Experienced Turkish nurses' attitudes towards mental illness and the predictor variables of their attitudes

Narratives and Mental Illness: Understanding the Factors That Impact Stigmatizing Attitudes and Behavioral Intentions

Entertainment television has been explored to reduce stigmatizing attitudes toward mental illness by incorporating positive stories about characters with mental illness. Guided by mediated contact theory and the extended elaboration likelihood model, this study examines whether exposure and engagement with entertainment narratives, featuring characters with mental illnesses of varying levels of public stigma, impacts stigmatizing attitudes and intentions to interact with individuals with mental illness generally. Participants (n = 234) were randomized to one of the three conditions: (1) a more stigmatized mental illness (schizophrenia), (2) a less stigmatized mental illness (depression), or (3) a non-mental illness control (cancer). Participants in the more stigmatized condition reported significantly less identification with characters than those in the less stigmatized condition, and greater identification with the characters were associated with more positive attitudes and behavioral intentions. Narrative counterarguing was associated with less positive attitudes and intentions toward people with mental illness. Implications based on these findings include identifying ways to increase engagement with less familiar mental illnesses to optimize the positive outcomes associated with narrative engagement.

Public attitudes towards depression and schizophrenia in an urban Turkish sample

Stigma towards mental illness influences help-seeking behavior and prevents individuals with a mental illness from seeking the appropriate treatment for their condition. In Turkey, a shift from inpatient psychiatric mental health care towards a community-based, low-threshold system highlights the importance of understanding public attitudes towards the mentally ill. This study aims to underpin developments in mental health care through culturally sensitive research. Public stigma towards schizophrenia and depression is examined for the first time simultaneously in a community sample. Unlabeled case vignettes of either schizophrenia or depression as well as an assessment of mental illness attribution and the desire for social distance (SDS) were presented to an urban Turkish sample (N = 295). Analysis of variance revealed that attribution to mental illness determines significant levels of stigma for schizophrenia, however not for depression. Furthermore, desire for social distance (SDS) was significantly higher for the schizophrenia condition compared to depression. Depression and schizophrenia evoke different reactions within the Turkish population, specifically the attribution to mental illness increases stigma. This finding is discussed in light of the contact hypothesis, and furthermore contextualized within literature on familiarity with depression symptoms on the one hand, and perceived dangerousness and symptom severity of schizophrenia on the other hand. Implementation of timely and culturally sensitive adapted interventions within the ongoing reform of the Turkish mental health care system is recommended.

The Variability of Nursing Attitudes Toward Mental Illness: An Integrative Review

Mental illnesses are common worldwide, and nurses' attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses' attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses' attitudes toward mental illness. Fourteen studies conducted across 20 countries that 4282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential gaps in nursing curriculum regarding mental illness.

Stigma and mental health treatment of adolescents with depression in jordan

Stigma is a fundamental barrier to seeking and engaging in mental health treatment for individuals managing depression. This study examines stigma perceptions of mental health treatment for Arab adolescents managing depression using a vignette survey completed by adults in public spaces in Amman, Jordan (n = 108). The vignette was systematically changed across four different conditions that varied the described youth's gender and whether or not they were receiving treatment for their depression. Two-way ANOVAs found that gender and receipt of mental health treatment influenced perceptions of stigma. Seeking treatment, however, did not increase perceived stigma, and receiving mental health treatment rather than no treatment was found as more likely to be a helpful approach for both males and females. Findings indicate that personal level stigma may have greater effects on females whereas public stigma may exert more influence on males. Participants endorsed that adolescents with depression are most likely to be helped when a family sought treatment rather than not seeking treatment. Findings also indicate that the community seems to appreciate the need for treatment and the likelihood of benefiting from formal mental health services.

Stigma and adolescents with psychosis in the Middle East: implications for engaging in mental health treatment

Stigma is a fundamental barrier to individuals seeking out mental health treatment in the Middle East. The impact of stigma may be amplified if the engagement in and utilization of mental health services for psychosis further stigmatizes individuals and their families. One hundred four Jordanians (N = 104) participated in an experimental vignette survey examining stigma perceptions and social exclusion related to adolescents with psychosis, with the vignettes varying in sex of the youth and whether their family had sought mental health services. The results found that seeking treatment did not add to perceived stigma, and both the male and female adolescents receiving mental health treatment were viewed as significantly more likely to be helped than those not in treatment (p < 0.001). Therefore, receiving mental health treatment did not further stigmatize these Arab youth with psychosis. In addition, seeking out and engaging adolescents and their family in mental health treatment were positively perceived and may help to improve the youth's prognosis and outcomes.

Stigma towards people with mental illness in developing countries in Asia

BACKGROUND

There is a wide range of literature on stigmatization and discrimination of people with mental illness. Most studies, however, derive from Western countries. This review aims at summarizing results from developing countries in Asia published between 1996-2006.

METHOD

Medline search focusing on English-speaking literature.

RESULTS

Comparable to Western countries, there is a widespread tendency to stigmatize and discriminate people with mental illness in Asia. People with mental illness are considered as dangerous and aggressive which in turn increases the social distance. The role of supernatural, religious and magical approaches to mental illness is prevailing. The pathway to care is often shaped by scepticism towards mental health services and the treatments offered. Stigma experienced from family members is pervasive. Moreover, social disapproval and devaluation of families with mentally ill individuals are an important concern. This holds true particularly with regards to marriage, marital separation and divorce. Psychic symptoms, unlike somatic symptoms, are construed as socially disadvantageous. Thus, somatisation of psychiatric disorders is widespread in Asia. The most urgent problem of mental health care in Asia is the lack of personal and financial resources. Thus, mental health professionals are mostly located in urban areas. This increases the barriers to seek help and contributes to the stigmatization of the mentally ill. The attitude of mental health professionals towards people with mental illness is often stigmatizing.

CONCLUSION

This review revealed that the stigmatization of people with mental illness is widespread in Asia. The features of stigmatization-beliefs about causes of and attitudes towards mental illness, consequences for help-seeking-have more commonalities than differences to Western countries.

Beliefs of psychiatric nurses about schizophrenia: a comparison with patients' relatives and psychiatrists

BACKGROUND

What patients' relatives and health professionals think about causes, treatments and psychosocial consequences of schizophrenia can influence its detection and outcome.

AIMS

To compare the beliefs about schizophrenia in 190 nurses, 110 psychiatrists and 709 relatives of patients with this mental disorder, recruited in 30 randomly selected mental health centres.

METHODS

In each centre, the key-relatives of the first consecutive 25 subjects with schizophrenia, and the nurses and psychiatrists who had been working in the service for at least one year, were asked to complete the Questionnaire on the Opinions about Mental Illness (QO).

RESULTS

The factors most frequently mentioned by psychiatrists and nurses among the causes of schizophrenia were heredity, stress and family conflicts, while those most frequently mentioned by relatives were stress, traumas and love breakdown. Nurses had opinions: (a) similar to those expressed by psychiatrists concerning patients' ability to work equally as other people, and patients' punishability in case of illegal acts; (b) similar to those expressed by relatives about patients' unpredictability and political rights; (c) significantly different from the other two samples as concerns recognition of patients' affective rights.

CONCLUSIONS

Family psychoeducational interventions and nurses' training should address not only clinical aspects but also disability and psychosocial consequences of schizophrenia.

Public attitudes to depression in urban Turkey - the influence of perceptions and causal attributions on social distance towards individuals suffering from depression

BACKGROUND

The aim of this study was to determine public attitudes towards patients with depression and the influence of perception and causal attributions on social distance towards individuals suffering from depression in urban areas.

METHODS

This study was carried out with a representative sample in Istanbul which is the biggest metropolis in Turkey. Seven hundred and seven subjects completed the public survey form which consisted of ten items screening the demographic features and health status of the participants, and 32 items rating attitudes towards depression.

RESULTS

The respondents' attitudes towards depression were very negative and nearly half of the subjects perceived people with depression as dangerous. More than half of the subjects stated that they would not marry a person with depression, and nearly half of the subjects stated that they would not rent their house to a person with depression. One-quarter of the subjects stated that depressive patients should not be free in the community. The subjects who considered depression as a disease and who believed that weakness of personality and social problems cause depression had negative attitudes towards depression.

CONCLUSIONS

In Istanbul, people recognise depression well, but their attitudes towards it are fairly negative. The urban public has unfavourable attitudes towards depression and a tendency to isolate patients from the society. Notwithstanding the high prevalence, there is still considerable stigmatisation associated with depression.

Attitudes of hospital staff toward mentally ill patients in a teaching hospital, Turkey

The aim of this study was to examine the attitudes of hospital staff toward major mental diseases: schizophrenia and depression. Negative attitudes were common among all of the hospital staff, and were more common among academicians, resident physicians and nurses. Causes of attitude variations were discussed.

BACKGROUND

Attitudes of hospital staff are important for admission, early diagnosis and treatment, and the rehabilitation process of mentally ill patients.

AIMS

The main objective of this study was to investigate and compare hospital workers' attitudes toward and knowledge of schizophrenia and depression.

METHODS

In 2001, a total of 160 hospital staff (40 academicians, 40 resident physicians, 40 nurses and 40 hospital employees) in a teaching hospital were interviewed with a questionnaire. The questionnaire included items about background information, a one-paragraph vignette, questions on social distance and expected burden, recognition of mental illness, hospitalization, prognostic outcome, and to whom and where the patient should be admitted.

RESULTS

Although academicians, resident physicians, and nurses have sufficient knowledge about schizophrenia and depression, the frequency of their negative attitudes towards mentally ill subjects was more than that for uneducated hospital employees.

CONCLUSIONS

It was commented that this difference might be as a result of negative effects of the medical education system.

[Causes and psychosocial consequences of schizophrenia: opinions of mental health personnel]

OBJECTIVE

Description of the opinions about causes and psychosocial consequences of schizophrenia in a sample of psychiatric professionals, recruited in 29 Italian Mental Health Centres (MHC).

DESIGN

Each professional was asked to read a case-vignette describing a patient who met the ICD-10 criteria for schizophrenia. Referring to case-vignette, he/she was asked to fill the Questionnaire on the Opinions about Mental Illness--Professionals' version (QO-P). Professionals' opinions were explored in relation to: a) their socio-demographic variables and professional background; b) geographic location of the MHC.

SETTING

29 MHC stratified by geographic area (Northern, Central, Southern Italy) and population density of their catchment areas (> 100,000 inhabitants; between 100,000 and 25,000 inhabitants; < 25,000 inhabitants) and randomly selected.

RESULTS

Data on 465 professionals were collected. 75% of the sample identified in the vignette a case of schizophrenia, 22% of depression/anxiety disorder. Factors most frequently mentioned as causes of the detected disorder were heredity (68%), stress (61%), family difficulties (46%). More pessimistic opinions about psychosocial consequences of schizophrenia were found among nurses and among professionals of Southern Italy, among those with lower educational level, older age and among those working longer in psychiatry. No statistical difference in the opinions about psychosocial consequences of schizophrenia was found among staff who referred the case-vignette to schizophrenia and those who did not.

CONCLUSIONS

The results of this study outline the need to: a) include issues such as disability and psychosocial consequences of mental disorders in the basic training of professionals; b) increase the number of professionals trained in evidence-based psychosocial interventions.

Influence of a 3-week psychiatric training programme on attitudes toward mental illness in medical students

The present study was carried out to assess the influence of psychiatric training, including direct patient contact, on attitudes toward mental illness. An experimental group consisting of medical students going through their 3-week training in psychiatry was compared with a control group going through training in ophthalmology. The psychiatric training involved direct patient contact and course work. Attitudes toward three different vignettes were assessed before and after training. Analyses showed that there were no significant changes in the attitudes of the psychiatry group when compared to the ophthalmology group. Inconsistent findings in the literature were pointed out and a more analytical approach, focusing on the specific features of exposure, was suggested.

Effect of psychiatric labels on attitudes toward mental illness in a Turkish sample

The influence of specific psychiatric labels and types of psychopathology on various attitudes were investigated in a sample (N = 84) of visitors of patients in a Turkish hospital. Vignettes representing two types of psychopathology with and without labels were used as the stimulus material and the attitudes toward those descriptions were assessed with the use of a questionnaire. Statistical analyses showed that labels had significant influence on recognition of mental illness, social distance, expected physical burden, and perception of treatment necessity. Type of psychopathology significantly influenced recognition of mental illness, social distance, expected physical burden, prognosis, and treatment choice. The results were discussed within the context of previous findings and the need for research pointed out.

Influence of having a hospitalized mentally ill member in the family on attitudes toward mental patients in Turkey

The influence of having a mentally ill member in the family on various attitudes was assessed. An exposed group (those having a mentally ill member) was compared with a no-exposure group. The attitudes assessed toward two vignettes included recognition of mental illness, social distance, expected burden, expected influence on one's health, treatment choice, and prognosis. The total sample consisted of 84 subjects selected from the family members of patients from psychiatric (exposed) and other (no-exposure) clinics. Direct experience with a mentally ill family member did not make a significant difference in the attitudes toward the vignettes, but the type of psychopathology did. The results were discussed within the context of findings from Western cultures.