scholarly journals Attitudes toward assisted suicide requests in the context of severe and persistent mental illness: A survey of psychiatrists in Switzerland

2019 ◽  
Vol 17 (6) ◽  
pp. 621-627 ◽  
Author(s):  
Martina A. Hodel ◽  
Paul Hoff ◽  
Scott A. Irwin ◽  
Nikola Biller-Andorno ◽  
Florian Riese ◽  
...  
Keyword(s):  
Mental Illness ◽  
Anorexia Nervosa ◽  
Assisted Suicide ◽  
Psychiatric Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Refractory Depression ◽  
Persistent Mental Illness ◽  
German Speaking ◽  
Case Vignettes

AbstractObjectiveSwitzerland is among the few countries worldwide where a request for assisted suicide (AS) can be granted on the basis of a primary psychiatric diagnosis. Psychiatrists play an increasingly important role in this regard, especially when the request for AS arises in the context of suffering caused by severe and persistent mental illness (SPMI). The objective of the survey was to assess general attitudes among psychiatrists in Switzerland regarding AS requests from patients with SPMI.MethodIn a cross-sectional survey of 1,311 German-speaking psychiatrists in Switzerland, participants were asked about their attitude to AS for patients with SPMI, based on three case vignettes of patients diagnosed with anorexia nervosa, treatment-refractory depression, or severe persistent schizophrenia.ResultFrom a final sample of 457 psychiatrists (a response rate of 34.9%) whose mean age was 57.8 years, 48.6% of respondents did not support access to AS for persons diagnosed with SPMI, 21.2% were neutral, and 29.3% indicated some degree of support for access. In relation to the case vignettes, a slightly higher percentage of respondents supported the patient's wish to seek AS: 35.4% for those diagnosed with anorexia nervosa, 32.1% for those diagnosed with depression, and 31.4% for those diagnosed with schizophrenia.Significance of resultsAlthough a majority of the responding psychiatrists did not support AS for SPMI patients, about one-third would have supported the wishes of patients in the case vignettes. In light of the increasing number of psychiatric patients seeking AS and the continuing liberalization of AS practices, it is important to understand and take account of psychiatrists’ perspectives.

scholarly journals Compulsory Interventions in Severe and Persistent Mental Illness: A Survey on Attitudes Among Psychiatrists in Switzerland

2021 ◽  
Vol 12 ◽  
Author(s):  
Julia Stoll ◽  
Martina A. Hodel ◽  
Florian Riese ◽  
Scott A. Irwin ◽  
Paul Hoff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Mental Illness ◽  
Anorexia Nervosa ◽  
Cross Sectional Survey ◽  
Persistent Mental Illness ◽  
Decision Making Capacity ◽  
Case Vignettes ◽  
Persistent Depression

Background: Some psychiatric patients develop severe and persistent mental illness (SPMI), which, for a variety of reasons, can be therapy-refractory. Sometimes, treatment is not considered helpful by the patients themselves and does not improve their subjective quality of life. Furthermore, many SPMI patients experience compulsory interventions such as seclusion, restraint, or treatment against their will, which can cause harm.Methods: In a cross-sectional survey of 1,311 German-speaking psychiatrists in Switzerland, participants were asked about the care of SPMI patients in general, and about their attitudes with regard to compulsory interventions in particular, using three case vignettes of patients with severe and persistent anorexia nervosa, schizophrenia and depression.Results: Out of 1,311 contacted psychiatrists, 457 (34.9%) returned the completed survey. In general, 91.0% found it important or very important to respect SPMI patients' autonomy in decision making. However, based on three different clinical case vignettes, 36.8% of psychiatrists would act against the wishes of the patient with severe and persistent schizophrenia, 34.1% against the wishes of the patient with severe and persistent depression, and 21.1% against the wishes of the patient with severe and persistent anorexia nervosa, although all patients were stated to have preserved decision-making capacity. With regard to the case vignettes, 41.1% considered compulsory interventions leading to a temporary reduction of quality of life acceptable in the patient with severe and persistent schizophrenia, 39.4% in the patient with severe and persistent depression, and 25.6% in the patient with severe and persistent anorexia nervosa, although it was stated in all three case vignettes that two independent experts ascribed the patients decision-making capacity regarding their illness and further treatment.Conclusions: Many psychiatrists in our sample found themselves in an ethical dilemma between autonomy and the provision of medical care. While most respondents respect the autonomy of SPMI patients, many saw the need to perform compulsory interventions even though it was clearly and prominently stated that two independent psychiatrists had ascribed the patients in the case vignettes decision-making capacity. Further examination of these conflicting views is warranted, perhaps along with the development of guidelines for such situations.

Stigma and attitudes towards mental illness: Gender differences in a sample of Italian medical students

2017 ◽  
Vol 41 (S1) ◽  
pp. S739-S739 ◽  
Author(s):  
M. Pascucci ◽  
M. La Montagna ◽  
D. Di Sabatino ◽  
E. Stella ◽  
R. Nicastro ◽  
...  
Keyword(s):  
Gender Differences ◽  
Mental Illness ◽  
Medical Students ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Female Gender ◽  
Reference Points ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Students Attitudes

Introductionstigma in mental illness is characterized by discrimination towards people affected by mental disorder. Consequence of the paradigm “stigma-injury-discrimination” is the social exclusion of these patients and the denial of their rights. Medical students, those who should be important reference points for psychiatric patients, are instead one of the categories that contribute to their stigmatization.ObjectivesTo study the attitudes of medical students towards psychiatric patients.AimsThe present study analyzes gender differences in a sample of Italian medical students towards mental illness.MethodsA total of 339 Italian medical students completed a cross-sectional survey, in Rome and Foggia (Italy). We used the Italian version of Community Attitude towards the Mentally Ill test (CAMI) to analyze the students’ attitudes.ResultsThere is a substantial difference among the attitudes towards mental disorders in female and male students. Female students have obtained less stigmatizing results in 9 of the CAMI test items (P < 0.05), in Benevolence (P = 0.001) and Social Restrictiveness subscales (P = 0.043) and in the total score (P = 0.013).ConclusionsThese results are in line with those achieved in scientific literature, confirming that women tend to show more humanitarian attitude towards the mentally ill. Even in the original article of the validation of the CAMI test, the authors found better attitudes in women in all subscales, with the exception of Social Restrictiveness subscale (that in our analysis also correlates with the female gender).Disclosure of interestThe authors have not supplied their declaration of competing interest.

Differences In The Attitudes Of Clinical And Pre-clinical Medical Students To Mental Illness

2016 ◽  
Vol 33 (S1) ◽  
pp. S433-S433
Author(s):  
O. Adekunte ◽  
C. Oliver ◽  
B. Owen
Keyword(s):  
Mental Illness ◽  
Medical Students ◽  
Psychiatric Patients ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
People With Mental Illness ◽  
Significant Difference ◽  
Elective Period ◽  
Competing Interest

BackgroundThe quality of care provided to psychiatry patients by doctors can be influenced by attitudes towards mental illness. Equally important is the attitude of medical students as future treating doctors towards mental illness. This survey compares the differences in the attitudes of pre-clinical and clinical years student to mental illness.AimsTo compare attitudes of pre-clinical and clinical medical students’ to mental illness.MethodsA cross-sectional survey of 212 clinical students (CS) and pre-clinical students (PS) at Newcastle University. Each responded anonymously to an electronic questionnaire. The responses take the form of: Yes/No, free text, order of preference, and Likert scale. Results were analysed based on basic statistical analysis.ResultsLittle differences exist between the 2 groups in their beliefs that psychiatric patients are not difficult to like, mental illness can be a result of social adversity, psychiatry patients often recover and that people with mental illness should be offered a job with responsibility. However, 54% PS disagreed that mental illness often leads to violence, compared to 66% CS and 87% of PS identified that mental illness can be genetic in origin compared with CS of 91%.ConclusionThis survey did not identify any significant difference between the attitudes of pre-clinical and clinical students in most of the domains. However, a higher percentage of clinical students associate violence with mental illness and are unwilling to consider an elective period in psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Public and physicians’ support for euthanasia in people suffering from psychiatric disorders: a cross-sectional survey study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirsten Evenblij ◽  
H. Roeline W. Pasman ◽  
Agnes van der Heide ◽  
Johannes J. M. van Delden ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Psychiatric Disorders ◽  
General Public ◽  
Assisted Suicide ◽  
Psychiatric Patients ◽  
Good Health ◽  
Survey Study ◽  
Political Debate ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional

Abstract Background Although euthanasia and assisted suicide (EAS) in people with psychiatric disorders is relatively rare, the increasing incidence of EAS requests has given rise to public and political debate. This study aimed to explore support of the public and physicians for euthanasia and assisted suicide in people with psychiatric disorders and examine factors associated with acceptance and conceivability of performing EAS in these patients. Methods A survey was distributed amongst a random sample of Dutch 2641 citizens (response 75%) and 3000 physicians (response 52%). Acceptance and conceivability of performing EAS, demographics, health status and professional characteristics were measured. Multivariable logistic regression analyses were performed. Results Of the general public 53% were of the opinion that people with psychiatric disorders should be eligible for EAS, 15% was opposed to this, and 32% remained neutral. Higher educational level, Dutch ethnicity, and higher urbanization level were associated with higher acceptability of EAS whilst a religious life stance and good health were associated with lower acceptability. The percentage of physicians who considered performing EAS in people with psychiatric disorders conceivable ranged between 20% amongst medical specialists and 47% amongst general practitioners. Having received EAS requests from psychiatric patients before was associated with considering performing EAS conceivable. Being female, religious, medical specialist, or psychiatrist were associated with lower conceivability. The majority (> 65%) of the psychiatrists were of the opinion that it is possible to establish whether a psychiatric patient’s suffering is unbearable and without prospect and whether the request is well-considered. Conclusion The general public shows more support than opposition as to whether patients suffering from a psychiatric disorder should be eligible for EAS, even though one third of the respondents remained neutral. Physicians’ support depends on their specialization; 39% of psychiatrists considered performing EAS in psychiatric patients conceivable. The relatively low conceivability is possibly explained by psychiatric patients often not meeting the eligibility criteria.

Correlations between medical students’ specialty choice and different attitudes towards mental illness

2017 ◽  
Vol 41 (S1) ◽  
pp. S739-S739
Author(s):  
M. Pascucci ◽  
E. Stella ◽  
M. La Montagna ◽  
D. Di Sabatino ◽  
R. Nicastro ◽  
...  
Keyword(s):  
Mental Illness ◽  
Medical Students ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Specialty Choice ◽  
Reference Points ◽  
Undergraduate Medical Students ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties

IntroductionDiscrimination and stigmatization cause an important burden for people suffering from psychiatric disorders. The medical doctors, those who should be important reference points for psychiatric patients, are instead one of the categories that contribute to their stigmatization.ObjectivesIt is extremely important to study and to know the attitudes of undergraduate medical students towards psychiatric disorders, since these individuals will be involved in the care of these patients throughout their careers.AimsThe present study analyzes the attitudes of a group of Italian medical students towards mental illness, highlighting the differences between the students who would choose surgical specialties from those who prefer medical ones.MethodsA total of 339 medical students of different medical schools, in Rome and Foggia (Italy), completed a cross-sectional survey. The Italian version of community attitude towards the mentally Ill test (CAMI) was used to evaluate the students’ attitudes.ResultsThe students that would choose medical specialties reported less stigmatizing responses in 11 CAMI items (including five items with P < 0.01), in benevolence and community mental health ideology subscales (P = 0.003) and in the total score (P = 0.003).ConclusionsIt is evident that the students that prefer the surgical specialties have more stigmatizing attitudes towards psychiatric patients. Negative feedbacks on Psychiatry from non-psychiatrist colleagues may have a fundamental role in stigmatizing mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Acceptability of Assisted Suicide in Patients With Severe and Persistent Mental Illness

GeroPsych ◽  
2020 ◽  
pp. 1-8
Author(s):  
Sophie Gloeckler ◽  
Manuel Trachsel
Keyword(s):  
Mental Illness ◽  
Pilot Study ◽  
Psychiatric Diagnosis ◽  
Assisted Suicide ◽  
Shared Values ◽  
Psychiatric Nurses ◽  
Attitudes And Beliefs ◽  
Future Studies ◽  
Persistent Mental Illness ◽  
Moral Attitudes

Abstract. In Switzerland, assisted suicide (AS) may be granted on the basis of a psychiatric diagnosis. This pilot study explored the moral attitudes and beliefs of nurses regarding these practices through a quantitative survey of 38 psychiatric nurses. The pilot study, which serves to inform hypothesis development and future studies, showed that participating nurses supported AS and valued the reduction of suffering in patients with severe persistent mental illness. Findings were compared with those from a previously published study presenting the same questions to psychiatrists. The key differences between nurses’ responses and psychiatrists’ may reflect differences in the burden of responsibility, while similarities might capture shared values worth considering when determining treatment efforts. More information is needed to determine whether these initial findings represent nurses’ views more broadly.

scholarly journals Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 154
Author(s):  
Sisira Donsamak ◽  
Marjorie C. Weiss ◽  
Dai N. John
Keyword(s):  
Respiratory Infections ◽  
Acute Diarrhoea ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Community Pharmacies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Case Vignettes ◽  
A Chain

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.

Social stigma in severe mental illness in Tunisia: Clinical and socio-demographic correlates

2017 ◽  
Vol 41 (S1) ◽  
pp. S577-S577 ◽  
Author(s):  
U. Ouali ◽  
R. Jomli ◽  
R. Nefzi ◽  
H. Ouertani ◽  
F. Nacef
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cultural Context ◽  
Social Inclusion ◽  
Psychiatric Patients ◽  
Social Stigma ◽  
Cross Sectional Study ◽  
Local Context ◽  
Cross Sectional ◽  
Competing Interest

IntroductionMental patients generally internalize some of the negative conceptions about how most people view them: they might be considered incompetent or untrustworthy or believe that people would not want to hire, or marry someone with mental illness. A lot of research on stigma has been conducted in western countries; however, little is still known on the situation in Arab-Muslim societies.ObjectivesTo evaluate social stigma as viewed by patients suffering from severe mental illness (SMI)MethodsThis is a cross-sectional study on clinically stabilized patients with schizophrenia and Bipolar Disorder (BD) according to DSM IV, who were interviewed in our out-patients clinic with the help of a semi-structured questionnaire, containing 8 opinions on the social inclusion and stigmatization of psychiatric patients, with special reference to the local cultural context (e.g.: “It is better to hide mental illness in order to preserve the reputation of my family”)ResultsWe included 104 patients, 51% with schizophrenia and 49% with BD. Mean age was 38.4 years (18–74 years); 59.6% were males. Overall social stigma scores were high. Social stigma in patients was correlated with gender, age, place of residence and diagnosis. Patients with BD showed significantly less social stigma than patients with schizophrenia.ConclusionOur results show the need for a better understanding of this phenomenon in patients with SMI, but also within Tunisian society, in order to elaborate anti stigma strategies adapted to the local context.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals EFFECT OF EDUCATION ON STIGMA AND DISCRIMINATION TOWARDS MENTAL ILLNESS: A MULTIVARIATE ANALYSIS OF COVARIANCE

2021 ◽  
Vol 21 (2) ◽  
pp. 329-337
Author(s):  
Mariana Tumin ◽  
Md Mizanur Rahman ◽  
Zulkifli Jantan
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Education Level ◽  
Analysis Of Covariance ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Linear Effect ◽  
Stigma And Discrimination ◽  
Significant Difference ◽  
Related Stigma

People with mental illness often encounter stigma and discrimination. Mental illness-related stigma and discrimination represent the enormous obstacles that stand in the way of delivering mental health care. Little is known about stigma and discrimination toward mental illness in rural Sarawak. Thus, this study aimed to identify the stigma and discrimination towards mental illness among Sarawak’s rural community and the factors affecting them. A cross-sectional survey was carried out on 840 respondent adults aged 21 and above. A validated Community Attitude towards Mental Illness (CAMI) and Discrimination towards Mental Illness questionnaire was used for data collection. A Two-way Multiple Analysis of Covariance (Two-way MANCOVA) test was carried out to determine how much gender and education level influence stigma and discrimination towards mentally ill patients. Analysis showed that there was a statistically significant difference of standardised stigma and discrimination scores with education level (p<.001), but not with gender (p>.05). Age had a positive linear effect on both stigma and discrimination, whereas experience with mentally ill patients negatively affected both stigma and discrimination. Individuals with a lower level of education, older in age, and lesser experience in dealing with the mentally ill would have a higher level of stigma and discrimination towards mental illness. Thus, targeted and practical strategies need to be organised and implemented to combat mental illness-related stigma and discrimination.

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