Changing the attitudes of Hong Kong medical students toward people with mental illness

This study examines the personal and attitudinal variables that are associated with helping behavior in a hypothetical general practice setting. We explored the effect of an antistigma seminar during a psychiatric clerkship on medical students' attitudes toward the mentally ill. We randomly assigned three rotations of students (81 students) to receive the seminar and three rotations (85 students) as controls. The students expressed views about patients with schizophrenia or depressive disorder portrayed in video vignettes. How dangerous the students perceived target individuals to be was the major determinant of helping behavior. The students' gender, religious affiliation, affective reaction, skill assessment, and controllability attribution were less consistent in predicting behavior. Exposure to the seminar and clerkship experience significantly improved attitudes, but attributes of responsibility and readiness to provide medical care for psychiatric patients were the most resistant to change. We identified certain issues that should be highlighted in future antistigma programs.     

Assessing community attitudes toward mental illness

Staff of a Veterans Administration hospital combined recruitment of family-care sponsors with an assessment of community attitudes toward mental illness. They mailed questionnaires to 989 persons in a small community 35 miles from the hospital. Most of the 235 respondents believed that mental illness is caused by a lack either of physical health or of proper nurturing, rather than seeing it as punishment for sins. Respondents were generally optimistic about the chances of recovery. Respondents with no children at home were more receptive to the ideal of accepting a family-care patient, while those with children at home were highly ambivalent. From the responses, the staff were able to locate several family-care sponsors.     

Adolescent attitudes toward serious mental illness

While there is a growing literature on mental illness stigma and strategies for reducing stigma among adults, less is known about how children and adolescents view persons with mental illness. In this paper, we describe the Attitudes Toward Serious Mental Illness Scale-Adolescent Version (ATSMI-AV) and our initial examinations of its factor structure and variations among subgroups of adolescents. Findings suggest that strategies aimed at reducing stigma in this age group would be wise to specifically target categorical thinking about mental health and mental illness and perceptions of persons with mental illness being violent and out of control.     

Current attitudes of medical students and house staff toward terminal illness

A survey questionnaire about attitudes toward terminal illness was administerd to all medical students, interns, and all medical, surgical, and psychiatric residents at the Downstate Medical Center. The majority of students and new physicians surveyed reported that patients with terminal illness should be told their diagnosis—a reversal of attitudes as compared with those revealed by studies done before 1970. Most of the respondents also expressed the view that they would want to be told of their own fatal illness. The attitudes at different levels in medical school, internship, and residency did not differ significantly despite the differences in formal education and clinical experience of the respondents. Implications of these findings are discussed with particular emphasis on the need to teach an individualized approach to the dying patient.     

Stigmatizing attitudes and social perception towards mental illness among Moroccan medical students

ObjectivesThis study aimed to explore medical students’ attitudes, social perception, and knowledge towards mental illness and identify the associated factors.MethodsA cross-sectional study was conducted in the Medical Faculty of Fez. A representative sample of 420 Moroccan students from the first to the seventh years was selected randomly during the academic year (2018/2019). They completed the Mental Illness Clinicians Attitudes scale (MICA) and a self-questionnaire exploring sociodemographic data, the university course, social perception and knowledge towards mental illness, and the potential consideration of psychiatry as a career.ResultsThe average age of participants was 21.73 years (SD ± 2.60), and 72.4% (n = 304) of respondents were female (M/F gender ratio = 0.39). The participants held stigmatizing attitudes and negative social perceptions towards mental illness, as indicated by the high score of the MICA scale (mean = 57.24; SD ± 9.95). Females (p = 0.02) and married students (p = 0.02) showed significantly more tolerant attitudes. The attitudes of students (p = 0.37) who completed the psychiatry clerkship were slightly more favorable (p = 0.15). There was no significant difference in attitudes according to the level of study (p = 0.06). Students with a lower socioeconomic level tended to be less stigmatizing (p = 0.08). The assessment of knowledge about mental illness among students objectified major gaps. A total of 17.9% (n = 75) considered psychiatry as a career.ConclusionThe attitudes of medical students in this study were stigmatizing, and this should without delay motivate Moroccan research, educational and health authorities to investigate further scientific research in this area to address these attitudes and remedies.     

Racial differences in stigmatizing attitudes toward people with mental illness

OBJECTIVE: Stigma is a significant impediment to the successful treatment of individuals with mental illness, especially among racial minority groups. Although limited, the literature suggests that African Americans are more likely than Caucasians to believe that people with mental illnesses are dangerous. The authors reexamined this issue and assessed whether racial differences also extend to beliefs about how people with mental illness should be treated if violent. METHODS: A nationally representative probability sample of 1,241 respondents participated in a telephone survey. The analysis focused on the 81 African-American and 590 Caucasian respondents who participated in a vignette experiment about a person with schizophrenia or major depressive disorder. The authors analyzed respondents' perceptions that the person would be violent, as well as their attitudes about blame and punishment. RESULTS: African Americans were more likely than Caucasians to believe that individuals with schizophrenia or major depression would do something violent to other people. At the same time they were less likely to believe these individuals should be blamed and punished for violent behavior. These racial differences were not attributable to sociodemographic factors. CONCLUSIONS: The study found racial differences in stigmatizing attitudes toward individuals with mental illness; however, African Americans' negative perception did not necessarily result in endorsement of harsher treatment of mentally ill persons. This study highlights the complexity of the stigma process and emphasizes the need to consider racial differences in developing interventions targeted to improve public attitudes.     

Community attitudes toward and knowledge of mental illness in South Africa

Abstract. Background: Although recent advances in psychiatry have increased our understanding of psychiatric disorders,many people with chronic or severe psychiatric disorders may be unaware that effective treatment is available. It is possible that ignorance and stigma prevent such persons from seeking appropriate help, and that community attitudes and beliefs play a role in determining the help-seeking behaviour and successful treatment of the mentally ill. Nevertheless, there is little research on the attitudes of lay persons toward mental illness within the South African community. Objectives: The aim of this study was to investigate the knowledge and attitudes of the general South African public toward mental illness, specifically regarding the causes of illness and treatment options. Method: The study design employed a questionnaire survey. Structured interviews (n = 667) were conducted with members of the general public. One of eight vignettes, portraying depression, schizophrenia, panic disorder or substance abuse, with subtle or obvious symptoms, was presented to each respondent. Results: The main findings were that cases were most often conceptualised as stress-related or due to a lack of willpower rather than as medical disorders. Treatment advocated was more often to talk the problem over than to consult professional medical help. Psychotherapy was the preferred treatment option, particularly in vignettes where symptom presentation was subtle, and in cases of substance abuse. Conclusions: These data suggest that stigma and misinformation regarding mental illness exist, influencing preferred treatment modality and help-seeking behaviour. More work needs to be done to educate the public about the psychobiological underpinnings of psychiatric disorders and about the value of effective treatments. A better understanding of these disorders amongst the public would presumably lessen stigmatisation and encourage the use of currently available and effective interventions.     

Effect of type of cause on attitudes toward mental illness and relationships between the attitudes

The effects of four types of supposedly causative factors on judgements of mental illness, social distance, and prognosis were assessed among university students. Correlations between the components of attitudes were also examined. A vignette format was utilized. Analysis showed that the etiology of the case and the sex of the respondents had no significant influence except for sex in only one social distance item. However, there were statistically nonsignificant tendencies. Correlations revealed few significant relationships between the components of attitudes. The results are considered to be in line with previous research in the sense that attitudes toward mental illness are not highly structured.     

Effects of a one-hour educational program on medical students' attitudes to mental illness

A new 1-h educational program was developed to change attitudes towards mental illness, and was conducted on 95 first-year medical students in order to investigate its effects on their attitudes towards mental illness, using a pre- and postquestionnaire study design. A similar study without the program was conducted on 94 first-year medical students as controls. After the program, more students replied that they would accept former patients on relatively close social distance items. Favorable attitudinal changes were observed in terms of 'psychiatric services', 'human rights of the mentally ill', 'patients' independence in social life', and 'cause and characteristics of mental illness'. In contrast, no significant change was observed in the control group. These results suggest that attitudes towards mental illness could be changed favorably by this program.     

Rural attitudes toward and knowledge of mental illness and treatment resources

The stigma associated with mental illness is purported to be a major factor in the resistance of rural residents to mental health services. Through mail questionnaires and personal interviews, the authors gathered data from 3,057 rural residents in six Midwestern states on their attitudes toward and knowledge of mental illness and mental health services. They also examined the relationships between the demographic characteristics of the respondents and their knowledge and attitudes. In contrast to the findings of several other studies, the rural respondents in this study reported positive attitudes about treatment of mental illness. They expressed a high level of awareness of a variety of mental health services and appeared satisfied with those services. The authors discuss possible reasons for the discrepancies between the findings of this study and the studies reporting negative attitudes.     

Police officers' attitudes toward and decisions about persons with mental illness

OBJECTIVE: A significant portion of police work involves contact with persons who have mental illness. This study examined how knowledge that a person has a mental illness influences police officers' perceptions, attitudes, and responses. METHODS: A total of 382 police officers who were taking a variety of in-service training courses were randomly assigned one of eight hypothetical vignettes describing a person in need of assistance, a victim, a witness, or a suspect who either was labeled as having schizophrenia or for whom no information about mental was provided. These officers completed measures that evaluated their perceptions and attitudes about the person described in the vignette. RESULTS: A 4 x 2 multivariate analysis of variance (vignette role by label) examining main and interaction effects on all subscales of the Attribution Questionnaire (AQ) indicated significant main effects for schizophrenia label, vignette role, and the interaction between the two. Subsequent univariate analyses of variance indicated significant main effects for role on all seven subscales of the AQ and for label on all but the anger and credibility subscales. Significant role-by-label interaction effects were found for the responsibility, pity, and credibility subscales. CONCLUSION: Police officers viewed persons with schizophrenia as being less responsible for their situation, more worthy of help, and more dangerous than persons for whom no mental illness information was provided.     

Distress precipitated by psychiatric training among medical students

The author found that, for 35 (22%) of the 159 medical students who sought consultation with her in a medical school mental health service, their training in psychiatry precipitated the consultation. For 18 of these 35 students, acute anxiety or depression was the problem, and 17 were motivated to explore psychotherapy in response to psychiatric courses and clerkships. The author discusses the causes of conflicts engendered by psychiatric teaching: acute symptoms result from a transitory imbalance in the development of the student's identification with both patient and physician. Recognition of this dual identification can heighten psychiatric teachers' sensitivity to the problems that medical students may experience during psychiatric training.