Medical Student Attitudes About Mental Illness: Does Medical-School Education Reduce Stigma?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students’ attitudes toward patients with mental health problems deteriorate as they progress through medical school.
Authors examined medical students’ attitudes to mental illness, as compared with attitudes toward other medical illness, and the influence of the number of years spent in medical school, as well as of several key socio-demographic, ethnic, and cultural variables.
A group of 760 U.K. medical students completed a nationwide on-line survey examining their attitudes toward patients with five conditions (pneumonia, depression, psychotic symptoms, intravenous drug use, long-standing unexplained abdominal complaints), using the Medical Condition Regard Scale (MCRS). Students were also asked whether they had completed the psychiatry rotation or had personal experience of mental disorders themselves or among their friends or family members. They were also asked about their ethnic group (using U.K. national census categories), religious affiliation, and how important religion was in their lives. Independent-samples t-tests and one-way ANOVA were used to compare differences between groups on the MCRS.
Students showed the highest regard for patients with pneumonia and lowest regard for patients with long-standing, unexplained abdominal complaints. Although attitudes toward pneumonia were more positive in fifth-year students than in first-year students, attitudes toward unexplained chronic abdominal pain were worse in fifth-year students than in first-year students. Personal experience of mental health treatment, or that among family and friends, were associated with less stigmatizing attitudes. Men showed more stigmatization than women for nearly all conditions; Chinese and South Asian students showed more stigmatizing attitudes toward delusions and hallucinations than their white British counterparts.
Medical students in this survey showed the lowest regard for patients with unexplained abdominal pain, and these attitudes were worse in the most experienced medical students. Students’ gender, culture and direct or indirect experience of mental illness influenced stigmatizing attitudes.
- Byrne P: Stigma of mental illness and ways of diminishing it. Adv Psychiatr Treat 2000; 6:66–72 CrossRef
- Schulze B, Angermeyer MC: Subjective experiences of stigma: a focus-group study of schizophrenic patients, their relatives, and mental health professionals. Soc Sci Med 2003; 56:299–312 CrossRef
- Thornicroft G, Brohan E, Kassam A, et al: Reducing stigma and discrimination: candidate interventions. Int J Ment Health Syst 2008; 2:3 CrossRef
- Mehta N, Kassam A, Leese M, et al: Public attitudes toward people with mental illness in England and Scotland, 1994–2003. Br J Psychiatry 2009; 194:278–284 CrossRef
- DOH: Attitudes to Mental Illness 2010 Research Report. Department of Health, 2010 Contract No.: JN 207028.
- Schulze B: Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry 2007; 19:137–155 CrossRef
- Korszun A, Dharmaindra N: Stigma, Culture and Mental Health Education. Academic Faculty Annual Meeting, Royal College of Psychiatrists; Keele, UK2009.
- Chew-Graham CA, Rogers A, Yassin N: “I wouldn’t want it on my CV or their records”: medical students’ experiences of help-seeking for mental health problems. Med Educ 2003; 37:873–880 CrossRef
- Dharmaindra N, Korszun A: The Undeserving Patient — Medical Students’ Attitudes to People with Mental Health Disorders. International Stigma Conference; London2009.
- Walters K, Raven P, Rosenthal J, et al: Teaching undergraduate psychiatry in primary care: the impact on student learning and attitudes. Med Educ 2007; 41:100–108 CrossRef
- Galka SW, Perkins DV, Butler N, et al: Medical students’ attitudes toward mental disorders before and after a psychiatric rotation. Acad Psychiatry 2005; 29:357–361 CrossRef
- Fabrega H Jr: Does a clerkship affect students’ views of psychiatric patients? J Nerv Ment Dis 1995; 183:736–742 CrossRef
- Feldmann TB. Medical students’ attitudes toward psychiatry and mental disorders. Acad Psychiatry 2005;29:354–6. CrossRef
- Littlewood R, Jadhav S, Ryder AG: A cross-national study of the stigmatization of severe psychiatric illness: historical review, methodological considerations, and development of the questionnaire. Transcult Psychiatry 2007; 44:171–202 CrossRef
- Chambers M, Guise V, Välimäki M, et al: Nurses’ attitudes to mental illness: a comparison of a sample of nurses from five European countries. Int J Nurs Stud 2010; 47:350–362 CrossRef
- Karim K, Edwards R, Dogra N, et al: A survey of the teaching and assessment of undergraduate psychiatry in the medical schools of the United Kingdom and Ireland. Med Teach 2009; 31:1024–1029 CrossRef
- Christison GW, Haviland MG, Riggs ML: The Medical Condition Regard Scale: measuring reactions to diagnoses. Acad Med 2002; 77:257–262 CrossRef
- Creed F, Guthrie E, Fink P, et al: Is there a better term than “medically unexplained symptoms”? J Psychosom Res 2010; 68: 5–8 CrossRef
- Mayer EA: Clinical practice. Irritable bowel syndrome. N Engl J Med 2008; 358:1692–1699 CrossRef
- Cook TM, Wang J: Descriptive epidemiology of stigma against depression in a general population sample in Alberta. BMC Psychiatry 2010; 10:29 CrossRef
- Roth D, Antony MM, Kerr KL, et al: Attitudes toward mental illness in medical students: does personal and professional experience with mental illness make a difference? Med Educ 2000; 34:234–236 CrossRef
- McCrorie P: Graduate students are more challenging, demanding, and questioning. BMJ 2002; 325:676 CrossRef
- Calvert MJ, Ross NM, Freemantle N, et al: Examination performance of graduate-entry medical students compared with mainstream students. J R Soc Med 2009; 102:425–430 CrossRef
- Mathers J, Sitch A, Marsh JL, Parry J. Widening access to medical education for underrepresented socioeconomic groups: population-based cross-sectional analysis of U.K. data, 2002–6. BMJ;342.
- Yang LH: Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singapore Med J 2007; 48:977–985
- Furnham A, Wong L: A cross-cultural comparison of British and Chinese beliefs about the causes, behaviour manifestations, and treatment of schizophrenia. Psychiatry Res 2007; 151:123–138 CrossRef
- Conrad MM, Pacquiao DF: Manifestation, attribution, and coping with depression among Asian Indians from the perspectives of health care practitioners. J Transcult Nurs 2005; 16:32–40 CrossRef
- Lee S, Juon HS, Martinez G, et al: Model minority at risk: expressed needs of mental health by Asian American young adults. J Community Health 2009; 34:144–152 CrossRef
- Chakraborty A, McKenzie K, Bhui K, et al: A Randomised Control Trial (RCT) of Undergraduate Cross-Cultural Psychiatry Training. World Cultural Psychiatry Research Review. 2009; 4:65–73
- Medical Student Attitudes About Mental Illness: Does Medical-School Education Reduce Stigma?
Volume 36, Issue 3 , pp 197-204
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Author Affiliations
- 1. Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts
- 2. The London School of Medicine, UK