Familiarity with and social distance from people who have serious mental illness

Evaluation of a training program to support depression screening for older adults in community pharmacies

INTRODUCTION

This study aimed to evaluate the impact of a training program on community pharmacists' and pharmacy staff's perceived knowledge and attitudes regarding depression, as well as community pharmacists' confidence and acceptability, regarding late-life depression (LLD) screening.

METHODS

A training program was developed and delivered to participants in the EMPATHISE pilot study, whereby pharmacists delivered LLD screening and provided referrals when warranted. The study took place in community pharmacies across New South Wales, Australia. Training consisted of Mental Health First Aid training, and training on the identification of LLD. A 68-item survey was developed using validated questionnaires exploring participants' stigma, attitudes, knowledge and acceptability of such services. Participants were invited to complete the survey at baseline (T1), immediately post-training (T2), and 3-months post-training (T3). Changes in responses were analysed descriptively and using the Friedman test.

RESULTS

Twenty-seven of the 78 participants at baseline completed the survey across all timepoints, including 21 community pharmacists (78 %). Across the three timepoints, some improvements in participants' attitudes towards depression were observed. From T1-T2 and T1-T3, participants demonstrated some improvements in their acceptability and confidence regarding LLD screening, and increased knowledge regarding use of the Geriatric Depression Scale-15.

CONCLUSION

This training program improved aspects of participants' knowledge and attitudes towards LLD, as well as their confidence and acceptability regarding LLD screening, suggesting a need for training prior to pharmacist-delivered LLD screening. This training program may be incorporated into future studies focusing on service delivery models to help support pharmacists' early identification of LLD.

Substance Use Disorder Stigma and Professional Decision Making Among Pre-Professional Healthcare Trainees

Provider stigma toward people who have substance use disorders (SUDs) may be a barrier to effective treatment delivery. The purpose of this study was to measure provider stigma among healthcare professionals-in-training and determine whether stigma levels were associated with professional decision making. A sample of 240 participants were recruited from the following academic programs at a large university in the southeastern United States: Nursing, Social Work, Counseling, Marriage and Family Therapy, and Psychology. Through an online, anonymous survey, provider stigma and other constructs were measured. The participants were also asked to make two hypothetical professional decisions: one regarding their choice to provide treatment for an SUD patient and the other regarding their likelihood of attending a professional development event (i.e., conference session) on the topic of SUDs. Results showed that self-reported stigma toward patients with SUDs was associated with a reduced likelihood of choosing to provide treatment for a patient with SUD (compared to patients with other conditions) and a reduced likelihood of attending SUD training at an upcoming conference (compared to other conference topics). Results have potential implications for the development of training programs for pre-professional healthcare trainees.

'Zombie drugs': Dehumanising news frames and public stigma towards people who use drugs

BACKGROUND

News media is an important determinant of public understanding of drug policy topics. Recent media reporting around the use of synthetic drugs such as xylazine makes frequent use of non-human metaphors, including reference to the effects of 'zombie drugs'. We investigated whether presentation of news stories which included such dehumanising frames were associated with i) increased stigmatising attitudes towards people who use drugs; and ii) lower support for relevant harm reduction programmes.

METHODS

We undertook a cross-sectional online experimental study with a randomised factorial design, using a nationally representative sample (UK). Participants (N = 1417) were randomly presented with one of six simulated news stories based on recent reports of the identification of xylazine in the drug market. Stories differed with respect to text (neutral or referred to either a 'zombie drug', or a drug that 'turns people into zombies'); and accompanying imagery (neutral or depicting immobile people under the influence of drugs). Stigmatising attitudes and support for harm reduction were assessed using instruments including an adapted version of the Attribution Questionnaire-Substance Use Disorders (AQ-SUD) and analysed using MANOVA.

RESULTS

Data were obtained for 1235 participants (52 % female; mean age 47 ± 16). Attitudes towards people who use drugs were more stigmatising amongst participants presented with either of the dehumanising text conditions (both p < 0.001). There was no main effect of imagery and no interaction between text and imagery on stigma scores. Support for harm reduction programmes did not differ between conditions.

CONCLUSION

Our study is the first to show that dehumanising 'zombie' framing frequently used in news reporting is associated with higher public stigma towards people who use drugs. News media is an important source of public education on drugs, so to avoid reinforcing stigma the use of dehumanising language and framing, such as 'zombie' metaphors, should be avoided. Organisations working to reduce stigma towards people who use drugs should encourage news outputs and journalists to avoid this type of representation.

Binge eating disorder recognition and stigma among an adult community sample

BACKGROUND

Despite being the most prevalent eating disorder, Binge eating disorder (BED) remains largely unrecognized and lacks awareness among the general public, where it is also highly stigmatized. Common stigma surrounding BED includes the belief that individuals with this disorder are responsible for their condition and lack willpower and self-control. Research on BED recognition and stigma among lay adults is scarce. Enhancing public recognition of BED and reducing the stigma associated with it is crucial, as this could significantly improve access to treatment. The aim of the present study was to examine BED recognition and stigma within an adult community sample, and to identify associated respondent characteristics, including sociodemographic and psychosocial factors.

METHODS

A sample of 894 adults (88.6% women; Mage = 35.20 ± 14.52) completed an online survey. Participants were presented with a vignette depicting a woman with BED and obesity, followed by questionnaires assessing BED recognition, stigma, and other respondent characteristics. Independent samples t-tests were performed to compare participants who recognized BED in the vignette with those who did not, based on sociodemographic characteristics (i.e., gender, age, income, education) and psychosocial variables (i.e., explicit and internalized weight bias, familiarity with BED). A multiple linear regression analysis was performed to identify the sociodemographic and psychosocial variables that were the most important in explaining the variance in stigma towards BED.

RESULTS

Results indicated that 33% of participants identified BED as the main problem in the vignette. Those who recognized BED were younger, more educated, more familiar with BED, and exhibited lower levels of stigma towards BED. The most significant factor in explaining stigma towards BED was explicit weight bias, particularly attributing obesity to a lack of willpower and disliking people with obesity. Identifying as a man and older age were also associated with greater stigma towards BED.

CONCLUSION

The findings of the current study highlight the importance of comprehensive public awareness campaigns to improve recognition of BED and to reduce associated stigma.

The Mental Health Literacy and Stigma Scale-Bilingual Cultural Adaptation: Validity and Reliability Pilot Study in Nursing Students

AIM

To describe and evaluate the psychometric properties (reliability and construct validity) of the Mental Health Literacy and Stigma Scale-Bilingual (MHLaSS-B).

DESIGN

This is a methodological study designed in a convenience sample of 271 Portuguese and Spanish nursing students who volunteered to participate in the research.

METHODS

The Mental Health Literacy and Stigma Scale-Bilingual version (Spanish and Portuguese) was used for data collection. MHLaSS-B intercultural adaptation followed three stages: translation, back-translation and pilot test and the thinking-aloud techniques. Content validity was performed by Content Validity Index and Modified Kappa statistic. Construct validity and reliability tests were performed. Internal consistency was assessed by Cronbach's alpha. Data were analysed using SPSS programs. Ethics committee approval and permission from the institution involved were obtained.

RESULTS

The MHLaSS-B has 28 items of one-factor structure. Cronbach's alpha was 0.702. The cumulative variance explained was 23.14%. Respondents show High literacy and Low Stigma (M = 23.4).

PATIENT OR PUBLIC CONTRIBUTIONS

The availability of the MHLaSS-B allows the general population of Portugal and Spain to have a versatile instrument for assessing stigma and MHL. The MHLaSS-B presents good psychometric properties, and it can be a useful tool for novice health workers to better understand the aspects they should pay attention to manage MHL and stigma successfully. The MHLaSS-B is a reliable, adaptable instrument that is now available and it can be used in investigation, teaching and clinical practice.

WeARTolerance: Evaluating the impact of an arts-based program to reduce mental health-related stigma in young people

The stigma surrounding mental health remains a significant barrier to help-seeking and well-being in youth populations. The invisibility of mental health issues highlights the critical need for improved knowledge and stigma reduction, underscoring the urgency of tackling this issue. Arts-based interventions have shown promise in addressing stigma, yet comprehensive longitudinal studies in community settings are limited. This research evaluates the "WeARTolerance'' arts-based program in reducing mental health stigma among diverse youths. The program integrated psychoeducational and creative activities (e.g., visual arts, cinema, music, and theatre) to explore mental health themes, with 125 teenagers and young adult participants (M = 13.70; SD = 2.06). The present mixed-method study was split into two phases with complementary objectives: 1) evaluate quantitatively the program's impact in reducing social stigma and related outcomes; 2) explore in-depth qualitative feedback about the program. For the first phase, reliable self-report questionnaires were used to measure mental health knowledge, social stigma, intergroup anxiety, and social distance in pre-, post-, and 6-month follow-up periods. Participants' age and past psychiatric issues were fixed factors with random intercepts, and mixed effects models were used to analyze the attitudinal outcomes across time. In the second phase of this validation, nine teenagers aged between 12 and 16 participated in two focus groups conducted three months after the program. Its contents underwent thorough analysis using content analysis techniques. The quantitative results from Phase 1 demonstrated a decreasing trend in all primary outcomes. In phase 2, participants acknowledged the activities' relevance, reported overall satisfaction with the program, and showed great enthusiasm and willingness to learn more. Arts-based interventions like "WeARTolerance" are valuable for challenging stigma and fostering understanding in youth populations and provide an alternative and creative way to increase mental health literacy. The study proposes a program to reduce youth mental health stigma through arts-based elements, early intervention, and psychoeducation, involving collaborations between professionals and artists to promote youth engagement. Future studies should include indirect social contact and randomized controlled interventions.

Attitudes of Health and Mental Health Professionals, and Police Staff towards Mentally Ill Offenders in Greece

Mentally ill offenders face stigma, being perceived as both dangerous and unpredictable. This leads to social discrimination, which causes devaluation, distancing, and unequal treatment towards them. Critical and dismissive attitudes of healthcare professionals and police toward these patients undermine their care, treatment, and prospects for rehabilitation. This study investigated the attitudes and stereotypes of health professionals and police officers who frequently interact with mentally ill offenders. Participants completed three scales: Attitudes Toward Mentally Ill Offenders (ATMIO), Community Attitudes Toward the Mentally Ill (CAMI), and Familiarity Level Scale. The sample included 523 professionals, 283 health professionals, 139 mental health professionals, and 101 police officers, with an average age of 41.4 years and 40.3% having over 20 years of experience. Results showed that all groups displayed negative attitudes toward mentally ill offenders, with little variation between them. This highlights the need for professionals to recognize their biases when caring for this population.

Medical student's attitude toward severe mental illness and its associated factors at the university of Gondar, Northwest Ethiopia

Introduction

Mental illness is mental and emotional disturbances that affect individual thinking, feeling, decision-making, mood, and daily functioning. A poor attitude toward severe mental illness means an individual has a distorted perception or attitude toward severely mentally ill patients. Despite the presence of a high burden of negative attitudes toward severe mental illness, there is a limited study conducted on Ethiopian University students. Therefore, this study aimed to reveal the prevalence of poor attitudes toward severe mental illness and its associated factors among University Gondar medical students in Northwest Ethiopia.

Method

An institutional-based cross-sectional study design was employed from Jun 25 to August 15, 2022. A structured self-administered questionnaire was used to screen the attitudes of students toward severe mental illness. Mental Illness Clinician's Attitude fourth version and Mental Health Knowledge Schedule score tools were used to screen the attitude of students. Bi-variable logistic regression analysis was employed and variables with a p-value of less than 0.25 were entered into the multivariable logistic regression for further analysis. Factors with a p-value less than 0.05 at a 95 % Confidence Interval (CI) in the multivariable logistic regression analysis were considered statistically significantly associated.

Results

From the total of 423 study participants with a 100 % response rate the overall prevalence of poor attitude towards severe mental illness among university students was 68.1 % with a 95 % CI (63.6-72.6). Age (18-24) [AOR = 2.47; 95 % CI: (1.37,4.45)], being male [AOR = 3.22; 95 % CI: (2.01-5.17)], from a rural area [AOR = 1.82; 95 % CI: (1.13-2.93)], and with no family history of mental illness [AOR = 2.07; 95 % CI: (1.12-3.82)] were statistically significantly associated factors with poor attitude towards severe mental illness.

Conclusions

and recommendations: Approximately three-fourths of university Gondar medical students (68.1 %) had poor attitudes towards severe mental illness. Age (18-24), being male, originating from a rural area, and with no family history of mental illness were significantly associated with a poor attitude toward severe mental illness. Awareness creation about mental illness can change the attitude of students which can be done by the mental health department to give as a common course can help the student to have a positive attitude.

Pilot evaluation of a brief training video aimed at reducing mental health stigma amongst emergency first responders (the ENHANcE II study)

BACKGROUND

First responders (i.e. police and ambulance staff) have increasingly become part of the mental health care system, often being the first port of call for those experiencing a crisis. Despite their frequent involvement in supporting those with mental health problems, there is evidence that mental health stigma is high amongst first responders.

AIMS

The aim of the present study was to evaluate a brief training video aimed at reducing mental health stigma amongst first responders.

METHODS

First responders watched a training video based on the cognitive behavioural model of mental health stigma, and involved contributions from people with lived experience, and first responders. Measures of mental health stigma were collected before and after viewing the training.

RESULTS

The training video produced small but significant improvements in mental health stigma, and these effects did not differ between police and ambulance staff. We were unable to determine what psychological constructs mediated this change in stigma. The feedback on the training video was generally positive, but also indicated some key areas for future development.

CONCLUSIONS

The present study provides encouraging evidence that levels of mental health stigma can be improved using a resource-light training intervention.

Chinese College Students' Stigmatization towards People with Mental Illness: Familiarity, Perceived Dangerousness, Fear, and Social Distance

BACKGROUND

Attribution models have been examined in Western countries. However, little is known about the applicability of the attitude-emotion-behavior model within Chinese culture. This study aimed to examine the association between familiarity, perceived dangerousness, fear, and social distance towards persons with mental illness (PMI) in the Chinese context.

METHODS

An online cross-sectional survey was conducted from October to November 2022 in mainland China. A total of 1493 college students completed a questionnaire evaluating familiarity, perception of dangerousness, fear, and social distance regarding PMI. Path analysis was employed to validate the model proposed in this study.

RESULTS

Participants expressed moderate to high levels of stigma towards PMI. Familiarity was negatively associated with social distance (p < 0.01). Participants who perceived PMI as dangerous were more prone to exhibit a reaction of fear (p < 0.001), consequently leading to social distance (p < 0.01). However, the mediating effect of perceived dangerousness and fear on the relationship between familiarity and social distance was not significant (p > 0.05).

CONCLUSIONS

The results of this study provide support for Corrigan's attributional model of stigma in the Chinese context. Contact-based interventions for stigma reduction should emphasize multiple elements of contact, including the quality of contact, rather than familiarity.

The evaluation and analysis of irritable bowel syndrome-related short videos on social media (TikTok)

BACKGROUND

TikTok is one of the fastest growing social media platforms. Irritable bowel syndrome (IBS) has recently become a trending topic of interest among TikTok users.

AIM

To better understand the quality and accuracy of information presented in the most popular IBS-relevant videos on TikTok.

METHODS

We reviewed videos with the tag 'IBS'. We excluded those not relevant to IBS or lasting <10 s or >10 min. Baseline characteristics about the videos were collected. Two independent reviewers assessed each video using DISCERN and Patient Education Materials and Assessment Tool (PEMAT) tools, two validated instruments to assess the quality of patient education materials.

RESULTS

Of 100 videos, 33% were uploaded by participants with a defined medical background. The median DISCERN score of videos uploaded by participants with a medical background was 2.43 (2.00-3.10); from participants with a non-medical background, it was 1.37 (1.23-1.70) (p < 0.01). The median PEMAT Understandability scores of videos uploaded by participants with or without a medical background were 92.86 (86.61-95.00) and 80.95 (75.76-89.58), respectively (p < 0.01). The median PEMAT Actionability scores of videos uploaded by participants with or without a medical background were 100.00 (66.67-100.00) and 0.00, respectively (0.00-45.83; p < 0.01).

CONCLUSION

Videos posted by medical professionals are easier to understand and to act on, and are more reliable and unbiased, and more likely to recommend shared decision making about treatment.

Causal Explanations, Treatability, and Mental Illness Stigma: Experimental Study

OBJECTIVE

The purpose of this study was to test the effects of causal explanations, information about treatability, and type of psychiatric diagnosis on how the public reacts to an individual described as having a specific mental illness versus subclinical distress.

METHODS

A 5 (mental health condition) × 2 (treatability) × 4 (causal explanation) vignette experiment was embedded in an online survey, followed by assessments of prognostic optimism and desire to maintain social distance from the vignette character. Data were collected, in late 2022, from a probability sample (N=1,607) representative of the U.S. adult population. Ordinary least-squares regression was used to estimate the effects of the experimental conditions, covariates, and interactions on respondents' desire for social distance and their prognostic optimism.

RESULTS

Attribution of mental illness to a genetic predisposition (vs. no attribution) significantly (p<0.001) predicted unwillingness to socially interact with the vignette character, regardless of the character's psychiatric diagnosis. Describing the illness as treatable with medication or psychotherapy (vs. no treatability information) also reduced willingness to socially interact, yet it also increased optimism for recovery. Desire for social distance and prognostic pessimism were greater for alcohol use disorder, opioid use disorder, or schizophrenia compared with major depression or subclinical distress.

CONCLUSIONS

Attributing mental illness solely to genetics predicts social rejection of people diagnosed as having psychiatric disorders. Efforts to reduce stigma, increase social acceptance, and protect the mental health of individuals diagnosed as having a mental illness should include not framing mental illness exclusively in genetic terms.

Involving Persons With Lived Experience to Improve Vocational Students' Stigmatizing Attitudes Toward Mental Disorders: A Quasi-Experimental Study

BACKGROUND

Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students' stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest-posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students' negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.

Impact of clinical rotational posting on attitude toward psychiatry of undergraduate medical students in Malaysia

Background

Almost all over the world, psychiatry training of undergraduate medical students has been criticized to be deficient in imparting required knowledge and improving the perception of students towards psychiatry and psychiatric treatment. Considering the large mental health need gap in the community, it is essential to improve undergraduate students' attitude toward psychiatry.

Aim

Hence, this study was planned to study the impact of psychiatry clinical posting on attitude toward psychiatry of undergraduate medical students.

Materials and Methods

Undergraduate medical students undergoing psychiatry posting were assessed on the first and last day of clinical posting with the help of semi-structured proforma consisting of sociodemographic information, favored future career choice, the relevance of psychiatry to their future careers, the usefulness of particular knowledge and skills, the value of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry.

Results

After their clinical posting, students had a more positive attitude towards the usefulness of psychiatry knowledge in future general practice and the usefulness of psychiatry knowledge from undergraduate training in the future. Knowledge of alcohol withdrawal management, detection and management of delirium, and Mental Health Acts were perceived more essential in the future. Also, specialties such as deaddiction and child and adolescent psychiatry were felt more useful in future practice. After posting, students perceived that psychiatry can also be learned at medical and surgical wards as well as during home visits. However, despite some positive changes in attitude toward psychiatry, there was no significant change in choosing psychiatry as a career by the students after posting.

Conclusion

Undergraduate psychiatry training during clinical posting was able to make some positive changes in the knowledge and attitude of students. However, still, there were lacunae in some areas of concern. Preference of psychiatry as a branch of specialization was not increased after posting. This indicates the need for better reforms in psychiatry education at the undergraduate level to improve the perception of undergraduate students about psychiatry.

Mental illness through the perspective of undergraduate medical students in Greece: a cross-sectional study at Aristotle University of Thessaloniki

Introduction

Numerous studies reveal that mental health-related stigma, stereotypes, and prejudices negatively affect the patients, jeopardizing their health, prognosis, and social opportunities. Healthcare professionals, who are in the first line of combating mental disease, are expected to play a significant role in drastically changing discriminatory and stigmatizing attitudes toward psychiatric patients and in diminishing the existing healthcare and social disparities. In this study, we aimed to explore and highlight the views of Greek medical students-that is of the future physicians-toward mental illness and people suffering from it.

Materials and methods

It is a cross-sectional, observational study, in which 324 undergraduate students from the most populous Greek medical school of the Aristotle University of Thessaloniki, participated online, during the spring semester of 2022. The tools used were the Opinions about Mental Illness Scale (OMI) that assesses one's viewpoints about mental illness, the Social Distance Scale (SDS) that captures the desired degree of social distancing from patients with mental disorders, and the Level of Contact Report (LCR-12) that estimates the level of familiarity with them.

Results

Participants displayed rather positive attitudes regarding the etiology of mental illness, social integration, and discrimination toward psychiatric patients [as evaluated with the respective OMI subscales; Etiology mean score (μ):8.87 ± 4.68, Social Integration (μ):17.79 ± 5.42, Social Discrimination (μ):13.54 ± 11.17], and more clearly favorable opinions concerning the need for social provision or the enactment of restrictive measures [as expressed with the relative OMI subscales; Social Care (μ):22.74 ± 4.56, Social Restriction (μ):13.27 ± 8.98], while claiming to be quite familiar with mental disorders and individuals experiencing them (as assessed with LCR; μ: 8.71 ± 2.16), and relatively willing to interact with them (as measured with SDS; μ:8.95 ± 4.23). Degree of familiarity with mental illness was directly proportional to the desire for contact with patients living with it, while the higher both were, the more improved most of the aforementioned OMI sectors were found to be. Female sex, clinical medical education, previous clinical psychiatric training, and living with or being a person with a mental disorder were the factors that defined a statistically refined profile in many of the aspects above.

Conclusion

Our findings are in accordance with many prior and recent studies, while showing improved opinions compared to those of previous research in Greek student and healthcare population. They are calling for vigilance, rather than complacency, as well as educational and social interventions, in order to enable current and future healthcare professionals to perform their function to its fullest extent. Implications of our results and further research suggestions are included.

The symptom experience of newly diagnosed Chinese patients with Crohn's disease: A longitudinal qualitative study

AIMS

To longitudinally explore the symptom experience of Chinese patients with Crohn's disease within the first year following their diagnosis.

DESIGN

A longitudinal qualitative study.

METHOD

Eighteen newly diagnosed Chinese patients with Crohn's disease were recruited through purposive sampling. Semi-structured interviews were conducted at four time points: soon after diagnosis, 3, 6 and 12 months post-diagnosis. Data were collected between January 2021 and February 2022. Conventional content analysis was used for data analysis of each time point. Afterwards, the data of each time point were compared longitudinally. COREQ checklist was followed.

RESULTS

Three themes and eight sub-themes were formed through analysis: feelings towards symptoms (symptoms make me feel uneasy, symptoms make me feel inferior and symptoms make me feel helpless); acceptability of symptoms (difficult to accept, have to accept, be able to accept); functions of symptoms (assessing disease conditions and treatment effects, warning of disease management).

CONCLUSIONS

Overall, the negative emotions related to symptoms gradually decreased over time, and the patient's acceptance of symptoms increased within the first year following diagnosis. In addition, when the disease was in remission after treatment, the warning function of symptoms gradually weakened.

IMPACT

The process of how patients accept their symptoms found in this study provides a basis for nurses to improve patients' acceptance of symptoms and reduce their symptom-related negative emotions. This study also emphasizes the phenomenon that patients gradually ignore some symptoms with their increased acceptance level, which warrants additional health education to strengthen their awareness of self-management.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was required to design or undertake this study. Patients contributed only to the data collection and member checking.

A cross-sectional study of opinion about mental illness among undergraduate medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training

Background

A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training.

Materials and Methods

This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data.

Result

Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting.

Conclusion

Opinions can change based on one's experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

Effects of Affective Proximity and Treatment on Emotional Response toward People with Substance Use

BACKGROUND

Emotions act as mediators of the relationship between stereotypes and inclinations to discriminate against and isolate individuals with substance use disorders (SUD). Emotional responses toward people with SUD are more negative than toward those people with non-drug-related mental disorders. This study explored the effects of affective bonds with substance users and treatment on the type and frequency of emotions, valence, and interpersonal distance.

METHODS

A convenience sample of 1,195 individuals was included in this survey-based study. Participants responded to questions regarding their knowledge of psychoactive drugs and beliefs about substance use disorders and were requested to report the emotions they imagined having felt in four scenarios depicting a substance user whose characteristics varied according to two dimensions: the substance user was a relative or an unknown; the substance user was in treatment for SUD, or not.

RESULTS

Emotions toward relative drug users were more negative and expressed greater interpersonal distance. Treatment was associated with more positive valence and lower interpersonal distance, but emotions toward relatives in treatment were more negative than those not.

CONCLUSION

Specific interventions for relatives of people with SUD may be necessary because of the emotional burden caused by the courtesy stigma.

How do Americans perceive the stigma of leprosy?

The stigma of leprosy will have reduced effects if people cannot reliably perceive it. Two factors impact these perceptions: familiarity and entitativity. One hundred and forty-five participants tested this assertion using an online platform to complete measures of stigma about leprosy as well as measures of familiarity and entitativity. The group of 145 completed the same measures of stigma, entitativity, and familiarity 1 week later. Standard deviations of time 1 and time 2 measures of stigma were used as indices of consistent (reliable) perceptions at the individual level. Results showed partial support for familiarity being positively associated with reliable responding. Moreover, high entitativity scores were associated with greater stigma perceptions at time 1 and time 2. Ongoing research on these indicators may be important in crafting future anti-stigma programs for leprosy.

Addressing stigma within the dissemination of research products to improve quality of care for pregnant and parenting people affected by substance use disorder

Substance use disorders are a common and treatable condition among pregnant and parenting people. Social, self, and structural stigma experienced by this group represent a barrier to harm reduction, treatment utilization, and quality of care. We examine features of research dissemination that may generate or uphold stigmatization at every level for pregnant and parenting individuals affected by substance use disorder and their children. We explore stigma reduction practices within the research community that can increase uptake of evidence-based treatment programs and prevent potential harm related to substance use in pregnant and parenting people. The strategies we propose include: (1) address researcher stereotypes, prejudice, and misconceptions about pregnant and parenting people with substance use disorder; (2) engage in interdisciplinary and transdisciplinary collaborations that engage with researchers who have lived experience in substance use; (3) use community-based approaches and engage community partners, (4) address stigmatizing language in science communication; (5) provide contextualizing information about the social and environmental factors that influence substance use among pregnant and parenting people; and (6) advocate for stigma-reducing policies in research articles and other scholarly products.

Stigmatizing attitudes toward Internet gaming disorder, Problematic smartphone use and Problematic social networking site use: An experimental vignette study

Public stigma on substance and gambling disorders have been well documented. Negative effects of stigma include shame, embarrassment, fear being judged and the determent of help-seeking behaviors among stigmatized individuals. Less is known about the public perception toward Internet gaming disorder (IGD) and other widespread problematic behaviors that share some characteristics with established behavioral addictions, such as Problematic smartphone use (PSU) and Problematic social networking sites use (PSNSU). The purpose of this study is to compare the public perception of problematic Internet gamers, problematic smartphone users and problematic social networking sites users using an experimental within-group vignette study design. A sample of 280 adults (F = 72.1%; M_age = 32.84, SD = 13.85) was recruited and completed the study online. Participants were presented with male OR female vignettes (i.e. the gender of the target in the vignette was randomized) describing an individual with IGD, PSU, and PSNSU. A repeated-measures ANOVA followed by post hoc tests using Bonferroni's correction was used. IGD was seen as more serious, more noticeable, and less understandable than both PSU and PSNU. Moreover, participants' emotional reaction (e.g., anger and sadness) and desired social distance were significantly stronger toward IGD. However, vanity attributions were higher for individuals with PSNSU, which were also more blamed compared to both IGD and PSU. PSU was seen as more controllable than both IGD and PSNSU. The results, taken together, suggest that IGD is perceived as more inherently problematic, but PSNSU also seem to deserve scientific attention as individuals showing symptoms of PSNSU are blamed more than problematic Internet gamers. Our findings provide initial information that can be used when developing interventions to impact stigma toward technological addictions.

Justification of Discrimination against People with Mental Illness in Republic of Korea

AIMS

This study aimed to analyze the process in which individual values and beliefs affected social distance against people with mental illness by mediating cognition, based on applying the justification-suppression model to the stigma of mental illness.

METHODS

An online survey was conducted with 491 adults aged 20 to 64 years. Their sociodemographic characteristics, personal values, and beliefs, justification for discrimination, and social distance were measured to assess their perceptions of, and behaviors towards, persons with mental illness. Path analysis was performed to examine the magnitude and significance of the hypothetical relationship between variables.

RESULTS

Protestant ethic values and morality significantly affected the justification of inability and dangerousness and attribute responsibility. Excluding attribute responsibility, the justification of inability and dangerousness significantly predicted social distance. In other words, the higher the Protestant ethic values, the higher the morality of binding, and the lower the morality of individualizing, the higher the level of justification based on inability and dangerousness. Such justification has been found to increase social distance from persons with mental illness. In addition, mediating effects were the largest in the path of the morality of binding → justification of dangerousness → social distance.

CONCLUSIONS

The study proposes various strategies to deal with individual values, beliefs, and justification logic to reduce social distance against those with mental illness. These strategies include a cognitive approach and empathy, both of which inhibit prejudice.

The Impact of a Culturally Meaningful Storytelling Intervention on Stigma and Attitudes About Mental Health Treatment

ABSTRACT

The fear of being devalued or discriminated against is a salient deterrent to seeking mental health care, especially in communities of color where racial stigma also impacts mental health and perceptions of service utilization. To address this issue, our research team partnered with This Is My Brave Inc to develop and evaluate a virtual storytelling intervention to highlight and amplify the voices of Black and Brown Americans living with mental illness and/or addiction. We utilized a pretest-posttest survey design administered electronically to viewers of the series (n = 100 Black, indigenous, people of color and n = 144 non-Hispanic White). Results indicated that postintervention, scores on public stigma and perceived discrimination measures were significantly reduced. We identified significant interaction effects, such that Black, indigenous, people of color viewers showed a greater rate of improvement on outcomes. This study provides strong preliminary evidence of the impact of a culturally meaningful virtual approach to addressing stigma and improving attitudes about mental health treatment.

Mental health awareness of secondary schools students: Mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health

Purpose

The mental health situation among adolescents in Malaysia has reached a worrying state with the rising number of cases. Despite a significant increase in the literature on mental health, there is a lack of studies that focused on mental health awareness. Therefore, this study aimed to investigate the factors affecting Malaysian youth's mental health awareness as well as the mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health.

Methods

Self-administered questionnaires were distributed to 450 secondary school students aged 15-19 years old in Kuala Lumpur and Melaka who were recruited via purposive sampling. Data analysis was performed using SPSS and SmartPLS to obtain the descriptive analysis, measurement model, and structural model.

Results

The results indicated that mental health awareness was influenced by knowledge on mental health and attitude towards mental health. The findings also revealed that familiarity and media exposure were important determinants of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Moreover, the results indicated that knowledge on mental health positively mediated the relationship between media exposure and mental health awareness. Besides, attitude towards mental health also found to play mediating roles between familiarity and mental health awareness, as well as between media exposure and mental health awareness.

Conclusion

This study contributed important knowledge to the limited literature in this contemporary domain. An effective public mental health campaign is needed to reduce the burden of disease and the cost of mental illness.

Public's Attitudes Toward Mentally Ill Offenders in Greece

Mentally ill offenders constitute a vulnerable population group with unique characteristics, and have endured multiple public stigmatizations, which has not been sufficiently studied. The purpose of this study was to capture attitudes of the public toward mentally ill offenders in relation to their perceptions of mental illness in general, as well as their degree of familiarity with it. Our sample of 2059 people can be overall described as a men preponderance, married, with mean value age of 26 years, higher educational level, and medium or higher socio-economic status. Participants completed the ATMIO, CAMI, and Familiarity scales online. The total familiarity index value with mental illness was found to be 4.88, which counts as moderate to low. It was also concluded that women and those with a high educational level sustained more positive attitudes toward mentally ill offenders. However, negative stereotypes (with a mean value of 26.20), stigmatizing attitudes related to risk in the community (mean 16.10), and reduced responsibility for actions (mean 9.45) were recorded, while some (mean 16.50) showed compassion and emphasized on the mentally ill need of rehabilitation. The youngest people were the ones who recorded the most absolute and harsh attitudes. These findings validate the need of raising awareness and informing, especially, the young public about issues of mental health, including the need to oppose prejudices with everyday measures, which can be accessible to the new generation. Besides, we should extend research to various professional groups that come in contact with mentally ill offenders in order to collect data, which could contribute for intervening policies and formulating different sets of strategies for those people.

Effects of media representations of drug related deaths on public stigma and support for harm reduction

BACKGROUND

Drug related deaths (DRD) are at historically high levels in the United Kingdom (UK), but some approaches that have the potential to reduce risk of mortality remain controversial. Public support makes an important contribution to drug policy development but there are high levels of public stigma towards people who use drugs (PWUD), and this is partly shaped by media representations. We investigated whether depiction of the characteristics of decedents represented in news articles about DRD was associated with differences in stigmatising attitudes and support for harm reduction policy.

METHODS

We undertook a cross-sectional online study with a randomised design, conducted with a nationally representative sample (UK). Participants (N = 1280) were randomly presented with one of eight simulated news stories that reported on a DRD that differed with respect to drug (ecstasy or heroin), and the gender (male or female) and age (younger or older) of the decedent. Data were analysed using MANOVA.

RESULTS

Data were obtained for 1248 participants (51.0% female; mean age 45.7±15.4). Stigma was higher towards depictions of male, older, and heroin deaths (all p < .001). Harm reduction support was higher in those participants seeing older compared to younger subjects (p = .035), and the older ecstasy decedent compared to younger decedent (p = .029).

CONCLUSION

Presentation of some types of DRD are associated with higher public stigma towards the decedent than others. Those groups developing agenda-setting activities designed to reduce stigma or foster public support for harm reduction policies should consider the different ways in which audiences may respond to the depiction and framing of DRD in news media.

Understanding stigma toward schizophrenia

Schizophrenia is arguably one of the most stigmatized psychiatric disorders, with patients frequently seeing the burden of stigmatization as a "second illness." Thus, the purpose of this study was to investigate the relationships among the main aspects of the stigma toward schizophrenia. This study used a vignette methodology with 2053 individuals from the general population in Italy. The main aspects of stigma - causal beliefs, recommended treatments, social distance, perception of dangerousness, and avoidance - were investigated through participants' responses, and a latent variable structural equation model (SEM) approach was used to test the relationships among them. Perceived dangerousness predicts the desire for social distancing from an individual with schizophrenia, which predicts the desire for avoidance. In addition, biogenetic causal beliefs of schizophrenia and position on the appropriate medical treatment predict the perception of dangerousness and thus a greater desire for social distance. This study contributes to the literature on the stigmatization of mental health by improving our understanding of the phenomenon. Highlighting the relationships between aspects of stigma allows for a discussion of the implications for anti-stigma interventions.

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

BACKGROUND

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.

AIMS

This study aimed to investigate affiliate stigma and its influencing factors among family caregivers of PMI in Hong Kong.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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.

Creating a hierarchy of mental health stigma: testing the effect of psychiatric diagnosis on stigma

BACKGROUND

Levels of mental health stigma experienced can vary as a function of the presenting mental health problem (e.g. diagnosis and symptoms). However, these studies are limited because they exclusively use pairwise comparisons. A more comprehensive examination of diagnosis-specific stigma is needed.

AIMS

The aim of our study was to determine how levels of mental health stigma vary in relation to a number of psychiatric diagnoses, and identify what attributions predict levels of diagnosis-specific stigma.

METHOD

We conducted an online survey with members of the public. Participants were assessed in terms of how much stigma they had, and their attributions toward, nine different case vignettes, each describing a different mental health diagnosis.

RESULTS

We recruited 665 participants. After controlling for social desirability bias and key demographic variables, we found that mental health stigma varied in relation to psychiatric diagnosis. Schizophrenia and antisocial personality disorder were the most stigmatised diagnoses, and depression, generalised anxiety disorder and obsessive-compulsive disorder were the least stigmatised diagnoses. No single attribution predicted stigma across diagnoses, but fear was the most consistent predictor.

CONCLUSIONS

Assessing mental health stigma as a single concept masks significant between-diagnosis variability. Anti-stigma campaigns are likely to be most successful if they target fearful attributions.

The Stigmatizing Attitudes of Syrian University Students Toward Schizophrenia

Background: Stigma is frequently considered an obstacle to schizophrenia treatment and recovery. However, little is known regarding the stigma experienced by persons with schizophrenia among Syrian college students.

Methods: A total of 963 students from Syrian colleges and universities participated in this study, using a questionnaire with a case vignette illustrating schizophrenia. The questionnaire inquired about people's attitudes toward schizophrenia and their desire to avoid contact with people with schizophrenia. The current study investigated college students' stigma toward people with schizophrenia, desire for social distancing, gender (male and female), and major (medical and non-medical) differences.

Results: The people described in the vignette were deemed "dangerous" (28%) and "could snap out of the problem" (50.20%), according to the respondents. Female students were more likely than male students to agree that "schizophrenia is not really a medical disease" (4.40% vs. 8.9%, p ≤ 0.05). Compared with medical students, non-medical students were more likely to agree that "The problem is a reflection of personal weakness" (20% vs. 21.7%, p < 0.05). Many respondents said they would not "marry into the family of someone with schizophrenia" (95.6%) or "work closely with them" (77.6%). 

Conclusion: In this study, it was observed that a considerable percentage of Syrian college students exhibited stigma toward persons with schizophrenia and really wanted to avoid social interaction with them, with female and non-medical students having higher stigma toward people with schizophrenia in several subscale items. The findings imply that more anti-stigma interventions for Syrian college students should be implemented to help avoid or lessen the stigma toward people with schizophrenia.

Public Stigma and Personal Networks: Confronting the Limitations of Unidimensional Measures of Social Contact

One of the most promising directions for reducing mental illness stigma lies in Allport's contact theory, which suggests that intergroup interactions reduce stigma. Here, we argue that stigmatizing attitudes are driven by the nature, magnitude, and valence of community-based ties to people with mental illness (PMI), not simply their presence. Using the 2018 General Social Survey (N = 1,113), we compare network-based measures of contact to traditional survey indicators. We find that knowing someone with mental illness, or even number of people known, explains little about desire for social distance, perceptions of dangerousness, or endorsement of treatment coercion. However, having stronger relationships with more PMI, having more friends and family (but not more peripheral ties) with mental illness, and knowing people in treatment are associated with less stigma endorsement. In contrast, we find that exposure to PMI who are perceived as dangerous is associated with greater levels of stigma.

Attitudes of health professionals towards people with substance use disorders in Brazil, controlling for the effects of social desirability

Health professionals are in a strategic position to help people with substance use disorders (SUDs) who seek health services for support or treatment. However, it is known that professionals' attitudes towards people who use alcohol and other drugs are marked by stigmatizing attitudes that create barriers to access quality treatment and make it difficult for the user to adhere to it. From this, the present study aimed to investigate the attitudes of 264 health professionals from specialised services and primary health care (PHC) in the Southeast region of Brazil, through Opening Minds Scale for Healthcare Providers (OMS-HC), taking into account the hypothesis of contact with the subject as a predictor of more positive attitudes. For this, a Multiple Hierarchical Regression was carried out to ascertain the contribution of the variables used in the explanatory model of attitudes. In addition, the measure of social desirability (SD), assessed by Brazilian Portuguese adaptation of Marlowe-Crowne Social Desirability Scale, was used as a control variable in the regression model to obtain a more robust and accurate model regarding the presence of biased responses, pervasive in studies on attitudes. In general, our findings showed that contact/familiarity with substance use, either through direct contact with users or through the respondent's own use, predicted more positive attitudes, with specialised service professionals expressing more positive attitudes than those working in PHC. Blaming the user for his/her condition presented itself as a predictor of more negative attitudes. Studies like this are of paramount importance for understanding the relationship established between professionals and service users and, therefore, for tailoring interventions and programs that aim to reduce stigmatizing attitudes and provide better access to health for people with SUDs. The importance of using the SD measure as a control variable in Regression is also emphasised, as an effective way to overcome to a common limitation in studies of attitudes.

Social distance towards schizophrenia in health professionals

OBJECTIVE

The stigma and prejudice of the public regarding psychiatric disorders are a long-standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self-rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan.

METHOD

This study used a cross-sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18-item Social Distance Scale for schizophrenia, and the 19-item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self-rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia.

RESULT

In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (n = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (β ± SE = -0.26 ± 0.14, p = .057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance.

CONCLUSION

High levels of self-rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and training are imperative to increase familiarity and knowledge of schizophrenia. Appropriate education could be implemented from different perspectives, including communication skills, resources of social support, and topics to reduce stigma and prejudice.

Ethnic Differences in Attitudes and Preventive Behaviors Related to Alzheimer's Disease in the Israeli Survey of Aging

OBJECTIVES

To examine ethnic differences in attitudes and preventive behaviors related to Alzheimer's Disease (AD) in Israel.

METHODS

A household representative sample included 1198 older adults (M age = 70.78, SD = 9.64) who participated in the Israeli branch of the Survey of Health, Aging, and Retirement in Europe (SHARE-Israel), collected during 2015 and 2017. Descriptions of the groups (long term Israeli Jews (LTIJ), immigrants from the Former Soviet Union (FSU) and Palestinian Citizens of Israel (PCI)) were computed, and hierarchical regressions tested whether group differences were maintained after controlling for demographic, human and economic resources, Internet use, and AD familiarity.

RESULTS

Attitudes towards AD were the most negative among FSU and more accepting among PCI while AD-related preventive behaviors were highest among FSU, lowest among PCI, with LTIJ between them. After including demographic, human and economic resources, and familiarity with AD, differences in AD-preventive behaviors significantly decreased. In contrast, differences in attitudes among the groups remained stable even after other variables were accounted for, so that PCI were the most accepting and FSU manifested greatest avoidance of contact with persons with AD.

CONCLUSIONS

The findings provide directions for culturally sensitive psycho-educational and other interventions for both the public and healthcare providers.

Knowledge, stigma, and beliefs toward mental illnesses among schoolteachers in Damascus

BACKGROUND

Teachers have an important role in promoting the mental wellbeing of their students, hence their knowledge and attitudes toward mental health disorders should be assessed. A very few studies regarding this topic were conducted in Syria, but due to the recent events which have had occurred the country, it is essential to deal with students who suffer from mental illnesses professionally especially that such disorders may be stigmatized by the society.

AIMS

This paper aims to investigate knowledge, beliefs, and attitudes toward mental disorders in a sample of Syrian schoolteachers.

METHOD

A cross-sectional study using self-administered questionnaire was conducted in Damascus and Refdimashq, involving 400 teachers from 16 schools.

RESULTS

The results showed that the prevalence of stigmatizing positions toward psychiatric illnesses was low among teachers. The contributors did not state a correlation between spiritual beliefs and psychological disorders. It was also found that teachers were neutral in their knowledge about mental illnesses and psychiatric treatment or interventions along with their mental health resources. However, 42.5% of the participants use the internet for such purposes.

CONCLUSION

In general, teachers of Damascus and its Refdimashq had a reasonable degree of awareness about mental disorders and treatments. Furthermore, neither stigma nor the relation between religious thoughts and mental disorders had been ascertained.

Modeling the effects of Crisis Intervention Team (CIT) training for police officers: How knowledge, attitudes, and self-efficacy drive de-escalation skills and referral decisions

OBJECTIVE

Prior research on Crisis Intervention Team (CIT) training for police officers has demonstrated improvements in knowledge, attitudes, self-efficacy, and stigma, but how these factors work together to influence behavioral outcomes like de-escalation skills and referral decisions remains unstudied.

METHOD

251 CIT-trained and 335 non-CIT officers completed in-depth surveys measuring these six constructs. We used structural equation modeling to test fit of the data to our hypothesized model and made indicated changes to improve fit.

RESULTS

An alternate 8-path model (with three paths originally hypothesized being removed) fit reasonably well, and allowing path coefficients to differ for CIT and non-CIT groups resulted in models with similar fit statistics.

CONCLUSION

CIT training enhances knowledge and attitudes, both of which have beneficial effects on stigma. Though an important outcome itself, lower stigma does not have an effect on de-escalation skills and referral decisions, though self-efficacy clearly does.

Personality, self-esteem, familiarity, and mental health stigmatization: a cross-sectional vignette-based study

There has been little research exploring the relationship between personality traits, self-esteem, and stigmatizing attitudes toward those with mental disorders. Furthermore, the mechanisms through which the beholder's personality influence mental illness stigma have not been tested. The aim of this study is to examine the relationship between Big Five personality traits, self-esteem, familiarity, being a healthcare professional, and stigmatization. Moreover, this study aims to explore the mediating effect of perceived dangerousness on the relationship between personality traits and desire for social distance. We conducted a vignette-based representative population survey (N = 2207) in the canton of Basel-Stadt, Switzerland. Multiple regression analyses were employed to examine the associations between personality traits, self-esteem, familiarity, and being a healthcare professional with the desire for social distance and perceived dangerousness. The mediation analyses were performed using the PROCESS macro by Hayes. Analyses showed associations between personality traits and stigmatization towards mental illness. Those who scored higher on openness to experience (β = - 0.13, p < 0.001), (β = - 0.14, p < 0.001), and those who scored higher on agreeableness (β = - 0.15, p < 0.001), (β = - 0.12, p < 0.001) showed a lower desire for social distance and lower perceived dangerousness, respectively. Neuroticism (β = - 0.06, p = 0.012) was inversely associated with perceived dangerousness. Additionally, high self-esteem was associated with increased stigmatization. Personal contact or familiarity with people having mental disorders was associated with decreased stigmatization. Contrarily, healthcare professionals showed higher perceived dangerousness (β = 0.04, p = 0.040). Finally, perceived dangerousness partially mediated the association between openness to experience (indirect effect = -  .57, 95% CI [- .71, - 0.43]) as well as agreeableness (indirect effect = - 0.57, 95% CI [- 0.74, - 0.39]) and desire for social distance. Although the explained variance in all analyses is < 10%, the current findings highlight the role of personality traits and self-esteem in areas of stigma. Therefore, future stigma research and anti-stigma campaigns should take individual differences into consideration. Moreover, the current study suggests that perceived dangerousness mediates the relationship between personality traits and desire for social distance. Further studies are needed to explore the underlying mechanisms of such relationship. Finally, our results once more underline the necessity of increasing familiarity with mentally ill people and of improving the attitude of healthcare professionals towards persons with mental disorders.

The Effectiveness of Mental Health Literacy Curriculum among Undergraduate Public Health Students

Mental health literacy (MHL) plays an important role in public health. Improving MHL can promote mental health at the individual and public levels. To date, no published studies have assessed the effectiveness of MHL curriculum interventions among undergraduate public health students. The participants in this study were undergraduate public health students (n = 48) who were enrolled in an 18-week MHL curriculum for 100 min per week. MHL was assessed using the Mental Health Literacy Scale for Healthcare Students. A paired sample t-test was performed to examine the immediate and delayed effects of the MHL curriculum. The total MHL score significantly improved, and a moderate effect size was found directly after the intervention and six weeks later. There were significant differences in the recognition of mental illness (p < 0.01), help-seeking efficacy (p < 0.05), and help-seeking attitude (p < 0.05) in the five components of MHL between pre- and post-test. Furthermore, significant improvements were obtained for the maintenance of positive mental health (p < 0.05) and reduction of mental illness stigma (p < 0.001) between the pre-test and follow-up. Our findings provide evidence for the development and implementation of an MHL curriculum for public health education.

Knowledge, contact and stigma of mental illness: Comparing three stakeholder groups in Hong Kong

BACKGROUND

It remains unknown what the impacts of multiple dimensions of contact (e.g. level, quantity and quality) are on the stigma of mental illness.

AIMS

To explore the relationship between the multiple dimensions of contact and stigma of mental illness among family members (FM), mental health workers (MHW) and community residents (CR) in Hong Kong.

METHODS

The stigma, contact and knowledge were measured in FM, MHW and CR in Hong Kong. Multiple regression analyses were used.

RESULTS

MHW (n = 141) had higher knowledge, more contact and lower stigma of mental illness than CR (n = 95) or FM (n = 62). Knowledge and contact quality were significantly associated with lower stigma of mental illness in the three groups. However, contact level and contact quantity were not significantly associated with most stigma components. The contact level was positively associated with stigma of mental illness among FM and CR.

CONCLUSIONS

The results of this study highlight the differences in knowledge, contact and stigma of mental illness among different stakeholder groups. This study suggests that positive contact (e.g. equal, supportive, voluntary and pleasant contact) reduces stigma of mental illness, while negative contact (e.g. unfriendly, unsupportive, unpleasant contact) may increase stigma. The Enhancing Contact Model (ECM) should be tested in future anti-stigma interventions.

Leveraging Neuroscience to Fight Stigma Around Mental Health

Labels serve as identifiers and convenient descriptors of inanimate and animate objects. In humans, given labels can easily become part of an individual's self-perceived identity. Negative labels ascribed to a person can result in internalized stigma, a state that will shape the subject's biography. This can ultimately impact the person's mental and physical health since perceived and/or anticipated stigma discourages the use of social and health services. Per definition, stigma involves labeling of persons with physical, mental, or social characteristics that do not match the observer's arbitrarily conditioned and calibrated sense of norms (public stigma); such labeling may eventually become embedded in rules, regulations, and laws (structural stigma). Internalized stigma projects onto a person's emotions and actions. Public (enacted) stigma results from stereotyping (collectively agreed-upon notions about a group of persons that are used to categorize these people) and devaluation, which subsequently leads to social distancing, discrimination, and blatant abuse of human rights. Much of what we know about stigma results from research in the psychosocial sciences and, more recently, from social neuroscience. The stigma around mental health has generated much attention in the field of psychiatry where, to date, most research has focussed on epidemiology and anti-stigma interventions. This essay intends to stimulate thought, debate, and research within the behavioral neuroscience community and, therefore, to inform evidence-based design and implementation of neuroscience-based approaches by other professionals working towards the elimination of the stigma attached to mental illness. The article starts by considering the concept of stigma and the psychological processes that give rise to the phenomenon; it also considers how projected and perceived stigma are multiplied. Finally, after a brief review of the few existing neuroscientific explorations of stigma, gaps in our knowledge of the neurobiological basis of stigma are identified and discussed.

Effect of Exposure to Visual Campaigns and Narrative Vignettes on Addiction Stigma Among Health Care Professionals: A Randomized Clinical Trial

IMPORTANCE

Stigma toward people with opioid use disorder (OUD) is pervasive in clinical settings, impeding delivery of high-quality care. To date, no study has evaluated the effect of different stigma-reduction messages or messengers among health care professionals.

OBJECTIVE

To evaluate the effect of OUD-related messages delivered by different messengers on stigma and attitudes toward people with OUD among health care professionals.

DESIGN, SETTING, AND PARTICIPANTS

This randomized clinical trial examined the effects of OUD-related messages delivered by a visual campaign alone or in combination with a written narrative vignette from the perspective of 1 of 3 messengers. Health care professionals in the US were recruited from 2 national online survey panels (Ipsos KnowledgePanel and SurveyHealthcareGlobus). A total of 1842 participants completed a web-based survey measuring stigma toward people with OUD from November 13 to 30, 2020.

INTERVENTIONS

Eight groups were exposed to 1 of 2 message frames. One frame (Words Matter) emphasized the harm of stigmatizing language, and the other (Medication Treatment Works) focused on the effectiveness of medications approved by the US Food and Drug Administration for the treatment of OUD. Message frames were communicated through either a visual campaign alone or a visual campaign in combination with a written narrative vignette from the perspective of a simulated patient with OUD, a clinician, or a health care system administrator.

MAIN OUTCOMES AND MEASURES

Dimensions of stigma toward people with OUD were measured on 5-point Likert scales that included items about desire for social distance from people with OUD, perception of individual blame for OUD, perspective of OUD as a medical condition, and support for increased governmental spending on OUD treatment. The level of warmth felt toward people with OUD was measured by a feeling thermometer (range, 0-100 points).

RESULTS

Among 1842 participants, the mean (SD) age was 47 (13) years; 1324 participants (71.9%) were female, 145 (7.9%) were Hispanic, 140 (7.6%) were non-Hispanic Black, 1344 (73.0%) were non-Hispanic White, and 213 (11.6%) were of other non-Hispanic race (ie, individuals who did not self-report race as Black or White and did not self-report ethnicity as Hispanic). Compared with nonexposure, exposure to the combination of visual campaign and narrative vignette communicating the importance of nonstigmatizing language from the perspective of a patient with OUD was associated with a lower probability (difference, -16.8 percentage points, 95% CI, -26.1 to -7.4; P < .001) of unwillingness to have a person with OUD marry into the family (a measure of social distance preference) and a 7.2-point (95% CI, 3.2-11.1; P < .001) higher warmth rating. Participants exposed to the combined visual campaign and patient vignette about the value of medication treatment for OUD also had significantly lower levels of stigma compared with those in the nonexposed control group (eg, unwillingness to have a person with OUD as a neighbor: difference, -15.3 percentage points; 95% CI, -24.6 to -6.0; P = .001).

CONCLUSIONS AND RELEVANCE

In this study, messages about nonstigmatizing language and effective medication for OUD reduced stigma among health care professionals. Stigma-reduction efforts targeting health care professionals may improve health care system capacity to serve people with OUD.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05127707.

Exploring Empathy and Compassion Using Digital Narratives (the Learning to Care Project): Protocol for a Multiphase Mixed Methods Study

BACKGROUND

Digital stories-first-person, self-made, 2- to 3-minute videos-generate awareness, impart knowledge, and promote understanding on topics such as mental illness. Digital stories are a narrative-based art form often created by individuals without formal training in filmmaking to relate personal experiences. Somewhat like digital narratives, video testimonies created within the social marketing or fundraising campaigns of government agencies and private or public corporations aim to reduce the stigma of mental illness while supporting research and services. In video testimonies, personal stories are captured on camera by professional filmmakers. Sharing critical life events greatly benefits tellers and listeners alike, supporting catharsis, healing, connectiveness, and citizenship.

OBJECTIVE

This study explores digital stories and video testimonies featuring mental illness and recovery in their ability to elicit empathy and compassion while reducing stigma among viewers.

METHODS

Using mixed methods, phase 1 will involve a search of Canadian social marketing activities and fundraising campaigns concerning mental illness and recovery. Phase 2 will involve the organization of digital storytelling workshops in which participants will create digital stories about their own experiences of mental illness and recovery. In phase 3, a pilot randomized controlled trial will be undertaken to compare marketing and fundraising campaigns with digital stories for their impact on viewers, whereas phase 4 will focus on knowledge dissemination.

RESULTS

Ethics approval for this study was received in March 2021. Data on the feasibility of the study design and the results of the controlled trial will be generated. This study will produce new knowledge on effective ways of promoting mental health awareness and decreasing stigma, with practical importance for future social marketing and fundraising campaigns. The anticipated time for completion within the 2-year study period includes 9 months for phase 1 (knowledge synthesis activities identifying social marketing and fundraising campaigns) and phase 2 (storytelling workshops), 11 months for phase 3 (feasibility assessment and data collection: randomized controlled trial), and 2 months for phase 4 (knowledge dissemination).

CONCLUSIONS

The knowledge generated will have practical implications for the public and for future social marketing and fundraising campaigns promoted by government agencies as well as nonprofit and for-profit organizations by enhancing our understanding of how individuals and societies respond to stories of mental distress and what prompts citizens to help others.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04881084; https://clinicaltrials.gov/ct2/show/NCT04881084.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/33525.

Approval of Coercion in Psychiatry in Public Perception and the Role of Stigmatization

Background: Coercion is routinely used in psychiatry. Its benefits and drawbacks are controversially debated. In addition, the majority of persons with mental health problems are exposed to stigmatization and are assumed to be dangerous. Stigmatization is associated with negative consequences for individuals with mental illness such as disapproval, social rejection, exclusion, and discrimination. Being subjected to coercive measures can increase the stigmatization of the affected persons, and stigmatization might lead to higher approval for coercion. Aims of the Study: This study aims to examine the approval for coercive measures in psychiatry by the general public, and to explore its relation with person- and situation-specific factors as well as with stigmatization. Method: We conducted a representative survey of the general population (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to read a vignette depicting psychopathological symptoms of a fictitious character and indicate whether they would accept coercive measures for the person in the vignette. Desire for social distance and perceived dangerousness were assessed as measures of stigmatization. Findings: The person in the case vignette exhibiting dangerous behavior, showing symptoms of a psychotic disorder, being perceived as dangerous, and treatment being understood as helpful increased approval of coercion in general, while familiarity of the respondents with mental illness decreased approval. Conclusions: The public attitude regarding the approval of coercion in psychiatry is highly differentiated and largely follows the current legal framework and medical treatment guidelines. Higher approval occurred in situations of self-harm or harm to others and when coercive measures were thought to have a beneficial effect for the affected persons. A considerable part of the approval for coercion is predicted by stigmatization. With the increasing severity of coercive measures, the influence of person- and situation-specific factors and of familiarity with mental illness decreased and generalizing and stigmatizing attitudes became stronger predictors for the approval of more severe measures.

A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia

BACKGROUND

Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects.

OBJECTIVE

The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia.

METHODS

A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia.

RESULTS

Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample.

CONCLUSION

Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.

Resisting stigma and evaluating realism in a direct-to-consumer advertisement for psychiatric drugs

Purpose

This study aims to examine how experience with mental illness influences perceptions of stigma and realism in a specific direct-to-consumer advertisement (DTCA) for bipolar depression.

Design/methodology/approach

An online survey had participants watch a 90 s advertisement for a prescription bipolar depression drug and then answer 24 questions about stigma, mental illness experience and the realism of the portrayals in the advertisement.

Findings

Findings show that people who identify as having experience with mental illness tend to see the ad as more stigmatizing and less realistic. Additionally, people who expressed more stigmatizing beliefs also tended to see more stigma present in the ad. Finally, the study reconfirms conclusions of previous research that people who have experience with mental health conditions possess fewer stigmatizing beliefs overall regarding mental illness.

Research limitations/implications

The sample population, while diverse in age and somewhat diverse in location, were highly educated, suggesting that they were not representative of the general population. Future studies may want to use more representative samples. A more nuanced approach to understanding experience is needed. While the sample in this study was purposively derived from communities with a higher rate of mental illness, a comprehensive experience scale to measure degrees of experience with mental illness would enhance understanding of this construct. Researchers may also want to look more deeply into the emotional responses of consumers who view these ads. To develop a greater understanding of the trajectory of DTCA, studies of online advertising for psychiatric drugs are needed.

Practical implications

The results of the study suggest that respondents with experience with mental illness may find ads that sell psychiatric medications unrealistic. This study presents the topic of realism in DTCA as an important construct for determining how consumers may perceive portrayals of disorders.

Social implications

The fact that people who have experience with mental illness found the Latuda ad to be generally unrealistic suggests that DTCA may be failing to represent mental illness in a way that demonstrates care for patients. Additionally, this research confirms that people who have had exposure to and experience with mental illness tend to hold less stigmatizing beliefs, (Link and Cullen, 1986; Corrigan et al., 2001; Angermeyer et al., 2004) a finding which supports the continuing project of increasing mental health literacy and awareness in the general population.

Originality/value

This study investigates the reactions of people who identify as having some experience with mental illness to see if they accept the portrayals of mental illness in DTCA or resist them by challenging their realism or identifying stigmatizing elements.

Mediating effects of stigma on the relationship between contact and willingness to care for people with mental illness among nursing students

BACKGROUND

Previous studies have demonstrated that contact positively impacts nursing students' willingness to care for people with mental illness. However, studies that have explored the mechanism of such a relationship between contact and willingness remain few.

OBJECTIVES

To examine the direct relationship between contact and nursing students' willingness to care for people with mental illness and to explore the potential mediating roles of stigma.

DESIGN

This was a cross-sectional study design.

SETTINGS

The study was conducted in a nursing school in Nanjing city, China.

PARTICIPANTS

A total of 839 nursing students were recruited in the study through convenience sampling.

METHODS

Nursing students' stigma, contact, and willingness to care for people with mental illness were measured online through the Stigma toward People with Mental Illness Scale (SPMI), the Level of Contact Report, and one item of "which degree indicates your willingness to provide care for people with mental illness," respectively. The structural equation model was applied to explore the potential mediating roles of stigma.

RESULTS

Contact with people suffering from mental illness directly affected nursing students' willingness to care for them (β = 0.076, p < 0.05). Meanwhile, stigma partly mediated the effect of students' contact on willingness to care for people with mental illness (β = 0.048, p < 0.05).

CONCLUSIONS

High level of contact can improve nursing students' willingness to care and the relationship is partly mediated by stigma. Measures to improve the level of contact and reduce stigmatizing attitudes of nursing students are accordingly essential in influencing them to have more willingness to care for people with mental illness.

The Effects of Immersive Virtual Reality in Reducing Public Stigma of Mental Illness in the University Population of Hong Kong: Randomized Controlled Trial

Background

Public stigma in mental health often brings various adverse effects on people with mental illness. Researchers have been developing different interventions in combating public stigma.

Objective

This study investigates the effects of immersive virtual reality (IVR) in reducing the public stigma of mental illness using a single-blinded randomized control trial.

Methods

A pre-post experimental design with a 1-week follow-up was conducted. Participants (N=206) were recruited through the mass mail system of The Chinese University of Hong Kong and randomized into 3 conditions: immersive animation, text, and control. In the immersive animation condition (n=72), participants experienced the simulation of daily life and the stigma experienced as an animated story protagonist with mixed anxiety and depressive disorder with IVR. In the text condition (n=65), participants experienced an identical story to the immersive animation condition with first-person audio narration using the same virtual reality headset. In the control condition (n=69), participants watched a video about planets with IVR. All participants received interventions with a researcher-assisted Oculus Go virtual reality headset. Participants’ public stigma was measured through self-administered online questionnaires and compared across conditions and at different time points using repeated measures analysis of variance. Simple and sequential mediation analyses on the relationship of condition (immersive animation vs text) and follow-up public stigma with possible mediators, including sense of embodiment and story transportation, were conducted using PROCESS.

Results

Public stigma did not differ significantly across conditions at pre-experiment (P>.99). In the immersive animation and text conditions, public stigma was significantly reduced at postexperiment and at the 1-week follow-up compared to pre-experiment (all with P<.001). Public stigma in the control condition at postexperiment and follow-up remained unchanged compared with pre-experiment (P=.69). Immersive animation had significantly lower public stigma than the control at postexperiment (P=.003) and follow-up (P=.02). Text also had lower public stigma than the control at postexperiment (P=.007) and follow-up (P=.03). However, immersive animation did not significantly differ from text in public stigma at postexperiment and follow-up (both P>.99). In simple mediation models, both sense of embodiment (95% CI –0.22 to 0.46) and story transportation (95% CI –0.18 to 0.00) were not significant mediators. In the sequential mediation model, both sense of embodiment and story transportation were significant sequential mediators. Sense of embodiment was positively associated with story transportation (P<.001), while story transportation was negatively associated with public stigma (P<.001). The indirect effect of the sequential mediation model was significant (95% CI –0.38 to –0.11).

Conclusions

This study provides novel findings and a rigorous comparison in understanding the effects of IVR on public stigma. The findings showed that IVR and text with audio narration performed similarly and significantly in stigma reduction. Sense of embodiment and story transportation were found to be sequentially associated with public stigma reduction.

Trial Registration

Centre for Clinical Research and Biostatistics Clinical Trial Registry CUHK_Ccrb00638; https://www2.ccrb.cuhk.edu.hk/registry/public/632

Knowledge of the community regarding mental health problems: a cross-sectional study

BACKGROUND

Knowledge of the community regarding mental health problems has a remarkable impact on the attitude, the help-seeking path, and prevention of stigma and discrimination against patients with mental health problems. It is also the cornerstone for designing evidence-based community mental health interventions. However, the evidence is scarce in developing countries like Ethiopia. This study aimed to assess the knowledge regarding mental health problems and associated factors among communities of Jimma Zone, Oromia, Ethiopia.

METHODS

A community-based cross-sectional study was conducted in the Jimma zone from March 1 to 22, 2020. A structured, pretested, and interviewer-administered questionnaire was used to collect data from 420 study participants selected through a systematic sampling technique. The knowledge about mental health was measured by the adapted version of the Mental Health Knowledge Schedule tool. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Multivariate logistic regression analysis was done, and p-value < 0.05 and 95% CI were used to determine the predictors of the outcome variable.

RESULTS

The overall knowledge score showed (188, 44.8%) of the respondents had inadequate knowledge. Moreover, (75, 17.9%) of the respondents reported psychiatric disorders are contagious, and (138, 32.9%) mentioned leaving alone is the treatment for mental illness. Talking or laughing alone and showing strange or unusual behaviors were described as symptoms of mental illness by the majority (407, 96.9%) and (403, 96.0%) of respondents, respectively. Brain dysfunction was attributed to the cause of mental illness by most (390, 92.9%) of the study participants. Similarly, the percentage of responses that attributed the causes of mental illness to possession by an evil spirit, God's punishment, and witchcraft were significantly high (368, 87.6%), (321, 76.4%) and (259, 67.1%), respectively. Furthermore, regression analysis showed that respondents who were able to read and write were 64% less likely to have adequate knowledge than those in secondary school and above educational status (AOR = 0.34, 95% CI (0.16-0.69)).

CONCLUSION

Knowledge of mental illness among the general public was relatively poor and higher levels of education were associated with good knowledge of mental health problems; this suggests the need for due emphasis on public education to improve the mental health literacy status of the community.