Educational interventions in secondary education aiming to affect pupils' attitudes towards mental illness: a review of the literature

Dealing with persons who have mental health problems is an issue that many people are likely to face with, whether they are health professionals or not. Positive attitudes towards people with mental illness play a major factor in their quality of life and social inclusion. Since adolescents will become active adult members of their communities in the near future, this paper reviews educational interventions in secondary education and how they aim to affect adolescent attitudes towards mental illness. Twelve studies conducted on the relevant issue have been identified. The results indicate a positive impact on attitudes towards mental illness and improvements in the knowledge of mental health and illness among secondary school pupils. However, the limited number of studies highlights the need for further 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.     

Attitudes towards people with mental illness: a cross-sectional study among nursing staff in psychiatric and somatic care

Stigma and discrimination have been identified as important obstacles to the integration of people with mental illness in society. In efforts to reduce stigma and discrimination, health professionals play an important role as they have frequent contact with and responsibility for treatment and rehabilitation of consumers. The aim of the present study was to investigate attitudes towards mental illness and people with mental illness among nursing staff working in psychiatric or somatic care. The sample consisted of 120 registered or assistant nurses who were interviewed about intimacy with mental illness and attitudes about seven different mental illnesses. The results showed that nursing staff in somatic care, to a higher degree than nursing staff in mental health, reported more negative attitudes with regard to people with schizophrenia as being more dangerous and unpredictable. In contrast, professional experience, intimacy with mental illness and type of care organization were found to be more associated with attitudes to specific mental illnesses concerning the prospect of improvement with treatment and the prospect of recovery. In conclusion, attitudes among nursing staff are in several respects comparable with public opinions about mental illness and mentally ill persons. In order to elucidate if negative attitudes about dangerousness and unpredictability of persons with specific mental illnesses are associated with realistic experiences or with prejudices further studies with a qualitative design are suggested.     

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.     

Victimization of people with enduring mental illness in the community

The deinstitutionalization of care for the mentally ill has been in vogue for about fifty years. Broadly speaking, this transition can be seen to exhibit the following main trends: a dramatic decline in the inpatient population of psychiatric hospitals, coupled with a corresponding increase in community facilities such as psychiatric units in general hospitals, day hospitals, and day centres. It has been claimed that deinstitutionalization ends previously enforced seclusion, enhances human dignity and allows individual privacy. The deinstitutionalization movement has inevitably led both to large numbers of former long-stay patients being cared for in the community and to significant numbers of individuals developing enduring mental illness in the community without ever having had a long inpatient tenure. The findings of recent studies (Gould 1992, Brockington et al. 1993) suggest that there is a positive public attitude towards the mentally ill. However, Kelly (1997), while carrying out Quality of Life research, found that over half of the community-based long-term mentally ill he surveyed reported that they had experienced harassment/victimization. This paper is not a report on the Quality of Life research but a discussion on the theme of victimization that has emerged from the study. The extent of the problem is discussed as are the implications for mental health professionals.     

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.     

Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature

The aim of this paper was to review the existing literature pertaining to stigma, negative attitudes and discrimination towards mental illness, specifically as viewed through the lens of the nursing profession. The results of the literature review were synthesized and analysed, and the major themes drawn from this were found to correspond with Schulze's model identifying three positions that healthcare workers may assume in relation to stigma of mental illness: 'stigmatizers', 'stigmatized' and 'de-stigmatizers'. In this paper, the nursing profession is examined from the perspectives of the first two major themes: the 'stigmatizers' and 'stigmatized'. Their primary sub-themes are identified and discussed: (1) Nurses as 'the stigmatizers': (a) nurses' attitudes in general medical settings towards patients with psychiatric illness and (b) psychiatric nurses; (2) Nurses as 'the stigmatized': (a) nurses who have mental illness and (b) stigma within the profession against psychiatric nurses and/or psychiatry in general. The secondary and tertiary sub-themes are also identified and reviewed.     

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.     

Severe mental illness, statutory supervision and mental health nursing in the United Kingdom: meeting the challenge

Within the United Kingdom a combination of limited resources and public fears about the behaviour of mentally ill people living in the community has led the government to prioritize those with severe mental illness. In support of this legislation has been passed which provides for those mentally ill deemed 'at risk' to be supervized in the community against their will. This supervisory role will be mainly undertaken by mental health nurses. Through examination of relevant British and American literature, this paper argues that mental health nursing at a national level lacks a defined role which the new legislation may provide, thereby enhancing the profession's voice in overall mental health policy formulation. Such a role, however, also poses important questions for mental health nurses' practice, their relationships with users, colleagues and the wider society. Such issues may have unforeseen negative consequences for users. It is argued that the legislation will pose important dilemmas for mental health nurses in these domains. It is argued that a proactive research agenda needs to be established which is relevant and of use to practitioners when confronted with issues in their supervision role. Areas for future research are suggested.     

社区工作人员对待精神疾病的态度及服务需求调查

目的 了解社区工作人员对待精神疾病的态度及服务需求.方法 对131名社区工作人员采用精神疾病有关态度问卷和精神疾病社区康复服务需求感知问卷进行测评分析.结果 社区工作人员对精神疾病的态度总均分为（34.03±7.62）分,总体接纳度为56.7％;在服务形式、服务内容、心理干预、社会功能康复等方面有不同程度的需求.结论 社区工作人员对精神疾病患者的接纳度较低,对社区工作康复需求较高,应对其进行康复技能培训,以提高其康复服务水平.     

Mental health nursing and physical health care: A cross‐sectional study of nurses' attitudes,practice, and perceived training needs for the physical health care of people with severe mental illness

Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however, there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical health care and explore associations with their practice and training. A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n = 585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice regarding cancer screening and smoking cessation. Having received post‐registration physical health‐care training and working in inpatient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post‐registration physical health training or had an additional adult/general nursing qualification. Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognized. However, there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.     

Improving community mental health nurse targeting of people with severe and enduring mental illness: experiences from one English health district

BACKGROUND: Successive governments have urged mental health service providers to target their attentions on people with severe and enduring mental illness (SEMI). However, community mental health teams (CMHTs) in general, and community mental health nurses (CMHNs) in particular, have been criticized for failing to meet this requirement. This paper reports selected findings from a wider study that assessed the impact of an initiative designed to facilitate service targeting: the establishment of registers of patients with SEMI in general practices throughout an English health district. The paper describes changes in the nature of community mental health nursing contacts with a sample of patients on these registers. METHODS: Six general practices were randomly selected from the 65 practices in the district and comparisons made between patients on the six mental health registers who either had, or did not have, community mental health nursing contact. These comparisons related to the year before the establishment of the registers, the year during which they were being established and the year following this. RESULTS: A total of 274 patients were included on the sample registers, with practices varying considerably in relation to proportions of mental health registered patients with community mental health nursing contact. Overall, the number of patients in contact with CMHNs was found to have decreased over time, except for those on level 2 of the Care Programme Approach. CONCLUSIONS: No evidence was found to support the hypothesis that the establishment of the registers had improved CMHN targeting of patients with SEMI. However, findings were inconclusive because shortages of CMHNs and the disruption associated with widespread service reorganization meant the registers were never fully implemented in practices during the study period.     

African American women's beliefs about mental illness,stigma, and preferred coping behaviors

We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment‐seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community‐dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, including family‐related stress and social stress due to racism, is cyclical, and has serious consequences but can be controlled by treatment. Participants endorsed low perceptions of stigma. Major preferred coping strategies included praying and seeking medical and mental health care. Age differences were found in all variables except stigma. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:480–492, 2009     

Development and Psychometric Testing of the Attitudes Toward Mental Illness in Pediatric Patients Scale

PROBLEM:  To develop the Attitudes toward Mental Illness in Pediatric Patients (ATMIPP) Scale measuring nonpsychiatric provider attitudes toward pediatric patients with mental illness.
METHODS:  Responses from 492 nonpsychiatric and 30 psychiatric providers were evaluated for reliability and validity. Cronbach's alpha was used for reliability while factor analysis and known-groups technique were used for validity.
FINDINGS:  The scale's internal consistency was 0.85. Factor analysis revealed three factors (Comfort, Tolerance, and Unbiasness) accounting for 74.5% of the variance. Compared to nonpsychiatric providers, psychiatric providers had significantly more positive attitudes on the ATMIPP ( p < 0.001).
CONCLUSIONS:  The ATMIPP has evidence of reliability and validity for the sampled population.