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      Mental illness attitudes and knowledge in non-specialist medical doctors working in state and private sectors

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          Abstract

          Background

          An increasing number of South Africans utilise primary healthcare services (either in the state or private sector) for mental health concerns; hence, there is a need to objectively assess these doctors’ attitudes and knowledge of mental illness.

          Aim

          To investigate aspects of knowledge and attitudes towards mental illness of a group of private and state-employed non-specialist medical doctors.

          Method

          Doctors in the state sector who were working at a primary healthcare level and who were not working towards, or did not hold, a specialist qualification were considered eligible for the study. Doctors in the private sector who were working as general practitioners and who did not hold a specialist qualification were considered eligible for the study. Data were collected by means of a self-administered questionnaire. A link to the study questionnaire, information about the study, details of the researcher and matters pertaining to informed consent were emailed to potential participants.

          Results

          Of the 140 practitioners who responded to the survey, 51.4% ( n = 72) worked in the state sector, 41.4% ( n = 58) worked in the private sector and 7.1% ( n = 10) worked in both the state and private sectors (χ 2 1 = 45.31, p < 0.010). The majority (> 50%) of participants in all three groups had a positive attitude towards mental illness (χ 2 2 = 1.52, p = 0.468). Although there were no significant associations between attitude and socio-demographic characteristics ( p > 0.05), male SS doctors reported feeling less comfortable when dealing with mentally ill patients ( p = 0.015); SS doctors who did not have family contact with mental illness were less likely to feel that mentally ill patients did not pose a risk to others ( p = 0.007), and PS doctors under the age of 35 years were more likely to feel adequately trained to treat mental illness ( p = 0.026). The majority (> 50%) of participants in all three groups had an adequate level of knowledge of mental illness (modal scores = 10). There were no significant associations between knowledge and socio-demographic characteristics ( p > 0.05).

          Conclusion

          Despite the findings of a positive attitude and adequate knowledge of mental illness amongst the participants of this study, it is recommended that more targeted interventions are established to further improve mental health awareness and knowledge of doctors at both undergraduate and postgraduate levels of study.

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          Most cited references90

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          The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013.

          Since the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature. We applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings. Pooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates. Despite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.
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            Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis.

            Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies.
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              Mental illness stigma, help seeking, and public health programs.

              Globally, more than 70% of people with mental illness receive no treatment from health care staff. Evidence suggests that factors increasing the likelihood of treatment avoidance or delay before presenting for care include (1) lack of knowledge to identify features of mental illnesses, (2) ignorance about how to access treatment, (3) prejudice against people who have mental illness, and (4) expectation of discrimination against people diagnosed with mental illness. In this article, we reviewed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help seeking.
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                Author and article information

                Journal
                S Afr J Psychiatr
                S Afr J Psychiatr
                SAJPsy
                The South African Journal of Psychiatry : SAJP : the Journal of the Society of Psychiatrists of South Africa
                AOSIS
                1608-9685
                2078-6786
                31 May 2021
                2021
                : 27
                Affiliations
                [1 ]Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
                Author notes
                Corresponding author: Yumna Minty, yumnaminty@ 123456gmail.com
                Article
                SAJPsy-27-1592
                10.4102/sajpsychiatry.v27i0.1592
                8182464
                5e292956-7d4e-4b1c-ac1c-adcbfaf01b44
                © 2021. The Authors

                Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

                Categories
                Original Research

                mental illness,stigma,attitudes,mental health literacy,knowledge,doctors,healthcare workers,primary healthcare

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