Attitudes towards people with mental illness among psychiatrists, psychiatric nurses, involved family members and the general population in a large city in Guangzhou, China.

Bin Sun,Minglin Zhang,Xini Huang,Sha Nie,Ni Fan,Hongbo He,Robert A Rosenheck

doi:10.1186/1752-4458-8-26

Abstract

PurposeStigma towards people with mental illness is believed to be widespread in low and middle income countries.MethodsThis study assessed the attitudes towards people with mental illness among psychiatrists, psychiatric nurses, involved family members of patients in a psychiatric facility and the general public using a standard 43-item survey (N = 535). Exploratory factor analysis identified four distinctive attitudes which were then compared using Analysis of Covariance (ANCOVA) among the four groups, all with ties to the largest psychiatric facility in Guangzhou, China, adjusting for sociodemographic differences.ResultsFour uncorrelated factors expressed preferences for 1) community-based treatment, social integration and a biopsychosocial model of causation, 2) direct personal relationships with people with mental illness, 3) a lack of fear and positive views of personal interactions with people with mental illness, 4) disbelief in superstitious explanations of mental illness. Statistically significant differences favored community-based treatment and biopsychosocial causation (factor 1) among professional groups (psychiatrists and nurses) as compared with family members and the general public (p < 0.001); while family members, unexpectedly, showed far weaker personal preferences for direct personal relationships with people with mental illness than all three other groups (p < 0.001).ConclusionBoth psychiatrists and nurses showed greater support for social integration and biopsychosocial understandings of mental illness than the lay public, most likely because of their training and experience, while family members showed the least positive attitudes towards direct personal relationships with people with mental illness. These findings suggest support for a more extensive, formal system of care that gives family members some distance from the problems of their relatives and support in their care.

Highlights

Sigma and negative attitudes towards people with mental illness have been found to be common worldwide among both trained health professionals as well as the general population [1,2]
The implementation of community-based mental health treatment and the achievement of social reintegration of people with mental illness in Lower Middle Income Countries (LMICs) may depend on the development of positive attitudes towards this often stigmatized population within their families and the general public
This study sought to explore the perceptions about mental illness and the attitude toward the people with mental disorder among participating health care professional, patients’ family members and the general public with ties to the Guangzhou Psychiatric Hospital (GPH)

Summary

Introduction

Sigma and negative attitudes towards people with mental illness have been found to be common worldwide among both trained health professionals as well as the general population [1,2]. The implementation of community-based mental health treatment and the achievement of social reintegration of people with mental illness in LMICs may depend on the development of positive attitudes towards this often stigmatized population within their families and the general public. The Guangzhou Psychiatric Hospital (GPH) was the first psychiatric hospital in China [8] and is currently the largest psychiatric institution in Guangzhou city (population 13 million) and Guangdong province (population 100 million) and provides a useful setting in which to study variation in attitudes towards people with mental illness in a highly urbanized area of Southern China, and, perhaps, in China, more generally, the most populous LMIC in the world.

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