Attitudes of psychology students to depression and its treatment: Implications for clinical practice

Abstract

Stigma and mental health literacy affect access to and quality of treatment of major depression. Though mental health professionals seem better able to recognize major depression than the general public, they often hold similarly stigmatizing attitudes towards people suffering from the disorder. These attitudes are shaped jointly by the public stigma attached to mental illnesses as well as by the content and delivery of mental health professionals' undergraduate training. In line with this, the present study aimed to explore psychology students' ability to recognize major depression, their attitudes towards the disorder, and their views surrounding helpfulness of various interventions. A random sample of 167 undergraduate students was recruited from the psychology department of one public university in Athens. During one university hour, students were administered a vignette describing a woman fulfilling the DSM-IV criteria for major depression. A self-report questionnaire exploring students' recognition abilities, attitudes to depression and views on the helpfulness of various treatment modes was also administered. In total, 80.2% of students correctly recognized major depression from the vignette. Concerning their attitudes, students were unsure about the illness and ambivalent towards the person who suffers from it. With regard to available treatments for depression, students considered discussion with a friend to be the most helpful intervention. Counseling, cognitive behavioural therapy and psychoanalysis were also viewed in a positive light. On the contrary, antidepressants were not deemed helpful by most students. Finally, recognition of as well as attitudes towards depression and its treatments seemed to improve during the second year of undergraduate study; however they remained unchanged thereafter. Consistent with these, psychology students seem to have only a rudimentary knowledge on depression, that cannot not be qualified as mental health literacy. The core misconception espoused pertains to the view that major depression is not a medical illness; a finding which can also be interpreted in light of the lingering controversy on the medicalization of normal sadness and human predicament. The clinical implications of these findings are substantial. Mental health professionals-educators should reflect on their own beliefs and attitudes towards depression, as they may convey stigmatizing messages to their students and thus perpetuate the stigmatization of the illness. Concomitantly, psychology students' attitudes to depression and its treatment might render them incapable of understanding their patients, responding to their needs and providing them with appropriate help, while they may hinder their effective collaboration with psychiatrists.

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

“…Stigma against persons with mental illness is also common in low-and middle-income countries (LMICs) [4]. The majority of medical students in a study in India held a negative view of depression, and they did not consider it to be a real illness [5]. In a comparative study, depression was found to be more stigmatized by Sri Lankan medical students than among medical students in the United Kingdom [6].…”

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

“…Stigma against persons with mental illness is also common in low-and middle-income countries (LMIC) [4]. The majority of medical students in a study in India held a negative view of depression, and they did not consider it to be a real illness [5]. In a comparative study, depression was found to be more stigmatized by Sri Lankan medical students than among medical students in the United Kingdom [6].…”

“…In both high-income countries (HICs) and LMICs, there is conflicting evidence about whether medical school education improves or worsens attitudes towards mental illness. After completing a psychiatry rotation, student attitudes toward mental illness improved in a few studies [7][8][9], but they stayed the same or worsened in others [5,10,11]. When comparing the attitudes of nonclinical hospital staff versus clinicians, staff held more positive views of people living with mental illness [12].…”

“…When comparing the attitudes of nonclinical hospital staff versus clinicians, staff held more positive views of people living with mental illness [12]. Taken together, findings from these studies suggest that formal medical education fails to reliably improve attitudes towards mental illness, and, in some cases, it may increase stigma [5,10,12]. There is a need for research to evaluate interventions, especially in LMIC, to reduce mental health-related stigma among medical students [13,14].…”

“…Medical schools should be targeted for stigma reduction interventions because students routinely express negative attitudes towards mental illness [2], and the current curriculum models might be increasing stigma [5,10,12]. With regard to medical students in HIC, contact with service users did not demonstrate attitude change [21,22].…”