Undergraduate nursing students’ stigma and recovery attitudes during mental health clinical placement: A pre/post‐test survey study

Abstract

Undergraduate nursing students have been reported to hold negative and stigmatizing attitudes towards mental health consumers and to be under‐prepared for mental health clinical placement. This study aimed to investigate undergraduate nurses’ stigma and recovery attitudes to mental illness, and describe their understandings of personal recovery on entry and exit to traditional mental health clinical placement. A pre/post‐test survey was administered to N = 249 nursing students in Australia. Demographic data, attitudes towards mental health nursing and clinical placement, the Opening Minds Scale for Healthcare Providers (OMS‐HC), Recovery Attitudes Questionnaire (RAQ‐7), and an open‐ended question on understandings of personal recovery from mental illness were collected on entry (T1) and exit (T2) to placement. At T1, students reported moderate stigma and positive attitudes towards recovery (OMS‐HC mean = 34.6; RAQ‐7 mean = 4.0). At T2, there was a reduction in stigma (social distance P = 0.02, d = 0.26) and improvement in recovery attitudes (P < 0.01, d = 0.40). Attitudes towards mental health nursing and placement also improved (P < 0.01). Having a family member with mental illness predicted improvements in stigma and recovery attitudes. On entry to placement, most students described accurate understandings of personal recovery, which were maintained during placement. The findings indicate that mental health clinical placements are effective in improving students’ mental health stigma and recovery attitudes and provide a prime opportunity to attract students into the field. Co‐produced or consumer‐led education provided by peer workers during clinical placements may improve students’ stigmatizing attitudes and stimulate their interest to work in the field.

Level of Stigma among Spanish Nursing Students toward Mental Illness and Associated Factors: A Mixed-Methods Study

“…Another key finding was that manifestations of stigma were lower in students with a family member with a mental health problem. In our data, this fact acts as a protective factor, as it did in prior studies [34,48]. In line with Barrett and Jackson [54], we can say that early reduction of stigma within the nursing syllabus could be key to increasing nursing students’ confidence while at the same time encouraging changes in stigmatising attitudes, as occurs in our results.…”

“…Our methodological approach, combining a qualitative process and a quantitative process, allowed us to collect the real experiences of students [35,36]. The analysis of our results shows that manifestations of stigma were lower in students in a higher year of study, coinciding with previous studies [34,48,49,50]. However, there is existing literature that states the opposite, highlighting that health professionals are not immune to stigmatising the patients they work with [14,51].…”

“…We therefore agree that it is important to consider the type of teaching that professionals receive when it comes to designing actions to reduce stigma. In the case of nursing, we can observe that stigma reduces as students advance in their degree due to the training students receive in their 3rd year, which is when they study a module in psychiatry and mental health, as happens in previous studies [34,52]. Thus, we could say that more theoretical training and longer clinical placements are associated with more positive student attitudes towards mental health nursing, as happens in previous studies [50,53].…”

“…Previous studies [33,34] show that qualitative research on what can be learnt from students’ personal experiences with family and friends with mental illnesses is needed. This approach will influence students’ attitudes and help students who have not experienced this situation.…”

“…Furthermore, there is currently limited evidence on the stigma and recovery attitudes of nursing students before and after a traditional mental health clinical placement. To improve future undergraduate nursing education, it is vital to understand the impact that existing education and clinical placement has on undergraduate students’ attitudes to mental health consumers and mental health nursing [34].…”