MATERIALS: Focus group and individual interviews with patients, carers, healthcare staff, religious authorities, traditional healers and community members.
DISCUSSION: Four stages of help seeking were identified: (1) noticing symptoms and initial labelling, (2) collective decision-making, (3) spiritual diagnoses and treatment and (4) psychiatric diagnosis and treatment.
CONCLUSION: Spiritual diagnoses have the advantage of being less stigmatising, giving meaning to symptoms, and were seen to offer hope of cure rather than just symptom control. Patients and carers need help to integrate different explanatory models into a meaningful whole.
MATERIALS AND METHODS: A total of 122 year 4 medical students responded to this study. The Attitudes Towards Mental Illness (AMI) and Attitudes Towards Psychiatry (ATP) questionnaires were administered before and after an 8-week attachment in psychiatry.
RESULTS: We found that students had somewhat favourable attitudes towards psychiatry and mental illness at the start of their attachment, with a mean score of 108.34 on ATP (neutral score, 90) and 68.24 on AMI (neutral score, 60). There was a significant increase in the mean scores of both scales following the psychiatric attachment for female students (ATP: P = 0.003; AMI: P <0.0005), but not male students (ATP: P = 0.435; AMI: P = 0.283).
CONCLUSIONS: An 8-week clinical posting of fourth-year medical students in psychiatry was associated with an increase in positive attitudes to mental illness and to psychiatry among female students but not among male students.
METHOD: An audio-taped focus group interview was undertaken with 14 medical students using a semi-structured interview guide. The recorded discussion was transcribed verbatim and thematic analysis was performed.
RESULTS: Initial apprehension about interacting with patients lessened as the students engaged in shared activities. Students described their increased awareness of the normality and competence of psychiatric patients. As future doctors, they reported a greater understanding of the benefits of social inclusion for patients and carers alike. Promoting positive experiences of patient contact … may be important in influencing medical students' attitudes to people with mental illness
DISCUSSION: Medical students' joint participation in a group activity programme for people with mental illness in non-hospital settings may have advantages in promoting positive attitudinal change. Clinical teachers could usefully incorporate this type of experience into the undergraduate psychiatry curriculum.
METHODS: Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken.
RESULTS: A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies.
CONCLUSIONS: There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.
MATERIALS AND METHODS: Using stratified sampling at the community level, 640 parents including 419 mothers and 221 fathers participated in the study. Tools included a socio-demographic pro-forma; Parental attitude inventory (PAI) to assess parenting attitudes, Parent Global Report of the Alabama Parenting Questionnaire (APQ) to assess current parenting dimensions, and the parent version of the Strengths and Difficulties Questionnaire (SDQ) to assess behavioural problems among adolescents. We examined the prevalence and predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents from paternal and maternal reports.
RESULTS: Paternal and maternal reports of total difficulties (11.3 %, 13.6 %), externalizing (2.3 %, 1.9 %) and internalizing behaviours (8.6 %, 7.4 %) among adolescents are reported. Predictors of abnormal behaviours per paternal reports included lower social class and poor paternal control. Being a male adolescent increased the odds of total difficulties and externalizing problems. Favourable maternal attitude, good maternal warmth and control predicted the reduced likelihood of total difficulties and externalizing behaviours per maternal reports. Paternal control and maternal warmth and control were found to reduce the likelihood of internalizing behaviours among adolescents.
CONCLUSION: Maternal attitude, paternal control and maternal warmth and control dimensions emerged as significant predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents.