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Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial

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Abstract

Objective

If presented with serious mental illness (SMI), individuals’ low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students.

Methods

One hundred and two pre-clinical medical students (20–23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students’ mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up.

Results

A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants’ scores on all subscales changed significantly across time, regardless of conditions. To determine how participants’ scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up.

Conclusions

Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.

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References

  1. Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(3):363–85.

    Article  Google Scholar 

  2. Hinshaw SP, Stier A. Stigma as related to mental disorders. Annu Rev Clin Psychol. 2008;4:367–93.

    Article  PubMed  Google Scholar 

  3. Byrne P. Stigma of mental illness and ways of diminishing it. Adv Psychiatr Treat. 2000;6(1):65–72.

    Article  Google Scholar 

  4. Hengartner MP, Loch AA, Lawson FL, Guarniero FB, Wang Y, Rössler W, et al. Attitudes of mental health professionals towards persons with schizophrenia: a transcultural comparison between Switzerland and Brazil. Arch Clin Psychiatry. 2012;39(4):115–21.

    Article  Google Scholar 

  5. Ng CH. The stigma of mental illness in Asian cultures. Aust NZ J Psychiatry. 1997;31(3):382–90.

    Article  CAS  Google Scholar 

  6. Verhaeghe M, Bracke P. Associative stigma among mental health professionals: implications for professional and service user well-being. J Health Soc Behav. 2012;53(1):17–32.

    Article  PubMed  Google Scholar 

  7. Nordt C, Rossler W, Lauber C. Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophr Bull. 2006;32(4):709–14.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Corker E, Hamilton S, Henderson C, Weeks C, Pinfold V, Rose D, et al. Experiences of discrimination among people using mental health services in England. Brit J Psychiatry. 2013;202:58–63.

    Article  Google Scholar 

  9. Henderson C, Corker E, Lewis-Holmes E, Hamilton S, Flach C, Rose D, et al. England’s time to change antistigma campaign: one-year outcomes of service user-rated experiences of discrimination. Psychiatr Serv. 2012;64(3):451–7.

    Article  Google Scholar 

  10. Rao H, Mahadevappa H, Pillay P, Sessay M, Abraham A, Luty J. A study of stigmatized attitudes towards people with mental health problems among health professionals. J Psychiatr Ment Health Nurs. 2009;16(3):279–84.

    Article  CAS  PubMed  Google Scholar 

  11. Lauber C, Nordt C, Braunschweig C, Rössler W. Do mental health professionals stigmatize their patients? Acta Psychiatr Scand. 2006;113(s429):51–9.

    Article  Google Scholar 

  12. Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ. Stigmatization of people with mental illnesses. Brit J Psychiatry. 2000;177:4–7.

    Article  CAS  Google Scholar 

  13. Thornicroft G, Rose D, Kassam A. Discrimination in health care against people with mental illness. Int Rev Psychiatry. 2007;19(2):113–22.

    Article  PubMed  Google Scholar 

  14. Allport GW, Ross JM. Personal religious orientation and prejudice. J Pers Soc Psychol. 1967;5(4):432.

    Article  CAS  PubMed  Google Scholar 

  15. Rusch N, Angermeyer MC, Corrigan PW. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry. 2005;20:529–39.

    Article  PubMed  Google Scholar 

  16. Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rusch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63(10):963–73.

    Article  PubMed  Google Scholar 

  17. Yamaguchi S, Wu SI, Biswas M, Yate M, Aoki Y, Barley EA, et al. Effects of short-term interventions to reduce mental health-related stigma in university or college students: a systematic review. J Nerv Ment Dis. 2013;201(6):490–503.

    Article  PubMed  Google Scholar 

  18. Mino Y, Yasuda N, Tsuda T, Shimodera S. Effects of a one-hour educational program on medical students’ attitudes to mental illness. Psychiatry Clin Neurosci. 2001;55(5):501–7.

    Article  CAS  PubMed  Google Scholar 

  19. Üçok A, Soyguer H, Atakli C, Kuşçu K, Sartorius N, Duman ZC, et al. The impact of antistigma education on the attitudes of general practitioners regarding schizophrenia. Psychiatry Clin Neurosci. 2006;60(4):439–43.

    Article  PubMed  Google Scholar 

  20. Friedrich B, Evans-Lacko S, London J, Rhydderch D, Henderson C, Thornicroft G. Anti-stigma training for medical students: the Education Not Discrimination project. Br J Psychiatry Suppl. 2013;55:s89–94.

    Article  PubMed  Google Scholar 

  21. Knaak S, Hawke L, Patten S. That’s Just Crazy Talk program evaluation report. Mental Health Commission of Canada 2013(http://www.mentalhealthcommission.ca/English/initiativesand-projects/opening-minds/). Retrieved on 20th October 2015 from http://www.mentalhealthcommission.ca/English/system/files/private/document/Stigma_OM_Thats_Just_Crazy_Talk_Evaluation_Report_ENG.pdf

  22. Pettigrew TF. Intergroup contact theory. Annu Rev Psychol. 1998;49(1):65–85.

    Article  CAS  PubMed  Google Scholar 

  23. Clement S, van Nieuwenhuizen A, Kassam A, Flach C, Lazarus A, de Castro M, et al. Filmed v. live social contact interventions to reduce stigma: randomised controlled trial. Br J Psychiatry. 2012;201(1):57–64.

    Article  PubMed  Google Scholar 

  24. Stubbs A. Reducing mental illness stigma in health care students and professionals: a review of the literature. Australas Psychiatry. 2014;22(6):579–84.

  25. Altindag A, Yanik M, Ucok A, Alptekin K, Ozkan M. Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia. Psychiatry Clin Neurosci. 2006;60(3):283–8.

    Article  PubMed  Google Scholar 

  26. Angermeyer MC, Matschinger H, Corrigan PW. Familiarity with mental illness and social distance from people with schizophrenia and major depression: testing a model using data from a representative population survey. Schizophr Res. 2004;69(2):175–82.

    Article  PubMed  Google Scholar 

  27. Patten SB, Remillard A, Phillips L, Modgill G, Szeto AC, Kassam A, et al. Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students. BMC Med Educ. 2012;12(1):1.

    Article  Google Scholar 

  28. Papish A, Kassam A, Modgill G, Vaz G, Zanussi L, Patten S. Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial. BMC Med Educ. 2013;13:141.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kumagai AK. A conceptual framework for the use of illness narratives in medical education. Acad Med. 2008;83(7):653–8.

    Article  PubMed  Google Scholar 

  30. Mann CE, Himelein MJ. Putting the person back into psychopathology: an intervention to reduce mental illness stigma in the classroom. Soc Psychiatry Psychiatr Epidemiol. 2008;43(7):545–51.

    Article  PubMed  Google Scholar 

  31. Modgill G, Patten SB, Knaak S, Kassam A, Szeto AC. Opening minds stigma scale for health care providers (OMS-HC): examination of psychometric properties and responsiveness. BMC Psychiatry. 2014;14(1):1.

    Article  Google Scholar 

  32. Roth D, Antony MM, Kerr KL, Downie F. Attitudes toward mental illness in medical students: does personal and professional experience with mental illness make a difference? Med Educ. 2000;34(3):234–6.

    Article  CAS  PubMed  Google Scholar 

  33. Boysen GA, Vogel DL. Education and mental health stigma: the effects of attribution, biased assimilation, and attitude polarization. J Soc Clin Psychol. 2008;27:447–70.

    Article  Google Scholar 

  34. Galletly C, Burton C. Improving medical student attitudes towards people with schizophrenia. Aust N Z J Psychiatry. 2011;45(6):473–6.

    Article  PubMed  Google Scholar 

  35. Reinke RR, Corrigan PW, Leonhard C, Lundin RK, Kubiak MA. Examining two aspects of contact on the stigma of mental illness. J Soc Clin Psychol. 2004;23(3):377–89.

    Article  Google Scholar 

  36. Jarvie AL, Buxton JA, Szeto AC, Austin JC. A pilot study of the effect of exposure to stand-up comedy performed by people with mental illness on medical students’ stigmatization of affected individuals. UBC Med J. 2013;5(1):15–8.

    Google Scholar 

  37. Chan JYN, Mak WWS, Law LSC. Combining education and video-based contact to reduce stigma of mental illness: “The Same or Not the Same” anti-stigma program for secondary schools in Hong Kong. Soc Sci Med. 2009;68:1521–6.

    Article  PubMed  Google Scholar 

  38. Knaak S, Modgill G, Patten S. Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Canadian journal of psychiatry Revue canadienne de psychiatrie. 2014;59(10 Suppl 1):S19–26.

    PubMed  PubMed Central  Google Scholar 

  39. Michaels PJ, Corrigan PW. Measuring mental illness stigma with diminished social desirability effects. J Ment Health. 2013;22(3):218–26.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Tuan Najwa Hanim Tuan Chik and Asma’ Huda Hatim for assisting with data collection.

Author information

Authors and Affiliations

  1. Universiti Putra Malaysia, Serdang, Malaysia

    Aaron Fernandez, Kit-Aun Tan, Boon How Chew & Sazlina Shariff Ghazali

  2. Mental Health Commission of Canada, Calgary, Canada

    Stephanie Knaak

Authors
  1. Aaron Fernandez
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  2. Kit-Aun Tan
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  3. Stephanie Knaak
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  4. Boon How Chew
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  5. Sazlina Shariff Ghazali
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Corresponding author

Correspondence to Aaron Fernandez.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding Sources

No funding was obtained for this study.

Ethical Considerations

Informed consent was obtained from all individual participants included in the study.

Disclosure

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Fernandez, A., Tan, KA., Knaak, S. et al. Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial. Acad Psychiatry 40, 905–911 (2016). https://doi.org/10.1007/s40596-016-0592-1

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  • DOI: https://doi.org/10.1007/s40596-016-0592-1

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