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

Abstract

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.

Academic performance and subtypes of psychological traits in undergraduate nursing students: A latent class analysis

“…Recent studies demonstrated that undergraduate nursing students often encounter emotional problems due to academic stress [18,5]. The underlying stressors include frequent academic assessment and disparity between academic studies and medical practice, which often will affect the outcome of nursing training.…”

“…Students who often feel overwhelmed by study burnout are more likely to fail in exams due. It is well known that psychological health has a positive impact on sustainable competitiveness, and is negatively correlated with study burnout [5]. Studies have also examined the effect of rumination on the psychological health of students [6].…”

The Storytelling Brain: How Neuroscience Stories Help Bridge the Gap between Research and Society

“…These difficulties contribute to, and are compounded by, the association of mental illness with societal stigma (Carrara et al, 2019;Charette-Dussault and Corbière, 2019;Heim et al, 2019). Improved communication among researchers, clinicians, patient communities, and the public may mitigate stigma by conveying that mental illness is a brain disease, and not fundamentally different from ailments that affect other organs of the body, such as heart or kidney disease.…”

The Effect of Contact-Based Interventions on the Attitudes and Behaviors of Nursing Students towards People with Mental Illness: A Literature Review

“…It is important to carefully assess the attitudes and behaviors of nursing students towards people with mental illness and to correct negative ones before their first contact in psychiatric training to ensure that students have more positive experiences [23]. Furthermore, student nurses and other healthcare students are the future mental health professionals and have the potential for changing the future of mental healthcare.…”

“…However, little is known on effective approaches to correct these negative attitudes and behaviors [10] [23], despite the previous reviews [10] [23] [26]- [36] that have shown that contact-based interventions have demonstrated positive attitudinal and behavioral changes for nursing students towards people with mental illness. The following is a brief description of the aim and focus of these previous reviews.…”