Mental Illness Clinicians Research Articles

Help-seeking behaviors for mental health problems in medical students: Studies in Thailand and India

To compare the rate of help-seeking from mental health professionals (MHPs) and other sources of help for mental health problems of medical students in Thailand and India, and explore factors associated with help-seeking from MHPs. Cross-sectional survey-based study was conducted in two medical schools in Thailand and India. Students were asked to rate their preferences for each source of help on a Likert-scale basis. Mental health status was measured by the General health questionnaire-12 (GHQ-12). Attitudes and stigma toward mental illness were collected using the Mental illness clinician's attitude scale: medical student version or MICA v2. 593 students participated in the survey. The percentage of students who chose to seek help from any source was lower in Thailand than in India. 81 % of students in India site chose to seek help from MHPs, compared to 66 % in Thailand site. The risk factors for avoiding seeking help from MHPs in Thailand were history of alcohol use (OR = 1.88, p = .014) and total GHQ score (OR = 1.11, p = .006), whereas having GHQ score ≥ 2 was a significant risk factor in India (OR = 2.20, p = .044). Total MICA score, which reflected overall attitude toward mental illness, was not associated with seeking help from MHPs. The rate of help-seeking behaviors for mental health problems and factors associated differed between medical students in Thailand and India. A high GHQ score was a common risk factor of not seeking help from MHPs in both countries.

Investigating stigma attitudes towards people with mental illness among residents and house officers: an Egyptian study

BackgroundStigma is a basic component of the negative discrimination that people with mental illness experience every day. It blocks access to facilities that have been created to help people with mental illness. Furthermore, the attitudes held by people with authority (including clinical staff and officers) towards people with mental illness are likely to influence their attitude towards them and hence the experience and treatment outcome of the patients. The aim of this work is to study and compare the attitudes of Egyptian residents of different clinical specialties and house officers towards patients with mental illness. The current study aimed to study the attitudes of Egyptian medical residents and house officers towards patients with mental illness and compare between both groups. This cross-sectional comparative study was designed to assess 150 residents and 201 house officers at Ain Shams University Hospitals by using the Mental Illness Clinician Attitude Scale version 4 (MICA-4) and newly designed questions related to stigma.ResultsThe study revealed that the scores of MICA questionnaire were significantly lower than the cut point for negative attitude in both residents and house officers (P < 0.0001). In addition, there was a trend of an increase in MICA scores throughout the three levels of seniority but with no statistically significant difference. Furthermore, there was no statistical significant finding regarding the majority of MICA items or stigma sheet questions across the different specialties.ConclusionStigma is one of the most disabling factors that prevent people with mental illness to live a normal social and occupational life and thus receive a good quality of life and equal chance of medical health care as other non-psychiatric patients.

Effects of contact-based, short-term anti-stigma training for medical students : Results from arandomized controlled trial.

Mental health stigma (MHS) places aburden on those affected that far exceeds psychosocial harms. Contact-based anti-stigma work has been found effective for several target groups. For medical students however, its efficacy remains unclear. The purpose of this study was to examine the efficacy of contact-based, trialogic anti-stigma training for medical students. Arandomized controlled trial (RCT) was conducted, controlling for standard clinical placement in psychiatry. External validity was maximized by including all students (n = 204) who started their 6‑week obligatory psychiatry course during the study period between March and July 2018. Assessments were conducted at the beginning of each of the two covered terms and immediately postintervention. Students who received the anti-stigma training displayed significantly less stigmatizing attitudes after the intervention, measured using the MICA (Mental Illness-Clinicians' Attitudes) scale as primary outcome. Analogous findings were noted for social distance and stereotypes, whereas these could not be observed for emotional reactions. All significant changes were independent of gender and age. The positive results underpin the research in this field and point towards the inclusion of comparable interventions in regular student curricula. Given the limitation of amissing late follow-up, however, further research regarding the persistence of stigma reduction is needed.

Stigmatizing attitudes of tertiary hospital physicians towards people with mental disorders in Saudi Arabia.

Objectives:To measure stigma among doctors in one of the major specialized hospitals in Saudi Arabia.Methods:This cross-sectional study was conducted at King Abdullah Medical City, Jeddah, Saudi Arabia between October and November 2018. Eighty physicians were recruited in this study. The participants administered the sociodemographic questionnaire as well as the Mental Illness Clinicians’ Attitude 4th version (MICA 4).Results:The overall MICA score ranged between 31 and 61 with a mean±SD of 45.75±7.54. The highest reported score was among outpatient physicians (51.33±6.66), while the lowest score was among consultants/assistant consultants (43.17±7.82).Conclusion:The results of this study showed a relatively high MICA-4 score that could indicate a high stigmatizing attitude among physicians toward patients with mental illnesses compared with the other MICA-4 studies. Thus, training workshops could improve the attitudes in the short-term.

Impact of clinical posting in psychiatry on the attitudes towards psychiatry and mental illness in undergraduate medical students

BackgroundA major public health problem around the world today is mental illness. Although there are several studies on the topic, it is rarely conducted in the context like the current...

Clinical decisions and stigmatizing attitudes towards mental health problems in primary care physicians from Latin American countries.

ObjectiveThe aim of this paper is to investigate how doctors working in primary health care in Latin American address patients with common mental disorders and to investigate how stigma can affect their clinical decisions.MethodsUsing a cross-sectional design, we applied an online self-administered questionnaire to a sample of 550 Primary Care Physicians (PCPs) from Bolivia, Brazil, Cuba and Chile. The questionnaire collected information about sociodemographic variables, training and experience with mental health care. Clinicians’ stigmatizing attitudes towards mental health were measured using the Mental Illness Clinicians' Attitudes Scale (MICA v4). The clinical decisions of PCPs were assessed through three clinical vignettes representing typical cases of depression, anxiety and somatization.ResultsA total of 387 professionals completed the questionnaires (70.3% response rate). The 63.7% of the PCPs felt qualified to diagnose and treat people with common mental disorders. More than 90% of the PCPs from Bolivia, Cuba and Chile agreed to treat the patients presented in the three vignettes. We did not find significant differences between the four countries in the scores of the MICA v4 stigma levels, with a mean = 36.3 and SD = 8.3 for all four countries. Gender (p = .672), age (p = .171), training (p = .673) and years of experience (p = .28) were unrelated to stigma. In the two multivariate regression models, PCPs with high levels of stigma were more likely to refer them to a psychiatrist the patients with depression (OR = 1.03, 95% CI, 0.99 to 1.07 p<0.05) and somatoform symptoms somatoform (OR = 1.03, 95% CI, 1.00 to 1.07, p<0.05) to a psychiatrist.DiscussionThe majority of PCPs in the four countries were inclined to treat patients with depression, anxiety and somatoform symptoms. PCPs with more levels of stigma were more likely to refer the patients with depression and somatoform symptoms to a psychiatrist. Stigmatizing attitudes towards mental disorders by PCPs might be important barriers for people with mental health problems to receive the treatment they need in primary care.

Attitude of medical students toward mentally ill patients: impact of a clinical psychiatric round

Background Stereotyped cognitive schemes are the main cause of casting out patients with mental illness. Educational psychiatry programs have to be re-evaluated as medical students often have misconceptions about psychiatry. Objective The aim of the present study was to examine the attitude of fifth-year medical students toward psychiatric patients and disorders, and to reveal the influence of psychiatric study experience on their attitudes. Participants and methods In this interventional study, 300 fifth-year students from Ain Shams University Medical School were enrolled. Sociodemographic data sheet, Fahmy and El Sherbiny's Social Classification Scale, and the Mental Illness Clinician Attitude Scale-2 were used on the first and last day of a 3-week clinical psychiatric round. Results Data before and after the round were compared and showed no significant change in Mental Illness Clinician Attitude Scale-2 scores among the studied sample after the psychiatric round. Only 4% of the students chose psychiatry as a future career with neutral attitude and had worse attitude after rotation. Students who had significant positive attitude at the beginning of the round ended up with a significantly more negative attitude, whereas those with significantly negative attitudes improved at the end of the round. Conclusion Three weeks may not be sufficient time to allow students to follow up the patients to notice their improvement as regards treatment and return to their functional baseline. Thus, students perceived mentally ill patients being untreatable. Greater emphasis on doctor-patient relationship and exposure to patients with psychiatric illness, which responds rapidly to treatment and students taking direct patient responsibility, may lead to the production of more favorable attitudes.

Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice.

BackgroundMental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students’ attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness.MethodYear 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career.ResultsAttitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students’ interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students ‘definitely considering’ psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up.ConclusionThe clerkship made a modest impact on students’ attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.

Critical Synthesis Package: Mental Illness Clinicians' Attitudes Scale (MICA)

Critical Synthesis Package: Mental Illness Clinicians' Attitudes Scale (MICA)

Stigma Related to Mental Illness in Medical Students From Madrid.

Introduction Several studies show a high prevalence of stigma related to mental illnes. This implicate the presence of prejudiced behaviours and false beliefs when treating with people with mental disorders. The literature reveals elevated rates of stigmatization in general population. Also, it is documented in general healthcare professionals and even in mental health workers or medicine students. This scene supposes an obstacle in several vital areas. The evaluation of stigma in medicine students become fundamental considering that they will be professionals soon. Objectives To evaluate the attitudes towards mental illness in a sample of medicine students from Madrid. Material and Methods The MICA (Mental Illness Clinician’ s Attitudes) scale v4 was used to evaluate the objective. Different sociodemographic variables were also included just like information about the clinical speciality the would like to choose. The posible association between theese variables and the scale reults was evaluated. 100 medical students in their 5°-6° year of the degree completed this questionnaire. The sample was collected from the Universidad Complutense de Madrid. A descriptive and analytical analysis were carried out using the statistics programme spss v. 21. Results and Conclusions The results suggest that the rates of stigma between medical students from this sample are higher than desirable. That situation reinforce the need of encourage anti-stigma programmes which probably should include a longer contact between medical students and psychiatric patients.

Stigmatisation of mental illness among employees of a Northern Nigerian University.

Background:Prejudices against people with mental illness are widespread in many societies leading to a number of detrimental consequences. In order to adequately develop programmes and services that will help protect the rights and privileges of people with mental illness, it is imperative to study the nature of stigma and factors associated with it. Our objective in this study was to observe the level of stigmatisation of the mentally ill among employees of a Nigerian University and the factors associated with it.Materials and Methods:The study was carried out at the Ahmadu Bello University Teaching Hospital and the Ahmadu Bello University main campus. Employing a two-staged random sampling technique, 15 departments were chosen from both institutions, after which 10 participants were further sampled from each department to obtain a total of 150 participants. All the participants were administered the socio-demographic questionnaire and Mental Illness Clinicians’ Attitude 4th version (MICA 4).Results:The findings indicate that 53.4% of respondents’ classified as high stigmatisation while 46.6% was classified as low stigmatisation. Low scores on stigmatisation were observed among departments of psychiatry, nursing and ophthalmology, while high scores were observed among respondents from administration and engineering. Relationship between variables and predictors of stigmatisation were also established.Conclusion:There is a high tendency to stigmatise persons with mental illness except where there has been some contact with mental health practice or among the clinical departments in the hospital. We recommend community psychiatry care for the mentally ill and psycho-education for staff periodically to reduce this level of stigmatisation.

Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems: something to worry about? A pilot study.

This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (GPs,n=55),mental healthcare professionals (MHCs,n=67) andforensic psychiatric professionals (FPs,n=53). A modest positive attitude towards psychiatry was found in the three groups (n=176). Significant differences were found on the total MICA-score (p<0.001). GPs scored significantly higher than the FPs and the latter scored significantly higher than the MHCs on all factors of the MICA. Most stigmatizing attitudes were found on professionals' views of health/social care field and mental illness and disclosure. Personal and work experience did not influence stigmatizing attitudes. Although all three groups have a relatively positive attitude using the MICA, there is room for improvement. Bias toward socially acceptable answers cannot be ruled out. Patients' view on stigmatizing attitudes of professionals may be a next step in stigma research in professionals.

355 – Stigmatising attitudes of mental health care professionals, forensic psychiatric professionals and general practitioners: a pilot study

Objective Studying stigma in health care professionals may be helpful to address stigma in people with mental illness. The purpose of this study is to assess (stigmatising) attitudes of mental health care professionals (MHC), forensic psychiatric professionals (FP) and general practitioners (GP) in the Netherlands. Method The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatising attitudes in three different groups of health care professionals. Scores range from 16 (minimum stigma) to 96 (maximum stigma). Additionally, background information was obtained including gender, age, work and personal experience. Results All three groups of health care professionals had a positive attitude towards psychiatry and patients with a mental health problem. However, the total MICA score differed significantly between the three groups (p Conclusion General practitioners showed in comparison to mental health care professionals a significantly higher stigmatising attitude. The scores still represent a mild positive attitude towards psychiatry and psychiatric patients. Although all three groups have a relatively positive attitude, there is still room for improvement.