Intended Behaviour Scale Research Articles

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

Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries

The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students’ responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1–4 grades, 189; 5–6 grades, 68); 268 Turkish (females, 43.3%; 1–4 grades, 90; 5–6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1–4 grades, 312; 5–6 grades, 138); 512 Azerbaijani (females, 24%; 1–4 grades, 468; 5–6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1–4 grades, 208; 5–6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.

Knowledge, attitude and behaviours toward people with mental illness among Tunisian nursing students and nonhealth care students: A cross-sectional study

BackgroundAlthough being in the frontline of healthcare and having a crucial role in the reduction of stigma, evidence has shown that nurses and undergraduate nursing students hold unfavourable attitudes toward mental illness. There is, to our knowledge, no previous study that explored attitudes toward mental illness among nursing students in Tunisia, nor in North African countries. AimWe aimed to assess stigma in nursing students as compared to nonhealth care students, and the relationship between stigma and education variables in the nursing students group. MethodsThe 'Community Attitudes toward the Mentally Ill', the 'Mental Health Knowledge Schedule', and 'Reported and Intended Behaviour Scale' were administered to 255 nursing students and 332 nonhealth care students. FindingsDespite nursing students being more knowledgeable about mental disorders than nonhealth care students; they held significantly more stigmatising attitudes toward people with mental disorders in two dimensions: Authoritarianism and Community mental health ideology. After controlling for confounders, we found that having taken mental health courses significantly predicted more favourable attitudes toward people with mental disorders and better knowledge of mental health stigma. Being interested in working in psychiatric wards helped predict more favourable attitudes and intended behaviours. DiscussionIn general, results from this study are of concern as it presents evidence of an overall similar or even greater tendency to negative attitudes toward mental illness among nursing students than among nonhealth care students. ConclusionThere is an urgent need for antistigma interventions in nursing schools. These interventions should target nursing students with the most negative attitudes, including male students and those who have never had personal experience with mental illness. Interventions should also work to build up nursing students’ interest in mental health nursing during their undergraduate years.

Stigma Towards Mental Illness at an Academic Tertiary Care Center in Lebanon

ObjectiveIndividuals with mental illness may fall victim to stigma. In this cross-sectional study, the authors aimed to explore correlates of stigma towards mental health in a Lebanese private university and its associated tertiary medical center.MethodsThe authors surveyed students, staff, and faculty at the American University of Beirut and its associated medical center. They assessed stigmatizing behaviors via the Reported and Intended Behavior Scale (RIBS), perceived stigma via the Perceived Devaluation and Discrimination Scale (PDDS), and attitudes towards collaborating with mental health professionals via the Doctors’ Attitudes toward Collaborative Care for Mental Health (DACC-MH).ResultsA total of 270 participants (response rate of 18%) provided their responses. The mean scores on the RIBS and PDDS were 15.26 ± 4.75 and 32.25 ± 2.70, respectively. Participants who had higher scores on RIBS were more likely to be younger than 25 years of age (OR=1.869; p=0.026), to have a history of mental illness (OR=2.657; p=0.003), and to interact with individuals with a psychiatric disorder (OR=2.287; p=0.028).ConclusionsResults show a mixed pattern of stigmatizing behaviors and perceptions towards mental illness. This highlights the need for mental health awareness campaigns and interventions in the country.

Development and validation of the Brazilian Portuguese Version of the Reported and Intended Behaviour Scale (RIBS-BP).

The object of the study was to translate and validate the Reported and Intended Behaviour Scale (RIBS) into Brazilian Portuguese. A native Brazilian speaker fluent in English translated the RIBS into Brazilian Portuguese. Comprehensibility and face validity were assessed through discussions with mental health professionals and volunteers recruited from the community. Brazilian Portuguese version of the questionnaire was back-translated into English by another Brazilian researcher fluent in English and the researcher who developed the original RIBS was consulted to check the adequacy of the questionnaire translation, and approved the final translated version. RIBS-BP was administered to 1,357 caregivers from a community-based cohort. Internal consistency and factor loading were assessed through confirmatory factor analysis (CFA). Differential item functioning was examined using Multiple Indicator Multiple Causes for subgroups of gender, socioeconomic status, and caregiver education. To assess external validity, we examined whether responses in RIBS-BP varied among these subgroups, considering respondents’ previous contact with people with mental illness. CFA fit indices were good to excellent (root mean square error of approximation [RMSEA] = 0.07; 90% confidence interval, CI [0.04, 0.10]; comparative fit index [CFI] = 1.00; Tucker-Lewis Index [TLI] = 1.00). All loadings were above 0.4 (0.73 to 0.89), indicating that intended behavior items are related to the same unidimensional latent factor. In the latent model, higher socioeconomic status was associated with less intended stigma-related behavior (β = 0.20, p <.001), adjusted for education and gender. RIBS-BP has good internal consistency, demonstrate measurement invariance among subgroups, and appears to be a valid measure of stigma, representing a suitable tool to assess reported and intended stigma-related behaviors in Brazil. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

The relationship between stigma and help-seeking intentions in college students

IntroductionFew people seek mental health care despite the high prevalence of mental illnesses and their serious consequences. Barriers explaining this lack or absence of help-seeking have been the subject of several studies with stigma being the most prominent barrier.ObjectivesWe aimed to assess the relationship between stigma and help-seeking intentions in a sample of Tunisian college students.MethodsThis was a cross-sectional survey. The “Mental Health Knowledge Schedule”, and the “Reported and Intended Behavior Scale” were administered to a total of 714 college students (62.2% female; mean age =20.9).ResultsMore than one-third of students (39.6%) felt that it would be “unlikely” or “very unlikely” to seek the help of a health professional for mental health problems. Pearson product moment correlations indicated that help-seeking intentions significantly and positively correlated with behavior (p&lt;0.001, r=0,103) and knowledge (p&lt;0.001, r=0,163). The multiple hierarchical linear regression analysis found that after controlling for demographic variables (gender, age) and other personal-related variables (marital status, family income, living environment, substance use, personal psychiatric history), help-seeking intentions were significant contributors to behaviors and knowledge.ConclusionsGiven that stigma and discrimination against people with mental illness is a real and perceived barrier to seeking help and treatment, psycho-educational campaigns should be put in place to address the negative perceptions and attitudes of the general population about mental health issues, and should be tailored to the needs of specific groups (including students in different disciplines), taking into account their attitudes, fear and concerns about mental illness.

Behavior of general population toward mentally ill persons in Digital India: Where are we?

Background:We aimed to find out the overall reported and intended behavior of the general population of India toward mentally ill persons.Materials and Methods:Participants were included in an online survey using a nonprobability snowball sampling technique. After taking informed consent, sociodemographic details were recorded, and the “Reported and Intended Behaviour Scale” was administered.Results:Out of 818 responses, 684 responses were eligible for study after exclusion. The mean age (standard deviation) of the study population was 31.01 (7.79) years. Maximum participants reported that they did not live (76.6%), did not work (75.7%), did not live nearby (66.4 %), or have not had a close friend (79.8%) with mental health problems. However, most individuals neither agreed nor disagreed to live (48.5%), work (38%), and live nearby (42.7%) a mentally ill person, but maximum individuals strongly agreed to continue a relationship with a friend having mental health problems (34.5%). There were 77.5% males and 32.2% healthcare workers. Regarding intended behavior, there was a significant difference between healthcare workers and persons other than these as well as between males and females. Participants who had previous interaction with the mentally ill person were more willing to interact with the same.Conclusion:Most people do not intend to have stigmatized behavior toward mentally ill persons. Healthcare workers and males have less negative social reactions toward mentally ill persons in different domains of life. However, there is still a need to intensify awareness about mental health.

Mental health stigma in Ukraine: cross-sectional survey.

This study aimed to assess among Ukrainian adults: (1) knowledge of mental disorders; (2) attitudes towards people with mental health disorders, and to the delivery of mental health treatment within the community; and (3) behaviours towards people with mental disorders. A cross-sectional survey of Ukrainian adults aged 18-60 was conducted. Stigma-related mental health knowledge was measured using the mental health knowledge schedule. Attitude towards people with mental health disorders was assessed using the Community Attitudes towards Mental Illness scale. The Reported and Intended Behaviour scale was used to assess past and future intended behaviour towards people with mental health disorders. Associations between gender, age, and educational level and the knowledge and attitudes measures were identified. There was evidence of a positive association between being male and positive intended behaviours towards people with mental health disorders [mean difference (MD) = 0.509, 95% confidence interval (CI) 0.021-0.998]. Older age was negatively associated with positive intended behaviours towards people with mental health disorders (MD = -0.017, 95% CI 0.0733 to -0.001). Higher education was positively associated with stigma-related mental health knowledge (MD = 0.438, 95% CI 0.090-0.786), and negatively associated with authoritarian (MD = 0.755, 95% CI 0.295-1.215) attitudes towards people with mental health problems. Overall, the findings indicate a degree of awareness of, and compassion towards, people with mental illness among Ukrainian adults, although this differed according to gender, region, and education level. Results indicate a need for the adoption and scaling-up of anti-stigma interventions that have been demonstrated to be effective.

Knowledge, attitude and behaviours toward mental illness and help-seeking in a large nonclinical Tunisian student sample.

Mental disorders are widespread among students. However, mental health help-seeking remains low. Several reviews and meta-analyses have shown that the main barrier to seeking help from mental health professionals is stigma. This paper aimed to assess stigma in a sample of students, and its association with help-seeking intentions and comfort with disclosing a mental illness. The 'Community Attitudes toward the Mentally Ill', the 'Mental Health Knowledge Schedule', and the 'Reported and Intended Behaviour Scale' were administered to a total of 714 college students (62.2% female; mean age=20.9). We found that 43.8% of students agreed that one of the main causes of mental illness is a lack of self-discipline and willpower, 21.9% did not consider depression as a mental illness, and 39.6% felt that they would be 'unlikely' or 'very unlikely' to seek the help of a health professional for mental health problems. Females had higher scores in help-seeking intentions (p < .001) and knowledge of mental illness (p=.019). Students' age negatively correlated with knowledge (p < .001, r=-.147). Pearson correlations indicated that help-seeking intentions positively correlated with more favourable future intentions of being in contact with a person with a mental illness (p< .001, r= .103) and greater mental health knowledge (p< .001, r= .163); and that comfort with disclosing significantly and negatively correlated with attitudes (p < .001, r=-.125). To date, few young people see mental health professionals as a preferred source of support, and action is needed to change this perception or reform mental health services to make them more attractive to this age group.

Public Stigma, Knowledge and Behaviors of the Attendees of Outpatient Clinics towards People with Mental Illness, Jeddah, Saudi Arabia

Background: Mental stigma represents a critical obstacle for delivering mental health care.&#x0D; Aims: To determine public stigma, knowledge &amp; behaviors of the attendees of outpatient clinics towards People with Mental Illness (PWMI), King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.&#x0D; Methods: A cross-sectional study was done in 2018. A sample of 600 attendees of outpatient clinics of KAUH were included. A standardized interviewing data collection sheet was used. It included three scales namely: the Community Attitudes towards the Mentally Ill (CAMI), Mental Health Knowledge Schedule (MAKS) &amp; Reported and Intended Behavior Scale (RIBS). Authoritarian, socially restrictiveness, benevolent &amp; Community Mental Health Ideology of CAMI sub-scales were calculated. Descriptive, inferential, and multiple linear regression analyses were applied.&#x0D; Results: About two-thirds of the participants agreed that mental illness causes lacking self-discipline &amp; will power. Gender was significantly associated with all CAMI sub-scales (P &lt; 0.01). An increasing level of knowledge about mental illness was associated with lower stigma towards PWMI (P&lt; 0.001). After controlling confounders in regression analyses, gender and knowledge were significant predictors of all CAMI sub-scales. Concerning MAKS, about half of participants incorrectly identified stress &amp; grief as types of mental illness. Regarding RIBS, living with (30.2%), and having a neighbor (28.8%) with mental illness were the commonest reported experiences.&#x0D; Conclusions: Negative attitudes towards PWMI still prevailed. Mental stigma was higher among males, older people, lower-educators, lower-income &amp; those with poor mental knowledge. Participants had a moderate intention to accept PWMI. Anti-stigma intervention educational programs are required.

Attitudes towards People with Mental Illness and Low Interest in Psychiatry among Medical Students in Central and Eastern Europe.

This study aimed to examine attitudes towards people with mental illness and psychiatry and interest in career choice in psychiatry among medical students from three medical schools in Czechia and Slovakia. A total of 495 medical students participated in a cross-sectional study. Participants completed (1) the Medical students' version of mental illness: clinicians' attitudes (MICA-2) scale, (2) the Reported and intended behaviour scale (RIBS), (3) the Attractiveness of working on a psychiatry-related position scale (P-ATTRACT), and (4) the Status of psychiatry scale (P-STATUS). Descriptive statistics, group comparisons and regression models were calculated. From 23 to 30% of students considered a specialization in psychiatry. However, only about 1% of them had a strong interest in psychiatry as a future career, moreover, students of higher years of study found psychiatry less attractive compared to those who are in the beginning of the study. The consideration of specialization in psychiatry was found to be statistically significantly associated with less stigmatizing attitudes and lower social distance towards people with mental illness. There were statistically significant differences in stigmatizing attitudes among medical schools, with a medical school emphasizing the education in psychiatry the most showing more positive attitudes. It is necessary to increase the interest in psychiatry and minimize stigma among medical students. Psychiatry curriculum in Central and Eastern European region should include more psychiatry-related courses, training in community and out-patient facilities, peer-lectors, and offer counselling after exposure to emotionally challenging clinical situations.

Psychometric validation of the Reported and Intended Behavior Scale (RIBS) with adolescents.

Psychometric validation of the Reported and Intended Behavior Scale (RIBS) with adolescents.

Supplemental Material for Development and Validation of the Brazilian Portuguese Version of the Reported and Intended Behaviour Scale (RIBS-BP)

Supplemental Material for Development and Validation of the Brazilian Portuguese Version of the Reported and Intended Behaviour Scale (RIBS-BP)

The Youth Aware of Mental Health Intervention: Impact on Help Seeking, Mental Health Knowledge, and Stigma in U.S. Adolescents

PurposeSuicide is a leading cause of death among U.S. youth aged 12–18 years. Youth Aware of Mental Health (YAM), a promising, universal, school-based mental health promotion/suicide primary prevention intervention for adolescents, has been evaluated in Europe but not in the U.S. The present study used an uncontrolled, pretest/post-test design to document the potential for YAM to reduce suicidal ideation, attempt, and suicide. A demonstration that help seeking behaviors, mental health literacy, and mental health stigmatizing attitudes improve after the intervention would suggest that the program is promising in the U.S., as well as in Europe, and that further investigation is merited. MethodsYAM was delivered to 1,878 students in 11 schools as part of regular school curricula. A subset of these students (n = 436) completed surveys before and 3 months postdelivery. Surveys included five questions about help seeking behaviors, a measure of intent to seek help (General Help Seeking Questionnaire), two mental health literacy scales, and two mental illness stigma scales (Reported and Intended Behavior Scale and Personal Stigma and Social Distance Scale). Both McNemar's test and repeated measures linear models were used to determine whether the survey outcomes changed after YAM delivery. ResultsAmong the 436 adolescents (286 and 150 in Montana and Texas, respectively), significant increases were found pre- to post-intervention in three of five help seeking behaviors, along with improved mental health literacy and decreased mental health-related stigma. Intent to seek help was unchanged. ConclusionsSeveral help seeking behavioral factors, mental health knowledge, and stigma improved post-YAM intervention. All three domains are likely protective against suicide. A randomized controlled trial testing the efficacy of YAM in preventing suicidal behaviors is warranted.

Effect of brief social contact video compared with expert information video in changing knowledge and attitude towards psychosis patients among medical students.

Direct contact interventions are known to reduce stigma. Effects of both filmed and direct social contact were found similar in reducing stigma. This study aims to understand the effect of video intervention, especially the effects between patient-sharing video and expert information video, among the medical students. Seventy-two medical students were recruited from two consecutive clinical study periods. Students from one period were in the patient-sharing group, watching a 7-minute patient-sharing video. The others were in expert information group watching a 5-minute psychosis video. Subject's desire of social distance (Reported and Intended Behaviour Scale) knowledge (the Social Contact Intended Learning Outcome) attitude towards mental illness (Clinicians Attitudes Scales version 4) and emotional reactions (the Emotional Reactions to Mental illness Scales) were measured. Assessments were done at baseline, immediately after video watching and at 1 to 2 weeks follow-up. Within-group ANOVA was used to assess the difference between time points. Group by time effect was explored. Significant improvement in knowledge level was found with a significant group by time effect (F = 6.261, P = .004) for PS group and was maintained at follow-up. Post-intervention attitude was significantly improved in PS group but not maintained. Only social distance was improved significantly in EX group (F = 8.093, P = 0.003). Both groups had a significant reduction in fear sub-score. This study provided evidence on the effect of patient-sharing video in improving the attitude and knowledge of medical students. Expert information video about psychosis can improve social proximity. Combining these approaches may improve stigma and knowledge among medical students.

Time to Change\u2019s social marketing campaign for a new target population: results from 2017 to 2019

BackgroundSince 2009 Time to Change has included among its strategies a social marketing campaign to tackle the stigma surrounding mental health problems. At the start of its third phase (2016–2021) the target group of the campaign was kept as people aged between mid-twenties and mid-forties but changed to middle-low income groups and the content was focused on men.MethodsParticipants (n = 3700) were recruited through an online market research panel, before and after each burst of the campaign. They completed an online questionnaire evaluating knowledge (Mental Health Knowledge Schedule, MAKS); attitudes (Community Attitudes toward Mental Illness, CAMI); and desire for social distance (Intended Behaviour subscale of the Reported and Intended Behaviour Scale, RIBS). Socio-demographic data and awareness of the campaign were also collected.ResultsFor each of the 3 bursts, significant pre-post awareness differences were found (OR = 2.83, CI = 1.90–4.20, p < 0.001; OR = 1.72, CI = 1.22–2.42, p = 0.002; OR = 1.41, CI = 1.01–1.97, p = 0.043),and awareness at the end of the third burst was 33%. Demographic factors associated with awareness for one or more bursts included having children, familiarity with mental illness, male sex, being Black, Asian or other ethnic minorities and living in London or the East Midlands regions. An improvement across bursts in the “living with” subscale item of the RIBS, and in the “recover” and “advice to a friend” MAKS items were found. Familiarity with mental illness had the strongest association with all outcome measures, while the awareness of the campaign was also related with higher scores in MAKS and RIBS.ConclusionsThese interim results suggest that the campaign is reaching and having an impact on its new target audience to a similar extent as did the TTC phase 1 campaign. While over the course of TTC we have found no evidence that demographic differences in stigma have widened, and indeed those by age group and region of England have narrowed, those for socioeconomic status, ethnicity and sex have so far remained unchanged. By targeting a lower socioeconomic group and creating relatively greater awareness among men and in Black and ethnic minority groups, the campaign is showing the potential to address these persistent differences in stigma.

Assessment of Mental Health Stigma Components of Mental Health Knowledge, Attitudes and Behaviors Among Jordanian Healthcare Providers.

Health care providers (HCPs)' stigma perception can determine their behaviors and attitudes toward providing mental health services. This study aimed to assess stigma components of knowledge, attitude, and behavior among HCPs in Jordan. A cross sectional descriptive study using a convenience sample of 541 HCPs utilized. The Mental Health Knowledge Schedule (MAKS), the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS) were used to evaluate HCPs' perceived stigma. Mean scores on RIBS were lowest and at mid-point for MAKS and MICA. Results revealed significantly that HCPs perceived stigma demonstrated in greater negative attitudes correlated with less knowledge (r = .18, .17; p = .01, .009) for both physicians and nurses. And between attitudes and reported intended behavior (r = .13, p = .025) among nurses. This make them less likely to deal with mental health problems in primary healthcare centers. The reported stigma in this context is possibly due to lack of training, inadequate experience, and cultural dynamics. Indeed, awareness programs are important to prepare those HCPs to provide mental health care in these settings shall they are asked to.

There Is a Limit to Your Openness: Mental Illness Stigma Mediates Effects of Individual Traits on Preference for Psychiatry Specialty.

Objective: The widening gap between the need for mental health professionals and the low percentages of medical students pursuing a psychiatric career urges an examination of how individual traits, stigma attitudes, and related intended behaviors interact to better explain the variance in preferences for psychiatry as a specialty choice. Methods: Participants were second-year, preclinical medical students at Bologna University, Italy. The study consisted in completion of an online questionnaire evaluating preferences for the psychiatry specialty (one single item and a scenario-based response), personality traits (the Big Five Questionnaire), attitudes (Mental Illness for Clinicians’ Attitude scale), behaviors (Reported and Intended Behavior Scale), and fears toward mental illness (questionnaire created ad hoc). Sociodemographic data were also collected. Results: A total of 284 medical students [58.8% female, mean (SD) age 20.47 ± 1.90] completed the questionnaire. Preference for the psychiatry specialty was significantly and positively associated with openness to experience and negatively related with Mental Illness for Clinicians’ Attitude scale and Reported and Intended Behavior Scale. The full-mediation model provided good indices explaining 18% of the variance. Mental illness stigma was strongly and negatively associated with both openness to experience and preference for psychiatry, and the mediation results evidenced a positive and significant effect. Conclusions: Mental illness stigma influences medical students’ choice of psychiatry as a specialty, accounting for the effects of the openness to experience trait. Stigma awareness and reduction programs should be introduced as early as possible in medical education.

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.

Assessment of mental health and psycho-social support pilot program’s effect on intended stigmatizing behavior at the Saftawi Health Center, Gaza: a cross-sectional study

Background: In the midst of a global refugee crisis, addressing mental health is critical for refugee health care delivery. Understanding efficacy of mental health interventions is more important than ever.Aims: In this study, we aim to assess the efficacy of comprehensive mental health and psychosocial support services for refugees in Gaza by comparing intended stigmatizing behavior toward mental health disorders between two health centers (HCs)(Saftawi and Nasser).Methods: One year after these services by the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East were implemented at Saftawi HC, a randomly selected sample of HC patrons (n = 205) from Saftawi, and a comparable number from a control HC (n = 203 at Nasser) completed the Reported and Intended Behavior Scale (RIBS) regarding stigma towards mental illnesses. Multivariable linear regressions were used to determine the impact of these services in the HC on attitudes against mental health.Results: Saftawi respondents endorsed significantly less intended stigmatizing behavior compared to Nasser respondents (p < 0.001). Multivariable analysis demonstrated significantly less intended stigmatizing behavior at Saftawi compared to Nasser (p < 0.01) while controlling for demographic covariables.Conclusions: UNRWA primary care services and education implemented for refugees in Gaza was associated with reduced stigmatizing behavior toward mental health, which can help guide efficacious mental health care interventions within the Palestine refugee community and in other simiilar communities.