Health Care Students’ Attitudes towards People with Schizophrenia—A Survey of Eight University Training Programs

Bengt Svensson¹, David Brunt², Ulrika Bejerholm¹, Mona Eklund¹, Amanda Lundvik Gyllensten¹, Christel Leufstadius¹, Urban Markström³, Mikael Sandlund⁴, Margareta Östman⁵, Lars Hansson¹

¹Department of Health Sciences, Lund University, Lund, Sweden.
²School of Health Sciences and Social Work, Linnean University, Vaxjo, Sweden.
³Department of Social Work, Umea University, Umea, Sweden.
⁴Department of Clinical Sciences/Psychiatry, Umea University, Umea, Sweden.
⁵Faculty of Health and Society, Malmo University, Malmo, Sweden.

DOI: 10.4236/ojpsych.2014.44038                

Abstract

Background: Discrimination and stigmatization of people with mental illness are a global and complex phenomenon and there is evidence that negative attitudes and discrimination are also prevalent among health care staff and health care students. Methods: Attitudes towards people with schizophrenia among 1101 students in eight different university programs providing training for work in the health care and social sectors were explored, using a cross-sectional design. Results: In five of the eight training programs the majority of the students’ perceived people with schizophrenia as a danger to others. In several aspects police students were found to hold more negative attitudes than students from other programs. Students with previous experiences of work in mental health services and students knowing a person with schizophrenia showed more positive attitudes. Discussion: In order to decrease negative attitudes and prejudices towards people with schizophrenia among students, it is essential that the training includes personal contact with people with experience of being mental illness.

Keywords

Attitudes, Stigma, Schizophrenia, Students

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Thornicroft, G., Rosem D. and Kassam, A. (2007) Discrimination in Health Care against People with Mental Illness. International Review of Psychiatry, 19, 113-122. http://dx.doi.org/10.1080/09540260701278937
[2]	Angermeyer, M.C. and Dietrich, S. (2006) Public Beliefs about and Attitudes towards People with Mental Illness: A Review of Population Studies. Acta Psychiatrica Scandinavica, 113, 163-179. http://dx.doi.org/10.1111/j.1600-0447.2005.00699.x
[3]	Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P.W., Grabe, H.J., Carta, M.G. and Angermeyer, M.C. (2012) Evolution of Public Attitudes about Mental Illness: A Systematic Review and Meta-Analysis. Acta Psychiatrica Scandinavica, 125, 440-452. http://dx.doi.org/10.1111/j.1600-0447.2012.01826.x
[4]	Livingston, J.D. and Boyd, J.E. (2010) Correlates and Consequences of Internalized Stigma for People Living with Mental Illness: A Systematic Review and Meta-Analysis. Social Science & Medicine, 71, 2150-2161. http://dx.doi.org/10.1016/j.socscimed.2010.09.030
[5]	Rüsch, N., Angermeyer, M.C. and Corrigan, P. (2005) Mental Illness Stigma. Concepts, Consequences and Initiatives to Reduce Stigma. European Psychiatry, 20, 529-539. http://dx.doi.org/10.1016/j.eurpsy.2005.04.004
[6]	Sharac, J., McCrone, P., Clement, S. and Thornicroft, G. (2010) The Economic Impact of Mental Health Stigma and Discrimination: A Systematic Review. Epidemiologia e Psichiatria Sociale, 19, 223-232. http://dx.doi.org/10.1017/S1121189X00001159
[7]	Gulliver, A., Griffiths, KM. and Christensen, H. (2010) Perceived Barriers and Facilitators to Mental Health Help-Seeking in Young People: A Systematic Review. BMC Psychiatry, 10, 113. http://dx.doi.org/10.1186/1471-244X-10-113
[8]	Andrews, G., Henderson, S. and Hall, W. (2001) Prevalence, Co-Morbidity, Disability and Service Utilisation. Overview of the Australian National Mental Health Survey. British Journal of Psychiatry, 178, 145-153. http://dx.doi.org/10.1192/bjp.178.2.145
[9]	Sirey, J.A., Bruce, M.L., Alexopoulus, G.S., Perlick, D.A., Raue, P., Friedmann, S.J. and Meyers, B.S. (2001) Perceived Stigma as a Predictor of Treatment Discontinuation in Young and Older Outpatients with Depression. American Journal of Psychiatry, 158, 479-481. http://dx.doi.org/10.1176/appi.ajp.158.3.479
[10]	Crisp, A.H., Gelder, A.G., Rix, S., Meltzer, H.I. and Rowlands, O.J. (2000). Stigmatisation of People with Mental Illnesses. British Journal of Psychiatry, 177, 4-7. http://dx.doi.org/10.1192/bjp.177.1.4
[11]	Link, A.G., Phelan, J.C., Bresnahan, M., Stueve, A. and Pescosolido, B. (1999) Public Conceptions of Mental Illness: Labels, Causes, Dangerousness and Social Distance. American Journal of Public Health, 89, 1328-1333. http://dx.doi.org/10.2105/AJPH.89.9.1328
[12]	Phelan, J.C. and Link, B.G. (1998) The Growing Belief That People with Mental Illnesses Are Violent: The Role of the Dangerousness Criterion for Civil Commitment. Social Psychiatry and Psychiatric Epidemiology, 33, 7-12. http://dx.doi.org/10.1007/s001270050204
[13]	Dickerson, F.B., Sommerville, J., Origoni, A.E., Ringel, N.B. and Parente, F. (2002) Experiences of Stigma among Outpatients with Schizophrenia. Schizophrenia Bulletin, 28, 143-155. http://dx.doi.org/10.1093/oxfordjournals.schbul.a006917
[14]	Mann, C.E. and Himelien, M.J. (2004) Factors Associated with Stigmatization of Persons with Mental Illness. Psychiatric Services, 55, 185-187. http://dx.doi.org/10.1176/appi.ps.55.2.185
[15]	Schulze, B. (2007) Stigma and Mental Health Professionals: A Review of the Evidence on an Intricate Relationship. International Review of Psychiatry, 19, 137-155. http://dx.doi.org/10.1080/09540260701278929
[16]	Lauber, C., Nordt, C., Braunschweig, C. and Rossler, W. (2006) Do Mental Health Professionals Stigmatize Their Patients? Acta Psychiatrica Scandinavica, 113, 51-59. http://dx.doi.org/10.1111/j.1600-0447.2005.00718.x
[17]	Nordt, C., Rossler, W. and Lauber, C. (2006) Attitudes of Mental Health Professionals towards People with Schizophrenia and Major Depression. Schizophrenia Bulletin, 32, 709-714. http://dx.doi.org/10.1093/schbul/sbj065
[18]	Bjorkman, T., Angelman, T. and Jonsson, M. (2008) Attitudes towards People with Mental Illness: A Cross-Sectional Study among Nursing Staff in Psychiatric Care and Somatic Care. Scandinavian Journal of Caring Sciences, 22, 170-177. http://dx.doi.org/10.1111/j.1471-6712.2007.00509.x
[19]	Brinn, F. (2000) Patients with Mental Illness: General Nurses’ Attitudes and Expectations. Nursing Standard, 14, 32-36. http://dx.doi.org/10.7748/ns2000.03.14.27.32.c2792
[20]	Liggins, J. and Hatcher, S. (2005) Stigma toward the Mentally Ill in the General Hospital: A Qualitative Study. General Hospital Psychiatry, 27, 359-364. http://dx.doi.org/10.1016/j.genhosppsych.2005.05.006
[21]	Schulze, B. and Angermeyer, M.C. (2003) Subjective Experiences of Stigma. A Focus Group Study of Schizophrenic Patients, Their Relatives and Mental Professionals. Social Science & Medicine, 56, 299-321. http://dx.doi.org/10.1016/S0277-9536(02)00028-X
[22]	Schulze, B., Richter-Werling, M., Matschinger, H. and Angermeyer, M.C. (2003) Crazy? So What! Effects of a School Project on Students’ Attitudes towards People with Schizophrenia. Acta Psychiatrica Scandinavica, 107, 142-150. http://dx.doi.org/10.1034/j.1600-0447.2003.02444.x
[23]	Economou, M., Louki, E., Peppou, L.E., Gramandani, C., Yotis, L. and Stefanis, C.N. (2012) Fighting Psychiatric Stigma in the Classroom: The Impact of an Educational Intervention on Secondary School Students’ Attitudes to Schizophrenia. International Journal of Social Psychiatry, 58, 544-551. http://dx.doi.org/10.1177/0020764011413678
[24]	Serafini, G., Pompili, M., Haghighat, R., Pucci, D., Pastina, M., Lester, D., Angeletti, G., Tatarelli, R. and Girardi, P. (2011) Stigmatization of Schizophrenia as Perceived by Nurses, Medical Doctors, Medical Students and Patients. Journal of Psychiatric and Mental Health Nursing, 18, 576-585. http://dx.doi.org/10.1111/j.1365-2850.2011.01706.x
[25]	Linden, M. and Kavanagh, R. (2012) Attitudes of Qualified vs. Student Mental Health Nurses towards an Individual Diagnosed with Schizophrenia. Journal of Advanced Nursing, 68, 1359-1368. http://dx.doi.org/10.1111/j.1365-2648.2011.05848.x
[26]	Volmer, D., Maesalu, M. and Bell, J.S. (2008) Pharmacy Students’ Attitudes toward and Professional Interactions with People with Mental Disorders. International Journal of Social Psychiatry, 54, 402-413. http://dx.doi.org/10.1177/0020764008090427
[27]	Corrigan, P.W., Green, A., Lundin, R., Kubiak, M.A. and Penn, D.L. (2001) Familiarity with and Social Distance from People Who Have Serious Mental Illness. Psychiatric Services, 52, 953-958. http://dx.doi.org/10.1176/appi.ps.52.7.953
[28]	Svensson, B., Markstrom, U., Bejerholm, U., Bjorkman, T., Brunt, D., Eklund, M., Hansson, L., Leufstadius, C., Gyllensten, A.L., Sandlund, M. and Ostman, M. (2011) Test-Retest Reliability of the Swedish Version of Two Instruments for Measuring Public Attitudes towards Persons with Mental Illness. BMC Psychiatry, 11, 11. http://dx.doi.org/10.1186/1471-244X-11-11
[29]	Watson, A.C., Corrigan, P.W. and Ottati, V. (2004) Police Officers’ Attitudes toward and Decisions about Persons with Mental Illness. Psychiatric Services, 55, 49-53. http://dx.doi.org/10.1176/appi.ps.55.1.49
[30]	Cotton, D. (2004) The Attitudes of Canadian Police Officers toward the Mentally Ill. International Journal of Law and Psychiatry, 27, 135-146. http://dx.doi.org/10.1016/j.ijlp.2004.01.004
[31]	Corrigan, P.W., Edwards, A.B., Green, A., Diwan S.L. and Penn D.L. (2001) Prejudice, Social Distance and Familia- rity with Mental Illness. Schizophrenia Bulletin, 27, 219-225. http://dx.doi.org/10.1093/oxfordjournals.schbul.a006868