Community Attitudes Towards Mental Illness Research Articles

Stigma and Discrimination Among Professionals in Portuguese Integrated Continuing Care Units: Stigma and Discrimination in ICCUs

Introduction: Stigma surrounding mental illness (MI) poses a significant obstacle to treatment access, hinders recovery, and may lead to suboptimal care. Breaking the chains of prejudice and embracing tolerance are essential steps in fostering understanding and compassion for those living with MI. Aims: This study aims to describe the levels of stigma and discrimination against individuals suffering from MI among professionals in Portuguese Integrated Continuing Care Units (ICCUs). Methods: A quantitative, observational, cross-sectional study involving 163 participants utilized a sociodemographic questionnaire, alongside two assessment instruments – the Attribution Questionnaire (AQ-27) and Community Attitudes Toward Mental Illness (CAMI). Results: Results revealed significant differences in stigma levels based on education (pprejudice = .001; ptolerance = .007) and occupation (pprejudice = .025), higher stigma being associated with lower education levels and specific healthcare occupations (medical assistant). Additionally, a positive correlation was found between age and stigma perception (r = -236, pprejudice = .002; r = -167, ptolerance = .033). Conclusions: The findings underscore the urgent necessity for targeted anti-stigma interventions within Portuguese integrated continuing care units, focusing on mitigating education-based disparities, and addressing specific healthcare occupations that exhibit heightened stigma. Effectively combating stigma among professionals is crucial for fostering a more inclusive and compassionate environment in these care settings.

Pilot study of a manualised mental health awareness and stigma reduction intervention for Black faith communities in the UK: ON TRAC project

BackgroundBuilding partnerships between mental health services and Black faith communities to co-produce culturally tailored interventions is an essential step towards improving access to services and reducing stigma among the Black population. Given that Black faith organisations are considered a primary source of emotional and psychological support they are well positioned as ‘gatekeepers’ for services, to overcome barriers to engagement and build trusting relationships with the Black community. The aim of this paper is to pilot a manualised mental health awareness and stigma reduction intervention for Black faith communities in the UK, and to make an initial assessment of feasibility, acceptability and outcomes.MethodsThis study employed a mixed methods pre–post-design, based upon the Medical Research Council Framework (MRC) for complex interventions, and the Implementation Science Research Development.ResultsThe qualitative assessments indicate that the intervention was found overall to be acceptable and feasible to the Black faith community population. This pilot study did not find statistically significant changes for the Mental Health Knowledge schedule (MAKS), Reported and Intended Behaviour Scale (RIBS), intended help-seeking or willingness to disclose (Attitudes to Mental Illness Survey) measures. However, the direction of all the non-significant changes in these measures suggests positive changes in mental health knowledge, a reduction in participants’ desire for social distance, and greater willingness to disclose personal experiences of mental health problems. A statistically significant improvement in the Community Attitudes towards Mental Illness (CAMI) scale results indicated a lower level of stigmatising attitudes towards people with lived experience of mental health conditions (PWLE), and an increase in tolerance and support towards PWLE after the intervention. Significant improvement in the willingness to disclose measure suggests increased preparedness to seek help amongst participants, a lesser desire for social distance, and greater willingness to engage with PWLE after the intervention. Three key themes, including 9 subthemes were identified from the qualitative data analysis: (i) initial implementation and intention to adopt; (ii) perceived suitability and usefulness of intervention to address cultural issues relating to mental health in the Black community; and (iii) strengthening the capacity of faith leaders.ConclusionsThis ON TRAC pilot study shows that the intervention was feasible and acceptable, and that it has promising positive impacts and next requires larger scale evaluation. These results demonstrate that the intervention was a culturally acceptable way to potentially increase mental health awareness and reduce stigma in Black faith communities.Trial registrationISRCTN12253092.

Perception of Clergymen on the Care and Stigmatization of Persons with Mental Illness in Nigeria

Objectives: This study was designed to investigate clergymen's training, knowledge, perception and experience of mental illness.
 Methods: The study adopted both quantitative and qualitative study designs conducted among a total of 148 student population of the Nigerian Baptist Theological Seminary Ogbomoso. The stratified random sampling technique was used for the quantitative approach using the (Community Attitudes towards Mental Illness (CAMI) scale and the socio-demographic questionnaire while purposive sampling of the respondents was used for the qualitative approach. Data collated for the quantitative technique was analyzed using the Statistical Packages for the Social Sciences (SPSS) version 21.
 Results: The Focused Group Discussions (FGDs) and Key Informant Interviews (KII) respondents believe that all mental illnesses are traceable directly or indirectly to spiritual factors, that certain sociocultural discriminations exist and that the local church is a healing community. The Community Attitudes towards Mental Illness (CAMI) benevolence subscale reveals that 76.4% of them want tax money to be spent on treating mental illness although 57.4% view mental hospitals as prisons. The Social restrictiveness subscale showed that 46.6% did not agree to engage women with a previous history of mental illness as babysitters and 37.2% did not agree to have them as neighbours. On the community mental health ideology subscale; about 70.3% have them live in neighbourhoods although 82.4% of them feel the mentally ill are awkward.
 Conclusions: With improved mental health knowledge; the Baptist clergymen may ensure referral to orthodox medical services, encourage compliance and banish discrimination against the mentally ill crucial for the WHO scale up program in Nigeria.

Mental Health Literacy and Stigma in a Municipality in the North of Portugal: A Cross-Sectional Study.

Portugal has Europe's second-highest prevalence of psychiatric illnesses, and this is the reason why mental health literacy (MHL) and stigma should be addressed. This study aimed to investigate the mental health literacy and stigma levels among different groups of people from Póvoa de Varzim, a municipality in the north of Portugal. Students, retired people, and professionals (education, social, and healthcare fields) were recruited using a convenience sample from June to November 2022. Participants' MHL levels were evaluated using the Mental Health Promoting Knowledge Scale (MHPK), Mental Health Literacy Measure (MHLM) and Mental Health Knowledge Schedule (MAKS). Stigma levels were evaluated using Community Attitudes towards Mental Illness (CAMI) and the Reported and Intended Behaviour Scale (RIBS). A total of 928 questionnaires were filed. The respondents included 65.70% of women, a mean age of 43.63 (±26.71) years and 9.87 (±4.39) years of school education. MHL increased with age, education level and was higher in women (p < 0.001). A higher level of MHL was seen in health professionals (p < 0.001). Findings revealed that older people stigmatized people with mental illness more (p < 0.001), and the female gender stigmatize less (p < 0.001). In addition, results showed that stigma decreased with higher mental health literacy (r between 0.11 and 0.38; p < 0.001). To conclude, specific campaigns that promote mental health literacy should be tailored to specific profiles within this population to address those that have more stigma.

Mental illness stigma and attitudes among university students: descriptive study

Introduction. Social stigma towards mental illnesses provokes discrimination and exclusion. It is important to detect this stigma for its evaluation to establish intervention strategies that respond to needs. Objective. This study has the objective of ascertaining levels of stigma among students from the University of Burgos (UBU) towards people with mental health problems at various university faculties and to analyze the right response in each case. Results. The study involved the administration of the Questionnaire on Community Attitudes towards Mental Illness (CAMI) to a sample of 268 students from 7 educational faculties (Sciences, Health Sciences, Economics, Law, Education, Huma- nities and the Higher Polytechnic School). The results showed that the stigma of university students was influenced by different sociodemographic variables (sex, age, studies and contact with people with mental illness). Conclusions. University students who participated in the study have elevated stigmatizing attitudes towards mental health pro- blems. Direct contact with people with mental health problems prompted less stigmatizing attitudes and, in general, men held the most discriminatory attitudes. Educational interventions must be designed for this population group to reduce stigma and so that stigmatizing attitudes are no longer obstacles to professional and social development.

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

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.

Public stigma profile toward mental disorders across different university degrees in the University of Valencia (Spain).

BackgroundA large proportion of studies carried out in recent years in different populations have shown that stigma toward mental disorders is highly prevalent. In the present study we conducted a comprehensive assessment of stigma to describe and compare stigma toward mental disorders in students enrolled in five different university degrees.MethodsThree hundred and twenty-five students from the University of Valencia (Spain), attending the second term of their first-degree courses in the faculties of medicine, psychology, teaching, economics, and data science participated in this cross-sectional study. Stigma was measured using: the Reported and Intended Behavior Scale (RIBS), the Scale of Community Attitudes toward Mental Illness (CAMI), the Attribution Questionnaire (AQ-27), and the Knowledge about Mental Illness test (KMI).ResultsWe found different patterns of stigma according to gender, the fact of knowing or living with a person with mental disorders and the university degree studied. Overall, women show fewer stigmatizing attitudes than men but similar stereotypes and prejudice toward people with mental disorders. However, the pattern of results across degrees is more complex. Overall, students of medicine, psychology and teaching showed fewer stigmatizing attitudes than students of economics and data science but differences between degrees were more subtle in stereotypes and prejudice toward people with mental disorders.ConclusionOur study suggests the existence of different profiles of stigma in relation to mental disorders in university students. These profiles varied in relation with the degree being studied, gender and already knowing or living with a person with mental disorders.

Involving Persons With Lived Experience to Improve Vocational Students' Stigmatizing Attitudes Toward Mental Disorders: A Quasi-Experimental Study.

Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students' stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest-posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students' negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.

Knowledge of mental health and its correlation with attitudes and behaviors towards people with mental illness in the South West Region of Cameroon

Background: Mental illnesses are one of the health challenges that impose a heavy health burden on patients, families, and society at large due to a general disdain and lack of care in comparison to other illnesses. Objective: This study examined the general public’s knowledge and its relationship to attitudes and behaviors toward mental illnesses in Cameroon’s South West Region. Materials and Methods: This was a cross-sectional study with 400 respondents out of 1500 participants who were recruited via an online survey. The Mental Health Knowledge Schedule (MAKS), Community Attitudes Toward Mental Illness (CAMI), and Reported and Intended Behavior Scale (RIBS) were used to assess knowledge, attitudes, and behaviors toward mental illness, respectively. Sociodemographic information was also gathered. The cutoff points for low, medium and high scores were set at the 25th, 50th, and 75th percentiles of the MAKS, CAMI, and RIBS scores, respectively. Results: The survey was completed by 400 people out of the 1500 consenting participants recruited for the study. Approximately 72 percent of study participants had a high score for public stigma toward people with mental illness. In terms of knowledge, 32.1 percent had little knowledge of mental health, while 62.3 percent reported favorable attitudes toward people with mental illnesses. Tertiary education (β = 0.018, p 0.05), having a close relative/friend with mental illness (β = 0.029, p 0.05), and current or past history of mental illness (β = 0.079, p 0.05) all had a positive impact on knowledge of mental health after multivariate adjustments. Higher MAKS scores (β = 0.142, p 0.001), living in an urban area (β = 0.372, p 0.001), tertiary level of education (β = 0.812, p 0.001), having a close relative/friend with mental illness (β = 0.376, p 0.001), and having a current or past history of mental illness (β = 1.032, p 0.001) were associated with a lower likelihood of stigmatization against people with mental illness (higher CAMI scores). Higher MAKS scores (β = 2.120, p 0.001), higher CAMI scores (β = 1.043, p 0.001), having a close relative/friend with mental illness (β = 0.610, p 0.001), and having a current or past history of mental illness (β = 2.381, p 0.001) all had a significant impact on the positive behavior (higher RIBS scores) towards people with mental illness. Living in a rural area (β = -0.514, p 0.001) and being a non-healthcare worker (β = -0.245, p 0.05) were both associated with lower mental health knowledge. Conclusions: Our findings indicate that people who live in rural areas, non-healthcare workers, and people with a low level of education have poor knowledge, attitudes, and behaviors toward people with mental illness. To improve mental health knowledge, attitudes, and behaviors toward the mentally ill, these groups should be prioritized in health promotion interventions. Keywords: Serum lycopene, Lung cancer, Mortality risk, Cohort study

Advancing research to eliminate mental illness stigma: an interventional study to improve community attitudes towards depression among University students in Singapore

BackgroundAfter decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students.Methods390 university students from a local university in Singapore were voluntarily recruited for the study. The ARTEMIS intervention comprises an educational and social contact component, as well as a question and answer (Q&A) session with experts in the area of mental health. The Community Attitudes towards Mental Illness (CAMI) scale was administered at baseline, post-intervention and at 3-months follow-up. A confirmatory factor analysis (CFA) was conducted.ResultsThe CFA identified a 3-factor model for the CAMI with a decent fit (RMSEA = 0.06, CFI = 0.93, TLI = 0.93, SRMR = 0.06). Favourable shifts in attitudes across the factors were observed immediately after the intervention (p < 0.001). Gender (β = − 1.19, 95% CI: − 2.10, − 0.27, p = 0.01) and nationality (β = − 1.23, 95% CI: − 2.35, − 0.11, p = 0.03) were identified as significant correlates for the community mental health ideology (CMHI) factor. Linear effects indicated that having a close social contact with mental illness observed a smaller decrease in authoritarianism scores from pre- to post-intervention (β = 0.85, 95% CI: 0.18, 1.53, p = 0.01); whereas quadratic effects found a greater decrease in scores from post-intervention to after 3-months for benevolence (β = − 0.34, 95% CI: − 0.52, − 0.16, p < 0.001) and CMHI (β = − 0.22, 95% CI: − 0.45, − 0.002, p = 0.048).ConclusionThe anti-stigma intervention shows promising short-term results across the CAMI dimensions even after adjusting for sociodemographic correlates. However, the intervention did not observe the sustained attitude shifts after 3-months. Recommendations for future anti-stigma interventions were also considered.

Personality and attitudes towards people with mental disorders: Preliminary studies results.

The subject of psychological research all over the world is to understand the factors conditioning relationships between healthy people and people with mental disorders. Authors analysing attitudes towards people with mental disorders emphasize the importance of two types of determinants: personality factors and demographic and social variables. The aim of the research was to determine the interdependencies between personality traits and attitudes towards people with mental disorders, taking into account the moderating role of social distance and demographic and environmental variables. Polish version of Community Attitudes towards Mental Illness (CAMI) - Kwestionariusz Postaw (KP) was used to measure attitudes towards people with mental disorders. Personality traits were measured using the NEO-Five-Factor Inventory (FFI) Personality Inventory by Costa and McCrae-Polish Adaptation, and the polish version of the Social Distance Scale was used to measure the declared social distance. In all, 204 people participated in the research: 133 women and 71 men, aged 18-65 years, living in the Kuyavian-Pomeranian and Greater Poland voivodeships. The results showed that there is a relationship between personality traits: neuroticism, extraversion, openness to experience and agreeableness and an attitude towards people with mental disorders. Social distance, as the proposed moderator, did not significantly change the relationship between the variables. The results of the research have confirmed the important role of personality factors for attitudes, what should be remembered to exploration of presented phenomenon.

Changes in Attitudes toward Mental Illness in Healthcare Professionals and Students.

Mental-illness-related stigma not only exists in the public but also in healthcare systems. Healthcare providers (HCPs) who have stigmatizing attitudes or behaviors might be thought of as a key barrier to mental health service use, and influence the quality of healthcare. Although cumulative projects have been conducted to reduce stigma related to mental illness among HCPs around the world, little is known about whether the attitudes of HCPs toward mental illness have changed over time. Research on this topic is mixed with respect to whether attitudes of HCPs toward mental illness have become more or less positive. The aim of the current study was to help clarify this issue using a cross-temporal meta-analysis of scores on the Social Distance Scale (SDS), Opinions about Mental Illness (OMI), and Community Attitudes towards Mental Illness (CAMI) measures among health care professionals and students (N = 15,653) from 1966 to 2016. Our results indicated that both social distance (β = −0.32, p < 0.001) and attitudes (β = 0.43, p = 0.007) of HCPs toward mental illness have become increasingly positive over time. These findings provide empirical evidence to support that the anti-stigma programs and courses have positive effects on HCPs and can inform future anti-stigma programs focusing on improving the attitudes of HCPs toward mental illness, thereby improving the quality of healthcare provided.

Knowledge, attitude and behaviors towards patients with mental illness: Results from a national Lebanese study.

ObjectivesPatients with mental health disorders often have to endure the burdens of the condition itself and the stigma that follows. Since no study has been conducted in Lebanon on this topic, our objective was to assess the knowledge, attitude and behaviors towards public stigma of mental health diseases, among a sample of the Lebanese population.MethodsA cross-sectional study, conducted between November 2017 and May 2018, enrolled 2289 participants. The Mental Health Knowledge Schedule (MAKS), the Community Attitudes toward Mental Illness (CAMI) and the Reported and Intended Behavior Scale (RIBS) were used to assess knowledge, attitude and behaviors toward mental illness respectively. The 25th, 50th and 75th percentile of the MAKS, CAMI and RIBS scales scores were considered as cutoff points for low, medium and high scores respectively.ResultsA high knowledge score was found in 33.0% of the participants, whereas a high attitude score and a higher behavior score were found in 32.2% and 26.9% of the participants respectively. Living in North Lebanon (Beta = 1.331) and being familiar with a non-close person with mental illness (Beta = 0.811) were associated with higher knowledge of mental illness (higher MAKS score), whereas living in Bekaa (Beta = -8.693) and being 70 years old and above (Beta = -5.060) were associated with lower knowledge toward mental illness (lower MAKS score). Higher knowledge of mental illness (higher MAKS score) (Beta = 0.670), having a high level of education (university (Beta = 8.785), secondary (Beta = 6.084) and technical (Beta = 5.677)) were associated with less stigmatizing attitudes (higher CAMI scale). Being familiar with close people with mental illness (Beta = 0.577), less stigmatizing attitudes (higher CAMI scale) (Beta = 0.077) and higher knowledge of mental illness (higher MAKS score) (Beta = 0.115) were associated with higher favorable behaviors (higher RIBS score), whereas knowing a non-close person who have a mental illness (Beta = -0.720) was associated with lower favorable behaviors (lower RIBS score).ConclusionA mass media awareness campaigns that could transmit health messages to a wide public audience in the country to fight stigma toward mental illness, seems warranted.

Stigma toward people with mental health problems in Indonesia.

IntroductionMental health problems are serious issues in Indonesia. The prevalence of severe mental disorder in Indonesian population is 1.7‰. In community, people with mental disorder are often stigmatized, while in fact this stigmatization could negatively impact them. One of the most common form of discrimination toward people with mental disorder is the practice of pasung.MethodThis research conducted a survey study on 1,269 respondents in East Java (in which the prevalence of severe mental disorder is 2.2‰). The instruments used were Community Attitudes towards Mental Illness (CAMI), Mental Health Knowledge Schedule (MAKS), and a sociodemographic questionnaire.ResultThe result shows that better knowledge about mental health was associated with lower public stigma toward people with mental disorder. Significance differences in stigma toward people with mental illness were also found across groups of age, sex, experience of contact, history of mental disorder, attitude toward pasung, marital status, and income level.ConclusionThe finding implies that anti-stigma interventions in Indonesia should consider associated sociodemographic factors and use psychosocial approach to improve literacy and contact with mental health patients.

Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools.

We aimed to assess whether short video interventions could reduce stigma among nursing students. A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.

Are social networks useful to challenge stigma attached to mental disorders? Findings from the time to change social marketing campaign 2009–2014

IntroductionThe new channels of communication as social media (e.g. Facebook and Twitter) and the social marketing campaign (i.e. campaign focused on enabling, encouraging and supporting behavioural changes among target audiences) can represent useful strategies to challenge stigma attached to mental disorders.ObjectivesTo evaluate the efficacy of the social marketing campaign of the time to change (SMC-TTC) anti-stigma programme on the target population in England during 2009–2014.AimsTo assess the impact of the SMC-TTC anti-stigma programme in terms of:– use of the social media channels;– levels of awareness of the SMC-TTC;– changes in knowledge, attitude, and behaviour related to mental disorders.MethodsParticipants completed the mental health knowledge schedule (MAKS), the community attitudes toward mental illness (CAMI) and the reported and intended behaviour scale (RIBS), together with an ad-hoc schedule on socio-demographic characteristics.ResultsIn total, 10526 people were interviewed, it was found a growing usage of the SMC-TTC media channels and of the level of awareness of the campaign (P &lt; 0.001). Being aware of the SMC-TTC was found to be associated with higher score at MAKS (OR = .95, CI = .68 to 1.21; P &lt; .001), at “tolerance and support” CAMI subscale (OR = .12, CI = .09 to .16; P &lt; .001) and RIBS (OR = .71, CI = .51 to .92; P &lt; .001), controlling for confounders.DiscussionIn the general population, SMC-TTC has been found to be effective in improving attitudes and behaviours towards people with mental disorders.ConclusionsConsidering these promising results obtained in England, social media can represent the possible way forward for challenging stigma. The future on-going evaluation of the SMC-TTC may further shed light on the essential role of social media in reducing of stigma and discrimination.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009–2014 Time to Change programme

BackgroundIn England, during 2009–2014 the ‘Time to Change’ anti-stigma programme has included a social marketing campaign (SMC) using mass media channels, social media and social contact events but the efficacy of such approach has not been evaluated yet. MethodsThe target population included people aged between mid-twenties/mid-forties, from middle-income groups. Participants were recruited through an online market research panel, before and after each burst of the campaign (with a mean number of unique participants per each burst: 956.9±170.2). Participants completed an online questionnaire evaluating knowledge [Mental Health Knowledge Schedule (MAKS)]; attitudes [Community Attitudes toward Mental Illness (CAMI)]; and behaviours [Reported and Intended Behaviour Scale (RIBS)]. Socio-demographic data and level of awareness of the SMC were also collected. ResultsA total of 10,526 people were interviewed. An increasing usage of the SMC-media channels as well as of the level of awareness of SMC was found (P<0.001). Being aware of the SMC was found to be associated with higher score at MAKS (OR=0.95, CI=0.68 to 1.21; P<0.001), at ‘tolerance and support’ CAMI subscale (OR=0.12, CI=0.09 to 0.16; P<0.001), and at RIBS (OR=0.71, CI=0.51 to 0.92; P<0.001), controlling for confounders. ConclusionThe SMC represents an important way to effectively reduce stigma. Taking into account these positive findings, further population-based campaigns using social media may represent an effective strategy to challenge stigma.

Attitudes of Primary Care Health Workers Towards Mental Health Patients: A Cross-Sectional Study in Osun State, Nigeria.

World Health Organization (WHO) recommends integration of mental health services into primary health services; however attitude of primary health care workers is one barrier to this. A cross sectional survey using the Community Attitudes towards Mental Illness (CAMI) was done. One hundred and twenty primary care workers were randomly selected from three local government areas. Descriptive and inferential statistics were used in analyses. The results showed that most primary health care workers hold a benevolent (mean = 2.47, SD = 0.52) attitude towards the mentally ill. Workers with 10years or more experience tend to have less authoritarian (t = 3.19, p = 0.01) and less social restrictive (t = 3.90, p = 0.01) attitudes towards the mentally ill. There were no significant differences in attitude by gender, marital status, or designation of health care workers. The study showed that primary care workers have attitudes similar to that seen in the general population.

Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents.

To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness (CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.

The Attitudes of the Police towards Persons with Mental Illness: A Cross-sectional Study from Benin City, Nigeria

In developing countries, the police are often required to intervene in matters relating to the mentally ill. They also constitute an important point in pathways to care. Negative attitudes towards the mentally ill limit the effectiveness of the police in facilitating care. This study sought to determine the attitudes of police officers and men towards individuals with mental illness as a way of guiding the development of appropriate anti-stigma interventions. A cross sectional study of police officers and men (n=219) was undertaken between July and August 2012 in Benin- City, Nigeria, using the self-administered Community Attitudes towards Mental Illness (CAMI) questionnaire. Negative attitudes were prevalent among the police surveyed. They were authoritarian and less benevolent in their views regarding mental illness and the mentally ill. They were also majorly against ideas to incorporate mental health care in the community. Married policemen and those with greater than 12 years of formal education were found to be more benevolent in their attitudes towards the mentally ill. Clearly, anti-stigma campaigns involving educational sessions are needed in the Police force.