Attitudes Of Mental Health Professionals Research Articles

Surviving Maternal Incest

Although paternal incest has been well documented and studied, there is very little research on maternal incest, and victims rarely seek help. New clinical evidence suggests that maternal incest occurs at a much higher rate than previously thought. Estimates indicate approximately 5% of sexually abused girls and 20% of sexually abused boys have been victimized by women perpetrators. Myths that discourage the acceptance of male victimization are compounded by the idea of mothers as caregivers and nurturers. The societal taboo surrounding maternal incest can be particularly damaging to victims, resulting in guilt and shame. The attitudes of mental health professionals in regard to myths about maternal incest can promote conditions that either encourage or discourage men or boys from opening up about this type of abuse. This article reviews the prevalence and dynamics of maternal incest, the shame felt by victims and its consequences, treatment approaches, and areas of future research needed.

Perceptions and Attitudes of Mental Health Professionals toward the Mental Health Care Law in Saudi Arabia.

The Saudi Mental Health Care Law (SMHL) was established in 2014; however, no prior study has evaluated mental health professionals' perceptions or attitudes toward it. This cross-sectional study examines these aspects and their associated factors among psychiatrists, psychologists, social workers, and psychiatric nurses in Saudi Arabia (SA). The data were collected from 432 participants using an online electronic survey consisting of four sections, including the Mental Health Legislation Attitudes Scale (MHLAS). Psychiatrists comprised most participants (46.06%), followed by psychologists (36.34%). Most participants were 40 years of age or younger (83.10%). Of the 432 participants, 226 (52.31%) were females. Overall, 28.70% were unaware of the existence of the SMHL. A total of 172 (66.67%) out of 258 participants agreed that the legislation operates well in ensuring treatment for persons who require involuntary admission. There was a statistically significant association between specialty and opinions of treatment efficacy and care benefits of the SMHL (p = 0.031 and p < 0.001, respectively). Official implementation of SMHL in participants' facilities resulted in high MHLAS scores (p = 0.007). Reading or attending lectures and workshops related to the SMHL resulted in high MHLAS scores (p = 0.044 and p = 0.021, respectively). Negative opinions and uncertainty regarding the effect of SMHL on confidentiality were associated with low total MHLAS scores (p < 0.001). This study highlights the need to increase awareness of the SMHL among Saudi Arabian healthcare workers.

Beyond recovery: toward rights-based mental health care - A cluster randomized wait-list controlled trial of a recovery and rights training for mental health professionals with or without first person accounts.

Mental health models grounded in Recovery and Rights are driving the advancement of transformative care systems through multifaceted actions, which encompass Continuing Professional Development. The objective of this work is to evaluate a training activity developed through a participatory process that included people with lived experience of psychosocial distress, their relatives, and mental health professionals. The training focused on alternatives to diagnosis, recovery principles, rights-based care, and peer support. The evaluation followed a cluster randomized wait-list controlled design. Four hundred eighty-eight health professionals from eight care centers were randomized to three experimental conditions: a wait list control, which underwent a one-month interval between the baseline assessment and the training activity, and two experimental groups, with or without first-person accounts, which accessed the training immediately after completing the baseline assessment. The dependent variables measured at all follow-ups were beliefs and attitudes toward mental health service users' rights. One hundred ninety-two professionals completed at least one follow-up and were included in the analyses. We observed different evolutions of experimental and control groups with statistically significant differences for tolerance to coercion and total beliefs and attitudes scores. No differences were observed between the groups with or who attended training activities with or without first person accounts. Upon receiving the training activity, the control group had an evolution equivalent to the experimental groups. The results of this evaluation project provide compelling evidence for the need to expand recovery and rights training activities to reach a larger audience of mental health professionals These training activities hold the potential to positively influence the beliefs and attitudes of mental health professionals, ultimately contributing toward a better future for individuals with lived experience of psychosocial distress.

Attitudes of Spanish mental health professionals towards trans people: A cross-sectional study.

WHAT IS KNOWN ABOUT THE SUBJECT?: The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge, and cultural sensitivity in healthcare. The attitudes of health professionals are mediated by their social context, which can determine their behaviour or attitude towards users. WHAT DOES THE ARTICLE ADD TO EXISTING KNOWLEDGE?: The attitudes of mental health professionals towards trans people are related to variables such as the professional's age, gender, political ideology and religious beliefs. Mental health nursing, psychology and social work are the professions that present more favourable attitudes towards trans people. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The inclusion of a professional perspective that understands sexual and gender diversity among mental health professionals is required. It is necessary to train professionals to promote socio-healthcare based on respect and free from prejudice, discrimination and stigma. ABSTRACT: Introduction The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge and cultural sensitivity in healthcare. Aim Evaluation of the attitudes towards trans people of the professionals who work in the different Spanish mental health services. Method A cross-sectional design was used with a sample of professionals from different professional groups working in mental health units, hospitals and outpatient settings throughout Spain. Results Gender differences were found, with higher values in genderism and sexism among males. Negative attitudes and sexism have also been associated with age and religious beliefs. Mental health nursing, psychology and social work presented more favourable attitudes towards trans people than other mental health professionals. Discussion/Implications for Practice The inclusion of a professional perspective that understands sexual and gender diversity and the acquisition of professional attitudes based on evidence and patient-centred model are basic aspects to promote socio-healthcare based on respect and free from prejudices, discrimination and stigma.

Attitudes of Mental Health Professionals towards Telepsychology during the Pandemic: A Pilot Study.

This pilot study investigated mental health professionals' attitudes towards remote psychological consultations and internet-based interventions. An online survey in Italian and English was administered to a sample of 191 psychologists and psychotherapists to collect detailed information about their professional experience providing online psychological interventions a year and a half after the beginning of the SARS-CoV-2 pandemic. The results did not reveal a statistically significant association between the participants' theoretical approaches and the number of patients treated via the online modality. Overall, most of the participants found advantages to the online setting but also noted critical issues regarding privacy and the ease of integrating new technology into their clinical practice. According to the participants, despite the challenges that must be addressed, telehealth is a viable psychological therapeutic option that is destined to grow in importance in the near future.

Perceived Aetiology of Addiction and Stigmatizing Attitudes of Mental Health Professionals towards Substance Use Disorders Patients

Purpose: The study aimed to investigate the relationship between aetiological beliefs and stigmatizing attitudes of mental health professionals towards substance use patients. It was hypothesized that bio-genetic causal attributions would have a positive relationship with stigmatizing attitudes whereas psycho- social causal attributions would have a negative relationship with stigmatizing attitudes. Method: Correlational research design and purposive sampling strategy was used to collect a sample of 100 mental health professionals (MHPs) both from government hospitals and private addiction centres. Results: Results showed that Bio- genetic causal attributions had a positive relationship with stereotypic attitudes, treatment pessimism and non- permissiveness, however, no significant relationship was observed with moralism and treatment intervention. Also, psycho- social causal attributions had a positive relationship with stereotypic attitudes and moralism whereas no significant relationship was present with treatment pessimism, non- permissiveness and treatment intervention. Conclusion: The study highlights the multifaceted nature of stigma therefore the importance of combined aetiological information in anti- stigma interventions and empirically informed curriculum to reduce stigmatizing attitudes of mental health professionals. Keywords: Perceived Aetiology, Therapeutic Attitudes, Stigmatizing Attitudes, Substance Use Disorders

Evaluating the attitudes of mental health professionals towards trials of MDMA: a randomised vignette trial

ObjectivesTo compare attitudes of mental health (MH) professionals towards trials of methylenedioxymethamphetamine-assisted psychotherapy (MDMA-AP), with a neutrally labelled pharmacotherapy trial.DesignA randomised controlled vignette study design, with experimenters blinded to group...

The attitudes of mental health professionals on the employability of people with mental illness: A different view limiting employment rehabilitation.

ObjectivesMental health professionals are becoming increasingly involved in the process of employment rehabilitation of persons with psychiatric disabilities. However, few studies address the attitudes of these professionals toward the employability of those with mental illness. The aim of this research was to identify differences in the attitudes of medical and non‐medical mental health professionals, as well as to detect any association between attitude scores and the type of professional.MethodsA sample of 140 employees from public and third sector mental health organizations answered a questionnaire using a scale measuring their attitudes and views on the employability of people with psychiatric disabilities. The psychometric characteristics of the scale are provided together with the variations detected in the professionals’ attitudes.ResultsThis research shows that significant differences in the attitudes between medical and non‐medical mental health employees exist and that there is a need for the implementation of educational programs that may help to improve the attitudes of medical professionals toward the employability of people with mental illness.ConclusionThis research indicates the importance of improving the professionals’ attitudes to support people attempting to return to work.

Nutritional Psychiatry: Knowledge, Attitudes and Clinical Practice of Mental Health Professionals

IntroductionIn 2016 the United Nations launched their “Decade of action on nutrition” promoting a healthy and sustainable food pattern. The International Society for Nutritional Psychiatry Research held its first International Conference in 2017. Current evidence in this area consists mainly of association studies, while interventional studies with food supplements or altered diet patterns are starting to emerge.ObjectivesTo our knowledge practice based research on promoting healthy food and investigating the role of medical professionals is scarse in general and especially so in psychiatry. Hence, our research questions were: 1. What is the attitude of mental health professionals with regard to promoting healthy food in their patients. 2. What is the subjective knowledge and attention in training schemes on this topic.MethodsWe conducted a self-made online questionnaire using a 5 point Likert Scale. Surveys were sent out to 50 mental health professionals of our institution, including psychiatrists, psychiatric residents, General Practitioners and Mental Health Nurse Practitioners. Results were analysed with descriptive statistics.Results40 (80%) of the respondents returned the questionnaire. 65% of respondents considered promoting healthy food as a key task for themselves in their daily practice. 45% of respondents believed their patients would be reluctant to follow advice on healthy diet. 62% had sufficient knowledge on the subject to give professional advice, while 65% answered this topic received insufficient attention during their training.ConclusionsIn this survey we found the role of promoting healthy diet deserves more attention in mental health practice and training. Smartphone applications may ameliorate treatment adherence.DisclosureNo significant relationships.

Mental Health Professionals’ attitudes towards trans people

IntroductionSince the emergence of the term “transsexualism” in the Ninth International Classification of Diseases (ICD-9), disciplines related to mental health have contributed to the perpetuation of stereotypical attitudes towards trans people. Recent years have shown the significant prevalence of mental pathology suffered by this group, and the need for specialized training to improve access to the health system.ObjectivesThe main objectives of this research are: (a) to find and analyse the scientific evidence published which assesses the attitudes of mental health professionals towards the trans community; b) to establish the main variables that modify these attitudes, paying special attention to gender, ideology, sexual orientation and previous training or experienceMethodsA systematic review of the literature was conducted following the PRISMA recommendations.ResultsTendency towards more positive and liberal attitudes among professionals than in the general population.Higher values for extreme prejudice among those professionals who attributed gender diversity to a psychological, ethico-moral or religious cause.Association of depathologising practices with belief in the psychosocial nature of diversity, clinical training and interpersonal contact with LGBT people. The following socio-demographic variables were related: being a woman, clinical psychologists, progressive political ideology, professionals who strive to know their own limitations and biases.ConclusionsMore positive attitudes than the general population but still insufficient Specific training in gender diversity and minority issues would be a key element in improving care for transgender people. The attitudes of professionals depend, in part, on the personal characteristics of the therapists.DisclosureNo significant relationships.

Anti-stigma initiatives for mental health professionals-A systematic literature review.

WHAT IS KNOWN ON THE SUBJECT?: Negative attitudes towards mental illness lead to the formation of stigma. Stigma prevents the recovery of people diagnosed with mental illness. There is evidence of stigmatic attitudes towards mental ill health among mental health professionals. Anti-stigma initiatives, such as education and training, may be effective in enhancing or maintaining positive attitudes towards mental illness among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Education and training that is designed and delivered around a specific mental health diagnosis or condition appears an appropriate strategy that could benefit mental health professionals to develop a deeper appreciation and understanding of mental ill health and its impacts on individuals. Consumer involvement in the education and training of mental health professionals regarding the stigma of mental illness is recommended; however, this is an under-explored area of investigation. There is a weak evidence base regarding the long-term sustainability of effects from anti-stigma education and training. This should be addressed via further research in future. WHAT ARE THE IMPLICATIONS FOR PRACTICES?: Anti-stigma initiatives can support mental health professionals to develop stigma-free, recovery-oriented practices in their work. Further, such initiatives can improve the provision of evidence-based quality care for the consumers, facilitating their recovery. ABSTRACT: Introduction Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti-stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited. Aim To identify and analyse scientific literature pertaining to the effectiveness of anti-stigma initiatives regarding mental ill health among mental health professionals. Method A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer-reviewed journals with full-text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria. Results A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti-stigma initiatives were identified through the review, and these had positive impacts on mental health professionals' attitudes towards mental illness, for at least a short period. It was identified that contact-based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general. Conclusions This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti-stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact-based interventions and understanding the longer-term effects of the interventions among homogeneous groups. Full consideration of the varying level of clinical experience and expertise in mental health should guide the development and implementation of anti-stigma initiatives in this context. Implications for practice Anti-stigma interventions can have a positive impact on mental health professionals' knowledge, attitudes and supportive caring for people diagnosed with mental illness. Such anti-stigma interventions may meaningfully support stakeholders to address the impact of negative attitudes on the physical and mental health status of people diagnosed with mental illness. With sustained leadership, effort and reinforcement, it is possible to create workplace cultures that prioritize stigma-free and recovery-oriented behaviours and practices within mental health services.

The soft stigma: hidden manifestations of mental health workers&amp;apos; stigma against people experiencing mental illness

The stigma surrounding mental illness is one of the most intractable obstacles in the mental health field because it has so many causes, some primarily social and some related to other factors. There have been concerted efforts to reduce this stigma, but most of them are directed at the community and not toward mental health workers. Studies have investigated the experience of stigma by users of mental health services and the stigma attitudes of the general public, but little attention has been paid to the attitudes of mental health professionals. This article discussed hidden aspects of this stigma of mental health workers that often go unnoticed despite their harmful effects on patients, workers, and the mental health field in general. Six main manifestations were discussed in this article, which have significant effect on the interactions between the mental health field and the patients. Researching and highlighting these hidden manifestations would raise awareness of mental health workers&amp;apos; actions and language, benefiting society in general.

Knowledge and Attitudes of Mental Health Professionals towards Oral Care of Patients in Zimbabwe

Objective: This study aimed to assess the oral healthcare knowledge, attitudes, and practices among mental health professionals in Zimbabwe. There are numerous dental conditions associated with mental health conditions. It is, therefore, necessary to assess if mental health professionals are prepared to adequately manage and refer such cases where indicated. Methods: This was a descriptive cross-sectional study using convenience sampling to collect data using an online questionnaire administered to mental health professionals from the ten provinces of Zimbabwe. The target sample size was 82. Responses to each of the items in the knowledge and attitudes section were graded on a scale of 0 to 3. Descriptive statistics were performed. Composite scores were computed for knowledge and attitudes with the highest possible score for knowledge being 27 and the highest possible score for attitudes being 12. Open-ended responses in the knowledge section were manually analyzed and used to supplement findings from the closed-ended sections. Results: There were 71 respondents. 60.6% were females, the average (mean) age was 38.78, and the highest reported (mode) working experience was one year. The overall composite score for knowledge was 14.37 out of 27 (53.2%) and the overall composite score for attitudes was 7.66 out of 12 (63.3%). The open-ended section addressing practices revealed that only 1.4% of the respondents had received formal oral healthcare-related training. The rest of the respondents indicated they had no training or did not answer this question. Most respondents are not confident in handling oral health complications and several do not know the appropriate referral pathway. There were suggestions for further training and an increased interdisciplinary approach where oral health professionals work alongside mental health professionals. Conclusion: While the knowledge and attitudes regarding oral care are average amongst Zimbabwean mental health professionals, the practices remain below ideal. There is a need for increased training and a multidisciplinary approach. The formulation of a manual for oral care of mental health patients in the Zimbabwean context is also recommended.

Attitudinal Barriers Hindering Adoption of Telepsychiatry among Mental Healthcare Professionals: Israel as a Case-Study.

Despite proven advantages for the use of telemedicine in psychiatry, mental healthcare professionals have shown deep-seated mistrust and suspicion of telepsychiatry, which hinders its widespread application. The current study examines the attitudes of Israeli mental health professionals towards telepsychiatry and seeks to uncover the effects of experience and organizational affiliation on its adoption. The methodology included qualitative and thematic analysis of 27 in-depth interviews with Israeli mental health professionals, focusing on three major themes—clinical quality, economic efficiency, and the effects on the work–life balance of healthcare professionals. The attitudes of mental health professionals were found to be widely divergent and sharply dichotomized regarding different aspects of telepsychiatry and its suitability for mental healthcare services. However, there was a general consensus that telemedicine may not fulfil its promise of being a panacea to the problems of modern public medicine. In addition, attitudes were related to hierarchical position, organizational affiliation, and personal experience with telepsychiatry. Specifically, organizational affiliation influenced experience with and support for the assimilation of telepsychiatry. The study also revealed the role of organizational leadership and culture in promoting or inhibiting the proliferation and adoption of innovative technologies and services in modern medicine.

Mental Health Professionals' Attitudes Towards People with Severe Mental Illness: Are they Related to Professional Quality of Life?

The present study examines whether attitudes of mental health professionals (MHPs) towards severe mental illness are associated with professional quality of life. The Attitudes towards Severe Mental Illness (ASMI), the Maslach Burnout Inventory (MBI), and the Professional Quality of Life Scale-5 (ProQOL-5) were completed by 287 MHPs in Greece (25.4% males, 74.6% females). The results indicate that MHPs hold predominantly positive attitudes towards people with severe mental illness. Nonetheless, MHPs’ attitudes are deemed to be stereotypical according to ASMI concerning treatment duration, prospects of recovery, and whether patients are similar to other people. Higher scores in emotional exhaustion, depersonalization, compassion fatigue and ProQOL-5 burn out dimension were significantly associated with MHPs’ unfavorable attitudes, whereas higher scores in compassion satisfaction and personal accomplishment were associated with MHPs’ positive attitudes. Assessing compassion fatigue, compassion satisfaction and burnout levels could help identify the processes involved in the development or maintenance of MHPs’ stigmatizing attitudes.

Effect of recovery-based interventions on recovery knowledge and attitudes of mental health professionals, regarding recovery-oriented practice: A quantitative narrative review.

Mental health recovery is an enabling process encouraging consumers to live a productive life, notwithstanding the presence of debilitating symptoms of illness. The recovery model has been integrated into all areas of mental health. However, literature shows that mental health professionals are not equipped to provide recovery-oriented care to consumers. Researchers have recommended recovery-based interventions to develop knowledge, attitudes, and skills to promote recovery-oriented practice in mental health, yet there is a paucity of research regarding the effect of recovery-oriented interventions on the knowledge and attitudes of mental health professionals to improve recovery-oriented practice. Therefore, the purpose of the current review is to understand the effectiveness of interventions on recovery knowledge and attitudes of mental health professionals regarding recovery-oriented practice. The papers were identified through the Population Intervention Comparison and Outcome strategy. The heterogeneity of the selected papers led to a narrative review instead of a systematic review with meta-analysis. The analysis suggested that recovery-based interventions are effective in enhancing the recovery knowledge and attitudes of mental health professionals. Recovery-based interventions have the potential to reduce the use of physical restraints and improve work satisfaction among mental health professionals. The limitations of the studies were the heterogeneity of the selected populations and the absence of strong methodologies to assess the effect of the interventions. Therefore, future investigations should be focused on the effect of interventions on a homogeneous group using randomized controlled trials.

Knowledge and attitude of mental health professionals towards psychodrama as a psychotherapeutic tool

Aim: To understand the attitude and knowledge of mental health professionals towards psychodrama. Materials and Methods: Knowledge and attitude towards psychodrama was studied during a basic psychodrama workshop for 30 mental health professionals, which included psychiatrists, residents of psychiatry, psychologists, social workers and mental health nurses. A specially designed 10 item questionnaire was used for a pre and post-test which evaluated on various aspects of psychodrama to know the attitude and knowledge towards this unique therapeutic tool. Participants were asked to rate their experience of the psychodrama session. Written informed consent was taken from all participants. Results and Discussion: Results showed that in all 10 questions there was a marked, positive change in the post test results. The 3 hours basic course made an impact on attitude and knowledge of psychodrama of all participants. The acceptance of the session, by the participants, delivered an average score of 7.8 on a 10 point scale. Conclusion: Mental health professionals must necessarily undergo workshops on psychodrama in order to bring about positive and impactful results in their clinical applications, which would go a long way in effective clinical therapies. Psychodrama with proper training can have a wide range of clinical applications in various psychiatric settings. Keywords: Psychodrama, Psychotherapy, Knowledge, Attitude.

Determinants of mental health professionals' attitudes towards recovery: A review.

ObjectiveThe attitudes of mental health professionals towards consumers’ recovery are far more pessimistic than what is needed for the recovery-orientation to truly permeate systems of care. It has become pressing to depict determinants for these attitudes and how they evolve during professionalization. This, in the hopes to adjust not only medical education, but also ongoing training of professionals.MethodsA systematic search of PubMed and PsycINFO databases was conducted, yielding a net 15 303 records. Twenty-two publications from specific educational journals and reference lists were added. Finally, thirty-four full texts were read, from which twenty-two articles were included.ResultsFrom the reviewed studies emerged five main determinants: profession, education, age, clinical experience, and nature of the contact with consumers. Traditional clinical placements during residency, negative experiences with acute patients, younger age and the professional attitudes of psychiatrists seem to all be determining factors for professionals’ pessimistic attitudes towards recovery.ConclusionsThis review found specific determinants for attitudes in recovery and four out of five can be acted upon. For a recovery-orientation to be implemented across our mental health system, we formulate recommendations within the Canadian context for revision of curriculum, recovery-specific training, and operationalisation through state/provincial technical assistance centers.

Knowledge and attitudes of Spanish mental health professionals towards advance healthcare directives.

WHAT IS KNOWN ON THE SUBJECT?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences. AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities. However, the use of AHDs as described above is not yet a reality in Spain. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice. Although providers had a moderate-low level of knowledge about AHDs, they presented positive attitudes towards them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up-to-date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process. More in-depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation. The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. ABSTRACT: Introduction Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method We cross-sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing-care technician was associated with stronger positive attitudes. Discussion Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented.

Knowledge and attitudes of mental health professionals and students regarding recovery: A systematic review.

This review was conducted to synthesize and critically appraise the literature on knowledge, attitudes, understanding, perceptions, and expectations of mental health professionals (MHPs) and mental health professional (MHP) students' regarding recovery. A systematic search in Scopus, CINAHL, PsycINFO, Web of Science, Medline, and Embase as well as Google scholar and web-based repositories was conducted. The searches were conducted using a combination of key terms: "mental health professionals", "students", 'knowledge', "understanding", "perception" "attitude", "expectation", "recovery". After screening and quality assessment, the review included 29 studies (18 quantitative, 8 qualitative, and 3 mixed-method studies) published in English, from January 2006 to June 2019, and was analysed systematically using a mixed-method synthesis. The findings revealed that there is increasing evidence (especially among MHPs) of knowledge, attitudes, understanding, perceptions, and expectations regarding recovery. However, there are disparities in how MHPs perceive and understand recovery. While some understood it to mean a personal process, others explained it as a clinical process. In addition, there was limited knowledge among the MHPs and MHP students regarding the nonlinearity nature of the recovery process and expectations regarding recovery. The implications from these findings are the need for more in-service training for MHPs, and examination of the curriculum used to educate MHP students. In particular, they should be sufficiently informed about the nonlinearity nature of the recovery process and how to develop hopeful and realistic expectations for consumers throughout the recovery process. The review was preregistered with PROSPERO (Registration No: CRD42019136543).