Abstract
BackgroundStigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. We developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with patients diagnosed with schizophrenia (PDS) using the newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP).MethodsSSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with PDS. Participants were individually allocated to two groups: educational lecture group (56; only attending a lecture on schizophrenia) or contact-based intervention group (59; communicating with PDS and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention.ResultsA total of 4 factors and 27 items were extracted from the exploratory factor analysis to comprise the SSCP. Cronbach’s α of SSCP, social distance at professional pharmacy service (factor I), attitudes towards PDS (factor II), self-disclosure (factor III), and social distance in personal (factor IV) were 0.89, 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were − 9.0 (− 16.0 – − 5.0) in the contact-based intervention group and − 3.0 (− 7.0–1.0) in the educational lecture group, reflecting a significant reduction of stigma levels in the contact-based intervention group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20–39 years or with negligible experience of communicating with PDS at work and/or in private life.ConclusionsSSCP and the educational program for community pharmacists that focuses on communication with PDS were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia.Trial registrationUMIN Clinical Trials Registry (UMIN000043189, registered on January 30, 2021), Retrospectively registered.
Highlights
Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry
Patients diagnosed with schizophrenia account for nearly 50% of all long-term hospitalized patients (≥1 year), and concerns have been expressed over their prolonged hospitalization [1]
A negative stereotype or stigma of mental disorders is rooted among many pharmacists [3, 4] and other healthcare professionals [5, 6] and represents a major barrier to patient support in community-based psychiatry
Summary
Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. A negative stereotype or stigma of mental disorders is rooted among many pharmacists [3, 4] and other healthcare professionals [5, 6] and represents a major barrier to patient support in community-based psychiatry. The stigma attached to mental disorders, schizophrenia, is stronger in Japan than in other countries [7]. Until 2002, the Japanese term for schizophrenia was “seishin bunretsu byo”, which means “split-mind illness”. In 2002, as a way to reduce the stigma caused by the term “seishin bunretsu byo”, a change in naming was decided. Patients should be diagnosed based on their individual recovery processes, as well as symptoms, after being completely overwhelmed by illnesses to lead a meaningful life despite ongoing symptoms and mental challenges
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