Background: Stigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatizing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals. Methods: We used a qualitative exploratory research design to contrast the differences and similarities regarding stigmatizing attitudes towards people with SMD in primary healthcare centers (PHC) from the perspective of two groups: (i) people diagnosed with a severe mental disorder, and (ii) healthcare professionals. Data was collected through semi-structured interviews and discussion groups and subsequently analyzed using Atlas.ti software. Results: Our results indicate that both service users and healthcare professionals manifest stereotypes, prejudices, and discriminatory behavior in health care. In addition, structural aspects of the health system and organizational culture appear to contribute to stigmatization. Both groups agreed that there is a need for healthcare professionals to have more education, specialization, and skill development related to mental health issues. Conclusions: Interventions to reduce the stigma towards people with SMD in PHC must consider delivery of information about mental disorders, development of skills in the healthcare professionals, and modifications in the culture of the health centers.
Background: People with severe mental disorders (SMDs) have higher disease and death rates than the general population. Stigma (negative attitudes and perceptions) contributes to limited access to health services and a lower quality of medical assistance in this population, and it is manifested as negative attitudes, social distance, and discrimination toward this social group. For these reasons, healthcare workers are a priority group for anti-stigma interventions. This study aims to assess the effectiveness of a program specifically designed to decrease negative attitudes and social distance and increase inclusive behaviors in healthcare workers toward people with SMD.Methods: The study will be a randomized clinical trial. A minimum of 210 healthcare workers from 11 primary care centers in the province of Concepción, Chile, will be randomly chosen to receive the program or be part of the control group. There will be a pre-, post-, and 4-months evaluation of social distance, attitudes, and behaviors of participants toward people with SMD using standardized scales such as the social distance scale, which is a scale of clinician attitude toward mental illness adapted from attitudes of clinicians toward mental illness, and self-reports. The intervention program will consist of education strategies, direct, and indirect contact with people diagnosed with SMD, and skill development. There will be six face-to-face sessions directly with the participants and two additional sessions with the directors of each healthcare center. The program will involve a facilitator who will be a healthcare professional and a co-facilitator who will be a person diagnosed with SMD.Discussion: This study will evaluate an intervention program especially designed to reduce stigma in healthcare workers toward people with SMD, a topic on which there is little background information, particularly in low- and middle-income countries. It is important to have interventions with proven effectiveness for this purpose to ensure equity in healthcare services.Trial Registration: This study was registered under ISRCTN.com (ISRCTN46464036).
Adolescent suicide is a serious public health problem in Chile. Given the high prevalence of suicidal behaviors and suicide, youth suicide researchers must approach participants, families, and communities with care. Special attention must be given to suicide-related trauma among survivors of suicidal behaviors and of suicide. In this article, we discuss how investigators can infuse the trauma-informed model in their work. Our discussion is organized around research stages and tasks: study design, recruitment, data collection and analysis, and care for the research team. We illustrate the integration of the trauma-informed (TI) model key elements and principles with examples from our work in youth suicide research. We posit that infusing the TI model in research aligns with the ethical mandate of beneficence. Our goal is to help other researchers reflect on how to design and implement TI informed research that is attuned to participants, staff, and communities. Public Policy Relevance StatementSuicide is the leading cause of death among Chilean adolescents. This manuscript highlights lessons learned from the design and implementation of public funded trauma-informed school-based suicidal behaviors study in Chile. Our findings support the need to implement trauma-informed suicide research in communities affected by high rates of suicidal behaviors and suicide.A dolescent suicide and suicidal behaviors are a serious public health concern in Chile. Suicide is the leading cause of death among youth between the ages of 15 and 24 years (Araya, 2019). Chile's youth suicide prevalence of 10.3 suicides per 100,000 youth is among the highest in the world (UNICEF Office of Research, 2017). The suicide rate for people ages 15-19 years increased from 8.6 to 12.9 for every 100,000 people between 2000 and 2010 (Araya, 2019). The findings of international studies describe a similar pattern. For example, the Organisation for Economic Co-Operation and Development ( 2015) reported that the deaths by suicide among Chilean teens increased from 4.9 to 10.8 between 2000 and 2011. With variations by geographic area and year of data collection, between 15% and 57% of teens surveyed reported suicidal ideation, and between 5% and 25% reported life time prevalence of suicide attempts (
Background While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. Objective: We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. Method The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. Results: These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. Discussion and conclusion Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.
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