Socially restrictive attitudes towards people with mental illness among the non-psychiatry medical professionals in a university teaching hospital in South India

Sathyanath, Shashwath; Mendonsa, Rohan Dilip; Thattil, Anitha Maria; Chandran, Varikkara Mohan; Karkal, Ravichandra

doi:10.1177/0020764015623971

Cited by 19 publications

(22 citation statements)

References 15 publications

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“…Besides widespread stigma in the general community, studies have also found nonpsychiatric healthcare and paramedical personnel to have stigmatizing attitudes against those with mental illnesses. [171819] Although in our study there was no significant association between perceptions of stigma and family history of mental illness or contact with someone else with a mental illness, one survey from a teaching hospital among nonpsychiatric medical professionals also found that social contact with an affected person was associated with less socially restrictive attitudes. [17] In view of this barrier of stigmatizing attitudes among healthcare workers, an interventional study aimed at reducing stigma through targeting nonspecialist healthcare workers is being planned in low-resource settings in Nepal.…”

Section: Discussioncontrasting

confidence: 69%

Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India

Guttikonda¹,

Shajan²,

Hephzibah³

et al. 2019

Indian Journal of Psychological Medicine

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Background:Stigma is an important factor that determines whether individuals seek treatment for mental illnesses. Studies assessing public perceptions regarding mental illnesses are scarce in India. This study documents the stigma perceived by a rural population toward patients with mental illness and their families.Materials and Methods:A cross-sectional pilot study was done in five villages, selected by simple random sampling, from a rural block in Vellore, Tamil Nadu. Households in each village were selected by systematic random sampling. From the selected households, 150 subjects aged 18–65 years, without known mental disorders, were chosen by convenience sampling, based on availability. Stigma was assessed using the Devaluation of Consumers Scale (DCS) and Devaluation of Consumer's Families Scale (DCFS).Results:The proportion with high perceptions of stigma associated with mentally ill persons was 63.8%, among the 150 interviewed rural respondents (women: 112, median age: 37 years). The proportion which perceived that there was public stigma toward families of those with mental illnesses was 43.4%. Older respondents (>37 years) had higher perceptions of stigma (odds ratio: 2.07; 95% confidence interval: 1.02–4.20) than others.Conclusion:The high perception of stigma associated with persons who are mentally ill as well as their families needs to be kept in mind while planning interventions to decrease the treatment gap for psychiatric morbidity, especially in rural areas.

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Section: Discussioncontrasting

confidence: 69%

Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India

Guttikonda¹,

Shajan²,

Hephzibah³

et al. 2019

Indian Journal of Psychological Medicine

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“…Stigma in mental health poses a significant barrier to recovery and social inclusion. 7 Although early intervention in psychiatric illness is associated with improved health outcomes, 8 stigma has been found to inhibit help-seeking behaviour. 9 Stigma in mental health is an independent predictor of poorer outcomes after controlling for the initial severity of symptoms and disability.…”

mentioning

confidence: 99%

Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan

et al. 2020

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Background The evidence base for stigma in mental health largely originates from high-income countries. Aims This study from Pakistan aimed to address the gap in literature on stigma from low- and middle-income countries. Method This cross-sectional study surveyed 1470 adults from Karachi, Pakistan. Participants from three groups (healthcare professionals, healthcare students and the general public) completed the adapted Bogardus Social Distance Scale (SDS) as a measure of stigma. Results All three groups reported higher scores of stigma toward mental disorders compared with physical disorders. SDS scores for mental illness in the general public were significantly higher than in healthcare students (mean difference (MD) 6.93, 95% CI 5.45–8.45, P < 0.001) and healthcare professionals (MD 6.93, 95% CI 5.48–8.38, P < 0.001). However, SDS scores between healthcare students and healthcare professionals were not significantly different (MD 0.003, 95% CI −1.14–1.14, P > 0.99). Being female was associated with lower stigma scores and being over the age of 30 years was associated with higher stigma scores. Conclusions Stigma campaigns in Pakistan need to target the general population. However, evidence of negative attitudes toward mental illness in healthcare students and healthcare professionals supports the need for stronger emphasis on psychiatric education within undergraduate and postgraduate training in Pakistan.

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“…Uganda, South Africa, Nigeria, Nepal, India and Ethiopia), where negative attitudes of service providers towards people with mental illness was identified as an important supply-side barrier to seeking mental health care across all countries [30]. Similarly, a study conducted with medical professionals (faculty members and postgraduate trainees) in Southern India reported that a significant number of the medical professionals had negative attitudes towards people with mental illness [32].…”

Section: Discussionmentioning

confidence: 99%

Perception of service users and their caregivers on primary care-based mental health services: a qualitative study in Nepal

Luitel¹,

Jordans²,

Subba³

et al. 2020

BMC Fam Pract

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Background Integration of mental health services into primary health care systems has been advocated as a strategy to minimize the tremendous mental health treatment gap, particularly in low- and middle-income countries. Barriers to integration of mental health into primary health care have been widely documented; however, very little is known about the perception of service users and their caregivers on primary care-based mental health services. This study assessed service users’ and caregivers’ perceptions of mental health services provided by trained primary health care workers in Nepal. Methods A qualitative study was conducted among people with depression, psychosis, alcohol use disorder and epilepsy, and their caregivers in Chitwan, a district in southern Nepal. Semi-structured interviews were conducted with 43 service users and 38 caregivers to assess their perceptions about the accessibility of the services, types of services they received, skills and competencies of health care providers, satisfaction and barriers to receiving services. Results Overall, both service users and caregivers were satisfied with the mental health services provided by primary health care providers. They also perceived health workers to be competent and skillful because the services they received were effective in reducing their mental health problems. Both psychological and pharmacological services were made available free of cost, however, they considered psychological services more effective than pharmacological treatment. Major challenges and difficulties accessing services were associated with frequent transfer of trained health workers, non-availability of the same health care provider at follow-ups, frequent stock-out of medicines or non-availability of required medicines, lack of a confidential space for consultation in health facilities, and stigmatizing and negative behavior of some health workers. Conclusion The results demonstrated that both service users and caregivers perceived primary care-based mental health services to be accessible, acceptable and effective. The key recommendations emerging from this study for improving mental health services in primary care include the provision of a separate cadre of psychosocial workers to provide psychological interventions, developing quick and efficient mechanisms for the procurement and supply of psychotropic medicines, establishing a confidential place within health facilities for consultation, and further training of health workers to reduce stigma.

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Socially restrictive attitudes towards people with mental illness among the non-psychiatry medical professionals in a university teaching hospital in South India

Cited by 19 publications

References 15 publications

Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India

Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India

Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan

Perception of service users and their caregivers on primary care-based mental health services: a qualitative study in Nepal

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