Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review

Vistorte, Angel Olider Rojas; Ribeiro, Wagner Silva; Jaen, Denisse; Jorge, Miguel Roberto; Evans‐Lacko, Sara; Mari, Jair de Jesus

doi:10.1177/0091217418778620

Cited by 105 publications

(109 citation statements)

References 48 publications

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“…This research is one of the first in Latin America to evaluate how stigmatization occurs towards people diagnosed with SMD from the perspective of those affected and PHC professionals. The results demonstrate that both service users with SMD and health professionals perceive discriminatory behavior towards people diagnosed with SMD, similar to that found in other studies [11]. However, the way in which discrimination is experienced is different for both groups.…”

Section: Discussionsupporting

confidence: 86%

“…Therefore, reducing stigma towards people diagnosed with SMD is one of the central challenges in the field of mental health [8][9][10]. Stigma manifested by personnel from primary healthcare centers (PHC) is expressed in different ways and influences the diagnosis and treatment of people with SMD [11]. For example, it has been found that physicians erroneously attribute physical symptoms to the mental disorder which results in physical health problems being minimized or undetected [9,12].…”

Section: Introductionmentioning

confidence: 99%

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Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Vaccari

Ramírez-Vielma

Saldivia

et al. 2020

Int J Ment Health Syst

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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.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Vaccari

Ramírez-Vielma

Saldivia

et al. 2020

Int J Ment Health Syst

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“…The importance of clinical skills and confidence for positive attitudes is supported by findings from primary care workers in high-income and LMICs (Vistorte et al, 2018). Health professional students likely need to have a certain level of skills and confidence before their clinical posting, in order to have non-aversive conversations with patients.…”

Section: Discussionmentioning

confidence: 93%

Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: a systematic review

Heim

Henderson

Kohrt

et al. 2019

Epidemiol Psychiatr Sci

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Aims This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken. Results A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies. Conclusions There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.

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“…The variable that was most associated with the number of visits was GP age, such that older GPs had less contact with patients. This could be related to older GPs having a more negative attitude toward patients with schizophrenia than their younger counterparts [28], although not all studies have found this result [24,29].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

Anguiano

Pérez

Aragón

et al. 2020

Preprint

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Background. Patients with schizophrenia and related disorders have more physical problems than the general population. Primary care professionals play an important role in the care of these patients as they are the main entry point into the healthcare system. We aimed to identify patient, general practitioner, and primary care centre factors associated with the number of visits of patients with schizophrenia and related disorders to general practitioners. Methods. A descriptive, cross-sectional study was conducted in 13 primary care centres belonging to the Clinical Management Unit of Mental Health of the Regional Hospital of Málaga, Spain. The eligible population was composed of patients with schizophrenia and related disorders attending these primary care centres in the study area. Our dependent variable was the total number of general practitioner visits made by patients with schizophrenia and related disorders during the 3.5-year observation period. The independent variables were grouped into three: a) patient variables (sociodemographic and clinical), b) general practitioner variables, and c) primary care centre characteristics. Descriptive, bivariate, and multivariate analyses using the random forest method were performed. Results. A total of 259 patients with schizophrenia and related disorders, 96 general practitioners, and 13 primary care centres were included. The annual mean was 3.9 visits per patient. The results showed that general practitioner age, patient gender, patient marital status, primary care centre to which the patient belonged, taking antipsychotic medication, presenting any cardiovascular risk factor, and frequency of mental health training sessions at the primary care centre were associated with an increased number of visits to general practitioners. Conclusions. The only general practitioner characteristic that was associated with the number of visits was age. There were also patient variables involved in the number of visits. Finally, mental health training for general practitioners was important for these professionals to manage patients with schizophrenia and related disorders.

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Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review

Cited by 105 publications

References 48 publications

Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: a systematic review

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

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