Abstract
BackgroundCare assistant workers as a new pattern of care providers in China play an important role in bridging the mental health treatment gap. Stigma and discrimination against people with mental disorders among care assistant workers is a barrier which adversely influences mental health service delivery. However, programs aimed at reducing stigma among care assistant workers are rare in China.MethodsA total of 293 care assistant workers from four districts of Guangzhou, China were randomly divided into an intervention group (n = 139) and a control group (n = 154). The intervention group received anti-stigma training and the control group received traditional mental health training. Both trainings lasted for 3 h. Participants were measured before and after training using Perceived Devaluation and Discrimination Scale (PDD), Mental illness: Clinicians’ Attitudes (MICA) and Mental Health Knowledge Schedule (MAKS). Data were analyzed by descriptive statistics, t-test, Chi square test or Fisher’s exact test. Multilinear regression models were performed to calculate adjusted regression coefficient of the intervention on PPD, MAKS, and MICA.ResultsThere were significant lower scores on PDD and MICA in the intervention group after training when compared with the control group (both P < 0.001). No significant difference was found on MAKS total score between the two groups after training (P = 0.118). Both groups had better correct identification of schizophrenia, depression and bipolar disorder before and after training.ConclusionsThese findings suggest that anti-stigma training may be effective in reducing the perception of devaluation-discrimination against people with mental illness and decreasing the level of negative stigma-related mental health attitudes among care assistant workers.
Highlights
Care assistant workers as a new pattern of care providers in China play an important role in bridg‐ ing the mental health treatment gap
Care assistant workers consisted of primary health workers, community policemen, community cadres, volunteers and others, all of whom were responsible for different kinds of mental disorders, such as schizophrenia, schizoaffective disorder, paranoid mental disorders, bipolar disorder, mental disorders due to epilepsy, mental retardation with mental
There was a significant lower Mental illness: Clinicians’ Attitudes (MICA) score in intervention group 45.8 (SD = 9.5) after the training when compared with the control group 52.1 (SD = 8.8) (Ab = − 4.34, 95% confidence intervals (CI) from − 6.06 to − 2.62, P < 0.001) after adjusting for education level, care assistant workers, and the baseline scores of the PPD and MICA
Summary
Care assistant workers as a new pattern of care providers in China play an important role in bridg‐ ing the mental health treatment gap. Stigma and discrimination against people with mental disorders among care assistant workers is a barrier which adversely influences mental health service delivery. The shortage of mental health related specialist workers increases the difficulty in delivering mental health care in LMICs. Evidence-based practices recommend task sharing as an effective approach to overcome the treatment gap and to scale up mental health care [8,9,10]. Kakuma et al have given a report about human resources of mental health care, which describes three groups of mental health workforce, such as specialist workers (psychiatrists, psychologists, neurologists, et al.), non-specialist health workers (doctors, lay health workers, caregivers, et al.) and other professionals (teachers, community workers). Trained and skilled non-specialist health workers and other professionals could deliver effective mental health care and relieve human resource crises [11,12,13]
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