Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice

Abstract

BackgroundMental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students’ attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness.MethodYear 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career.ResultsAttitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students’ interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students ‘definitely considering’ psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up.ConclusionThe clerkship made a modest impact on students’ attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.

Attitude of interns towards mental illness and psychiatry: A study from two medical colleges in South India

“…The findings are better than earlier studies(Lingeswaran, 2010;Rajagopal et al, 2004;Soufi and Raoof, 1992) however 30% considering it as unscientific is still is a significant figure. Majority (90%) had a positive opinion on the treatment efficacy which is in line with the recent study(Lyons and Janca, 2015).The attitude towards career and reward aspect of psychiatry was not very favorable, with around 40% having a negative opinion, considered psychiatry as having low prestige, were uncomfortable with mentally Ill patients, and were discouraged by friends and family from entering psychiatry. Though this is similar to earlier studies (Lyonsand Janca, 2015; Xavier and Almeida, 2010; Alexander and Kumaraswamy, 1993) the findings may be interpreted as less favorable, as majority of respondents in our study were females from a private medical college and studies (Khan et al, 2008; Gat et al, 2007; Al-Ansari and Alsadadi, 2002; Malhi et al, 2002; Tharyan et al, 2001; Aslam et al, 2009) show that female graduates /from private medical college have a more positive attitude of psychiatry.…”

Blogging and Social Media for Mental Health Education and Advocacy: a Review for Psychiatrists

“…Additionally, recent editorials have discussed the stigmatization of both patients and mental health practitioners [5], impacting and even dissuading medical students from entering the field [6]. By blogging, psychiatrists can proactively advocate for their patients by writing directly about issues related to mental health.…”

Mental health and clinical education

“…People with mental health problems are frequently stigmatised, marginalised and discriminated against in their communities . Some medical students have also been shown to have negative attitudes to patients with mental illness that are only partially improved during psychiatry rotations . Nursing students with little experience of interacting with people with mental illness frequently express negative stereotypes of mental health problems .…”