Mental health stigma and help-seeking intentions in police employees

Mental health problems among police employees are exacerbated by negative attitudes and beliefs around mental health help-seeking perpetuated by police culture. We collected anonymous survey data from 259 civilian and commissioned police employees to test hypothesized relationships among help-seeking stigma, help-seeking attitudes, and intended help-seeking behavior. Results demonstrated that mental help-seeking stigma was negatively associated with help-seeking attitudes, and in turn with reduced mental health help-seeking intentions. Structural equation modeling provided support for a model linking help-seeking stigma, help-seeking attitudes, and intentions to seek help. This path model was moderated by psychological distress and previous participation in mindfulness training, which had opposing effects on help-seeking stigma and (indirectly) on intended help-seeking. These results support the hypothesis that stigma around mental health help-seeking contributes to reduced help-seeking intentions, and provide insight into policies, practices, and interventions that police agencies may enact to combat stigma and positively influence mental health help-seeking.

Perspectives of university health care students on mental health stigma in Nigeria: Qualitative analysis

Mental illness is a significant public health burden in low- and middle-income countries. A wide treatment gap in mental health care exists within the Nigerian health care system and this gap is worsened by the presence of stigma associated with mental illness, which leads to delay in treatment or acts as a barrier to any care. In this study, our aim was to understand the factors that underlie mental illness stigma in order to inform the design of effective stigma-reducing interventions among health care students in Nigeria. We conducted four focus groups among university health care students in March 2019 in Nigeria. The students included nursing, pharmacy, and medical trainees from a university teaching hospital. We used an inductive-driven thematic analysis to identify codes and themes related to mental health stigma and conceptualization of mental health within the study group. Among the 40 participants, we identified how specific interpretations of religious and spiritual beliefs may be associated with stigmatizing behaviors such as social distancing and discrimination. Conceptualization of mental illness as a communicable disease and the attribution of mental illness to a moral failing contributed to stigma mechanisms. Overall, eight themes associated with mental health stigma and mental health-related concepts were found: spirituality, discrimination and devaluation, conceptualization of mental health, attribution theories, methods to reduce stigma, shortage of resources, violence and dangerousness, and maltreatment. We found that the co-existence of spiritual beliefs and biomedical and psychological models of mental health is a key factor to consider in the design of effective stigma-reducing interventions among university health students in Nigeria.

Understanding the Effects of Stigma Associated with Therapy

The purpose of our study is to understand the effects of the stigma associated with therapy in the final decision of people whether to seek psychotherapy or not. The study is based on a game-theoretical model which tries to explain the negative effects of the stigma on the total payoff one gets from therapy. The stigma arises from a lack of information on the importance of mental wellbeing. We hypothesise, and our data validates our claim that the people belonging to the age group of 18-25, are amongst the first generations to have received formal education on mental health and its importance, and thus we keep that age group out of our study. The model states that if the sum of the costs, namely the fear of judgement (direct stigma), the presumption of no real benefit arising from therapy (indirect stigma), and even the monetary cost, is more than the perceived benefit, people don’t seek therapy. To validate this model, we collect primary data of 251 respondents, filter out the responses of those belonging to the age bracket of 18-25 because of the reasons mentioned above, leaving us with 67 responses, enough to assume normality. We regress the variable, “Whether people consider seeking therapy in the future or not” on the following cost variables. The beta coefficients of the stigma cost variables come out to be significant and negative. Thus, our model correctly explains the reason why people may decide to not seek psychotherapy. Keywords: Mental Health, Stigma, Therapy, Game Theory

Clergy Perceptions of Mental Illness and Confronting Stigma in Congregations

Mental illness and stigma are key concerns in congregations and represent a key threat to community health. Clergies are considered influential in how congregants think about and respond to mental health issues, especially in African American congregations. In-depth interviews with 32 African American and White clergies were conducted to understand their unique perspectives on mental health and how they interact with their congregations based on those perspectives. Findings include six themes related to mental health stigma, namely, holistic definitions of health; African Americans and different conceptions of mental health (only reported by African American clergies); code words and language; depression as a special case; perceptions of mental health counseling and treatment; and clergy strategies for addressing mental health stigma. The clergies in this study recognized their influence on ideas related to mental health in their congregations, and most expressed active efforts toward discussing mental health and reducing stigma.

Attitudes and beliefs of Tunisian High-School teachers about schizophrenia: The impact of vignette gender

Background: Teachers have a crucial active role in provision of mental health services to students and fighting against mental health stigma in schools, hence their attitudes and beliefs toward mental illness should be assessed. Method: We carried-out a cross-sectional study with a non-probabilistic sample of 304 higher secondary school teachers. We used a structured questionnaire in which a vignette describing an individual with schizophrenia was presented, and was followed by a series of stigma-related questions. Results: A substantial proportion of teachers endorsed stressful life events (79.6%) as a cause of schizophrenia, elicited feelings of discomfort (41.4%) and incomprehension (41.1%) with the person displaying symptoms of schizophrenia, and agreed that the person’s condition will deteriorate even more (45.4%). Teachers perceived that the person described in the vignette is dependent on others, lacks will, is different from others and is unpredictable in 65.1%, 59.2%, 55.6%, and 49.7% of cases, respectively. In addition, 38.5% and 34.2% of teachers recommended turning to traditional healers and to a Sheikh or an imam of a mosque, respectively. Regarding gender effects, females with schizophrenia were regarded as more likely to be unable to make her own decisions and to be dependent on others than males, and were less likely to be recommended for seeking help from a family physician or to consult a psychiatric hospital than males. Conclusion: In the light of our findings, raising awareness of teachers of the impact of mental health issues on students should be prioritized in high schools in Tunisia.

Public Stigma on Depression Comorbid with Diabetes: A Vignette-Method Study in China

Background: Depression and diabetes are common illnesses affecting individuals with health challenges and family stress. Research suggested stigma-reduction interventions for families facing health-related stressors. This study examined factors predicting public stigma on depression alone or comorbid with diabetes. Methods: In Shanghai, China, consented respondents to a community-based survey read one of four vignettes varied by depression types and gender of the Vignette Subject (VS). This vignette method measures each respondent’s Individualized Public Stigma score, attitude toward the subject’s family with the Devaluation of Consumer’s Families score, and problem seriousness leading to stress. Results: 125 respondents expressed views on depression or diabetes-associated depression via their answers to a randomly assigned vignette. Results show significant associations with Individualized Public Stigma when entering the regression model with five variables: problem seriousness, knowing someone with a mental health problem, subject’s gender, attitude toward the subject’s family, and depression comorbid with diabetes. Regression statistics showed that a person’s Individualized Public Stigma scores could be predicted by two of these variables: perceived problem seriousness and sympathy toward the affected family. Yet, comorbidity with diabetes was not a significant predictor of stigma. Conclusions: This study concludes that the cultural value toward community support could be an educational means to help the public realize the importance of protecting the families affected by mental health stigma. Applying this theory in action, practitioners must assess how self-stigmatization interfaces with the public perception of the patient's family. In addition, when people have a highly sympathetic attitude toward the patient’s family and perceive the presenting problem as severe, they must be aware of the impact of individualized stigma on the patient. Future research must focus on these cultural perspectives to support early anti-stigma interventions.

Integrating Psychological Services Into Community-Based Clinics

In Alabama, where mental health stigma is a critical barrier to care, integrated behavioral health services are vital to address the mental health needs that underlie substance use disorder (SUD) and opioid use disorder (OUD). Since October 2019, our team has developed partnerships with one rural and two peri-urban primary care clinics to offer behavioral health services with an emphasis on SUD/OUD prevention, screening, and treatment. The patient populations receiving services at these three facilities are under-resourced with multiple disadvantages placing them at risk for morbidity, mortality, SUD/OUD, and poor behavioral and mental health outcomes. Behavioral health services have been delivered primarily via telehealth due to the COVID-19 pandemic. This presentation will describe the process, current status, and future goals for implementing integrated behavioral health care, with a focus on identifying the barriers and facilitators during the COVID-19 pandemic era.

The Impact of Mental Health Stigma and Ageism on Students’ Intention to Work with Older Adults: A Mixed Methods Design

Approximately 20% of older adults have a mental or neurological disorder which can cause significant disability. With a growing older adult population, there is a need for providers receiving specialized training in aging to provide quality care. However, there continues to be shortages of students seeking careers in geriatrics and especially in working with older individuals with mental health (MH) concerns. The present study explored the relationship between MH stigma, ageism and intention to work with older adults among undergraduate students. Undergraduate students (N=188) completed a battery of questionnaires including intention to work with older adults, positive and negative attitude towards older adults, and open-ended questions exploring MH stigma views. Regression results indicated that MH stigma, positive, and negative attitudes significantly predicted intention to work with older adults, (F(3, 182) = 8.51, p = .000). Examination of the coefficients revealed that positive attitudes significantly predicted intention to work with older adults (t=4.38, p=.000), and MH stigma demonstrated a trend towards significance (t=1.90, p=.059). Open-ended responses were analyzed using qualitative description methods which revealed themes consistent with negative and positive stereotypes, MH problems going undetected, and need for additional support in recognizing and treating MH conditions among older adults. Positive attitudes are an important predictor in students’ intention to work with older adults, and MH stigma may be an important factor to explore further. Qualitative themes also describe how MH concerns are an important area to focus on among older adults, although there continues to be evidence of aging stereotypes.

Impact of Opera on Mental Health Stigma: Pilot of Provider/Community Workshop

Background Arts can influence mental health stigma, but little is known about impact of operas. We examined effects of a two-opera workshop on complicated grief and schizophrenia. Methods Pre-post audience surveys with post-workshop discussion. The primary outcome was a 4-item measure of willingness to engage with persons with grief or schizophrenia. Secondary outcomes were perceptions of art affecting stigma and stigma mediators. Of 47 participants, 33 had pre-post surveys for both operas. Results There was a significant pre-post opera increase in audience willingness to engage with persons with grief or schizophrenia (p < .001). Perceptions of impact on mediators such as empathy, were significantly greater for the opera on schizophrenia relative to grief (p < .001).. Conclusion The pre- to post increase in audience willingness to engage with affected persons (primary) with greater impact on secondary mediators for the schizophrenia opera and post-discussion suggest that operas may be a forum for addressing mental health stigma and promoting empathy.