Medical Student Beliefs and Attitudes Toward Mental Illness Across Five Nations

Abstract

Negative attitudes toward people with mental illness are a widespread concern and may vary across countries. This study used a 36-item questionnaire to compare attitudes toward people with mental illness and beliefs about the causes of mental illness among medical students from the United States, Brazil, Ghana, Nigeria, and China (N = 1131). Exploratory factor analysis identified the underlying factor structure of the questionnaire, and analysis of covariance was then used to compare factors representing four nonstigmatized attitudes across students from the five countries. US Medical students scored highest on all four factors, followed by those from Brazil. Nigerian and Ghanaian students scored lowest on nonsupernatural etiology of mental illness, and Chinese students showed the lowest score on personal social acceptance and public policy acceptance of people with mental illness. Differences in medical student attitudes between these five countries suggest underlying sociocultural differences in attitudes with the more stigmatized attitudes in developing countries.

Attitudes towards mental illness among medical students in China: Impact of medical education on stigma

“…The question remains as to what can be done to reduce stigma both among medical students and in Chinese society more broadly. As noted above, the results from China reported here are consistent with a previous cross‐national survey involving 5 different countries (Stefanovics et al, ). In that study, medical students from the United States exhibited significantly more positive and progressive attitudes than those from other countries.…”

“…Stigma damages social interaction through lack of knowledge (ignorance), negative attitudes towards a group (prejudice), and functional exclusion (discrimination) (Ighodaro, Stefanovics, Makanjuola, & Rosenheck, ). Stigma can also significantly impede treatment initiation, continuation, and outcome, and reduces access to employment, housing, and social relationships (Stefanovics et al, ). To address stigma, there is a need to better understand its origins (Lauber & Rössler, ).…”

“…A review of recent studies showed that, in developing countries, the general public as well as mental health professionals view mentally ill people as dangerous, unpredictable, and fearsome and prefer to maintain social distance from them (Angermeyer & Dietrich, ), attitudes that have not changed in recent years (Lauber & Rössler, ). A recent survey of small numbers of medical students from one school in southern China showed that they expressed more stigma towards people with mental illness, and especially less social acceptance, than students from the United States, Brazil, Ghana, or Nigeria (Stefanovics et al, ). However, the study was based on small convenience samples and its generalizability is uncertain.…”

The experience of being a psychiatric nurse in South Africa: A qualitative systematic review

“…Negative and stigmatising public attitudes towards people who are mentally ill can impact the prevention and treatment interventions, together with the overall quality of life (Barke et al, 2011). Moreover, previous studies in Nigeria, Ghana, and Kenya (Iheanacho et al, 2014;Makanjuola et al, 2016;Stefanovics et al, 2016) have shown that individuals who hold a religiomagical explanatory model of causation show more stigmatization towards people with mental illness. In Nigeria, Cohen et al (2016) reported that people who are influenced by traditional beliefs in supernatural causes and remedies, may lead to an unhelpful or health-damaging response to mental disease, and a delay in seeking appropriate care.…”

Joining psychiatric care and faith healing in a prayer camp in Ghana: randomised trial

“…Belief in supernatural or spiritual causes of mental illness is common in Ghana, and consequently people seek care from traditional healers or evangelical pastors. [8][9][10][11] Recent legislation (Mental Health Act 846, 2012) seeks to expand access to psychiatric care, protect patients' rights and augment community-based services. The Act created a mental health authority for whom one initial priority is the improvement of care in prayer camps, although this aspect of the law has yet to be implemented.…”