Attitudes, stereotypes and social distance in health sciences students towards people diagnosed with severe mental disorder: A qualitative studyople diagnosed with severe mental disorder: A qualitative study
DOI:
https://doi.org/10.24310/escpsi.19.1.2026.21869Keywords:
stigma, attitudes, social distance, disclosure, severe mental illness, qualitative researchAbstract
Numerous studies have demonstrated the persistence of stigma toward people with Severe Mental Disorders (SMD) among healthcare professionals. This study investigated the attitudes of Health Sciences students toward people with SMD prior to entering professional practice. A qualitative study was conducted based on semi-structured interviews with 27 students from medicine, nursing, psychology, physiotherapy, occupational therapy, and social work. Subsequently, the content of the students’ responses was analyzed using NVivo software to examine and identify relevant themes.
The analysis revealed five central nodes: stereotypes about people with SMD, expectations regarding recovery and living with SMD, willingness to engage socially with these individuals, willingness to disclose one’s own mental health problems, and ideas about how to treat these service users.
The presence of negative stereotypes was identified among participants, attributing dangerousness and unpredictability to people with SMD, as well as low expectations for recovery. Reluctance to disclose one’s own mental health problems was also observed. However, positive attitudes were also identified, such as the willingness to help peers with mental health problems and to engage socially with people with SMD, as well as the importance of treating these individuals without judgment, for example.
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Castro, C., Labra, O., & Chamblas, I. I. (2022). El análisis de contenido. Revista Internacional de Ciencias Sociales Interdisciplinares, 10, 143–158. https://doi.org/10.18848/2474-6029/CGP/V10I01/143-158
Corrigan, P. W., & Fong, M. W. (2014). Competing perspectives on erasing the stigma of illness: What says the dodo bird? Social Science & Medicine, 103, 110–117. https://doi.org/10.1016/j.socscimed.2013.11.023
Corrigan, P. W., & Rao, D. (2012). On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Canadian Journal of Psychiatry, 57(8), 464–469. https://doi.org/10.1177/070674371205700804
Corrigan, P. W., & Watson, A. C. (2002a). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53. https://doi.org/10.1093/clipsy/9.1.35
Corrigan, P. W., & Watson, A. C. (2002b). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16–20. https://doi.org/10.1002/j.2051-5545.2002.tb00005.x
Denzin, N. K., & Lincoln, Y. S. (Eds.). (2011). The SAGE handbook of qualitative research (4th ed.). SAGE Publications.
Domer R. A. (2012). Increasing awareness of stigmatization : advocating the role of occupational therapy. https://pdfs.semanticscholar.org/ca96/9327bcaed35b0806971b678e41f0dfeaf0f3.pdf
Fox, C. R., & Hadar, L. (2006). Decisions from experience = sampling error + prospect theory: Reconsidering Hertwig, Barron, Weber, & Erev (2004). Judgment and Decision Making, 1(2), 159–161. https://doi.org/10.1017/S193029750000041X
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Aldine. https://doi.org/10.4324/9780203793459
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Penguin. https://doi.org/10.4324/9781315126845
Goldman, H. H., Gattozzi, A. A., & Taube, C. A. (1981). Defining and counting the chronically mentally ill. Hospital and Community Psychiatry, 32(1), 21–27. https://doi.org/10.1176/ps.32.1.21
Hayward, P., & Bright, J. A. (1997). Stigma and mental illness: A review and critique. Journal of Mental Health, 6(4), 345–354. https://doi.org/10.1080/09638239718356
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., et al. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), 467–482. https://doi.org/10.1016/S2215-0366(14)00023-6
Kingdon, D., Sharma, T., & Hart, D. (2004). What attitudes do psychiatrists hold towards people with mental illness? Psychiatric Bulletin, 28(11), 401–406. https://doi.org/10.1192/pb.28.11.401
Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111–116. https://doi.org/10.1177/0840470416679413
Krippendorff, K. (2018). Content analysis: An introduction to its methodology (4th ed.). SAGE Publications. https://doi.org/10.4135/9781071878781
Lam, T. P., Lam, K. F., Lam, E. W. W., & Ku, Y. S. (2013). Attitudes of primary care physicians towards patients with mental illness in Hong Kong. Asia-Pacific Psychiatry, 5(1), 1–10. https://doi.org/10.1111/appy.12012
Lien, Y. Y., Lin, H. S., Lien, Y. J., Tsai, C. H., Wu, T. T., Li, H., & Tu, Y. K. (2021). Challenging mental illness stigma in healthcare professionals and students: A systematic review and network meta-analysis. Psychology & Health, 36(6), 669–684. https://doi.org/10.1080/08870446.2020.1783014
Liggins, J., & Hatcher, S. (2005). Stigma toward the mentally ill in the general hospital: A qualitative study. General Hospital Psychiatry, 27(5), 359–364. https://doi.org/10.1016/j.genhosppsych.2005.04.006
Linden, M., & Kavanagh, R. (2011). Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia. Journal of Advanced Nursing, 68(6), 1359–1368. https://doi.org/10.1111/j.1365-2648.2011.05848.x
Lora, A., Bezzi, R., & Erlicher, A. (2007). Estimating the prevalence of severe mental illness in mental health services in Lombardy (Italy). Community Mental Health Journal, 43(4), 341–357. https://doi.org/10.1007/s10597-006-9074-8
Magliano, L., Read, J., Rinaldi, A., Costanzo, R., De Leo, R., Schioppa, G., et al. (2016). The influence of causal explanations and diagnostic labeling on psychology students’ beliefs about treatments, prognosis, dangerousness, and unpredictability in schizophrenia. Community Mental Health Journal, 52(3), 361–369. https://doi.org/10.1007/s10597-015-9936-2
Magliano, L., Read, J., Saliochi, A., Patalano, M., D’Ambrosio, A., & Oliviero, N. (2012). Differences in views of schizophrenia during medical education: A comparative study of 1st versus 5th–6th year Italian medical students. Social Psychiatry and Psychiatric Epidemiology, 48(10), 1647–1655. https://doi.org/10.1007/s00127-012-0641-9
Markström, U., Gyllesten, A., Bejerholm, U., Björkman, T., Brunt, D., Harrison, L., et al. (2009). Attitudes towards mental illness among health care students at Swedish universities: A follow-up study after completed clinical placement. Nurse Education Today, 29(6), 660–665. https://doi.org/10.1016/j.nedt.2009.02.006
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450. https://doi.org/10.1037/0022-006X.68.3.438
Masedo, A., Grandón, P., Saldivia, S., Vielma-Aguilera, A., Castro-Alzate, E. S., Bustos, C., Romero-López Alberca, C., Pena-Andreu, J. M., Xavier, M., & Moreno Küstner, B. (2021). A multicentric study on stigma towards people with mental illness in health sciences students. BMC Medical Education, 21, Article 324. https://doi.org/10.1186/s12909-021-02761-7
Mukherjee, R., Fialho, A., Wijetunge, A., Checinski, K., & Surgenor, T. (2002). The stigmatization of psychiatric illness: The attitudes of medical students and doctors in a London teaching hospital. Psychiatric Bulletin, 26(5), 178–181. https://doi.org/10.1192/pb.26.5.178
Oster, K., Withers, E., Blanco, T., Lupson, C., Steele, M., Giandinoto, J., & Furness, T. (2019). Undergraduate nursing students’ stigma and recovery attitudes during mental health clinical placement: A pre/post-test survey study. International Journal of Mental Health Nursing, 28(5), 1065–1077. https://doi.org/10.1111/inm.12634
Palou, R. G., Vigué, G. P., & Tort-Nasarre, G. (2020). Attitudes and stigma toward mental health in nursing students: A systematic review. Perspectives in Psychiatric Care, 56(2), 243–255. https://doi.org/10.1111/ppc.12480
Patton, M. Q. (2015). Qualitative research & evaluation methods (4th ed.). SAGE Publications. https://doi.org/10.4135/9781483303451
Read, J., & Harré, N. (2001). The role of biological and genetic causal beliefs in the stigmatization of 'mental patients'. Journal of Mental Health, 10(2), 223–235. https://doi.org/10.1080/09638230120035264
Reavley, N. J., Morgan, A. J., & Jorm, A. F. (2018). Disclosure of mental health problems: Findings from an Australian national survey. Epidemiology and Psychiatric Sciences, 27(4), 346–356. https://doi.org/10.1017/S204579601700056X
Riffel, T., & Chen, S. P. (2020). Stigma in healthcare? Exploring the knowledge, attitudes, and behavioural responses of healthcare professionals and students toward individuals with mental illnesses. Psychiatric Quarterly, 91(4), 1103–1119. https://doi.org/10.1007/s11126-020-09775-2
Rodríguez-Almagro, J., Hernández-Martínez, A., Rodríguez-Almagro, D., Quiros-García, J. M., Solano-Ruiz, M. del C., & Gómez-Salgado, J. (2019). Level of stigma among Spanish nursing students toward mental illness and associated factors: A mixed-methods study. International Journal of Environmental Research and Public Health, 16(23), Article 4870. https://doi.org/10.3390/ijerph16234870
Ross, C. A., & Goldner, E. M. (2009). Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 16(6), 558–567. https://doi.org/10.1111/j.1365-2850.2009.01367.x
Serafini, G., Pompili, M., Haghighat, R., Pucci, D., Pastina, M., Lester, D., et al. (2011). Stigmatization of schizophrenia as perceived by nurses, medical doctors, medical students and patients. Journal of Psychiatric and Mental Health Nursing, 18(7), 576–585. https://doi.org/10.1111/j.1365-2850.2011.01715.x
Servais, L. M., & Saunders, S. M. (2007). Clinical psychologists' perceptions of persons with mental illness. Professional Psychology: Research and Practice, 38(2), 214–219. https://doi.org/10.1037/0735-7028.38.2.214
Smith, J. K., & Weaver, D. B. (2006). Capturing the idealism of medical students. Annals of Family Medicine, 4(Suppl. 1), S32–S37. https://doi.org/10.1370/afm.502
Stuber, J. P., Rocha, A., Christian, A., & Link, B. G. (2014). Conceptions of mental illness: Attitudes of mental health professionals and the general public. Psychiatric Services, 65(4), 491–497. https://doi.org/10.1176/appi.ps.201300132
Uemura, L., Mariotti, M. C., & Muñoz Palm, R. C. (2015). Stigma and mental disorder: Occupational therapist’s perspective. Revista Terapia Ocupacional da Universidade de São Paulo, 26(3), 309–316. https://doi.org/10.11606/issn.2238-6149.rto.2015.95678
Vidourek, R. A., King, K. A., Nabors, L. A., & Merianos, A. L. (2014). College students perceived benefits and barriers to mental health help-seeking. Health Psychology and Behavioral Medicine, 2(1), 1009–1022. https://doi.org/10.1080/21642850.2014.917744
Vidourek, R., & Burbage, M. (2019). Positive mental health and mental health stigma: A qualitative study assessing student attitudes. Mental Health & Prevention, 13, 1–6. https://doi.org/10.1016/j.mhp.2019.03.001
Wagner, L. C., Geidel, A. R., Torres-González, F., & King, M. B. (2011). Cuidado en salud mental: Percepción de personas con esquizofrenia y sus cuidadores. Ciencia & Saúde Coletiva, 16(4), 2077–2087. https://doi.org/10.1590/S1413-81232011000400018
Waugh, W., Lethem, C., Sherring, S., & Henderson, C. (2017). Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: A qualitative study. Journal of Mental Health, 26(5), 457–463. https://doi.org/10.1080/09638237.2016.1275326
Weare, R., Green, C., Olasoji, M., & Plummer, V. (2019). ICU nurses feel unprepared to care for patients with mental illness: A survey of nurses’ attitudes, knowledge, and skills. Intensive and Critical Care Nursing, 53, 37–42. https://doi.org/10.1016/j.iccn.2019.01.005
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