Public stigma towards mental illness in the Greek culture

The Role of Contact and Emotional Intelligence in the Attitudes of General Population Towards Individuals Living With Mental Illness

Mental illness stigma is still a widespread phenomenon with damaging psychological and social consequences. This study is of relevance to the design of appropriate psychiatric services which reinforce the social integration of individuals living with mental illness. It investigates the relationship between contact, emotional intelligence (EI) and attitudes of the general population towards people with mental illness. This study utilized a random sampling method to collect data from 183 participants. Measures included the EI Scale for assessing EI, the level of contact (LOC) Report to examine the LOC with mental illness, and the Attitudes towards Mental Illness Scale to evaluate attitudes towards mental illness. Each of these instruments has been validated in previous research. Data analysis involved Pearson's correlation analysis, multiple linear regression, and mediation analysis to explore the relationships between variables. EI and particularly the abilities of use of emotion and other's emotional appraisal were associated with more positive attitudes towards mental illness. conversely, lower levels of contact were associated with higher levels of social care, indicating a complicated relationship between contact and attitudes. The findings highlight that a deeper understanding of the association between contact with individuals living with mental illness and attitudes towards them is needed, focusing on potential mechanisms that might modify this association. Additionally, a focal point that is underlined in this research is the important role of EI in affecting attitudes as it seems to offer promising directions in planning educational programs and stigma reduction interventions.

Knowledge and attitudes towards electroconvulsive therapy for psychiatric conditions in a single-center Jordanian hospital: a cross-sectional study

Background

Knowledge and attitude toward electroconvulsive therapy (ECT) play crucial roles in determining the acceptance of ECT as a viable and effective treatment option.

Results

This study involved 400 participants (57.3% female), aged 18–25 years (36.8%) and predominantly single (49.8%), with a bachelor’s degree or higher (78.8%). Only 1.8% had undergone ECT before. While 32.0% relied on social media for ECT information, only 9.5% had a family history of psychiatric illness, and 5.8% had previous psychiatric visits. Knowledge about ECT was moderate (4.51 ± 1.76). Attitudes were less favorable (2.45 ± 2.47), with concerns about ECT as punishment or inhumane treatment. Public stigma towards mental illness was moderate (mean score: 17.77 ± 6.89), with some disagreement on stereotypes. Significant differences were observed in the knowledge scale based on residing governorates and sources of information (p = 0.003 and < 0.001, respectively). Additionally, significant differences in the attitude scale were reported for sources of information (p = 0.002), and significant differences in public stigma were found among age groups (p = 0.023). Spearman’s correlation revealed moderate positive associations between knowledge and attitudes (0.314, p < 0.001) and weak positive associations between knowledge and public stigma (0.185, p < 0.001).

Conclusion

Patients with stigma and poor knowledge of ECT may affect their choice in undergoing or advising family members to take on ECT if medically prescribed.

Mental health-related stigma discrimination and prejudices among Greek healthcare professionals

Introduction

Research shows that mental health-related stigma, stereotypes, and prejudices have a negative impact on the patients themselves as well as on their families and social entourage. Healthcare professionals, whose expertise and professional ethos are historically acknowledged by public opinion, are expected to play a major role in combating discrimination against psychiatric patients. In this study, we aimed to assess the attitudes of Greek healthcare professionals toward mental illness and people suffering from it.

Materials and methods

It is a non-interventional, analytic study, in which 479 health workers from a tertiary hospital in Thessaloniki, Greece, participated. Every single hospital service -except the personnel of the Psychiatric Clinic- was included in our study: from the cleaning service to the administrative staff and the auxiliary staff such as stretcher carriers, food and nutrition services' staff, and social workers, the nursing staff, and finally the attending physicians, taking into consideration that the psychiatric patient, from the moment he/she enters the hospital, consecutively gets in contact with every work grade of the healthcare establishment. Participants' attitudes concerning mental illness have been evaluated using the Opinions about Mental Illness Scale (OMI), the Social Distance Scale (SDS), and the Level of Contact Report (LCR-12).

Results

Despite the high level of familiarity [as evaluated with LCR-12; mean score (μ): 8.82 ± 1.73], the employees displayed a rather poor willingness to interact with psychiatric patients (as measured with SDS; μ:11.68 ± 4.28), and endorsed significant prejudice toward individuals with mental disorders (assessed using OMI subscales; Social Discrimination μ: 22.99 ± 12.08, Social Restriction μ: 17.45 ± 9.07, Social Care μ: 21.04 ± 4.12, Social Integration μ: 16.38 ± 4.68, Etiology μ: 9.80 ± 4.95). Age and education stood out as the main determinants of participants' attitudes, with younger and highly educated participants to have shown a relatively refined profile.

Conclusion

These results are not significantly improved compared to those of previous decades in Greek healthcare professionals and call for critical reflection and targeted stigma-reduction efforts.

An age-period-cohort study of completed suicides in Greece: Patterns and implications for suicide prevention

Suicide is a dynamic phenomenon. Psychiatric medication intake, illicit drug and alcohol use or the preference for particular suicide methods shift continuously over time. To capture such variations -and their potential implications for suicide prevention-, we researched the forensic records of suicide cases for the period 1992-2016 at a large department of forensic medicine and conducted age-period-cohort (APC) analyses of our sample (1162 suicides, 77.45% males, 22.25% females). We primarily investigated socio-demographic and toxicological parameters. Benzodiazepine, alcohol and illicit drug use increased considerably towards the younger cohorts. The segment of individuals of foreign nationality raised significantly too; likewise, the proportion of prison suicides. Hanging appears increasingly preferred by the younger APCs (the opposite is true for jumping). Hanging seems more popular among males, prisoners, and those under the influence of illicit drugs; jumping by females and those less likely to have consumed alcohol or illicit drugs. Given that the method of a prior attempt, if a highly lethal one, usually gets repeated in the completed suicide, a history of an attempt by hanging should never be underestimated. The mental health needs of immigrants and prisoners look inadequately addressed. Young-middle aged immigrant prisoners appear a group at high suicide risk.

Risk factors associated with experienced stigma among people diagnosed with mental ill-health: a cross-sectional study

PURPOSE

to examine the relationship between religiosity, social support, trauma, quality of life and experienced stigma of mental illness amongst a population diagnosed with mental ill-health.

METHODS

A cross-sectional survey of day service users in Northern Ireland (n = 295) covering a range of issues including religiosity, social support, quality of life and prior experience of trauma. Stigma was measured using a recognised stigma scale. We used multinomial logistic regression to examine risk factors associated with experienced stigma.

RESULTS

Univariate analysis showed significant associations between stigma and age, number of friends, social support, quality of life and prior experience of trauma. Age, quality of life, and trauma remained independently associated with stigma in a multivariate logistic regression model (x2(12) = 98.40, p < 0.001).

CONCLUSION

Younger people, those with less social support, prior experience of trauma and with poorer quality of life are at increased risk of experiencing stigma related to their diagnosis of mental illness. The findings provide further understanding of stigma and are useful for those overseeing programmes to improve access to mental health treatment.

Effectiveness of a Problem-Solving, Story-Bridge Mental Health Literacy Programme in Improving Ghanaian Community Leaders' Attitudes towards People with Mental Illness: A Cluster Randomised Controlled Trial

In Ghana, people with mental disorders commonly experience negative attitudes and discrimination because of deep-rooted public stigma. The aim of the study was to assess the effectiveness of a mental health literacy programme in improving community leaders' attitudes toward people with mental disorders. A cluster randomised controlled trial, comprising an intervention and control group, participated in a 3-hour problem-solving, Story-bridge mental health literacy programme. Data were collected at baseline and 12-week follow-up. The intervention group performed better in most outcome measures at follow-up compared to the control group. There were statistically significant differences between the two groups, in perceived stigma, community mental health ideology (CMHI), and benevolence outcome measures over the two time-points. Overall, the findings suggest that the programme was somewhat effective in improving community leaders' attitudes and who might, subsequently, foster supportive, non-judgemental and empathetic attitudes toward individuals with mental disorders in their communities. There is scope for community psychiatric nurses and other primary health care workers to work with community leaders to increase public awareness of, and favourable attitudes toward, people with mental health problems in the community.

Factors Associated with the Type of Cesarean Section in Greece and Their Correlation with International Guidelines

BACKGROUND

Cesarean section (CS) rates have been increasing worldwide with different effects on maternal and neonatal health. Factors responsible for the growing trend of CSs, include maternal characteristics, medical insurance and convenient scheduling or financial incentives. Effective interventions and guidelines are required to reduce CS rates.

OBJECTIVE

The aim of this research was to investigate the factors contributing to CS rate increase and their correlation with international guidelines.

METHODS

The performed analysis included the available socio-demographic and medical information retrieved from the medical records and a related questionnaire in both emergency and elective CSs.

RESULTS

Out of the included 633 births, the cesarean delivery rate was 58%. Women with a previous CS showed higher percentages for Elective CS (66.1%) compared to Emergency CSs for the same reasons (8.9%). Furthermore, 23% of the patients underwent an Emergency CS because of failure of labor to progress while 18% of CSs were due to maternal desire.

CONCLUSION

The high rates of CS in Greece demonstrate the lack of use of international obstetric protocols, national strategies, Cesarean Section audits and a significant shortage of midwives. A decrease in iatrogenic and non-iatrogenic factors leading to the primary CS will decrease CS rates.

A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males

The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.

COVID-19 AND STIGMATISATION OF HEALTHCARE PROVIDERS

The aim: this study presents a Coronavirus Stigma Scale for Healthcare Providers that indicates the social stigmatisation rate and severity toward healthcare providers to a certain extent. This paper aims at raising awareness on the stigmatisation of healthcare providers who sacrifice their own lives for patients diagnosed or are at risk of being infected with COVID-19. Methods: the study uses a 12-item 5-point Likert-type Coronavirus Stigma Scale for Healthcare Providers, which was constructed based on the previously shortened and modified HIV Stigma Scale. The scale was distributed online to healthcare providers, and all the results obtained were then saved to an Excel file. Correlations were determined by using ANOVA and the independent t-test. Percentages, averages, figures and rates were calculated with SPSS. Results: the population of the study comprised 136 participants in total; 40 male and 96 female. Reliability and validity studies were conducted using Cronbach’s alpha and factor analysis. The stigmatisation rate toward healthcare providers was found to be significantly high, and the stigmatisation level was found to increase significantly with increasing age (p<0.05). Conclusions: the mistreatment of stigmatised healthcare providers during a pandemic where the need for them is elevated results in adverse outcomes; therefore, anti-stigma programmes need to be developed. It would be wise to find solutions such as acknowledging the stigma and introducing anti-stigma programmes.

Systematic review of the prevalence of mental illness stigma within the Greek culture

BACKGROUND

A number of primary studies have now assessed mental illness stigma within the Greek culture. A synthesis and appraisal of all available evidence is now required and will contribute to our growing understanding of the relationship between the cultural context and the formation of stigmatising attitudes.

AIM

To systematically review the prevalence of mental illness public stigma within the Greek and Greek Cypriot culture.

METHOD

Empirical articles with primary data pertaining to the prevalence of mental illness public stigma among Greek and/or Greek Cypriot populations were retrieved. Included studies were assessed for quality and extracted data were narratively synthesised.

RESULTS

A total of 18 studies met the inclusion criteria. Methodological quality was highly variable; only 1 study was adequately statistically powered, 10 studies employed at least some element of probability sampling and obtained response rates of at least 70%, while 10 and 13 studies employed reliable and validated prevalence tools, respectively. Studies sampled the general population (n = 11), students (n = 4), healthcare professionals (n = 2), police officers, employers and family members (all n = 1). Stigma was consistently identified in moderate and high proportions across all of these groups, particularly in terms of social discrimination and restrictiveness, social distance and authoritarianism. However, some evidence of benevolence and positivity towards high-quality social care was also identified.

CONCLUSION

The review highlights the wide-scale prevalence of mental illness stigma within the Greek culture and the need for further rigorous research including culturally tailored stigma interventions.

The Nursing Students' Experience of Psychiatric Practice in South Korea

In 1995, South Korea passed the Mental Health Act, and since this time it has developed many mental health policies and facilities. The aim of this study is to understand and explore the experience of nursing students in the changed psychiatric practice environment since 1995. The present study is a qualitative thematic analysis. Interviews were conducted with 11 third and fourth grade nursing students who had experienced psychiatric practice in South Korea. A thematic analysis of 11 in-depth student interviews identified three themes: 'orientation before psychiatric practice', 'facing the mental hospital', and 'change and choice'. After practicing, nursing students developed positive attitude regarding psychiatry. Educators will have to focus more on education and support in order for the students to maintain positive attitude throughout their experience. The research herein shows that the role of the educators and psychiatric nurses is extremely important for nursing students in the elimination of a negative attitude towards psychiatry.