The factors influencing the distance towards people suffering from schizophrenia differ between groups. Our findings should help to optimize campaigns fighting against stigma and discrimination.
Attitudes towards suicide among medical students in Madras (India) and Vienna (Austria) were compared using the SUIATT questionnaire by Diekstra and Kerkhof (1989). Results show a very restrictive attitude in Madras, rejecting the right to commit suicide, nearly always judging suicide as a cowardly act, and rejecting the idea of assisted suicide. On the other hand, in Vienna a more permissive attitude was found. It is interpreted that the Indian pattern comes close to a "medical" or "disease model", with stronger emphasis on mental illness, impulsiveness and emotional aspects, whereas the Viennese pattern reflects a "theoretical", "rational model", concentrating on cognitive factors and minimizing the influence of mental illness, emotional difficulties and restrictions related to suicidal behaviour. This pattern may be influenced by the public discussion on assisted suicide and the right to die in Europe in the last decade. Possible relations to the risk for actual suicidal behaviour are discussed using respective answers concerning previous suicidal ideation and suicide attempts. The answers concerning suicidal ideation seem to be strongly influenced by the different attitude patterns: only 16.8% reported previous suicidal ideation in Madras, compared to 51.5% in Vienna, whereas the percentage of reported suicide attempts is equal in both centres (5.9%:4.9%).
Purpose
In the recent years, it was possible to observe two trends: First, there has been a trend to greater mental health literacy, in particular towards a biological model of schizophrenia. Secondly, an increase in public acceptance of professional help and psychiatric treatment has been observed in western countries. This indicates that the societal idea about mental illness and how it can be treated has changed. However, no changes or even changes to the worse occurred regarding the attitudes towards those suffering from the illness, particularly concerning schizophrenia. Thus, the question arises as to whether similar trends can also be found in Austria.
Methods
We use data from two representative population surveys in Austria, conducted 1998 (n = 1042) and 2018 (n = 1010) using face-to-face interviews, the same sampling procedure, interview mode, and interview schedule.
Results
The data show that today Austrians tend to opt less frequently for genetic factors and chronic stress as causes of schizophrenia than 20 years ago. There were only slight changes regarding intended first help-seeking actions except for a stronger endorsement of lay help. The believe in an effective treatment of schizophrenia has increased significantly and there was a marked trend towards preference of medication over psychotherapy. Social acceptance of people with schizophrenia has increased, but also the ascription of violence.
Conclusion
In summary, the evolution of attitudes and beliefs concerning schizophrenia in Austria shows a rather inconsistent pattern and differs to some extent from what has been observed in other western countries. This is important to know when planning awareness-raising or stigma-reducing initiatives.
A medical rehabilitation concept showed positive therapy outcomes for patients with severe mental illness as well as for patients with neurotic disorders.
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