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Recommendations of mental health professionals and the general population on how to treat mental disorders

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

The objectives of the study are (1) to assess the mental health literacy of mental health professionals, (2) to determine whether there is agreement between different professional groups with respect to different psychopathological conditions and (3) to compare the professionals' knowledge with that of the general population.

Methods

Two representative samples of mental health professionals and laypersons were presented with a vignette depicting either a person with schizophrenia, major depression or without any psychiatric symptoms (‘non-case’). Out of 18 treatment proposals, the respondents were asked to indicate the proposals regarded as helpful and those considered as being harmful, respectively, for the person depicted.

Results

Mental health professionals view their profession and less often their treatment methods as helpful. Dealing with the situation alone, electroconvulsive therapy, hypnotics and sedatives are consistently regarded as harmful. For the individual with schizophrenia, mental health professionals agree about helpful treatments. Regarding depression, a lack of consensus is found about treatment proposals such as psychiatric hospitalisation, antidepressants and complementary and alternative medicine. An important part of mental health professionals suggests medical help (psychologists and general practitioners) for the non-case vignette. Fewer nurses, social workers, vocational workers and occupational therapists (‘other therapists’) as compared to psychiatrists and psychologists recommend standard treatment methods. Professionals and the general population significantly differ in their attitudes towards the treatment suggestions, especially regarding medication and alternative medicine.

Conclusions

To improve the treatment of mental disorders, various strategies must be considered. These include permanent education of all mental health professionals, especially nurses and other therapists. A special focus must be given to affective disorders and a potential (over-) treatment of normal behaviour.

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Acknowledgements

We are grateful to the study participants, to Luis Falcato for his help in grant application and to Eliza Holy and Catherine Braunschweig for their help with data collection. Finally, we would like to thank the unknown reviewers for their very helpful comments on a previous version of this paper. This study was supported by the Swiss National Science Foundation (grant no. 3200-067259).

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Authors and Affiliations

  1. Psychiatric University Hospital, Militärstrasse 8, PO Box 1930, 8021, Zurich, Switzerland

    Christoph Lauber, Carlos Nordt & Wulf Rössler

Authors
  1. Christoph Lauber
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  2. Carlos Nordt
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  3. Wulf Rössler
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Corresponding author

Correspondence to Christoph Lauber.

Appendix

Appendix

The first two vignettes were chosen according to Angermeyer and Matschinger [4]. Before including, the vignette text was submitted to five psychiatrists, all experts in psychopathology, for a blind diagnostic allocation. For each of the two vignettes, the experts were able to provide the correct diagnosis.

The depression vignette was as follows:

Within the last two months one of your friends, let's call him Beat, has changed very much in his character. Contrary to previous times he is feeling downcast and sad without any specific reason. He looks concerned and worried. There is nothing that brings him to a laugh. He hardly ever talks and, if so, he speaks with a low voice of worries concerning the future. Your friend feels useless and a failure. Attempts to cheer him up are not successful. He has lost all his interests. He complains of waking up repeatedly in the middle of the night and of being unable to get to sleep afterwards. In the morning he feels weary and without energy. He reports to hardly being able to concentrate on his work. Unlike before every task takes him a long time to do. He hardly does his duty at work. Thus, he already had to see his superior.

The schizophrenia vignette was:

Since half a year, one of your friends, let's call him Beat, has changed. He withdraws from his co-workers and friends more and more. He keeps out of everybody's way. If ever a conversation with him is possible there is just one single topic to talk about: the question whether certain people have the ability to read others' thoughts. He occupies himself with nothing but this exclusively. Contrary to his former habits he does not take care of his appearance any longer and seems to neglect himself increasingly. At work he seems absentminded and often makes mistakes. Therefore, he already had to see his superior. Finally, your friend did not go to work for a whole week, without giving any excuse. Since then he seems to be anxious and badgered. He says to be absolutely sure now that not only are people able to read others' thoughts but they are also able to directly influence these thoughts. But he does not know yet who is controlling his thoughts. Moreover, his thoughts were interrupted. He even hears these persons talking to him and giving him orders. Sometimes, they speak to one another making fun of him. In his apartment the situation is particularly bad. There, he feels like threatened and is terribly scared. Thus, he has not been staying at home for a week but did hide in a hotel and did not dare to go out.

The non-case vignette was formulated by the authors:

Since two months, one of your friends, let's call him Beat, has changed a little bit. He is more reflective and often speaks about the necessity to think about one's own upcoming perspectives. ‘In our time, everybody has to change if all, society and economy, is changing, too,’ says Beat. He speaks about new friends as his previous friends are deadlocked and therefore he is no longer interested in them. He evades specific questions about his family and his employment. Instead he is a lot talking about future sports activities. However, he rejects a suggestion for a bicycle tour. When saying goodbye, he is displeased about a remark on his small weight gain.

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Lauber, C., Nordt, C. & Rössler, W. Recommendations of mental health professionals and the general population on how to treat mental disorders. Soc Psychiat Epidemiol 40, 835–843 (2005). https://doi.org/10.1007/s00127-005-0953-7

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