Community Mental Health Ideology Research Articles

Impact of gender and age on attitudes towards mental illness in Sweden

Background: Factors such as respondent's sex, age, experience of mental illness and marital status have been found to impact public prejudices toward persons with mental illness. Aims: The impact of respondents’ sex, age, real-life experience and marital status on their attitudes towards mental illness was the focus of this study. Methods: Altogether, 2391 respondents completed the Swedish version of Community Attitudes toward the Mentally Ill, CAMI-S. Their answers were reduced by principal component analysis into four factors: Open-minded and Pro-integration, Fear and Avoidance, Community Mental Health Ideology and Intention to Interact with Persons with Mental Illness. By Structural Equation Modeling (SEM), the relations between public's sex and age on their attitudes toward mental illness on these four factors were assessed. Impact of experience and marital status on attitudes towards mental illness was assessed by analysis of variance (ANOVA). Results: Females were found to hold a greater open-mindedness and were positive to pro-integration, but they were also fearful and avoidant, more so than males, relative to persons with mental illness. With regard to getting older, as age increased, so did open-mindedness and a pro-integration attitude relative to persons with mental illness; on the other hand as age increased, community mental health ideology decreased. As attitudes of open-mindedness and pro-integration improved, so did attitudes representing community mental health ideology. Furthermore, as fear and avoidance increased, attitudes of open-mindedness and pro-integration increased but also the intention to interact with persons subject to mental illness was improved.

P-835 - Attitude toward mental illnessamong medical students: comparison between basic science and clinical medical students

Introduction and objectives Proper attitudes by medical students can impact on the quality of health care delivered to their patients. Negative attitude toward person with mental illness may form a barrier for patients to receive appropriate care. Aim The aim of this study is to determine the attitudes of medical students toward mentally ill and to investigate impact of medical education on attitude among medical students. Method The study comprised 200 clinical &135 basic science medical students at the medical school of Shiraz university who agreed to participate. Community Attitudes towards the Mentally Ill questionnaire were used to assess attitude toward mental illness The tool focuses on measuring levels of authoritarianism, benevolence, social restrictiveness and community mental health ideology. Result There was little difference in attitudes about mental illness Between basic science- and clinical medical student except for restrictiveness (p value Conclusion Our sample overly have positive attitude about mental illness ,but there is no significant positive correlation between years of studying in medical university and attitude about mental illness . Medical school need to develop new curricula to convey scientific information to students and implementing and evaluating suitable programs leading to appropriate attitude development.

Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia

This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland. Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest. A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures. Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level. Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences.

Swedish attitudes towards persons with mental illness

Background: Negative and stigmatizing attitudes towards persons with mental illness must be dealt with to facilitate the sufferers’ social acceptance. Aim: The present study aimed at survey Swedish attitudes towards persons with mental illness related to factors impacting these attitudes. Material and Methods: New CAMI-S based on the questionnaire “Community Attitudes to Mental Illness in Sweden” ([CAMI] Taylor & Dear, 1981) was developed with nine behavioral–intention items and thus comprised a total of 29 items. Of 5000 Swedish people, 2391 agreed to complete the questionnaire. Principal component analysis rendered four factors reflecting attitudes towards the mentally ill: Intention to Interact, Fearful and Avoidant, Open-minded and Pro-Integration, as well as Community Mental Health Ideology. The factors were analyzed for trends in attitudes. By MANOVA, the experience of mental illness effects on mind-set towards the sufferers was assessed. By means of logistic regression, demographic factors contributing to positive attitudes towards persons with mental illness residing in the neighborhood were assessed. Results: By New CAMI-S, the Swedish attitudes towards the mentally ill were surveyed and trends in agreement with living next to a person with mental illness were revealed in three out of four factors derived by principal component analysis. Aspects impacting the Swedish attitudes towards persons with mental illness and willingness to have him/her residing in the neighborhood comprised experience of mental illness, female gender, age (31–50 years), born in Scandinavia or outside Europe, only 9 years of compulsory school and accommodation in flat. Conclusion: The New CAMI-S came out as a useful tool to screen Swedish attitudes towards persons with mental illness. Most Swedes were prepared to live next to the mentally ill.

고용주의 정신장애인에 대한 태도조사

Purpose: The purpose of this study is to investigate employer's attitude towards mentally disabled people. Methods: The Lee (1996)'s questionnaire of community people's attitude on perception for mentally disabled people was used to collect data from 208 employers in Busan City. <TEX>${\chi}^2$</TEX>-test and t-test were used to explore related factors of employer's attitude. Results: Employers having experience of hiring physically or mentally disabled people showed higher CAMI scores (p=.002). Especially, employers having experience of hiring mentally disabled people showed higher scores in four components of authoritarianism, benevolence, social restrictiveness, and community mental health ideology than any other groups. In addition, we found differences in employers' attitude on authoritarianism and benevolence according to types of industries and the number of employees. Conclusion: We could suggest that employers experience of employing disabled and mentally disabled people could improve their positive attitude. Therefore, we call for various efforts and programs development to encourage employers to hire mentally disabled people.

Effectiveness of an Education Program to Reduce Negative Attitudes Toward Persons With Mental Illness Using Online Media

The purpose of this study was to develop an educational program to reduce negative attitudes toward persons with mental illness (PMIs) using online media and to test its effectiveness. A nonequivalent control group with a pre-posttest was employed in this study. A total of 143 lay people were enrolled. The study variables were knowledge and attitudes about mental illness, and social distance. The four domains of attitudes were authoritarianism, benevolence, social restrictiveness and community mental health ideology. Phase 1: In an attempt to develop an educational program, the researcher conducted interviews with lay people and families of PMIs, and reviewed the pertinent literature. Three mental health professionals were consulted after developing the program. The program consisted of eight sessions. Phase 2: Community mental health ideology differed significantly between groups after the experiment. Knowledge tended to increase in the experimental group, while social restrictiveness showed a tendency to decrease. However, the changes were not significant in either case. Authoritarianism, benevolence, and social distance were not significantly different between groups. There was a significant difference in the pattern of change over time for both groups regarding authoritarianism, benevolence, and social restrictiveness. The program developed here was partially effective at changing negative attitudes. The online video program can be used by community mental health nurses to enhance general knowledge and help reduce stigma.

Improving responses to depression and related disorders: evaluation of a innovative, general, mental health care workers training program.

BackgroundAustralian General Practitioners have been beneficiaries of extensive training in mental health care delivery over the last few years but less so other workers who support those with mental illness. Training is needed as it is widely recognised that the most effective interventions to prevent and treat mental disorders are often not readily available. The Mental Health Aptitudes into Practice (MAP) training package is a broad, innovative, interdisciplinary, general mental health training aimed at improving responses to individuals with depression and related disorders. The modular structure of this training program meant that such training could be targeted at those with varied backgrounds. Two hundred and seventy one days of free MAP training was delivered across Victoria in 2004/2005. The evaluation reported here assessed whether changes occurred in the trainees' confidence, mental health literacy, attitudes towards effective treatments, mental health knowledge and skills and community mental health ideology following training.MethodsThese elements were assessed using pen and paper tests prior, immediately following, 6 months after and then 12 months after the training. Trainees' confidence, mental health literacy and social distance were measured using scales that have been used in evaluations of Mental Health First Aid Training. Community mental health ideology was measured using a sub-scale of the Community Attitudes to the Mentally Ill (CAMI) scale. The trainees' knowledge and skills were accessed using instrumentation specifically designed for this evaluation.ResultsFollowing training, participants had more confidence in their ability to work with those who have mental health issues and less desire for social distance from them. Participants' knowledge and skills in relation to the treatment of mental disorders increased. These changes were observed immediately after training. The limited existing evidence suggests these changes were sustained six and twelve months later.ConclusionsMAP training can be used to develop the capacity and capabilities of mental health workers.

Attitudes towards mental illness in Sweden: Adaptation and development of the Community Attitudes towards Mental Illness questionnaire

The main purpose for the expansion of supported community care for persons with serious mental illness in Sweden was to ensure the right for these persons to live as citizens in the community. However, earlier research shows that negative attitudes towards mental illness present an obstacle for social integration of persons with serious mental illness. The aim of this study, conducted in Sweden, was to evaluate an existing instrument's (Community Attitudes towards Mental Illness, CAMI), validity and reliability. An additional aim was to adapt and develop the questionnaire to Swedish circumstances. After translation and modification of the original CAMI, the Swedish version of the questionnaire (CAMI-S) was distributed to all student nurses at three different universities in Sweden. The overall Cronbach's alpha coefficient was 0.90 of the original CAMI-S. A corrected inter-item total correlation excluded 20 items because they showed loading <0.43. The overall Cronbach's alpha coefficient on the 20 items (new CAMI-S) that showed loading, >0.43, was 0.903. A factor analysis of these items revealed that the data could be extracted in three factors labelled as: open-minded and pro-integration, fear and avoidance and community mental health ideology. Finally, in order to reach reliable results in attitude research, it is important to measure the respondent's attitude towards the object in common as well as the respondent's attitude to interact with the object. Accordingly, it is important to add behavioural intention items to the 'new CAMI-S'. Statements exemplifying how something 'ought to be' in an impersonal way have a good degree of stability over time and place.

Attitudes of Ward Attendants Towards Mental Illness: Comparisons and Predictors

In India few studies exist that explore attitudes of mental health professionals, especially psychiatric ward attendants, towards psychiatric illnesses. This study aimed to explore attitudes of psychiatric ward attendants since they work closely with psychiatric patients in the hospital ward, and which may differ given their cultural and social background. Five hundred psychiatric ward attendants were targeted and a 100 sample size chosen based on systematic random sampling. A control group from guardians attending the outpatient department of Central Institute of Psychiatry was selected using the same methods. Attitudes of both groups were assessed using Community Attitudes towards Mental Illness (CAMI) after written informed consent. There were no significant differences noted in Authoritarianism and Benevolence domains of CAMI. However, there were significant differences in the domains of Social Restrictiveness and Community Mental Health Ideology with psychiatric ward attendants scoring higher than the general attendants. Among the socio-demographic variables, there was significant correlation between age, duration of contact and educational background and various domains of CAMI. Psychiatric ward attendants had more positive attitudes than general attendants towards psychiatric illnesses. Socio-demographic variables like older age, higher education and longer duration of contact with the psychiatrically ill predicted more favourable attitudes.

Unitas: The clinic of the street—community mental health in practice

Whatever happened to community mental health? It died. Well, almost. The community mental health movement of the 1960s and 1970s represented a radical departure from the conservatism of the traditional medical model which stressed the biological and intrapsychic origins of mental illness. Community mental health ideology emphasized social, cultural, and environmental factors responsible for mental illness and its prevention. Community mental health downplayed the “cult” of the professional and played up the healing power inherent in the social fields and support structures a person is already embedded in. Emphasis was placed on professionals working collaboratively with and through community caretakers in promoting social adjustment for all in a particular social environment. This article describes how community mental health ideology has been operationalized for over 33 years, serving functioning and dysfunctioning youth through developing their capacities to be caretakers to each other and to younger community children in the form of a symbolic family. The impact of such relationships and the place of the “therapeutic community meeting” or “family circle” as vehicles of therapeutic leverage, are profusely illustrated. Yes, community mental health still lives, even in these times of managed care.

Community mental health care ideology and the mental health care professional

AbstractObjective: To measure the level of commitment by mental health care professionals within the Eastern Health Board to the concept of community mental health.Methods: An adapted version of the Baker-Schulberg Community Mental Health Ideology Scale was administered to a random sample of professionals (psychologists, psychiatrists, psychiatric nurses, community psychiatric nurses, social workers and occupational therapists).Results: Psychiatrists within this study had the lowest scores indicating the least level of commitment, and were also found to focus upon extrinsic issues, such as economic barriers, as possible obstacles to the development of a community mental health service in Ireland.Conclusion: Policy and decision making committees need to address the balance of the mental health care professionals represented on those committees.

Community mental health ideology of preprofessional students.

Adherence to the ideology of mental health was measured in a cluster sample of preprofessional students in four majors: psychology, social work, rehabilitation and health education. Mean inventory scores for the four groups did not differ significantly.

Performance on the Community Mental Health Ideology Scale by executive directors of community mental health centers.

Baker and Schulberg's Community Mental Health Ideology scale was administered to 53 executive directors of community mental health centers. Adherence to community mental health ideology was surprisingly low. Women directors were more community-oriented than men; ideology was not significantly related to age, discipline, or years of experience.

Mental health in a remote community.

A total of 118 persons, 44 male and 74 female, from a Northern Ontario community with a local psychiatric hospital were administered a community mental health attitude scale. The groups were relatives of discharged and current psychiatric patients, citizens with no psychiatric relatives, mental health professionals, and psychiatric patients. Significant differences were noted for educational level, age, and community mental health ideology. Analysis suggests that group membership could be predicted with 67% success for patients and 87% for others. Citizens from the community leaned toward a denial of social freedom and recognition for mentally-ill persons and toward treating them as disparate from the rest of the community.

System Needs for the Rehabilitative Treatment of the Revolving Door Population

The community mental health ideology is closely identified with deinstitutionalization and community psychology in its efforts to maintain as many people as possible in their natural environments. One frequently used means of evaluating the success of the community mental health movement is the examination of recidivism rats and average length of stay per patient admitted to psychiatric facilities. Examination of both U.S. and Canadian rehospitalization statistics has shown a population at risk of frequent rehospitalization. This “treatment resistant” group threatens the perceived effectiveness of the community mental health movement because of its impact on the recidivism measure. The revolving door population presents for service a multiplicity of problems that are of two basic varieties: psychiatric symptoms and social/vocational deficits. Descriptions and explanation of the services required to address these problems are presented. Issues of co-ordination, evaluation and system self-correction are discussed in relation to the seven service functions identified as necessary for improving the community tenure of this marginally functional population. Implementation issues that include key assumptions that must be adhered to by systems personnel, likely failure points in the planning of comprehensive mental health systems, and practicalities of manpower recruitment are discussed. Suggestions for the goals and strategies of the planning of comprehensive service systems for the revolving door population are presented.

Predicting psychotherapy duration from therapists' sex, professional affiliation, democratic values, and community mental health ideology.

Analyzed therapists' scores on the Community Mental Health Ideology (CMHI) and Democratic values scales and their sex and professional affiliation to predict the number of psychotherapy visits of 166 outpatients. A step-wise multiple regression indicated that all variables taken together accounted for 3% of the variance in treatment duration. A four-way analysis of variance revealed only a significant main effect for the CMHI scale. Thus, low-scoring CMHI therapists had significantly more therapy sessions with their clients than high-scoring CMHI therapists. The latter may emphasize briefer treatment approaches that stress outside resources and primary prevention.

Community mental health ideology presented in high school health textbooks: a content analysis.

The present study examined the community mental health ideology presented in high school health textbooks. A content analysis of texts in national use revealed that a hygiene model of mental health predominated. Further, substantial attention was devoted to drugs and alcohol as central issues for high school students, with particular emphasis on prevention through "consumer" education. Community mental health approaches were largely ignored, with brief mention made of the community mental health center as place where one can go to receive individual treatment. Mental illness was consistently presented as an individual's internal problem, unrelated to the social or ecological context of the individual. The findings were discussed in terms of implications for the exposure to mental health received by high school students and in terms of the need for public education about community mental health issues.

Scaling community attitudes toward the mentally ill.

The measurement of public attitudes toward the mentally ill has taken on new significance since the introduction of community-based mental health care. Previous attitude scales have been constructed and applied primarily in a professional context. This article discusses the development and application of a new set of four scales explicitly designed to measure community attitudes toward the mentally ill. The scales represent dimensions included in previous instruments, specifically, authoritarianism, benevolence, social restrictiveness, and community mental health ideology, but are expressed in terms of an almost completely new set of items that emphasize community contact with the mentally ill and mental health facilities. Data from a study of community attitudes about neighborhood mental health facilities in Toronto are used to test the internal and external validity of the scales. Results of the analysis provide strong support for the validity of the scales and demonstrate their usefulness as explanatory and predictive variables for studying community response to mental health facilities.

A regional evaluation of citizen mental health boards.

This is a report of an evaluation of citizen board functioning in an eighty-county region. Included in the study were seven county mental health boards, four state hospital boards, one community mental health center and four metropolitan catchment area boards. Board effectiveness criteria (knowledge of mental health legislation, policy-making effectiveness, knowledge of the community and agency procedures, organizational effectiveness) are related to demographic and ideological profiles for each board. Board effectiveness was measured by the Self-Diagnosis Guidelines (Institute for Voluntary Organizations, 1977). Board ideology was assessed with the Community Mental Health Ideology Scale (Baker & Schulberg, 1969). Results indicated that: (1) boards were generally not representative of their communities; (2) most boards saw themselves as only marginally effective; (3) the low self-ratings of boards were due to deficiencies in crucial areas of board responsibility; (4) there were significant differences in effectiveness among boards; and (5) board members reported less support for community mental health philosophy than some professional groups. Implications of the findings for mental health policy and legislation were drawn.

Relation of community mental health ideology and the community adaptation of formerly hospitalized individuals.

The relationship between community mental health ideology and the evaluation of community adjustment for 54 formerly hospitalized individuals was assessed. The results suggested that, while chronic patients discharged into the community have the capacity to adhere to community mental health ideology, such beliefs were significantly related to their evaluation of post-hospital adjustment. Moreover, how a client felt about this adaptation accounted for 39.4% of the variance. A significant ( r = .29) but weak relation was found between the community mental health ideology scores of the clients and their therapists.