Stigma Levels Toward Psychiatric Patients Among Medical Students—A Worldwide Online Survey Across 65 Countries

Abstract

Background: According to epidemiological data, over 450 million people worldwide suffer from mental disorders, presenting one of the major challenges of modern medicine. In their everyday lives, patients, in addition to fighting the disease itself, often struggle with stigmatization. This phenomenon negatively affects both the diagnostic and therapeutic processes, as well as the patients' everyday functioning. This study aimed to assess stigma attitudes toward psychiatry and psychiatric patients among undergraduate medical students.Methods: This study used a Computer-Assisted Web Interview (CAWI), which included the standardized items from the Mental Illness: Clinicians' Attitudes (MICA-2) scale to evaluate stigma. The study was disseminated via the internet to students from medical universities from 65 countries worldwide. Participation was voluntary and anonymous. The study involved 1,216 students from these 65 countries. Most of the sample were women, and most were medical faculty students and students living in cities with more than 500,000 residents. Taking into consideration Gross Domestic Product (GDP) per capita and Human Development Index (HDI) variables, it can be seen that there was a prevalence of medical students from highly developed countries.Results: For the whole sample, the mean MICA-2 score was 40.5 points. Women and medical and nursing students showed more positive attitudes toward psychiatric patients. Students from countries with the highest economic development levels also achieved statistically lower MICA-2 scores. Lower score means a more positive attitude.Conclusion: Stigma toward both psychiatry and psychiatric patients is common among undergraduate medical students. Female students and respondents with a history of mental disorders in countries with high HDI and GDP per capita indices show more favorable attitudes than other medical students. There is a need to further our understanding of the problem of stigmatization, both among the general population and among medical personnel, and to implement and maintain appropriate measures to reduce stigma toward psychiatry.

Mental illness attitudes in medical education: Assessing the stigma in medical students

“…The decrease in the follow-up scores can be considered an indicator of the decrease in the students stigmatizing ideas. These results are consistent with the literature (Babicki, Małecka, Kowalski, Bogudzińska, & Piotrowski, 2021;Desai et al, 2019;Masedo et al, 2021). Similarly, Simon and Verdoux (2018) report significant changes after an educational program with Psychiatry and Neurology students.…”

“…Also, collabora- tion with different disciplines with intervention design and application is of utmost importance, such as psychology, sociology, social work, etcetera. The most successful intervention should result from interdisciplinary work (Babicki et al, 2021;Corrigan et al, 2018;Potts et al, 2022).…”

A “patient as educator” intervention: Reducing stigmatizing attitudes toward mental illness among medical students

“…Our results are consistent with previous evidence suggesting that specific training in mental illness-related stigma may improve knowledge about mental health, but not the attitudinal and behavioral aspects of stigma toward mental health ( 41 ). It is of great concern that stigmatization and negative perceptions occur among medical students despite the provision of medical education and information about mental illnesses and their treatments ( 9 , 12 , 13 ). Therefore, anti-stigma interventions should adopt a multi-dimensional approach, go beyond theoretical knowledge, and separately target and assess improvements in attitudes and behaviors ( 7 , 41 ).…”

“…Most observational studies on attitudes and stigma toward mental illness have focused on the general population and healthcare workers, while only a few ( 10 – 13 ) have been conducted with medical students. Nonetheless, there is no evidence supporting the absence of stigma in this group.…”

The factors and outcomes of stigma toward mental disorders among medical and nursing students: a cross-sectional study

“…However, stigmatization of people with mental disorders was common in early career professionals [ 12 ]. A worldwide online survey across 65 countries showed that stigma toward both psychiatry and psychiatric patients was common among undergraduate medical students [ 13 ]. Medical students and nursing students believed that people with mental disorders symbolized aggression as well as unpredictability, and would never be able to recover sufficiently [ 14 ].…”