Stigma Attitudes Research Articles

Stigma processes, psychological distress, and attitudes toward seeking treatment among pedohebephilic people.

While stigma theories predict that stigma relates to negative attitudes toward seeking help, previous studies found mixed results among pedohebephilic individuals. We tested whether different stigma processes (i.e., general anticipated stigma, anticipation of negative therapist behavior upon disclosure, and internalized stigma), psychological distress, previous treatment experiences, and knowledge about psychotherapy can clarify attitudes toward seeking professional psychological help for this population. We conducted a pre-registered, online survey of English-speaking pedohebephilic individuals (N = 283, 88% male). Expected links between variables of interest and attitudes toward seeking treatment were assessed via structural equation modeling. After modification, the final model showed acceptable fit to the data, χ2 = 2170.61, df = 1462, p < .001, CFI = .905, RMSEA = .04, [.04,.05]. Internalized stigma predicted more positive attitudes toward seeking treatment. Lower anticipation of negative therapist behavior upon disclosure and higher knowledge about psychotherapy were also significant predictors of positive attitudes toward seeking treatment. General anticipated stigma did not predict attitudes toward seeking treatment. Our results suggest a complex association between different stigma processes and treatment-seeking, which differs from associations found for mental illness stigma. Specificity in our understanding of the components of stigma and how they interact with attitudes toward seeking treatment is required to tailor clinical work as well as messages around treatment services.

Emotion, Religious Coping, Stigma, and Help-Seeking Attitudes Among Asian Americans: Examination of Moderated Mediation

While there is an abundance of research on the relationship between stigma and help-seeking attitudes among Asian Americans, few studies have examined how emotion and religious variables influence this relationship. Thus, using a moderated mediation model, we investigated how emotion regulation, emotion socialization, and religious coping might affect the relationship between close others’ stigma, self-stigma, and help-seeking among a sample of Asian American students ( N = 105) from a Christian university. We predicted that (a) self-stigma would positively mediate the association between close others’ stigma and help-seeking attitudes, and (b) emotion regulation, emotion socialization, and religious coping would moderate this relationship. Mediation results showed that close others’ stigma was related to self-stigma, which in turn was associated with help-seeking attitudes. Moreover, this mediating relationship was moderated by religious coping ( n = 70) but not emotion socialization or regulation; emotion regulation and help-seeking attitudes, however, were positively correlated. These findings highlight the influence of religious coping and emotion regulation strategies on views of counseling, and we reflect on some implications of these findings.

Attitudes of psychiatrists towards people with mental illness: a cross-sectional, multicentre study of stigma in 32 European countries

Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce. A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978). A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d=-0.92, 95% confidence interval (CI)=-1.68 to-0.15, p=0.019), receiving medical treatment for a mental illness (d=-0.88, 95% CI=-1.71 to-0.04, p=0.040), as well as having a friend or a family member similarly affected (d=-0.68, 95% CI=-1.14 to-0.22, p=0.004)), being surrounded by colleagues who are less stigmatising (d=-0.98, 95% CI=-1.26 to-0.70, p<0.001), providing psychotherapy to patients (d=-1.14, 95% CI=-1.63 to-0.65 p<0.001), and being open to (d=-1.69, 95% CI=-2.53 to-0.85, p<0.001) and actively participating in (d=-0.94, 95% CI=-1.45 to-0.42, p<0.001) case discussion, supervision, or Balint groups. Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross-national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration. National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134). All authors received no funding for their contribution.

Sports and epilepsy: A comprehensive review in the Japanese context

Abstract: Introduction: Epilepsy, affecting 1% of the global population, is a neuropsychiatric disease often co-occurring with psychiatric disorders. It is characterized by recurrent “epileptic seizures” caused by abnormal electrical activity in the brain, which poses risks during exercise and damages athletic identity. In Japan, psychiatrists perform essential roles in the treatment of patients with epilepsy. Methods: This review examines and addresses the challenges and opportunities for individuals with epilepsy in athletic endeavors. Results: Historically, misconceptions regarding seizure triggers, societal stigma, and overprotective attitudes have limited physical activity among individuals with epilepsy, resulting in obesity and reduced wellbeing. However, exercise does not typically induce seizures. Recent research suggests that exercise benefits seizure control, quality of life, and comorbidities among individuals with epilepsy. Sports participation risks were categorized into three groups using tailored guidelines provided by the International League Against Epilepsy (ILAE). Water-based sports require controlled environments, monitoring, and distinctive attire due to the risk of drowning. In contact sports, precautions are required to address seizures prior to physical contact. Guidelines for children with epilepsy in school events emphasize inclusion, as restrictions may lead to social and developmental challenges. Few prominent athletes who openly disclosed their epilepsy diagnoses. Conclusion: Physical activity offers benefits to individuals with epilepsy, necessitating a re-evaluation of exercise restrictions. Guidelines and seizure type considerations are essential. Athletes’ openness about epilepsy enhances awareness and support, contributing to the overall well-being of this population. Dipruption of epilepsy on competitive mindset might extend to Athletic Identity (AI).

Factor structure and reliability of the Greek version of Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) Scale in a general population sample.

Mentally ill offenders constitute a group with a unique set of characteristics since they are doubly stigmatized by both their mental illness and the offence they have committed. The coexistence of these two circumstances significantly heightens negative public attitudes towards these people. The group of mentally ill offenders has been shown to elicit more stigmatic attitudes than offenders without a mental health condition. Nevertheless, research on stigma towards mentally ill offenders is rather limited, while the number of psychometric tools used to measure this stigma is even smaller compared to the number of relevant tools assessing mental illness stigma. The purpose of this study was to explore the attitudes towards mentally ill offenders in a Greek sample in terms of demographic characteristics, and at the same time to assess the psychometric properties of a specialized tool on stigma towards this patient group, namely the Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) scale in Greek. The study included 1031 participants from the general population who completed an online questionnaire on sociodemographic data as well as the ATMIO scale. The scale's structural validity was tested on the basis of the exploratory factor analysis after Quartimax rotation, and the internal relevance of its factors recorded a Cronbach's alpha value of more than 0.7, both for the whole scale and its individual factors. It was shown that more negative stereotypes towards mentally ill offenders were correlated with less compassion and less desire for their rehabilitation, with stronger belief and conviction that they represent a danger to the community, with less diminished responsibility, and a lot fewer positive attitudes in general. Women, older people, individuals with a lower education level and participants with children were found to hold more negative attitudes. The ATMIO scale translated in Greek is the first tool to measure attitudes towards mentally ill offenders in the country and shows satisfactory internal consistency and interpretation of its four-factor structure. It is a comprehensible and easy-to-complete scale, which can become a reliable tool to record attitudes towards mentally ill offenders also in our country.

Well-being, turnover intention, and stigma attitudes of mental health transition-to-practice nurses: A cross-sectional study.

There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses' well-being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well-being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross-sectional study were to describe demographic characteristics, perceived stress, well-being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post-graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well-being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well-being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well-being initiatives during transition and intervene early to provide support for nurses with mental distress.

A co-produced service evaluation of ethnic minority community service user experiences of a specialist mental health service during the COVID-19 pandemic

BackgroundFor ethnic minority communities in the UK, the COVID-19 pandemic amplified existing health inequalities and created other consequential disadvantages like increased vulnerability to COVID-19, higher rates of hospital admissions, increased mortality and poorer mental health outcomes. While longer-term impacts of COVID-19 are considered, it is crucial for NHS mental health services to understand the specific barriers and needs of ethnic minority communities to provide consistent and equitable access to mental health services. These aspects were the focus of a service evaluation of a Sussex-wide mental health service conducted in co-production with experts-by-experience, public members, health professionals and researchers from ethnic minority communities.MethodsCo-designed creative workshops (n = 13) and semi-structured qualitative interviews (n = 13) were used to explore experiences of accessing specialist mental health services during the COVID-19 pandemic. Participants were: Sussex Partnership NHS Foundation Trust (SPFT) service users recruited between October 2021 and January 2022; aged 16+; from ethnic minority community backgrounds. Data was analysed using Thematic Analysis.ResultsThe analysis yielded five overarching themes contextualising service users’ experiences: (1) limited awareness of SPFT mental health services; (2) effects of COVID-19 in gaining access to SPFT; (3) SPFT reaching out to ethnic minorities; (4) being supported, 4a) hiding my mental health status from friends and families, 4b) lack of ethnic diversity in services, and 4c) better provision of information and support services, (5) relationship between childhood experiences and current mental health. These findings led to seven key recommendations for future service developments within SPFT.ConclusionsAlthough this evaluation was set in the context of COVID-19, findings have highlighted specific mental health service needs for ethnic minorities that are applicable beyond the confines of the pandemic. Many benefited from online sessions seen as more inclusive. Mental health advocates, outreach and joint working with communities could help further reduce stigmatising attitudes and improve engagement with mental health services. Improved service awareness of the impact of childhood or historical traumas experienced by ethnic minority communities on current mental health, the role of cultural awareness training and availability of culturally adapted therapies is also needed. Many service improvement recommendations provided could impact all service users.

“It's a big added stress on top of being so ill”: The challenges facing people prescribed cannabis in the UK

BackgroundThis paper reports on the first qualitative study to interview people prescribed cannabis in the UK. Cannabis is a class B controlled substance under the 1971 Misuse of Drugs (MoD) Act, but a 2018 change to UK regulations provided for the prescription of cannabis for medical purposes. Relatively few people have been able to access a prescription, despite this policy change. This paper examines their experiences. MethodsQualitative, semi-structured interviews were conducted with 24 people with a prescription for cannabis, or their carers. Data was analysed using a reflextive thematic analysis approach. The findings are discussed using a zemiology (social harms) perspective which provides a language for critical reflection on the current cannabis policy context. ResultsAll participants reported that cannabis had significantly improved their mental and/or physical health, across a broad range of conditions. Many had been able to reduce their use of conventional medicines and reported that cannabis had relatively few side effects. Despite the potentially life-enhancing benefits of cannabis medicine, patients in the UK face multiple barriers to access. These include a lack of funding streams, bureaucratic supply problems, and a lack of training for doctors and police. Even for the few people able to obtain a prescription, the ongoing criminalisation of cannabis in the UK contributed to their experiences of stigmatisation. This often made it difficult and anxiety-inducing to take their medicine in public spaces. ConclusionThe UK government's lack of implementation of medical cannabis legalisation, combined with their ongoing prohibition position, is producing multiple harms to people who need cannabis medicine. The policy context is perpetuating stigmatising attitudes to cannabis which, as we demonstrate, contribute to social harms. We make recommendations on equality of patient access, and highlight the importance of education and policy change as means of combatting stigma.

Factors Influencing Attitudes Towards Safer Supply Programs for People Who Use Drugs: Findings From an Atlantic Canadian Province

Safer supply programs (SSPs) are harm reduction services where people who use drugs can access regulated pharmaceutical drugs (e.g., hydromorphone). Public attitudes, and factors that influence attitudes towards SSPs must be considered as they impact policy and funding decisions. A total of 384 participants were recruited from the community ( n = 160, 41.7%) and an Atlantic Canadian University ( n = 224, 58.3%) to complete an online survey. The majority of the sample was supportive of SSPs ( n = 316, 82.3%). Being of European origin, a younger age, identifying as female, displaying higher levels of Openness to Experience, and reporting less stigma towards people who use drugs were predictive of more positive attitudes towards SSPs. Openness to Experience mediated the relationship between stigma levels and attitudes towards SSPs. The findings of the current study suggest that when developing public awareness campaigns, considering the impact of demographic and psychological factors is important.

Poly-victimization of autistic adults: An investigation of individual-level correlates.

Autistic people experience high rates of violence and victimization which is largely due to structural injustices, including stigma and social attitudes. Identifying and addressing systemic and structural factors is vitally important, however effecting change in embedded social structures is likely to take some time, even with concerted efforts. In the meantime, it is important to understand whether there are other individual-level factors that may assist in developing preventative and protective strategies for autistic people. The current study investigated the role of individual-level risk factors in the victimization of autistic people. Specifically, we examined whether characteristics that are common among autistic people that is, lower social competence, higher compliance and emotion regulation difficulties or more ADHD features (inattention, impulsiveness and hyperactivity) were associated with poly-victimization in a community sample of 228 adults (118 autistic, 110 non-autistic). Our results show that only ADHD features were predictive of poly-victimization once socio-demographic background variables (age, sexual orientation) were adjusted for. Group status was not a significant predictor in the model and there were no interaction effects between any of the characteristics and group status. These findings suggest that, regardless of whether a person is autistic, ADHD features may place individuals at higher risk of experiencing multiple forms of violence in adulthood. Further research using longitudinal designs and larger, diverse samples is needed. Furthermore, the regression model only accounted for about one-third of the variance in poly-victimization which highlights the importance of looking beyond individual-level risk factors to structural and systemic factors that contribute to disproportionate victimization of autistic people.

Relationship of Midwife's Knowledge Level about HIV/AIDS with Stigma to Pregnant Women with HIV/AIDS in Primary Health Service of Banyumas Regency

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; The HIV/AIDS Situation Analysis conducted by the Banyumas Regency Health Office in September – October 2021 shows that HIV/AIDS cases are increasing rapidly. The high number of HIV/AIDS cases can lead to negative opinions or stigma attached to people living with HIV/AIDS (PLWHA). High knowledge of midwives can be a good behavior in preventing HIV transmission.. &lt;strong&gt;Objective&lt;/strong&gt;&lt;a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_1"&gt;[WU1]&lt;/a&gt; &lt;strong&gt;:&lt;/strong&gt; This research aims to analyze the correlation between the level of knowledge of midwives concerning HIV/AIDS and the stigma of pregnant women with HIV/AIDS in primary health care centers in Banyumas Regency. Independent variable in this study was the midwives' knowledge of HIV/AIDS and the dependent variable in this study is the stigma of midwives in pregnant women with HIV/AIDS &lt;strong&gt;Method&lt;/strong&gt;&lt;a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_2"&gt;[WU2]&lt;/a&gt; &lt;strong&gt;:&lt;/strong&gt; This study was descriptive analysis with cross-sectional research design. &lt;a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_3"&gt;[WU3]&lt;/a&gt; The research subjects were midwives who had never attended HIV counselor training at the Medical Support Service Health Center in Banyumas Regency with a total of 61 respondents&lt;a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_4"&gt;[WU4]&lt;/a&gt; which is obtained from the withdrawal sampling technique using cluster random sampling where according to Sugiyono's 2017 book that cluster random sampling is obtained by the formula for the number of respondents per cluster divided by the total number of respondents multiplied by the sample. The instrument used the HIV-KQ-18 questionnaire to measure the level of knowledge and the SHASS questionnaire to measure stigma attitudes. The analysis uses the Spearman rank correlation test. &lt;strong&gt;Results&lt;/strong&gt; &lt;strong&gt;:&lt;/strong&gt; A total of (14.80%) level of knowledge is sufficient and (1.60%) high stigma. There is no significant relationship between the level of knowledge of midwives and the stigma of pregnant women with HIV/AIDS in primary health services in Banyumas district. &lt;strong&gt;Conclusion&lt;/strong&gt;&lt;a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_6"&gt;[WU6]&lt;/a&gt; &lt;strong&gt;:&lt;/strong&gt; The knowledge of midwives about HIV/AIDS still needs to be improved. Efforts need to be made in relation to the stigma of midwives against PLWHA and educational institutions can add workshops with experts, Health Office, health services,&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords:&lt;/strong&gt;HIV, Midwife Stigma, Knowledge, Pregnant women&lt;/p&gt;&lt;div&gt;&lt;div&gt;&lt;p&gt; &lt;/p&gt;&lt;/div&gt;&lt;/div&gt;

Depression stigma, depression literacy, and psychological help seeking attitudes among school and university students

Very little research has specifically investigated depression stigma and its correlation with depression literacy and help-seeking attitudes among students. This study aimed to assess the levels and correlations of stigma, literacy, and psychological help-seeking attitudes related to depression among a sample of high school and university students in Jordan. A descriptive, correlational, cross-sectional design was employed using an anonymous, online, self-report survey. This study included a total of 650 students aged 16 to 24 years. The participants were found to have high levels of depression stigma, low levels of depression literacy, and negative attitudes towards seeking psychological help. The most frequently reported sources of psychological help were family members, relatives, and friends. A significant negative correlation was found between depression stigma and depression literacy. The predictive factors of depression stigma were depression literacy, age, gender, education, father's educational level, family size, and having history of mental health problems among family members, relatives, or friends. This study provides valuable information on the common mental health needs and concerns among students in Jordan. The findings also highlight the importance of developing and implementing depression awareness and prevention education campaigns for students in schools and universities. Such campaigns may increase students' knowledge about depression, enhance their use of mental healthcare services, and prevent or decrease their risk of developing depression.

Public Awareness and Attitudes towards Epilepsy: A Cross-Sectional Study

Epilepsy is surrounded by stigma and unfavorable attitudes as a result of several inaccurate or insufficient knowledge linked to the disease, and individuals have negative views of the disorder. They must have up-to-date knowledge and an acceptable approach to epilepsy and antiepileptic medications. This study aimed to assess the public general awareness of epilepsy and attitude toward persons living with epilepsy and its associated factors. A descriptive cross-sectional study was undertaken in Taif, Saudi Arabia, targeting the general public with a self-administered validated Arabic questionnaire. The questionnaire, which comprised two sections and included the responder's demographic information, was distributed over social media platforms between March 18, 2022, and June 3, 2022. A total of 500 respondents who met the inclusion criteria were included in the study. The characteristics of the subjects were described using descriptive statistics, and differences were assessed using the independent sample t-test and 2-way ANOVA. A p-value of ≤ 0.05 was used to determine statistical significance. A total of 500 individuals who met the inclusion criteria were included. The mean (standard deviation) score for general epilepsy awareness was 6.78(1.74), which is altogether considered as insufficient. Female participants had a substantially higher mean (SD) awareness score than male participants: 32.58(7.67); 95% CI: 31.34-33.68 versus 29.94(8.79); 95% CI: 28.93-30.95, P0.001. There were no significant differences in participants' awareness scores based on their nationality or occupation. Participants' attitudes towards PWE were mainly favorable, with 482 (96.4%) reporting that they would not be embarrassed if someone in their family had epilepsy, and that PWE should not hide their condition. According to this study, more people are aware of epilepsy and have a good attitude toward it. Furthermore, the study discovered a link between the three variables of interest and ...

‘At Least You’re Not Neurotypical’: Stigma, Mental Illness Disclosure, and Social Capital Among Privileged College Students

ABSTRACT This mixed-methods study investigated if individuals in high-resource, low-stigma environments experience any benefits from disclosing their mental illness. Participants were recruited from a small Midwestern liberal arts college. Survey data were collected on attitudes toward mental illness on campus (N = 384) that showed low levels of public stigma and moderate levels of self-stigma. Class year and mental health status were predictors of public stigma and campus-specific attitudes toward mental illness, but not self-stigma; race and gender were not significant predictors of either. Screening questions yielded 50 in-depth interviews about stigma on campus, mental illness disclosure, and students’ social capital. Qualitative coding revealed four findings: 1) students reported low levels of public stigma associated with mental illness; 2) white students, but not students of color, reported an inverted status hierarchy that incentivized mental illness disclosure; 3) white students garnered social capital from disclosing their mental illness; 4) mental illness was used by white students as a social buffer against shame over unearned privileges. In high-resource, low-stigma environments, privileged individuals may experience social motivation to publicly disclose mental illness. This has implications for student help-seeking behaviors and poor mental health outcomes on college campuses.

Exploration of Psychiatry Residents' Attitudes toward Patients with Substance Use Disorder, Bipolar Disorder and Schizophrenia in Saudi Arabia.

Stigmatizing attitudes of psychiatry professionals toward patients with various mental disorders may negatively impact treatment-seeking behaviors. However, in Saudi Arabia, little is known about psychiatry residents' attitudes toward individuals with a specific disease/disorder. Therefore, the purpose of this study was to assess psychiatry residents' attitudes toward patients with substance use disorder (SUD), bipolar disorder and schizophrenia in Saudi Arabia. Data for this cross-sectional study were collected from psychiatry residents (N = 79) in Saudi Arabia with a structured questionnaire containing sociodemographic and attitude-related variables. The 11-item Medical Condition Regard Scale (MCRS) for individuals with three conditions was used to assess participants' attitudes. A linear regression model was fitted to investigate the association. Based on the MCRS (on a scale of 11 to 66), participants' mean attitude scores were 41.59 (SD: 8.09), 54.53 (SD: 5.90) and 54.20 (SD: 6.60) for SUD, bipolar disorder and schizophrenia, respectively. Adjusted regression analysis demonstrated that senior residents, an age ≥ 27 years and a high confidence level were significantly associated with psychiatry residents' positive attitudes toward patients with the three conditions. Psychiatry residents' attitude scores were relatively lower (i.e., negative attitudes) for patients with SUD than for those with bipolar disorder and schizophrenia. Future longitudinal studies are recommended to explore the factors behind psychiatry residents' negative attitudes toward patients with addictive behaviors and mental illnesses.

Outcome assessment of a complex mental health intervention in the workplace. Results from the MENTUPP pilot study

ObjectiveMulticomponent interventions are recommendable to achieve the greatest mental health benefits, but are difficult to evaluate due to their complexity. Defining long-term outcomes, arising from a Theory of Change (ToC) and testing them in a pilot phase, is a useful approach to plan a comprehensive and meaningful evaluation later on. This article reports on the pilot results of an outcome evaluation of a complex mental health intervention and examines whether appropriate evaluation measures and indicators have been selected ahead of a clustered randomised control trial (cRCT).MethodsThe MENTUPP pilot is an evidence-based intervention for Small and Medium Enterprises (SMEs) active in three work sectors and nine countries. Based on our ToC, we selected the MENTUPP long-term outcomes, which are reported in this article, are measured with seven validated scales assessing mental wellbeing, burnout, depression, anxiety, stigma towards depression and anxiety, absenteeism and presenteeism. The pilot MENTUPP intervention assessment took place at baseline and at 6 months follow-up.ResultsIn total, 25 SMEs were recruited in the MENTUPP pilot and 346 participants completed the validated scales at baseline and 96 at follow-up. Three long-term outcomes significantly improved at follow-up (p < 0.05): mental wellbeing, symptoms of anxiety, and personal stigmatising attitudes towards depression and anxiety.ConclusionsThe results of this outcome evaluation suggest that MENTUPP has the potential to strengthen employees’ wellbeing and decrease anxiety symptoms and stigmatising attitudes. Additionally, this study demonstrates the utility of conducting pilot workplace interventions to assess whether appropriate measures and indicators have been selected. Based on the results, the intervention and the evaluation strategy have been optimised.

Reducing sickness absence and stigma due to mental health difficulties: a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail)

BackgroundCommon mental disorders are the leading cause of workplace absences. The Prevail intervention programme aims to reduce stigma and to educate staff and managers about evidence-based low intensity psychological interventions for common mental disorders (depression, anxiety, stress, and distress). Prevail is innovative in taking a public health approach. It is designed to be given to all employees irrespective of their past or current mental health. Prevail was evaluated in three studies examining: (1) the acceptability of the intervention and perceived usefulness; (2) whether the intervention altered stigmatic attitudes and motivation to seek help; and (3) whether the intervention reduced sickness absence, both overall and due to mental health problems.MethodsA two-armed cluster randomised control trial (RCT) evaluated the effectiveness of Prevail. Employees (N = 1051) at a large UK government institution were randomised to an active intervention or control arm in teams identified by their managers (n = 67). Employees in the active arm received the Prevail Staff Intervention. The managers in the active arm also received the Prevail Managers Intervention. Participants’ satisfaction and analysis of the Prevail Intervention were gathered by a bespoke questionnaire. Questionnaire measures of attitudes to mental health and mental health stigma were taken 1–2 weeks prior to the intervention and approximately 4 weeks post-intervention. Data relating to sickness absence were gathered via the official records in the time period 3-month post-intervention and for the same period 12 months earlier.ResultsPrevail was evaluated highly favourably by both the staff and their managers. Prevail produced significant reductions in self-stigma and anticipated stigma due to mental health difficulties. Crucially, sickness absence was significantly reduced by the Prevail Intervention.DiscussionPrevail achieved its goals of producing a palatable and engaging intervention that altered staff’s attitudes and stigmatic beliefs related to mental health and, crucially, produced a strong reduction in work-pace absenteeism. As the Prevail programme is aimed at common mental health problems and was not specialised to this particular workforce, the study provides the evidence-base for a mental health intervention programme that could be used by many organisations across the world.Trial RegistrationISRCTN12040087. Registered 04/05/2020. https://doi.org/10.1186/ISRCTN12040087. A full protocol for the randomised control trial was published: Gray NS, Davies H, Snowden RJ: Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health 2020, 20(1):1–9.

Nurses’ Attitudes and Stigma about Mental Illness and Substance Abuse

BACKGROUND: Stigma and negative attitudes can affect the quality of life of the mentally ill and people with substance use disorders. Nurses’ personal attitudes toward mental illness and substance abuse affect the care they provide. AIM: The aim of the study was to examine the attitudes of nurses toward mental illness and substance abuse. MATERIALS AND METHODS: This was a cross-sectional study conducted in March and April 2022 at the Neuropsychiatric Hospital among nurses. The survey was filled out by 100 nurses, 43 (43%) male and 57 (57%) female nurses. The survey consisted of a revised scale for measuring attitudes toward psychiatric patients, the scale of knowledge on psychiatric patients, and the social distance scale. The statistical analysis was performed using MedCalc® Statistical Software version 20.218. RESULTS: Compared to male nurses, female nurses are significantly more afraid of mental patients (χ2 test, p = 0.01), and estimate that they are aggressive and dangerous for the environment (Fisher’s exact test, p = 0.001). Compared to female nurses, male nurses change the way that they communicate significantly more with mentally ill people (χ2 test, p = 0.01, they are especially kind to mentally ill people, so as not to cause unwanted reactions (χ2 test, p &lt; 0.001). CONCLUSION: Nurses’ attitudes toward mentally ill people are negative, and there is a difference according to gender. Most nurses estimate that mentally ill patients are aggressive and dangerous to the environment and cannot fully feel understanding toward them.

Stigma and discrimination against people living with HIV by health care providers in Egypt

ObjectiveHIV/AIDS has been recently increasingly observed in developing countries including Egypt. This study aimed to explore stigma and discrimination attitudes of health care providers (HCPs) in Egypt, as elimination of stigma in healthcare settings is a priority to improve case detection and management.MethodsA Google form questionnaire using the validated Arabic version of Health Care Provider HIV/AIDS Stigma Scale (HPASS) was sent to physicians and nurses of Ministry of health (MOH) hospitals and University hospitals in 10 randomly selected Governorates in Egypt. Data was collected from July to August, 2022 from 1577 physicians and 787 nurses. Bivariate and multivariable linear regression analyses were used to identify the predictors of the stigmatizing attitude of HCPs towards People living with HIV (PLHIV).ResultsThe majority of HCPs had worries about contracting HIV infection from their patients (75.8% of physicians and 77% of nurses). They believed that protective measures are not good enough to protect them from getting infected (73.9% of physicians and 74.7% of nurses). About half of the participants had worries about the safety of performing blood investigations to PLHIV (54% of physicians and 59.9% of nurses). Less than half of HCPs believed they have the right to refuse providing care to patients to protect themselves (44.6% of physicians and 50.1% of nurses). Only 10.5% of physicians and 11.9% of nurses have previously refused to provide health care to PLHIV. There was a significantly higher mean score of prejudice and stereotype among nurses compared to physicians (prejudice; 27.34 ± 7.88 vs 26.17 ± 7.5, stereotype; 18.54 ± 4.61 vs 16.43 ± 5.21, for nurses and physicians, respectively). Less years of physicians’ experience (B = -0.10, p < 0.01) and rural residence (B = 1.48, p < 0.05) were significantly associated with higher prejudice score while having lower qualification (B = -1.47, p < 0.001) was significantly associated with higher stereotype score.ConclusionStandards of practice should be developed to adjust the services and prepare HCPs to provide medical care free from stigma and discrimination against PLHIV. Improving knowledge of HCPs regarding the methods of transmission of HIV, the use of infection control measures and the emotional factors shaping lives of PLHIV should be targeted through updated training programs. More concern should be directed to young providers in the training programs.

Understanding parental knowledge, attitudes and self-efficacy in professional help-seeking for child anxiety

BackgroundChild anxiety disorders are highly prevalent yet undertreated. As parents are often ‘gatekeepers’ to children receiving treatment and support, this study aimed to investigate modifiable parental factors affecting professional help-seeking for their children from general practitioners (GPs), psychologists, and paediatricians. MethodsIn this study, 257 Australian parents of children aged 5–12 years with elevated anxiety symptoms completed a cross-sectional online survey. The survey assessed help-seeking from a GP, psychologist, and paediatrician (General Help Seeking Questionnaire), as well as anxiety knowledge (Anxiety Literacy Scale), help-seeking attitudes (Attitudes Toward Seeking Professional Psychological Help), personal stigma (Generalised Anxiety Stigma Scale) and self-efficacy (Self-Efficacy in Seeking Mental Health Care). Results66.9% of participants had sought help from a GP, 61.1% from a psychologist, and 33.9% from a paediatrician. Help-seeking from a GP or psychologist was associated with lower personal stigma (p = .02 and p = .03 respectively). Participants who sought help from a psychologist also had more positive attitudes toward seeking professional support (p = .01). Conversely, knowledge of anxiety disorders and self-efficacy were not associated with help-seeking from any source. LimitationsLimitations of the study include the representativeness of our sample (female gender, higher education level); unexplained variance potentially accounted for by other factors (e.g., structural barriers); lack of prior validation of measures in a parent sample. ConclusionsThis research will inform the development of public health policy and psychoeducation interventions for parents, to reduce personal stigma and increase positive attitudes towards professional help-seeking, in turn improving help-seeking for child anxiety.