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Grandón P, Vidal D, Vielma-Aguilera A, Bustos C, Contreras Y, Castillo G, Cid P, Araya C, Flores R. Effectiveness of an intervention to reduce stigma towards people with a mental disorder diagnosis in university students of healthcare careers. Psychiatry Res 2023; 328:115428. [PMID: 37643532 DOI: 10.1016/j.psychres.2023.115428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023]
Abstract
Students in healthcare careers present stigma towards people with psychiatric diagnoses, so the development of interventions to reduce it is essential. This study aimed to evaluate the effectiveness of an intervention to reduce stigma towards people diagnosed with mental disorders in healthcare students in Chile. A randomized clinical trial with a before and after measurement was carried out. The intervention was part of a compulsory course and combined educational and contact strategies. A total of 244 fourth-semester students of medicine, nursing, dentistry, obstetrics, psychology, and social work participated. The intervention was effective in reducing stigmatizing attitudes and the desire for social distance. For almost all variables, the magnitude of the stigma reduction depended on the initial level of stigma, not on the profession. The intervention had positive effects on all careers. In conclusion, incorporating a stigma reduction intervention into mandatory professional training, with the active participation of the teacher in charge and experts by experience, can be a valuable tool to promote humanized and non-stigmatizing treatment.
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Affiliation(s)
- Pamela Grandón
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile.
| | - Daisy Vidal
- Department of Social Work, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Alexis Vielma-Aguilera
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Concepción, Concepción, Chile
| | - Claudio Bustos
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Yolanda Contreras
- Faculty of Medicine, Department of Obstetrics, Universidad de Concepción, Concepción, Chile
| | - Gustavo Castillo
- Department of Social Work, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Patricia Cid
- Faculty of Nursing, Department of Nursing Fundamentals and Public Health, Universidad de Concepción, Concepción, Chile
| | - Carlos Araya
- Department of Prevention and Public Health, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Raúl Flores
- Department of Prevention and Public Health, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
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Jara-Ogeda R, Leyton D, Grandón P. Stigmatization of people diagnosed with a mental disorder in secondary mental health centers in Chile: An ethnographic study. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3307-3324. [PMID: 35290673 DOI: 10.1002/jcop.22838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
To understand how stigmatization of people diagnosed with a mental disorder occurs in secondary mental healthcare staff in mental healthcare centers in Chile was the objective of the study. A descriptive qualitative and interpretative design with an ethnographic approach was used. Participants' observations, ethnographic, and semi-structured interviews were conducted with professionals at three secondary mental health centers. Qualitative descriptive and interpretative content analysis was used. Stigmatization of users is shaping up in their trajectory in the health center. Identity changes from person to "patient," which generates dependence on the expert role of healthcare professionals. Stigma is expressed in the interactions between a health institution, a professional team, and a user, reproducing power and control relationships associated with the biomedical model and reinforcing a cycle of chronification in the user. Health teams are stressed by discrepancies between the current mental health policy and the user's biomedical understanding.
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Affiliation(s)
- Romina Jara-Ogeda
- Magister in Psychology, Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Daniela Leyton
- Department of Anthropology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Pamela Grandón
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
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Grandón P, Saldivia S, Cova F, Bustos C, Vaccari P, Ramírez-Vielma R, Vielma-Aguilera A, Zambrano C, Ortiz C, Knaak S. Effectiveness of an intervention to reduce stigma towards people with a severe mental disorder diagnosis in primary health care personnel: Programme Igual-Mente. Psychiatry Res 2021; 305:114259. [PMID: 34752990 DOI: 10.1016/j.psychres.2021.114259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022]
Abstract
This study assessed the effectiveness of a program (called Igual-Mente, Equal-Mind) designed to reduce stigma in primary health care personnel. A random clinical trial was performed (ISRCTN46464036). There were 316 primary care professionals and technicians who were randomized and assigned to the experimental or control group. The program considered as strategies the education, the contact and the development of skills. There were six sessions with the primary care staff and two sessions with the managers of the health centers. It was executed by two facilitators, a professional psychologist and an expert by experience, i.e., a person diagnosed with a severe mental disorder (SMD). Attitudes, social distance, and humane treatment behaviors toward people with SMD were assessed. The intervention was effective in reducing stigma attitudes y social distance towards people diagnosed with SMD. The magnitude of the changes ranged from moderate to high in all these variables and the effects were maintained for four months after the end of the program. Regarding humane treatment behaviors, the effects were less clear. This study shows good results indicating that well-designed interventions can effectively reduce stigma towards people diagnosed with SMD, which is one of the main challenges of health systems.
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Affiliation(s)
- Pamela Grandón
- Psychology Department, Universidad de Concepcion, Concepcion, Chile.
| | - Sandra Saldivia
- Psychiatric Department, Universidad de Concepcion, Concepcion, Chile
| | - Felix Cova
- Psychology Department, Universidad de Concepcion, Concepcion, Chile
| | - Claudio Bustos
- Psychology Department, Universidad de Concepcion, Concepcion, Chile
| | - Pamela Vaccari
- Psychology Department, Universidad de Concepcion, Concepcion, Chile
| | | | | | | | - Camila Ortiz
- Psychology Department, Universidad de Concepcion, Concepcion, Chile
| | - Stephanie Knaak
- Social Sciences Department, University of Calgary, Calgary, Canada
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van 't Hof M, van Berckelaer-Onnes I, Deen M, Neukerk MC, Bannink R, Daniels AM, Hoek HW, Ester WA. Novel Insights into Autism Knowledge and Stigmatizing Attitudes Toward Mental Illness in Dutch Youth and Family Center Physicians. Community Ment Health J 2020; 56:1318-1330. [PMID: 32048132 PMCID: PMC7434787 DOI: 10.1007/s10597-020-00568-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 01/30/2020] [Indexed: 12/13/2022]
Abstract
Professionals' limited knowledge on mental health and their stigmatizing attitudes toward mental illness can delay the diagnosis of autism. We evaluated the knowledge on Autism Spectrum Disorder (ASD) and stigmatizing attitudes in 93 physicians at Dutch Youth and Family Centers (YFC). These physicians screen for psychiatric symptoms in children. We show that their general ASD knowledge scored 7.1 (SD 1.2), but their specific ASD knowledge was only 5.7 (SD 1.7) (weighted means on 1-10 scale, 1 = least knowledge, 10 = most knowledge). Our physicians had positive attitudes toward mental illness (CAMI scores 2.18 (SD 0.33) to 2.22 (SD 0.40) on a 5-point Likert scale) but they had higher levels of stigmatizing attitudes than other Western healthcare professionals. Their levels were considerably lower than in non-Western professionals. We found no relations between ASD knowledge, stigmatizing attitudes and demographic variables. In conclusion, ASD knowledge and stigmatizing attitudes toward mental illness in Dutch YFC physicians require attention.
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Affiliation(s)
- Maarten van 't Hof
- Sarr Expert Centre for Autism, Lucertis Child and Adolescent Psychiatry, Carnissesingel 51, 3083 JA, Rotterdam, The Netherlands.,Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands
| | - Ina van Berckelaer-Onnes
- Sarr Expert Centre for Autism, Lucertis Child and Adolescent Psychiatry, Carnissesingel 51, 3083 JA, Rotterdam, The Netherlands.,Faculty of Social and Behavioural Sciences, Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands.,Faculty of Social and Behavioural Sciences, Institute of Psychology, Methodology and Statistics Unit, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Monique C Neukerk
- Sarr Expert Centre for Autism, Lucertis Child and Adolescent Psychiatry, Carnissesingel 51, 3083 JA, Rotterdam, The Netherlands
| | - Rienke Bannink
- Department of Youth Health Care, Regional Public Health Service Rijnmond, 3003 AB, Rotterdam, The Netherlands
| | - Amy M Daniels
- Simons Foundation, 160 Fifth Avenue, New York, NY, 10010, USA
| | - Hans W Hoek
- Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands.,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA
| | - Wietske A Ester
- Sarr Expert Centre for Autism, Lucertis Child and Adolescent Psychiatry, Carnissesingel 51, 3083 JA, Rotterdam, The Netherlands. .,Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands. .,Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University, Endegeesterstraatweg 27, 2342 AK, Oegstgeest, The Netherlands.
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O'Ferrall-González C, Almenara-Barrios J, García-Carretero MÁ, Salazar-Couso A, Almenara-Abellán JL, Lagares-Franco C. Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students. J Psychiatr Ment Health Nurs 2020; 27:237-245. [PMID: 31663221 DOI: 10.1111/jpm.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/28/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.
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Affiliation(s)
- Cristina O'Ferrall-González
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain.,Research Group PAIDI CTS-391, University of Cádiz, Cádiz, Spain
| | - José Almenara-Barrios
- Department of Biomedicine, Biotecnology and Public Health, University of Cádiz, Cádiz, Spain
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