Mental health-related stigma and attitudes toward patient care among providers of mental health services in a rural Chinese county

2021 ◽  
pp. 002076402199280
Author(s):  
Yuer Deng ◽  
An-Li Wang ◽  
Rosemary Frasso ◽  
Mao-Sheng Ran ◽  
Tian-Ming Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Healthcare System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Educational Background ◽  
Mental Health Recovery ◽  
Public Health Issue ◽  
People With Mental Illness

Background and aims: The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers’ attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. Method: Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. Results: Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers’ attitudes toward providing care, (4) providers’ perception toward patients and family members, and (5) providers’ perception of training needs. Conclusions: This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners’ experiences and views to inform the design of training initiatives in rural or low-resource communities.

scholarly journals Mental health reform under policy mainstreaming: needed, but uncertain

2013 ◽  
Vol 23 (1) ◽  
pp. 11-16 ◽  
Author(s):  
M. Hogan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Healthcare System ◽  
Health Reform ◽  
50Th Anniversary ◽  
Mental Healthcare ◽  
Well Being ◽  
Mental Health Reform ◽  
Reform Legislation ◽  
People With Mental Illness

October 2013 marks the 50th anniversary of President John F. Kennedy's message to the US Congress on the need to reform mental healthcare. Much has changed in that time. In 2006, Frank and Glied summarized these changes and the forces behind them, finding that the well-being of people with mental illness was ‘better but not well.’ They also conclude that most improvements have been due to ‘mainstreaming,’ the inclusion of those with mental illness in broad reforms such as Medicare, Medicaid and Social Security. With the gradual assimilation of mental health concerns, leadership and resources into mainstream programmes and agencies, future improvements will require that these programmes are accessible and oriented to people with mental illness. The passage of broad health reform legislation in 2010 (the Affordable Care Act) reinforces this change; several of its provisions attempt to make healthcare more relevant to the population with mental illness. In this editorial, I discuss a set of challenges which remain for the population with mental illness in the healthcare system, and the prospects for change. These challenges include: (1) improving basic mental healthcare in primary care, (2) improving mental healthcare for children, (3) earlier detection and treatment of psychotic illness, (4) disability and unemployment and (5) the challenge of sustaining an adequate, speciality public mental healthcare system under conditions of mainstreaming. In general, I conclude that the prospects for successful reform are uncertain. Establishing mental healthcare specialization in mainstream systems has not been notably successful to date.

Stigma associated with mental illness and its treatment in the Arab culture: A systematic review

2018 ◽  
Vol 64 (6) ◽  
pp. 597-609 ◽  
Author(s):  
Monica Zolezzi ◽  
Maha Alamri ◽  
Shahd Shaar ◽  
Daniel Rainkie
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Qualitative Methodology ◽  
Data Extraction ◽  
Mental Healthcare ◽  
Quantitative Methodology ◽  
Arab Population ◽  
Manual Search ◽  
People With Mental Illness ◽  
Mental Health Treatments

Background: Mental health has not had the same public profile as physical health. This has contributed to the stigma associated with mental illness and to its treatments. Research investigating how the traditions and values amongst those with an Arab heritage contribute to stigmatizing beliefs, attitudes or actions in the provision of mental healthcare has not been widely reported. Aim: To systematically review the literature and summarize the findings of studies reporting stigmatizing beliefs, actions and attitudes toward treatment of people with mental illness in the Arab population. Methods: PubMed, Ovid, Psycharticles and Embase were used to identify original studies of non-institutionalized Arab adults or children reporting findings relevant to stigma toward mental illness. A manual search of the bibliography of all selected original studies was also undertaken. Independent data extraction was performed by two reviewers, who then met to compare data and reach consensus. Findings were classified as stigmatizing beliefs, actions or attitudes toward mental health treatments. Results: A total of 33 articles were retrieved for full review. Those utilizing qualitative methodology provided insight into the many ways mental illness is viewed and defined among those with an Arab heritage. Among the studies using quantitative methodology, most compared stigmatizing beliefs, attitudes toward mental health treatments or stigmatizing actions among different Arab populations, some also investigated correlations between characteristics of the Arab population tested with stigmatizing beliefs, actions and attitudes toward mental health treatments. Findings from studies undertaken in Qatar reported greater stigmatizing beliefs, actions or attitudes toward mental health treatments among Qatari versus non-Qatari Arabs. Conclusion: A large diversity in the stigmatizing beliefs, actions and attitudes toward treatment of mental illness within the Arab population were identified. The influence of cultural variations on stigma should be explored further and used to tailor anti-stigma interventions in this population.

scholarly journals The Mental Capacity Act and mental healthcare in prison: opportunities and challenges

2012 ◽  
Vol 36 (7) ◽  
pp. 241-243 ◽  
Author(s):  
Sharon Davies ◽  
Claire Dimond
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Healthcare ◽  
Legal Framework ◽  
Mental Capacity ◽  
Best Interests ◽  
People With Mental Illness ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk

SummaryThe UK Mental Health Act 1983 does not apply in prison. The legal framework for the care and treatment of people with mental illness in prison is provided by the Mental Capacity Act 2005. We raise dilemmas about its use. We highlight how assessing best interests and defining harm involves making challenging judgements. How best interests and harm are interpreted has a potentially significant impact on clinical practice within a prison context.

scholarly journals Refugees, the asylum system and mental healthcare in Ireland

2016 ◽  
Vol 13 (2) ◽  
pp. 35-37 ◽  
Author(s):  
Molly O'Connell ◽  
Richard Duffy ◽  
Niall Crumlish
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Asylum Seekers ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Refugee Status ◽  
Current Health ◽  
Refugee Mental Health ◽  
Service Policy ◽  
Refugees And Asylum Seekers

The number of people seeking refugee status in Ireland is increasing year on year and the burden of mental illness experienced by refugees and asylum seekers is high. The College of Psychiatrists of Ireland has recommended the establishment of a number of specialist refugee mental health teams. In this paper we discuss the Irish asylum system, the Irish evidence regarding mental illness in this population, and current health service policy regarding refugee mental health. We propose a model of specialist refugee mental healthcare delivery.

Evaluating the Indonesia Free Pasung Movement: Understanding continuing use of restraint of the mentally ill in rural Java

2021 ◽  
pp. 136346152110096
Author(s):  
Aliza J. Hunt ◽  
Robert Ern-Yuan Guth ◽  
Diana Setiyawati
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Participant Observation ◽  
Qualitative Interviews ◽  
National Policy ◽  
Mental Healthcare ◽  
People With Mental Illness ◽  
National Mental Health

Forcible restraint and confinement of persons suffering from mental illness occurs throughout the world, including in Indonesia. Since 2010, when Gerakan Bebas Pasung (GBP) or the Indonesian Freedom from Forcible Restraint ( Pasung) of Mentally Ill Persons movement was launched, national policy has been published to eradicate Pasung in Indonesia by improving the mental healthcare system. This article analyses this policy, specifically the National Mental Health Legislation (2014) and the Ministry of Health Regulation Tackling Forcible Restraint of People with Mental Illness (2017), and evaluates their current state of implementation through a local, in-depth case study. Using mental health institution mapping, two sets of semi-structured qualitative interviews with government officials and healthcare workers, and participant observation in a facility practicing Pasung, we identify the extent to which the 2017 regulation has been implemented in Winong village and discuss current efforts and persistent obstacles to eradicating Pasung. We suggest that despite reforms and the new treatment facility in our case study, the continuing use of Pasung is due to a combination of access to care issues and a widely held explanatory model of mental illness characterized by strong curative beliefs that, when disappointed, lead to a sense of threat and hopelessness.

scholarly journals Competitive Athletes' Experiences With Mental Illness And Psychological Treatment

2021 ◽  
Author(s):  
Rachel Jewett
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Race And Ethnicity ◽  
Help Seeking ◽  
Sport Participation ◽  
Psychological Treatment ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Future Research ◽  
Sport Culture

The purpose of the study was to explore the role of sport culture in athlete mental health, the importance of mental healthcare providers having an understanding of this context, and how athletes tend to access mental healthcare. Ten athletes with personal experience in these domains were interviewed and a thematic analysis was used. Athletes who attributed their mental health challenges to their sport participation thought it was important for their mental healthcare providers to have experience with sport. Normalization and validation of mental illness within the sport context and understanding competitive sport culture were identified as important. Facilitators of care access included a supportive cultural environment and influential individuals. Barriers included stigma and the financial cost of treatment. Coaches influenced athletes’ attitudes toward help-seeking. Implications for assessment and treatment of mental illness in athletes are discussed. Future research should explore gender, race, and ethnicity in athletes’ experiences with mental illness.

scholarly journals Social Context of Healthcare Utilization among People with Mental Illness in Southwestern, Nigeria

2014 ◽  
Vol 12 (2) ◽  
Author(s):  
Motunrayo M. Ayobola ◽  
Ezebunwa E. Nwokocha
Keyword(s):  
Mental Illness ◽  
Healthcare Utilization ◽  
Rational Choice Theory ◽  
Choice Theory ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Health Seeking ◽  
Southwestern Nigeria ◽  
People With Mental Illness

This study examined healthcare utilization among people with mental illness in Abeokuta and Ibadan, Southwest Nigeria as a way of understanding the context in which health seeking and treatment take place. The Health Belief Model and Rational Choice Theory were employed as theoretical framework. Data were collected using three qualitative methods. Twenty four In-depth Interviews (IDIs) were conducted among traditional healers, psychiatrist and significant others to patients. Four Key Informant Interviews (KIIs) were undertaken among mental healthcare providers. In addition, four FGDs were conducted among female and male participants in Ibadan. Findings revealed a strong perception that mental illness is caused mainly by supernatural force. The notion that mental illness is incurable, transmissible and infectious accounts for harassment and stigmatization of victims and their families which often explains the withdrawal of patients from medical care. Most of the participants preferred the traditional pathway to treatment, irrespective of its perceived limitations. It is essential to put in place a policy to discourage stigmatization and discrimination against mentally ill patients in order to encourage healthcare utilization.

scholarly journals Perspectives of healthcare providers, service users, and family members about mental illness stigma in primary care settings: A multi-site qualitative study of seven countries in Africa, Asia, and Europe

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258729
Author(s):  
Mirja Koschorke ◽  
Nathalie Oexle ◽  
Uta Ouali ◽  
Anish V. Cherian ◽  
Vayankarappadam Deepika ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Primary Care Providers ◽  
Mental Illness Stigma ◽  
Service Users ◽  
Care Providers ◽  
Primary Care Settings ◽  
People With Mental Illness

Background Stigma among healthcare providers is a barrier to the effective delivery of mental health services in primary care. Few studies have been conducted in primary care settings comparing the attitudes of healthcare providers and experiences of people with mental illness who are service users in those facilities. Such research is necessary across diverse global settings to characterize stigma and inform effective stigma reduction. Methods Qualitative research was conducted on mental illness stigma in primary care settings in one low-income country (Nepal), two lower-middle income countries (India, Tunisia), one upper-middle-income country (Lebanon), and three high-income countries (Czech Republic, Hungary, Italy). Qualitative interviews were conducted with 248 participants: 64 primary care providers, 11 primary care facility managers, 111 people with mental illness, and 60 family members of people with mental illness. Data were analyzed using framework analysis. Results Primary care providers endorsed some willingness to help persons with mental illness but reported not having appropriate training and supervision to deliver mental healthcare. They expressed that people with mental illness are aggressive and unpredictable. Some reported that mental illness is incurable, and mental healthcare is burdensome and leads to burnout. They preferred mental healthcare to be delivered by specialists. Service users did not report high levels of discrimination from primary care providers; however, they had limited expectations of support from primary care providers. Service users reported internalized stigma and discrimination from family and community members. Providers and service users reported unreliable psychiatric medication supply and lack of facilities for confidential consultations. Limitations of the study include conducting qualitative interviews in clinical settings and reliance on clinician-researchers in some sites to conduct interviews, which potentially biases respondents to present attitudes and experiences about primary care services in a positive manner. Conclusions Primary care providers’ willingness to interact with people with mental illness and receive more training presents an opportunity to address stigmatizing beliefs and stereotypes. This study also raises important methodological questions about the most appropriate strategies to accurately understand attitudes and experiences of people with mental illness. Recommendations are provided for future qualitative research about stigma, such as qualitative interviewing by non-clinical personnel, involving non-clinical staff for recruitment of participants, conducting interviews in non-clinical settings, and partnering with people with mental illness to facilitate qualitative data collection and analysis.

scholarly journals “I Am Not My Illness!”: Navigating the Mental Healthcare System in New Orleans

2019 ◽  
Author(s):  
◽  
Saira Mehmood ◽  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Critical Race Theory ◽  
Mental Health Services ◽  
Health Services ◽  
New Orleans ◽  
Healthcare System ◽  
Mental Health Professionals ◽  
Mental Healthcare ◽  
Mental Illnesses

This research examines the experiences of individuals diagnosed with chronic mental illnesses and how they navigated the mental healthcare system in New Orleans, Louisiana. To realize the main research objective, I analyzed how individuals with chronic mental illnesses perceive mental illness and stigma; the services individuals use to address their mental health needs and the barriers they face in this process; who individuals disclose their mental illness to and under what contexts; and how individuals diagnosed with mental illness and their caregivers understand and embody recovery. Situated between medical anthropology and urban anthropology, it examines the challenges individuals diagnosed with chronic mental illness and caregivers encounter in utilizing mental health services. Using critical race theory and studies on whiteness, I analyze the intersectional identities of individuals to understand how various axes of identities such as race, gender, age, and religion affect how people utilize mental health services, conceptualize stigma, how this is related to disclosure, and what recovery means to them. While I use stigma scales to measure various types of stigma, I triangulate this data with observations from participant-observation and interviews to reconceptualize stigma in what Tyler and Slater (2018) argue for approaching the social and political dynamics of stigma and acknowledging history. I do this through the use of stigma syndemics. Central to this is the role of mental health professionals and other key stakeholders, and how they interact with individuals utilizing community mental health services. I examine how past experiences such as trauma and incarceration limit access to housing programs, employment, and how this affects recovery. Lastly, I argue that for effective advocacy on mental health to occur, synergistic activism through coalition building needs to transpire between all the entities that affect individuals who have mental illnesses.

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