Stigma Of Illness Research Articles

A multifaceted approach in promoting positive mental health culture in Hong Kong secondary schools: The Mindshift educational networking programme.

Many young people with mental health problems refuse to seek help because of stigma and leave the problem untreated. Previous research suggests that contact interventions with education could improve the stigma of mental illness in young people, thereby encouraging help-seeking in distress. The current study examined the effectiveness of a multifaceted programme, the Mindshift educational networking programme (MENP), in promoting a positive mental health culture in Hong Kong secondary schools. The MENP provided activities at school, teacher and student levels to 14 Hong Kong secondary schools. School activities included visits, mental health talks and support for capstone projects. While teachers participated in workshops and regional seminars, students received ambassador training workshops, contact opportunities with people with psychosis and attachment programmes. The impact of MENP was evaluated by changes in students' knowledge, attitudes and behaviours toward people with psychosis and mental illness before and after the programme, as well as by teachers' feedback on the programme. This study analysed data from 55 students and 20 teachers. It was found that the MENP improved students' knowledge of mood symptoms (p= .03), acceptance of people with psychosis (p= .04) and intended behaviour toward people with mental illness (p= .02). The feedback of the teachers on the programme was positive. The results support the application of the multifaceted approach to promote a positive mental health culture in schools. The findings call on the government to implement the programme in schools in Hong Kong by providing financial support to relevant organizations.

Stigma Attitudes Towards People with Mental Illness among Professionals Working in a Psychiatric Hospital

Introduction: Mental illness stigma studies demonstrate the presence of stigmatizing attitudes towards people with mental illness both by the public and health professionals. This study aimed to analyze the attitudes of professionals working at a Portuguese psychiatric hospital towards people with mental illness. Material and Methods: A cross‑sectional observational study was conducted to examine the attitudes of professionals through application of Mental Illness Clinician Attitude Scale (MICA) and collection of sociodemographic data. Results: Scores of MICA questionnaire were significantly lower than the cut‑off point for negative attitude in general and across professional categories suggesting that overall professionals seem to manifest a positive attitude towards people with mental illness. There was a trend of decrease in MICA scores throughout increasing years of professional experience although not statistically significant. Conclusion: Our results do not contradict the need to continue fighting stigma, but instead to better evaluate how these attitudes translate into practice, by including behavioral outcomes in future research.

Mental Illness Stigma: The Psychometric Properties of the Persian Version of the Attribution Questionnaire (AQ-27-P)

The main objective of the present study was the translation of The Attribution Questionnaire (AQ-27) into Persian language (AQ-27-P), and analysis of psychometric properties for use in Persian-speaking population and to evaluate the responsibility and dangerousness models of mental illness stigma. 600 adults were selected through the quota sampling method from general population of Tehran city (Iran). The study conducted the translation/back-translation to translate the questionnaire and provide its Content validity. Cronbach’s alpha coefficient was examined to evaluate the reliability of the AQ-27-P. Test–retest reliability was assessed using an intraclass correlation coefficient. Structural Equation Modeling was used to test the responsibility and dangerousness models of stigma. The internal consistency of AQ-27-P was satisfactory (α = .88), ranging from .82 to .93. Test–retest reliability showed acceptable results for the total score (ICC = 0.74). All the fit indices relatively confirmed responsibility and dangerousness models of stigma, and all AQ-27 items loaded significantly into the corresponding latent factors. Unexpectedly, the results of the dangerousness model showed that fear had a negative relation with avoidance responses. The AQ-27-P is a standardized questionnaire with admissible psychometric properties, which can be used to assess stigmatizing attitudes in Persian-speaking populations.

Affiliate stigma of mental illness in family caregivers of persons with mental illness in Hong Kong.

Affiliate stigma of family caregivers may severely influence family caregiving, early treatment, and recovery of people with mental illness (PMI), and it may be impacted by the knowledge of mental illness and contact with PMI. However, little is known about the correlation between affiliate stigma of family caregivers of PMI and contact in Hong Kong. This study aimed to investigate affiliate stigma and its influencing factors among family caregivers of PMI in Hong Kong. A total of 106 family caregivers in Hong Kong participated in the study. The measurements included affiliate stigma, contacts (quantity, quality, and level), knowledge, prejudice, and discriminatory behaviors. Multiple regression analyses were employed. The mean score of affiliate stigma scale (ASS) in family caregivers was 2.17 (SD = 0.65). In regression analyses, the results showed that contact quantity and contact level were significantly associated with higher affiliate stigma and its cognitive domain, while contact quality (e.g. positive contact) were significantly associated with lower affiliate stigma and its all domains among family caregivers. The positive relationship between prejudicial attitudes and affiliate stigma was also found. Affiliate stigma is severe among family caregivers of PMI in Hong Kong. The results of this study indicate that contact, especially positive contact, contributes to reducing affiliate stigma among family caregivers of PMI. The results of this study are important for development of health policy on reducing stigma in family caregivers of PMI. The effectiveness of Enhancing Contact Model (ECM) should be examined in future anti-stigma interventions.

Increasing resiliency and reducing mental illness stigma in post-secondary students: A meta-analytic evaluation of the inquiring mind program

Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health “crisis” on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d > .50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program’s effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations.

Development and validity of the Value-based Stigma Inventory (VASI): a value-sensitive questionnaire for the assessment of mental health stigma

BackgroundIt has been hypothesized that mental illness stigma differs according to what matters most to people, and that this results in value-based differences in stigma within societies. However, there is a lack of stigma measures that account for a broad range of values, including modern and liberal values.MethodsFor the development of the Value-based Stigma Inventory (VASI) a preliminary item-pool of 68 VASI-items was assembled by mental health and stigma experts. For psychometric evaluation, we tested the VASI in an online sample of the general population (n = 4983).ResultsBased on item-characteristics as well as explorative and confirmatory factor analyses, a final version of the VASI was developed, comprising 15 items and 5 subscales. The VASI shows good psychometric properties (item difficulty = 0.34 to 0.67; mean inter-item correlation r = 0.326; Cronbach’s α = 0.879). Medium to high correlations with established stigma scales (SDS, SSMI), medium associations with instruments assessing personal values (PVQ, KSA-3) and small to no associations with a social desirability scale (KSE-G) attest to good convergent and discriminatory validity of the new instrument. Normative values for the VASI subscales are presented.ConclusionsThe developed VASI can be used to assess public stigma of mental illness including personal stigma-relevant value orientations.

Cultural reproduction of mental illness stigma and stereotypes

This study investigates how schemas and stereotypes about individuals with mental illness shape how information is transmitted between people. Mental illnesses are highly stigmatized identities, and prior work illustrates the persistence of mental illness stigma, despite public health efforts aimed at increasing awareness of the biological origins of mental illness (Pescosolido et al., 2010). Recent work has also demonstrated the utility of combining cultural cognition with social psychological theories of cultural meaning to investigate how stereotypes are transmitted through secondhand narratives (Hunzaker 2014, 2016). We connect this social psychological work with medical sociological literature on mental illness stigmas and propose that stereotypes function as cultural schemas that shape the way stories are remembered and retold about individuals with a mental illness. We then conduct a narrative transmission study to test this proposal, using schizophrenia as a case of interest. Consistent with prior work, we find that individuals who retell a story about a person with schizophrenia alter the narrative so that it becomes more consistent with stereotypes about individuals with schizophrenia. We also find that stereotype-inconsistent information is more likely to be transformed to align with culturally shared beliefs about schizophrenia. The findings extend prior work on how bias shapes the reproduction of mental illness stereotypes, and demonstrate how socially learned cultural beliefs can reinforce stereotypes, biases and stigma about mental illness.

Digital mental health literacy -program for the first-year medical students\u2019 wellbeing: a one group quasi-experimental study

BackgroundMedical students are prone to mental disorders, such as depression and anxiety, and their psychological burden is mainly related to their highly demanding studies. Interventions are needed to improve medical students’ mental health literacy (MHL) and wellbeing. This study assessed the digital Transitions, a MHL program for medical students that covered blended life skills and mindfulness activities.MethodologyThis was a one group, quasi-experimental pretest-posttest study. The study population was 374 first-year students who started attending the medical faculty at the University of Turku, Finland, in 2018-2019. Transitions was provided as an elective course and 220 students chose to attend and 182 agreed to participate in our research. Transitions included two 60-minute lectures, four weeks apart, with online self-learning material in between. The content focused on life and academic skills, stress management, positive mental health, mental health problems and disorders. It included mindfulness audiotapes. Mental health knowledge, stigma and help-seeking questionnaires were used to measure MHL. The Perceived Stress Scale and General Health Questionnaire measured the students’ stress and health, respectively. A single group design, with repeated measurements of analysis of variance, was used to analyze the differences in the mean outcome scores for the 158 students who completed all three stages: the pre-test (before the first lecture), the post-test (after the second lecture) and the two-month follow-up evaluation.ResultsThe students’ mean scores for mental health knowledge improved (-1.6, 95% Cl -1.9 to -1.3, P<.001) and their emotional symptoms were alleviated immediately after the program (0.5, 95% Cl 0.0 to 1.1, P=.040). The changes were maintained at the two-month follow up (-1.7, 95% Cl -2.0 to -1.4, P<.001 and 1.0, 95% Cl 0.2 to 1.8, P=.019, respectively). The students’ stress levels reduced (P=.022) and their attitudes towards help-seeking improved after the program (P<.001), but these changes were not maintained at the two-month follow up. The stigma of mental illness did not change during the study (P=.13).ConclusionsThe digital Transitions program was easily integrated into the university curriculum and it improved the students’ mental health literacy and wellbeing. The program may respond to the increasing global need for universal digital services, especially during the lockdowns due to the COVID-19 pandemic.Trial registrationThe trial was registered at the ISRCTN registry (26 May 2021), registration number 10.1186/ISRCTN10565335).

Revisiting Drug Compliance: The Need for a Holistic Approach in the Treatment of Severe Mental Disorders.

The limited practice of depot antipsychotics and psychoeducation use, recommended for overcoming the noncompliance of patients with severe mental disorders, is linked to a high incidence of treatment violation. Therefore, the development of personalized mental healthcare approaches is a crucial healthcare task. To describe and differentiate the role of clinical, social and psychological factors that lead to different level of treatment engagement of psychiatric inpatients. Secondary analysis of findings from 91 inpatients, based on the Treatment Motivation Assessment Questionnaire and Medication Compliance Scale, as well as the Scale of Internalized Stigma of Mental Illness and Perceived Discrimination and Devaluation Scale. Factorial analysis, cluster analysis and analysis of variance with p-level=0.05 and the calculation of the effect size (ES) according to Cohen's d and Cramer's V were used. The nature of therapy compliance in various categories of patients is mediated differentially, including: the severity of negative symptoms (ES=0.29), the global level of functioning and work maladjustment (ES=0.23-0.26), various motivational and behavioral styles (ES≥0.74) and the intensity of psychiatric stigmatization (ES≥0.88). Consideration of the clinical, social and psychological factors should empirically determine the strategies for the personalized use of prolonged antipsychotics and socio-psychotherapeutic interventions when developing an individual treatment plan for psychiatric in-patients.

‘Swinging the lead and working the head’ – An explanation as to why mental illness stigma is prevalent in policing

Policing can be injurious to the mental health of those delivering the service. The causes can be operational, organisational or a mixture of both. Mental health related stigma is prevalent within policing; thus, help seeking is avoided. Those who do seek help are often thought to be malingerers. Managers are considered to be ill equipped to identify and support those at risk. The processes and policies that are meant to support recovery do not meet the needs of the officers and staff living and working with mental ill health. Consequently, disclosing a mental health issue is seen as career destroying.

Socioeconomic status and mental illness stigma: How income level and social dominance orientation may help to perpetuate stigma.

Socioeconomic status and mental illness stigma: How income level and social dominance orientation may help to perpetuate stigma.

Serious Mental Illness in Post-Acute and Long-Term Care:Building Knowledge, Sharing Care

Serious Mental Illness in Post-Acute and Long-Term Care:Building Knowledge, Sharing Care

Older Adults and Serious Mental Illness: What We Know and What We Imagine

Older Adults and Serious Mental Illness: What We Know and What We Imagine

Risk factors and impact of stigma on psychiatric patients in Sohag

BackgroundStigma among psychiatric patients is pervasive all over the world. Our aim in this study was to investigate risk factors for stigma related to psychiatric disorders and to demonstrate the major consequences of mental stigma for patients who experience mental illness. We conducted a cross-sectional study and applied a stigma scale to 573 patients with psychiatric disorders who attended our outpatient psychiatry clinic. Participants were divided into two groups, group I (no.262) with low stigma score and group II (no.311) with high stigma score. The two groups were compared in term of socio-demographic characteristics (age, gender, level of education, residency, marital status, employment and socioeconomic level), factors related to the psychiatric disorder (duration of illness, number of psychiatric hospital admission and diagnosis) and impact of psychiatric illness (follow-up visits, adherence to medications and suicidal thoughts or attempts).ResultsThe mean age of patients with high stigma score (group II) was 29 ± 6 years. High stigma score was more common in females (53.7%), illiterate (11.9%), living in rural areas (58.2%), single (22.83%), unemployed (44.37%) and low socioeconomic class (59.49%). Patients with a high stigma score showed longer duration of psychiatric disorder (43 ± 8 months), more frequent number of psychiatric hospital admission (4.3 ± 0.5) and schizophrenia ((11.25%) and other psychotic disorders (6.49%) were common diagnoses. Patients with a high stigma score show poor adherence to medication (47.91%) and follow-up (44.05%) and a high frequency of suicidal ideation or attempt (47.91%). Significant risk factors predicting high mental stigma were level of education (explaining about 23% of the risk, P = 0.03), duration of mental illness (explaining about 25% of the risk, P = 0.019), number of hospital admissions (explaining about 22.7% of the risk, P = 0.032), diagnosis of mental illness (explaining about 27.7% of the risk, P = 0.01).ConclusionMental stigma is more prevalent among young aged individuals, females, single, unemployed, living in rural areas and those with lower educational and socioeconomic level. Mental stigma has a parallel correlation with psychiatric disorder duration, number of psychiatric hospital admissions, as well as diagnosis of psychotic disorder. The stigma of mental illness from the viewpoint of the patient may lead to delaying the access to care as well as poor adherence to medications and follow-up. Anti-stigma measures can contribute to diminishing the psychiatric illness effect.

Continuum beliefs and mental illness stigma: A systematic review and meta-analysis of correlation and Intervention studies

Abstract Promulgating a continuum model of mental health and mental illness has been proposed as a way to reduce stigma by decreasing notions of differentness. In a systematic review and meta-analysis, we examined whether continuum beliefs are associated with lower stigma, and whether continuum interventions reduce stigma. We searched three electronic databases (PubMed, Web of Science and PsycINFO) yielding 6726 studies. After screening, we included 33 studies covering continuum beliefs, mental illness and stigma. Of these, 13 studies were included in meta-analysis. Continuum beliefs are consistently associated with lower stigma. Interventions were effective in manipulating continuum beliefs but differ in their effects on stigmatizing attitudes. We discuss whether and to what extent attitudes towards people with mental illness can be improved by providing information on a mental health-mental illness continuum. It appeared to be relevant whether interventions promoted a feeling of “us” and a process of identification with the person with mental illness. We discuss implications for the design of future interventions using the example of our current online anti-stigma intervention, which was developed on the basis of these considerations, containing gamified elements with the purpose of identification and involvement.

Reliability and Validity of the Chinese Version of the Scale for Assessing the Stigma of Mental Illness in Nursing

Background: The prevalence of mental illness continues to increase in China, but research on stigma is still in its infancy, and there are even fewer studies on stigma among nurses. A comprehensive, effective and reliable tool is needed to assess stigma in nursing so that it can be reduced or eliminated to improve nursing quality. This study aimed to translate a 20-item scale for assessing the stigma of mental illness in nursing into Chinese and evaluate its reliability and validity.Methods: An improved Brislin translation model was used to translate the nursing mental illness stigma assessment scale into Chinese. Content and face validity were determined by a panel of experts. A convenience sample of 501 nursing students was chosen. Confirmatory factor analysis, concurrent validity and known group comparison were used to evaluate the scale's structural validity. The reliability was evaluated based on the internal consistency reliability and 2-week retest reliability.Results: The content validity index was 0.90. Confirmatory factor analysis showed that this study supported the three-factor model. The moderate correlation between the Chinese version of the Scale for Assessing the Stigma of Mental Illness in Nursing and the Perceived Devaluation Discrimination Scale suggested acceptable concurrent validity. Cronbach's α (0.863) and the retest coefficient (0.839) were indicative of internal consistency.Conclusion: The Chinese version of the Scale for Assessing the Stigma of Mental Illness in Nursing has acceptable concurrent validity, marginal factor validity, and satisfactory reliability in China. Therefore, the three-factor structure of the Chinese scale should be considered.Relevance to Clinical Practice: The Chinese version of the Scale for Assessing the Stigma of Mental Illness in Nursing can be used to understand the degree of mental illness stigma in nursing.

THE MENTAL HEALTH CHALLENGES FACING MUSLIM YOUTH IN THE ERA OF COVID-19

The objectives of this presentation are as follows: 1) participants will recognize the challenges and special needs of Muslim youth and families during COVID-19; 2) participants will identify the impact of COVID-19 on the emotional well-being of Muslim youth; and 3) participants will learn tools that help provide the Muslim youth with culturally and religiously sensitive care. Fatten Elkomy, ARNP, will discuss the impact of school closures and social isolation on Muslim youth. Rakin Hoq, MD, will focus on the religious interpretation of psychotic illnesses for Muslim youth as it relates to COVID-19. Sarah Arshad, MD, will discuss working with suicidal Muslim youth, and Rania Awaad, MD, will discuss her research with Muslim transitional-age youth during the COVID-19 pandemic and faith-based interventions. Muslim youth and families have diverse backgrounds and life experiences. COVID-19 has added to their stress levels, including the trauma of illness and death, uncertainty about the future, and feelings of isolation. It also increased the suffering of those youth who were struggling with mental illnesses. With the stigma of mental illness, the emotional needs of these youth were not well addressed. Thus, culturally sensitive intervention for these youth is recommended to address their special issues and needs. Child and adolescent psychiatrists can provide these youth and their families with the best care when they are able to recognize their special needs and help them overcome obstacles to care in this very challenging time.

Pathway to Service and Duration of Untreated Attention Deficit, Hyperactivity Disorder among Children Presented to a Governmental, Mental Health Hospital in Egypt

Abstract Background ADHD is one of the most common neurodevelopmental disorders. Despite the presence of evidence based approved diagnosing and treatment tools for ADHD, there still is an underdiagnoses and underutilization of these services. Untreated ADHD, unlike what some families may believe, doesn’t go away on its own, in fact, the condition may get worse with age, affecting more domains of the child’s life as an adolescent and later on as an adult. In addition, untreated ADHD impacts not only the patient, but also the family and the society as a whole. Objective to investigate different routes that parents take before reaching the child and adolescence psychiatric services. And to further explore various reasons for any delay in seeking psychiatric help. In addition we aimed to estimate the duration of untreated ADHD before patients receive proper psychiatric service and treatment. Patients and Methods A total of 350 cases were recruited in a cross sectional study that took place at the Child and Adolescence outpatient clinic at Abbassia mental health hospital in Cairo, Egypt. Results Results showed that the average delay in seeking Child and Adolescence psychiatric service and the duration of untreated ADHD was 3±2 years. The majority of parents, 27.1%, first consulted pediatricians as regards to their child’s symptoms. The most commonly reported source of referral was school teachers in 23.1%. The most distressing symptom stated by 28.1% of parents was impulsivity. Stigma of mental illness was the most frequently reported reason for delay in reaching out for psychiatric service. Conclusion we concluded that parents tend to take other routes through different professions before reaching Child and Adolescence Mental Health Services, this causes subsequent delay in receiving diagnosis and treatment for ADHD. In Addition, it was concluded that sociocultural beliefs affected parent’s pattern of help seeking.

Perceived mental illness stigma by medical students prior and after psychiatric training

Introduction. Patients diagnosed with mental health conditions are affected by high levels of stigma emerging from society, families, and medical care providers. The latter is one of the main reasons for difficult access and/or inadequate medical care received by psychiatric patients and for their increased number of comorbidities. Objective. The present study aimed to assess the levels of stigma towards patients diagnosed with mental illness expressed by six-year medical students, before and after the seven-week psychiatry clinical internship. Methods. Six-year medical students from Romanian and foreign languages sections filled out a questionnaire with demographic data, questions regarding their opinions on mental patients, and on the probability of choosing psychiatry as their specialty. Additionally, they completed a discrimination and devaluation questionnaire. The completion of questionnaires was performed twice: before the beginning and at the end of their clinical psychiatric internship. Results. A total of 349 students answered the questionnaires, belonging to different groups: Romanian group represented by 177 students, the English students as a total of 114, and the French students group represented by 58. In both evaluations, Romanian students showed higher levels of discrimination and increased reservation in approaching or understanding patients diagnosed with psychiatric illnesses. Significant mentality changes were noticed regarding the lack of difference between a mentally ill patient and a patient with physical health illnesses and in the process of how psychiatric patients should be treated. Conclusions. Cultural aspects and previous health education have a higher influence on perceived stigma in mental illness compared to other factors. Direct contact with patients did not change the perceptions of medical students and did not impact career options in a significant way.

Social Contact: Next Steps in an Effective Strategy to Mitigate the Stigma of Mental Illness

People living with mental illnesses and their families may conceal their conditions to avoid prejudice and discrimination. Stigma often prevents people from receiving adequate health care and other social support services which could exacerbate social and health consequences such as unemployment, homelessness, substance use, and compulsory hospitalization. In this paper, we discuss social contact as a promising anti-stigma strategy for enhancing social interactions among people with mental illnesses, their families, and those without mental illnesses. In particularly, we consider next steps for an approach that works to reduce the stigma-related burden of mental illness. For social contact to be effective in reducing mental illness stigma, it requires broad social buy-in as well as implementation within care systems. Engagement with this approach can be driven through diverse contact-based education using collaborative efforts of society, academic institutions, policy-makers, health professionals, media, and governments. Ultimately, this work aims to consider the next steps in enacting social contact as an anti-stigma strategy through direct interventions and contact-based education. The success of this approach requires pragmatic public policies to support its implementation.