Numerous studies conducted during the past decades indicate that the public's attitude toward the mentally ill is strongly prejudiced. Since the attitude of the general public also has an effect on community-based psychiatric care, we must ask how public opinion might be influenced. One possible approach could be through so called key community leaders--those who are highly respected in society because of their competence in a particular area. Doctors belong to this group of people. For this reason we questioned medical students, as future key community leaders, with respect to their attitudes toward the mentally ill within the framework of their first contact with psychiatric patients during their studies. In order to make a direct comparison possible, we interviewed a sample of the Mannheim population who live in a part of the city where a variety of complementary facilities have been set up. The comparison shows that medical students do not have a more positive attitude toward the mentally ill; in fact, in certain areas they have an even more negative attitude toward the mentally ill than the general population has. We were not able to establish what effect teaching has with respect to changing attitudes.
In this cross-sectional study we have investigated the attitudes and feelings toward the mentally ill among the residents of two Central European regions which are at considerably different stages of development in moving toward community-based care, to see if we could connect differing patterns of attitudes in the two regions to the varying levels of development of psychiatric care. By using the telephone survey method, representative samples of interviewees were presented with two complexes of questions, measuring the social distance of the interviewee to the mentally ill and his/her feelings toward the mentally ill. Social rejection and feelings of the people toward the mentally ill in both regions were similar in the direction they took, however not so much in the intensity. The population of the community care area showed a slightly stronger rejection. But factor analysis clearly suggests a more rational and sophisticated position toward the patients in this population. The people living in the custodially-oriented catchment area, on the other hand, showed a more vague pattern in their attitudes.
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