Effectiveness of an anti-stigma training on improving attitudes and decreasing discrimination towards people with mental disorders among care assistant workers in Guangzhou, China

Li, Jie; Fan, Yu; Zhong, Huaqing; Duan, Xiaoling; Chen, Wen; Evans‐Lacko, Sara; Thornicroft, Graham

doi:10.1186/s13033-018-0259-2

Cited by 76 publications

(52 citation statements)

References 52 publications

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“…In a resource-constrained setting as in Pakistan the LHWs can take the lead in community-based active case detection of depression as they share the same cultural and social context with the community ( 34 ). Pakistan has a well-established PHC system with rural health centers staffed by trained health workers accessible to all ( 35 ). LHWs inhabit the same rural settings (villages) they serve, being responsible for the provision of promotive and preventive health care during home visits to over a 100 households in their neighbor-hood ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, research indicates that excessive workload and competing priorities for the LHWs in an overstretched PHC system may hinder early detection ( 37 ). In such cases, peer volunteers (women from the same villages sharing the same culture and life-experiences as their clientele) could be an alternative strategy proven to be effective in reducing maternal depression ( 32 – 38 ). Moreover, the studies conducted on maternal depression in Pakistan ( 39 – 43 ) all have focused on validating a screening tool, finding out the prevalence, and analyzing risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

et al. 2021

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Background: Evidence indicates that mental health issues like depression, epilepsy, and substance misuse can be detected with reasonable accuracy in resource-poor settings. The Community Informant Detection Tool (CIDT) is one such approach used for detecting mental health problems, including depression. We adapted this community informant approach for detecting maternal depression in Pakistan.Methods: Adaptation of Community Informant Detection Tool for Maternal Depression (CIDT-MD) involved five steps. First, a scoping review of the literature was conducted to select an appropriate tool for adaptation. Second, in-depth interviews were conducted to explore the idioms of depression and distress, perceived causes, and the effects of maternal depression among currently depressed and recovered mothers (n = 11), mothers in law (n = 6), and Primary Care Providers (Primary Care Physicians and Lady Health Supervisors) (n = 6). Third, case vignettes and illustrations were created with input from a panel of mental health experts, incorporating the idioms of depression and distress used, causes, and effects for each symptom described. Fourth, to assess the comprehensibility of the illustrations and level of understanding, Focus Group Discussions (n = 4) were done with purposely selected community health workers (Lady Health Workers and Lay Peers, n = 28) trained in delivering maternal depression intervention. The final step was reflection and inputs by a panel of mental health experts on all steps to finalize the content of the tool.Results: Context-specific cultural adaptation in the presentation and format of CIDT-MD was conducted successfully. Lady Health Workers (LHW) and Lay Peers (LP) were found to be the most appropriate persons to use the tool and function as the informants. The adapted tool with all its vignettes and illustrations was found to be easily understandable, comprehensible, and culturally appropriate, meaningful, and contextually relevant by the community health workers and peers working in the relevant settings. They easily relate to and identify potentially depressed such women lining up with the tool. Lastly, the coding of the tool was found easy to follow as well.Conclusion: The Community Informant Detection Tool for Maternal Depression (CIDT-MD) is a culturally acceptable, easy to use, and comprehensible tool for detecting maternal depression in community settings of Pakistan. The community informants found the content and approach highly relevant to the local needs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

et al. 2021

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“…Thus, this research mainly aims at learning the baseline level of knowledge and attitudes among CAWs. Apart of this baseline study (part 1), we have further developed an anti-stigma training for CAWs in Guangzhou China (part 2), please see a prior publicaition for full details [ 21 ]. This project is part of the wider “Anti-stigma campaign in Guangzhou,China” (2017–2022).…”

Section: Methodsmentioning

confidence: 99%

Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

Duan

Zhong

et al. 2021

Int J Ment Health Syst

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Background Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01). Conclusion These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.

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“…Thus, this research mainly aims at learning about the current level of knowledge and attitudes among CAWs. We have also developed an anti-stigma training programme for CAWs in Guangzhou China, which is described elsewhere [17].…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…The knowledge and attitudes of CAWs towards people with SMD can in uence their behavior and quality of services provided for patients. Negative attitudes and discriminatory behaviors could cause adverse consequences, such as unwillingness to deliver care, or spending less time with such patients, or disregarding ignoring human rights [17]. However, it is still unclear what the current levels of knowledge and attitudes are among CAWs, especially for community policemen who are groups arising from Chinese socio-ecological system and their data are usually di cult to acquire.…”

Section: Introductionmentioning

confidence: 99%

Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

Duan

Zhong

et al. 2020

Preprint

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Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess the mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA). Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care had significant higher MICA scores when compared with other staff (P < 0.001). However, participants who disagreed additional item 1（views towards inpatients) and additional item 2 (affiliate stigma) had a significant lower MICA scores when compared with those who agreed (P < 0.001). Multivariable linear regression showed that after controlling some variables, care willingness and PDD total score were significantly positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significantly negatively associated with the MICA total score (all P < 0.01).Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of ‘violent mentally ill’ people to all people they deal with who have mental disorders. The results also indicate human rights are being paid attention to now, but need to be improved in the future. Strategies to improve attitudes and to reduce stigma and discrimination should be conducted with particular staff groups.

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Effectiveness of an anti-stigma training on improving attitudes and decreasing discrimination towards people with mental disorders among care assistant workers in Guangzhou, China

Cited by 76 publications

References 52 publications

Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

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