Abstract
BackgroundCare assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China.MethodsIn November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression.ResultsThe mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01).ConclusionThese findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.
Highlights
Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage
All of these CAWs were responsible for delivering various kinds of services to people with mental disorders, for example, schizophrenia, schizoaffective disorder, bipolar disorder, paranoid mental disorders, or mental disorders due to epilepsy
It is worth noting that CAWs in our study mainly provide mental health care to people with Severe mental disorders (SMD), such as schizophrenia, schizoaffective disorder, paranoid mental disorders, bipolar disorder, epilepsy or mental retardation, which is consistent with the “686 Program” [19]
Summary
Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. It is known that mental disorders account for 32.4% of years lived with disability and 13.0% of disability-adjusted life-years and confers a higher mortality risk [2, 3]. Li et al Int J Ment Health Syst (2021) 15:17 there is increasing evidence suggesting that mental disorders account for more than approximately 13% of the global burden of disease [1, 4, 5]. With the development of economy and society in high- income countries, it more common to see a trend to form a balanced care model between specialized hospitals and community care for improving mental health services in highincome countries [9]
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