The idea that the ED is a good place to identify undiagnosed mental health illnesses was confirmed. The use of an independent test such as the MINI was also shown to be useful to aid the emergency physician in identifying undetected mental illnesses.     

Varying views of life among people with long-term mental illness

The purpose of this study was to explore views of life among people with long-term mental illnesses. The participants' possible cognitive inability to express such views dictated a research design that was both fit for purpose and respectful of their integrity. The study, based on an ethnographic framework, involved photographs and interviews with five women and three men. The participants were the photographers, as well as the authors of their own narratives, and the photographs served as a starting point for the interviews. The interview material was analysed in terms of the phases of interpretation. Four main themes were identified: 'thoughts about God and the meaning of life and death', 'the meaning of relationships with others', 'how animals give meaning to life without demands' and 'the symbolic bearing of objects on life'. These four themes represent key existential issues among people with long-term mental illnesses, but they lack confidants to share or discuss these matters with.     

心理干预对重性精神疾病患者肇事肇祸危险度的影响

目的：探讨心理干预对社区重性精神疾病患者肇事肇祸危险度的影响。方法对603例社区重性精神疾病患者进行肇事肇祸危险度评估,并在常规治疗的基础上于随访时进行社区心理干预,观察1a。干预后再次评定患者的肇事肇祸危险度,并与干预前进行对比分析。结果心理干预后入组患者的肇事肇祸等级构成有显著变化（P＜0．05）,其中精神分裂症患者和初中及以上文化程度患者的肇事肇祸危险等级显著降低（P＜0．01）,精神发育迟滞患者和小学及以下文化程度患者的肇事肇祸危险等级无明显变化（P＞0．05）。结论心理干预能显著降低社区重性精神疾病患者的肇事肇祸危险度,但对精神发育迟滞患者及文化程度低的患者效果不明显。     

Primary care options to prevent mental illness

The common mental disorders, mainly anxiety and depression, constitute a major public health problem, incurring considerable costs in terms of use of health services and time lost from work. Risk factors include low socioeconomic status, poverty and poor housing, as well as stressful life events and difficulties such as demanding child care, separation or divorce, bereavement, loss of employment and caring for a dependant relative. Population approaches are probably necessary to reduce significantly the burden of such mental health problems, but health care measures are far from negligible. Primary care professionals have regular opportunities to identify people at risk of mental health problems and refer them to welfare and social support services (primary prevention). A number of interventions among high-risk groups have been shown to be effective, including problem-solving training and cognitive-behavioural approaches. The most important tasks in primary care are to identify people with depression, alcohol and drug misuse and eating disorders as early as possible in the course of their illness and to institute effective treatment (secondary prevention). Primary care teams should also join in shared care arrangements for patients with chronic disabling mental illnesses, in order to prevent recurrences and relapses (tertiary prevention).     

Attitudes towards mental illness in Sweden: adaptation and development of the Community Attitudes towards Mental Illness questionnaire

The main purpose for the expansion of supported community care for persons with serious mental illness in Sweden was to ensure the right for these persons to live as citizens in the community. However, earlier research shows that negative attitudes towards mental illness present an obstacle for social integration of persons with serious mental illness. The aim of this study, conducted in Sweden, was to evaluate an existing instrument's (Community Attitudes towards Mental Illness, CAMI), validity and reliability. An additional aim was to adapt and develop the questionnaire to Swedish circumstances. After translation and modification of the original CAMI, the Swedish version of the questionnaire (CAMI-S) was distributed to all student nurses at three different universities in Sweden. The overall Cronbach's alpha coefficient was 0.90 of the original CAMI-S. A corrected inter-item total correlation excluded 20 items because they showed loading <0.43. The overall Cronbach's alpha coefficient on the 20 items (new CAMI-S) that showed loading, >0.43, was 0.903. A factor analysis of these items revealed that the data could be extracted in three factors labelled as: open-minded and pro-integration, fear and avoidance and community mental health ideology. Finally, in order to reach reliable results in attitude research, it is important to measure the respondent's attitude towards the object in common as well as the respondent's attitude to interact with the object. Accordingly, it is important to add behavioural intention items to the 'new CAMI-S'. Statements exemplifying how something 'ought to be' in an impersonal way have a good degree of stability over time and place.     

Beliefs towards mental illness in Turkish physiotherapy students

Abstract

Mental health is a new area of specialization for physiotherapists. However, they usually meet patients with psychiatric co-morbidities secondary to other chronic diseases. It is important to explore the beliefs of future physiotherapists regarding mental illness in order to implement effective strategies to avoid possible stigmatizing attitudes that may interfere with the rehabilitation process. Moreover, the psychiatric field should be introduced to physiotherapists as a clinical and research area. Therefore, we aimed to question the beliefs of physiotherapy students regarding mental illness using the Beliefs towards Mental Illness Scale in two different universities in Turkey. The total score of 524 students was 46.5?±?14.5 out of 105 while the Dangerousness Subscale score was 21.2?±?5.8/40; Incurability and Poor Social and Interpersonal Skills Subscale score was 24.2?±?9.3/55 and Shame Subscale score was 1.1?±?1.9/10. Students who had a relationship with an individual having a mental problem and students who had consulted a psychiatrist/psychologist for any mental problem showed more positive beliefs. Future physiotherapists should be informed and trained regarding people with mental illness both to avoid stigma and to be aware of this area in physiotherapy settings. Therefore, it is important to implement new curricula for schools providing physiotherapy education including courses, lectures and clinical practices in the psychiatry field.     

Family history of mental illness and frequent mental distress in community clinic patients

OBJECTIVE: The objective of this study was to investigate the importance of family history of mental illness as a risk factor for self-reported frequent mental distress among patients who use community-based clinics. DESIGN: A cross-sectional survey was distributed to a convenience sample in three community clinics serving largely low-income patients. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables. RESULTSL: In this sample of primary care patients, 27.1% had frequent mental distress. Having a family history of mental illness or substance abuse was found to be associated with frequent mental distress in this population [adjusted odds ratio (OR) = 2.24, P = 0.000]. Also associated with increased odds of frequent mental distress were avoiding medical care owing to cost (OR = 1.86, P = 0.003) and obesity (OR = 1.73, P = 0.006). CONCLUSIONS: Having a family history of mental illness or substance abuse is independently associated with increased odds of frequent mental distress among primary care patients seen in community clinics. Three strategies are suggested for using this information to prevent frequent mental distress: health education via mass communication to the general population of primary care patients being followed in a clinic, health education to at-risk patients, and targeted screening of clinic patients who have the risk factor.     

The politics of knowledge: implications for understanding and addressing mental health and illness

While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to ‘do good’ in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations.     

A role for mental health nursing in the physical health care of consumers with severe mental illness

There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.     

HIV prevention for people with serious mental illness: a survey of mental health workers’ attitudes,knowledge and practice

Aim. The aim of this survey was to investigate the attitudes, knowledge and reported practice (capabilities) of mental health workers concerning humanimmunodeficiency virus (HIV) and other sexually transmitted diseases in people with serious mental illness. Background. People with serious mental illness are at increased risk of HIV and other sexually transmitted infections. Mental health workers have a key role to play in promoting sexual health in this population, but it is unclear how they perceive their role in this work and whether they have the capabilities to deliver sexual health promotion. Design. Cross sectional survey. Methods. A questionnaire was devised and distributed to 650 mental health workers working in a London (UK) NHS mental health service. Results. A response rate of 44% was achieved. Overall, workers reported positive attitudes to sexual health promotion and were knowledgeable about risk behaviours and risk factors for HIV infection. Adherence to glove wearing was good. However, participants’ knowledge about HIV/AIDS in people with schizophrenia was poor and most reported they were not engaged in sexual health promotion activities with people with serious mental illness. Glove wearing was predicted by those who had drug and alcohol training and clinical experience and knowledge of risk factors was predicted by previous health promotion training. No other demographic factors predicted any of the other subscales. Conclusion. Mental health workers require training to provide skills for health promotion regarding sexual health and HIV in people with serious mental health problems. In addition, there needs to be more research on risk behaviours. Relevance to clinical practice. The development of effective interventions to reduce this behaviour.     

Ethnic differences in reported unmet needs among male inpatients with severe mental illness

ACCESSIBLE SUMMARY: ? Literature suggests that ethnic minority groups are disadvantaged within current health care services in the UK. This study attempts to identify the rates and nature of unmet health and social needs across three ethnic groups. ? Inpatients of African ethnicity reported significantly less unmet needs than their White British counterparts. ? Unmet needs in the domains of psychotic symptoms, alcohol use and safety to self differed significantly across the three ethnic groups. ? Inpatients of White British heritage appeared to have more unmet needs and/or were more willing to disclose these compared to other ethnic groups. ? The ability to meet health and social needs is complicated by the presence of antisocial personality disorder and alcohol dependence. ABSTRACT: Health services are failing to meet the needs of ethnic minority groups with severe mental illness in the UK. Understanding these unmet social and health needs will assist service providers in developing culturally sensitive and responsive care pathways. Using a cross-sectional design, 165 service users were recruited from 10 acute inpatient wards across four South London boroughs. Needs were assessed using the Camberwell Assessment of Need Short Assessment Schedule and substance dependence and antisocial personality disorder were measured using the Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test and the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders. African, but not African-Caribbean, heritage continued to predict lower rates of reported unmet needs compared to White British (P < 0.001) following multivariate analysis. Different patterns of unmet needs were observed across ethnic heritage groups. Antisocial personality disorder and alcohol dependence were also independently associated with unmet needs. Consideration of a patient's ethnic identity and comorbidities is essential for effective needs assessment within psychiatric and mental health nursing.     

Educational programs and teaching strategies for health professionals responding to women with complex perinatal mental health and psychosocial concerns: A scoping review

BackgroundMental health and psychosocial concerns such as domestic violence in pregnancy and after birth are significant issues. Maternal health, social and environmental contexts have a direct influence on child development and long-term health. However, midwives, nurses and other health professionals lack confidence and skills in assessing, supporting and referring women with perinatal psychosocial concerns.Aim and objectivesThe aim of the scoping review is to review educational innovations and teaching strategies used to build skills and knowledge in health professionals and students to address psychosocial concerns including perinatal mental health, domestic violence and drug and alcohol misuse.DesignA scoping review was undertaken to help identify the breadth of papers reporting educational innovations and strategies particularly to address psychosocial concerns.MethodFour databases CINAHL, PsychoInfo, PubMed, OvidMedline and the grey literature were searched using a diverse range of terms for papers published in English between January 2009 and December 2020. This yielded 2509 papers and after review, 34 papers were included in the scoping review.ResultsThe 34 papers in this review found a diversity of educational initiatives and strategies delivered either face-to-face, online or in a blended mode addressing the learning needs of health professionals working with women with complex psychosocial concerns. The following characteristics in the papers were examined; focus of education, design and development, length, target audience including interprofessional focus, self-care, sensitive topics, debriefing, involving lived experience consumers and evaluation measures.ParticipantsIn the studies indicated that they benefited from hearing about the individuals’ lived experiences, opportunities for simulated practice and valued interprofessional learning experiences for both content and teamwork. The emergence of virtual modes offered some innovative and engaging ways to create a safe space for psychosocial education. However, the research does not provide guidance as to the best mode of delivery or length of programConclusionThis scoping review provides a broad overview of innovative and diverse educational methods and strategies being used in the nursing, midwifery and health disciplines to engage students and practitioners in learning in the areas of perinatal mental health and psychosocial care. Involvement of lived experience consumers in the design and delivery of education programs can positively impact learners’ knowledge and understandings of sensitive psychosocial topics. These diverse approaches could be used to shape the development and evaluation of future education programs.     

Stigma in the media: Investigating journalism students attitudes towards mental illness

Given the profound role that media play in public opinion, there exists an ongoing necessity to understand the portrayal of mental illness by journalists. There is a plethora of studies that have examined how mental illness is portrayed in the media, but few studies have sought to understand what journalist opinions about mental illness are, and none could be found regarding journalism students’ opinions. This study aimed to bridge this gap by examining journalism student’s attitudes towards mental illness using the Social Distance Scale (SDS). This study adheres to STROBE guidelines for cross-sectional studies. One hundred and seventy-two undergraduate journalism students (n = 172) completed the SDS with findings suggesting that students had moderate stigmatizing attitudes, with varying degrees of stigma present depending on the social context. Positively framed reporting and constructive media coverage surrounding mental illness may be improved by shared communication and education with health professionals who specialize in mental health: mental health nurses.     

Creative writing in recovery from severe mental illness

There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well‐received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority.