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      Understanding Stigma: A Pooled Analysis of a National Program Aimed at Health Care Providers to Reduce Stigma towards Patients with a Mental Illness

      , , , , ,

      Journal of Mental Health and Addiction Nursing

      Dougmar Publishing Group, Inc.

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          Abstract

          Background and Objective: The problem of mental illness-related stigma within healthcare is an area of increasing attention and concern. Understanding Stigma is an anti-stigma workshop for healthcare providers that uses social contact as a core teaching element, along with educational and action-oriented components. The objective of our study was to determine the impact of this program on healthcare providers’ attitudes and behavioural intentions towards patients with a mental illness, and also to ascertain whether various participant and program characteristics affected program outcomes. Our paper reports the results of a pooled analysis from multiple replications of this program in different Canadian jurisdictions between 2013 and 2015. Material and Methods: We undertook a pooled analysis of six separate replications of the Understanding Stigma program. All program replications were evaluated using a non-randomized quasi experimental pre- post- follow-up design. The Opening Minds Scale for Health Providers (OMS-HC) was used as the main assessment tool. Study-level and individual-level meta-analysis methods were used to synthesize the data. First, the ‘metan’ command was used to show outcomes by study, using a forest plot. Then, a pooled dataset was produced and analyzed using a random intercept linear mixed model approach with each program being modelled as a random effect. Program and participant characteristics were examined as independent variables using this approach. These were each entered individually. Individual tests included pre to post change by program version (original or condensed), by occupation (nurses versus other healthcare providers), by gender, age, and previous diagnosis of a mental illness. Results: Program effect sizes ranged from .19 to .51 (Cohen’s d), with an overall combined effect size of .30. The results of the mixed model analysis showed the improvement from pre to post intervention was statistically significant for the total scale and subscales. Analysis of program and participant factors found that version type, healthcare provider type, gender, and previous diagnosis of a mental illness were all non-significant factors on program outcomes. A significant inverse association was revealed between increasing age and score change. Results also showed a significant positive linear relationship between baseline score and improvement from pre to post intervention. Maintenance of scores at follow-up was observed for participants who attended a booster session. Conclusion: The results are promising for the effectiveness of this brief intervention model for reducing stigmatizing attitudes and improving behavioural intentions among nurses and other healthcare providers.  

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          Most cited references 14

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          'Diagnostic overshadowing': worse physical health care for people with mental illness.

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            Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies.

            As part of its ongoing effort to combat stigma against mental illness among health care providers, the Mental Health Commission of Canada partnered with organizations conducting anti-stigma interventions. Our objective was to evaluate program effectiveness and to better understand what makes some programs more effective than others. Our paper reports the elements of these programs found to be most strongly associated with favourable outcomes.
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              Mental health and stigma in the medical profession.

              Until recently, much of the recent upsurge in interest in physician health has been motivated by concerns about improving patient care and patient safety and reducing medical errors. Increasingly, more attention has turned to examining how the management of mental illness among physicians might be improved within the medical profession and one key direction for change is the reduction of stigma associated with mental illness. I begin this article by presenting a brief overview of the stigma process from the general sociological literature. Next, I provide evidence that illustrates how the stigma of mental illness thrives in the medical profession as a result of the culture of medicine and medical training, perceptions of physicians and their colleagues, and expectations and responses of health care systems and organizations. Lastly, I discuss what needs to change by proposing ways of educating and raising awareness regarding mental illness among physicians, discussing approaches to assessing and identifying mental health concerns for physicians and by examining how safe and confidential support and treatment can be offered to physicians in need. I rely on strategically selected studies to effectively draw attention to and support the central themes of this article.
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                Author and article information

                Journal
                Journal of Mental Health and Addiction Nursing
                JMHAN
                Dougmar Publishing Group, Inc.
                2561-309X
                February 15 2017
                March 03 2017
                : 1
                : 1
                : e19-e29
                Article
                10.22374/jmhan.v1i1.19
                © 2017

                Copyright of articles published in all DPG titles is retained by the author. The author grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any non-commercial third party the rights to use the article freely provided original author(s) and citation details are cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0/

                Product
                Self URI (journal page): http://jmhan.org/index.php/JMHAN

                Nursing

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