Nursing students' beliefs and attitudes towards mental illness: stigmatization, discrimination, and professional influences

The effect of psychiatric nursing students' internships on their beliefs about and attitudes toward mental health problems; a single-group experimental study

The World Health Organization (WHO) is revising the ICD-10 classification of mental and behavioural disorders, under the leadership of the Department of Mental Health and Substance Abuse and within the framework of the overall revision framework as directed by the World Health Assembly. This article describes WHO's perspective and priorities for mental and behavioural disorders classification in ICD-11, based on the recommendations of the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. The WHO considers that the classification should be developed in consultation with stakeholders, which include WHO member countries, multidisciplinary health professionals, and users of mental health services and their families. Attention to the cultural framework must be a key element in defining future classification concepts. Uses of the ICD that must be considered include clinical applications, research, teaching and training, health statistics, and public health. The Advisory Group has determined that the current revision represents a particular opportunity to improve the classification's clinical utility, particularly in global primary care settings where there is the greatest opportunity to identify people who need mental health treatment. Based on WHO's mission and constitution, the usefulness of the classification in helping WHO member countries, particularly low- and middle-income countries, to reduce the disease burden associated with mental disorders is among the highest priorities for the revision. This article describes the foundation provided by the recommendations of the Advisory Group for the current phase of work.

Dear editor We read with great interest the article by Shah,1 which outlines various approaches to increase the exposure of undergraduate medical students to specialties such as psychiatry. While Shah1 makes valid suggestions to tackle this issue without altering the undergraduate medical school curriculum, we believe that there is scope for significant improvements within the curriculum for psychiatry in particular. To initiate this process, the first step may be to acknowledge the intrinsic attitudes of medical students toward psychiatry. Misconceptions among medical students include perceiving psychiatry as emotionally challenging with difficult patients, being taught from an insufficient evidence base, and having a lack of prestige within the medical profession.2 The extracurricular exposure to psychiatry proposed by Shah1 would mainly target students with a pre-existing interest in psychiatry. In comparison, fundamental changes within the psychiatry curriculum of medical schools may have an impact on a larger proportion of the student body. Typically, psychiatry is taught in the later years of medical school. However, an early exposure to this vital specialty can be achieved via the integration of psychiatric components into teaching of other specialties. For example, medical students can be encouraged to adopt a more holistic approach during problem-based learning (PBL) sessions by considering the pertinent psychiatric aspects as learning objectives. McParland et al3 compared the effectiveness of PBL with traditional undergraduate psychiatry teaching at University College London and concluded that students showed better academic performance with the PBL course. In this case, although the attitudes of students toward psychiatry remained largely unchanged, the PBL teaching style enabled more effective learning of the subject, which translated into an improved clinical performance and knowledge base. Additionally, teaching of psychiatric conditions could be incorporated into the preclinical neuroscience course in order to explore the scientific basis of psychiatry. With the development of psychiatric neuroscience, residency training programs in the US have also started placing more importance on neuroscience education within psychiatry.4 Similar incorporation of psychiatry into neuroscience teaching in medical schools would allow students to appreciate the role of neuroscience in psychiatric practice early in their medical training. Importantly, this may also allow misconceptions about psychiatry to be dispelled early in medical school. Furthermore, Manassis et al5 highlighted that initial interest is a major factor influencing the choice of psychiatry as a specialty. Thus, early exposure to psychiatry in medical schools would also enable earlier identification of interested students, who can then be encouraged to pursue psychiatry. Other novel teaching techniques include the use of popular media such as clips from television programs6 to encourage discussion about the widespread presence of mental illness, alongside textbooks to consolidate learning. This was adopted in the development of a seminar program, at the University of Nebraska by McNeilly and Wengel,6 utilizing short vignettes from the television program “ER” to effectively demonstrate the practical applications of psychotherapeutic techniques and communication skills to medical students. Finally, an effective way to enhance the quality of psychiatry placements would be to involve teaching-oriented psychiatrists, without necessarily increasing the length of placements. To support this, a survey conducted among medical students reported that their attitudes toward psychiatry improved with encouragement from senior psychiatrists or if they were particularly inspired by a member of the psychiatric team during clinical attachments.7 Hence, practising physicians may be encouraged to reflect upon their impact on the attitudes of students and their future interest in pursuing psychiatry. We believe these suggestions would ultimately have minimal logistical and financial implications and can be easily incorporated into the curriculum of medical students. As junior doctors, we are highly likely to encounter patients with mental illnesses, as it affects over 25% of the population.8 Therefore, a solid understanding of psychiatry is crucial, regardless of the speciality that we ultimately pursue.

Aim: The aim of this study was to evaluate the relationship between beliefs towards mental illness and psychological help-seeking attitudes of medical vocational high school students. Material and Methods: The sample of this analytical study consisted of 364 students studying at a medical vocational high school from February 1, 2019 to March 31, 2019. Data were collected using Student Information Form, Belief towards Mental Illness Scale and Attitudes toward Seeking Psychological Help Scale-Shortened. Descriptive data were analyzed using Mann–Whitney U-test and Spearman’s rank correlation coefficient test since data were not normally distributed.Results: The mean total Belief towards Mental Illness Scale score of the students was 50.08±17.32. The mean scores of subscales were 22.31±7.66 for dangerousness, 2.12±2.75 for embarrassment, and 50.08±17.32 for desperateness/poor social and interpersonal skills. The mean scores of positive and negative psychological help-seeking attitudes of the students were 46.79±10.51 and 21.33±5.92, respectively. Positive psychological help-seeking attitude was found to have a weak and negative correlation with dangerousness (r=0.131) and desperateness (r=0.107) subscales whereas a weak and positive correlation was observed with the embarrassment (r=0.202) subscale (p0.05). Negative psychological help-seeking attitudewas found to have a moderate and negative correlation with the total Belief towards Mental Illness Scale (r=0.328) scores, embarrassment (r=0.364) and desperateness (r=0.328) subscales whereas a weak and negative correlation was observed with the dangerousness (r=0.159) subscale (p0.05). Conclusion: This study has shown that beliefs of the medical vocational high school students towards mental illness are at a moderate level whereas their psychological help-seeking attitudes are high. Furthermore, students’ beliefs towards mental illness have been found to affect their psychological help-seeking attitudes. In line with these results, we believe that there is a need for studies that will improve students’ beliefs towards mental illness in a positive way.

Background: Mental disorders account for approximately 14% of the global disease burden, as per the World Health Organization estimations. International research has highlighted the pervasive stigmatization and discrimination encountered by individuals with mental disorders, often emanating from medical students and healthcare practitioners. Aim: The primary objective of this study was to evaluate the level of knowledge and attitudes among undergraduate medical students concerning mental disorders. Materials and Methods: This cross-sectional observational study was conducted at PIMSR, Vadodara, involving the participation of approximately 212 students who provided valid informed consent. Demographic data were collected through a Google Questionnaire, while the assessment of knowledge and attitudes was carried out using the Mental Health Knowledge Questionnaire (MHKQ) and the Community Attitude towards Mental Illness (CAMI) scale, respectively. Statistical analysis was performed utilizing SPSS software. Results: Our findings revealed that 15% of participants exhibited a higher level of knowledge regarding mental disorders, while 21.2% displayed a greater degree of public stigma. Notably, individuals with enhanced knowledge demonstrated more favorable attitudes and reduced stigmatization, as indicated by a significant correlation between MHKQ scores and CAMI subscales. Furthermore, participants with a prior history of mental illness exhibited more positive attitudes, as evidenced by elevated scores in benevolence (t = 2.731, P < 0.05) and Community Mental Health Ideology ( t = 2.624, P < 0.05). In addition, those with relatives affected by mental disorders possessed superior knowledge ( t = 2.39, P < 0.05). Conclusion: Our study underscores the imperative to recognize the importance of altering attitudes and perceptions as a means to promote parity for individuals grappling with psychiatric conditions. The cultivation of improved knowledge and heightened awareness concerning mental disorders among healthcare professionals is pivotal in shaping a more favorable and empathetic attitude.

Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan.Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences).Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05).Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment.

Students must have communication skills to communicate their ideas and thoughts. The communication skill of students plays a role in physics learning because it can change the learning situation in a better direction. In addition to communication skills, collaboration skills must also be owned by the students in the learning of physics, one of which is used to conduct observations in groups. The purpose of this research is to know the relationship between communication skills and students’ collaboration skills, especially in physics. This research is experimental and the sample was taken by purposive sampling technique. In the results, there is a very high relationship between communication skills and students’ collaboration. The score students’ communication skills was 0.876, indicating that there was a direct relationship between students’ communication and collaboration skills, where students’ communication skills increase with the increasing of collaboration skill. Additionally, learning used of video tracker software created new knowledge and skills.

Background: The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods: A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May, 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results: Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). 418 (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. 169 (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p &lt; .05). Conclusion: Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment.

Offenders with mental health conditions are often viewed as dangerous and unpredictable. However, there is a large amount of inconsistency reported in attitudes towards this group and little work has focused specifically on the attitudes between community members and police officers. Using a between-subjects design, the current study aimed to explore any differences in perceptions of offenders with mental health conditions in community members and police officers, and to examine if this was impacted upon by police officer experience and gender. The sample consisted of 138 community and police officer participants who completed the Police and Community Attitudes towards Offenders with Mental Illness Scale. A significant difference was found between groups in their attitudes of offenders with mental health conditions; community members were found to hold significantly more positive attitudes then police officers. Level of police officer experience and gender did not have a significant impact on attitudes towards offenders with mental health conditions. The results add to the mixed literature base but provides a fresh insight into current attitudes in the UK. This has implications for offenders with mental health conditions given that community members and police officers are pivotal in successful reintegration and criminal justice outcomes.

Communication skills and mathematical reasoning are one of the goals of mathematics learning. Where communication is defined as the ability to write, read, listen, study, interpret, and evaluate ideas, symbols, terms, and mathematical information. Meanwhile, mathematical reasoning is a brain habit that if developed properly and consistently will make it easier to communicate mathematics both in writing and orally. Therefore, a relevant learning model is needed to optimize, improve, and develop students' communication and mathematical reasoning skills. One of these learning models is the Teams Games Tournament (TGT) type cooperative learning model. The purpose of this study is to find out: (1) Whether the improvement of communication and mathematical reasoning skills of students who obtain learning with the TGT type cooperative learning model is better than that of students who obtain learning with conventional approaches, and (2) What are the attitudes of students towards mathematics learning who acquire learning with the TGT type cooperative learning model. This study is an experimental research with a pretest-posttest control research design of the design group. The population in this study is all students of class XI MAN Darussalam Aceh Besar consisting of five classes. Meanwhile, the sample consisted of two classes, namely the experimental class and the control class which were taken by random sampling. The instruments used to obtain research data are in the form of communication and mathematical reasoning ability tests, and attitude scale questionnaires. The statistical test used to analyze data on improving communication skills and mathematical reasoning is a two-track anava test, while the attitude scale questionnaire is calculated based on percentages. The results of the study show that the overall improvement of communication and mathematical reasoning skills of students who obtain learning with the Teams Games Tournament type cooperative learning model is better than students who acquire learning with conventional approaches. From the results of the student questionnaire, it was concluded that in general, students have a positive attitude towards mathematics learning using the TGT type cooperative learning model

Effective communication as a key component of palliative care requires sufficient knowledge and experience to make nursing interventions successful. This quasi-experimental study was conducted to determine the effectiveness of the COMFORT communication model as an intervention to improve student nurses' communication skills while they are under clinical training in specialist palliative care inpatient units. The population sample included 86 student nurses who were randomly assigned into two groups of 40. The intervention group received training on communication skills using the COMFORT communication model. Nine lectures were delivered online or offline; the lectures lasted between 25 to 60 minutes. The control group received the conventional educational programme about communication with patients and families, according to the curriculum of the bachelor's degree in nursing. Data were collected using the Communication Skills Questionnaire and Communication Skills Attitude Scale and analysed using IBM® SPSS® Statistics 22.0. The findings showed that, after the implementation of COMFORT communication model, there was a statistically significant difference in communication skills between the intervention group (122.95±9.36) and the control group (110.1±8.92). There was also a significant difference in attitudes toward communication skills between the intervention group (90.25±8.86) and the control group (90.85±9.15) (P=0.0001). The findings of the study revealed that the COMFORT Communication model created significant statistical differences in the student's attitude, knowledge and communication skills. Novice nurses sometimes struggle with the level of communication skills needed when caring for patients with an end-stage illness. The implementation of the COMFORT communication model significantly improved communication skills and attitudes toward communication. Due to the need to establish effective communication as the core of nursing practice, the implementation of this training programme is recommended for students and qualified nurses, particularly when providing palliative care.

Background: The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods: A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May, 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and a modified form of the Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results: Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). 418 (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. 169 (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p &lt; .05). Conclusion: Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment.

Stigma in mental illness happens when someone has an unfair attitude or belief about a person with mental health challenges that causes social isolation, social discrediting and reduced likelihood of staying with treatment. The objective of this study is to see the influence of attitude factors and the effect of social media on stigma towards mental patients among public university students. A total of 350 students around the Klang Valley were involved in this study through simple random sampling. The questionnaires used are Stigma and Self-Stigma Scales (SASS), Community Attitude Towards Mental Illness (CAMI) scale and Effects of Social Media Use on Perception on Mental Illness (ESMUPMI). The findings of the study show that the majority of students show a high level of stigma towards mental patients (65%), medium (24%) and low (11%). This study also found that the majority (84%) of students agreed that social media was their main source of information about mental problems; believe that social media sharing about mental illness is accurate (71%) and believe that social media is influential in changing someone's opinion or perception of this issue. In addition, the findings also show that attitudes and social media affect stigma against mental patients (β=0.276 &amp; β=0.157,p&lt;0.01) and the R2 value is 0.206. Therefore, all hypotheses were accepted. On top of that, the government and institutions need to take steps to control the issue of stigma against mental patients in the community considering that mental illness has become the second highest disease in Malaysia since 2020.

The attitudes of medical students towards mental illness are important since these students will be providing care to this group in the future. To assess the beliefs and attitudes of undergraduate medical students regarding mental illness and to compare students at different levels. This descriptive, cross-sectional study was conducted among undergraduate medical students in the College of Medicine, Majmaah University, Saudi Arabia, during the 2018-2019 academic years. Male students were included from Years 3-5 (25 from each year) and 25 male interns using the proportionate stratified random sampling method. The participants responded to the Beliefs about Mental Illness (BMI) Scale and the Attitudes towards Mental Illness Questionnaire (AMIQ). Bonferroni post hoc tests were used to conduct between-group comparisons of the year 3 group, who were at the beginning of their psychiatric training, with the other groups with more training. This revealed significant differences in scores for 11 of 21 items on the BMI Scale (P < 0.05). All questions regarding the 4 vignettes of the AMIQ (substance abuse, depression, psychosis, and obsessive compulsive disorders) showed a significant difference between students in year 3 and those in the other groups who had more psychiatric training (P < 0.05). The current medical psychiatric training positively improved the beliefs and attitudes of medical students towards patients with mental illnesses.