Study on Mental Health-related Stigma

Study on Mental Health-related Stigma: Attitudes and Values of University Students Towards People With Mental Disorders

Mental disorders are currently among the main causes of disability worldwide. For this reason, various national and international organisations include the promotion of mental health among their strategic actions, with special emphasis on the fight against stigma. Evidence shows that stigma has a negative impact on the process of recovery and participation of people with mental disorders.

The general aim of this study is to find out about the attitudes of university students at the University of A Coruña towards people with mental disorders and specifically to intervene with students of the Bachelor's Degree in Occupational Therapy to assess whether taking part in a Mental Health Literacy Programme changes these attitudes.

Study Overview

• Status: Recruiting
• Conditions: Mental Health Disorder
• Intervention / Treatment: Other: Mental Health Literacy Programme

Detailed Description

In recent years, there has been a growing interest in developing and evaluating anti-stigma plans in the field of mental health. However, stigmatising, coercive or paternalistic attitudes persist in society and have a negative impact on the recovery process of people with mental illness.

The Mental Health Spain Confederation proposes tackling stigma through intersectional mental health literacy interventions that incorporate the gender perspective and are focused on the needs identified by people with mental disorders.

The New Mental Health Strategy of the National Health System (2021-2026) establishes the need to involve people and their families, as well as the different social agents in the fight against stigma, especially social and health professionals, as well as the media and educational personnel. The aim of this study is to understand the nature of stigma towards people with mental disorders. In order to do so, it is necessary to take into consideration the experiences and experiences of the people themselves in order to develop plans to promote mental health from a participatory and comprehensive perspective. Likewise, it is considered relevant to know the perceptions of future professionals from different areas of knowledge (students of the University of A Coruña), evaluating their attitudes and beliefs regarding mental health. Finally, the aim is to evaluate the impact of incorporating a specific module on mental health and stigmatisation. a specific module on mental health and stigma in the university curriculum of the students of the Occupational Therapy Degree.

This research has the following objectives: (1) find out the perception of people with mental disorders in relation to the social stigma of citizens and Health Science professionals; (2) find out how university students perceive people with mental health problems, and (3) evaluate the impact of incorporating a specific module on mental health and stigma in the university curriculum, specifically in the Bachelor's Degree in Occupational Therapy.

• Study Type: Interventional
• Enrollment (Anticipated): 740
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nereida Canosa Domínguez, Master; Phone Number: 881015967 881015967; Email: nereida.canosa@udc.es
• Study Contact Backup: Name: Betania Groba González, PhD; Phone Number: 5870 881015870; Email: b.groba@udc.es

Study Locations

• Spain
  • A Coruña, Spain, 15071
    • Recruiting
    • Nereida Canosa Domínguez
    • Contact: Nereida Canosa Domínguez; Phone Number: 5906 981 16 70 00; Email: nereida.canosa@udc.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria Group I:

• Be graduated at Occupational Therapy Degree at the University of A Coruña

Exclusion Criteria Group I:

• Have difficulties in understanding and/or communication
• Not being enrolled in the Mental Health module of the Degree in Occupational Therapy

Inclusion Criteria Group II:

• Student in the University of A Coruña

Exclusion Criteria Group II:

• Have difficulties in understanding and/or communication

Inclusion Criteria Group III:

• Have a mental disorder [according to the Diagnostic Manual Diagnostic Manual]
• Be a user of the Psychosocial and Labor Rehabilitation Centers of the Health Area of A Coruña

Exclusion Criteria Group III:

• Have difficulties in understanding and/or communication
• Be in a situation of legal incapacity.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Third year students of the Bachelor's Degree in Occupational Therapy; Third-year students of the Bachelor's Degree in Occupational Therapy will receive training on a specific module on mental health and stigma in the university curriculum.	Other: Mental Health Literacy Programme; Mental Health Literacy Program. This program is part of the training of third-year students of the occupational therapy degree at the University of A Coruña. We will follow a mixed method following a sequential explanatory design. The quantitative part corresponds to a quasi-experimental study, where a comparison will be made between the phase before and after the students take the program. The qualitative part will comprise a phenomenological study to collect the knowledge acquired by the students after taking the program.
No Intervention: Students of University of A Coruña; The students of the University of A Coruña will take part in an online survey to find out the attitudes and beliefs of future professionals from different areas of knowledge regarding mental health.
No Intervention: People with mental health disorder; Users of a Psychosocial and Labor Rehabilitation Centers in the A Coruña Health Care Area will take part in interviews to find out their experiences regarding the attributions made towards them by citizens and health professionals.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes on the measurement of the students of third-year of occupational therapy bachelor's degree attitudes and beliefs toward people with mental disorders	It is composed of 40 items, rated on a 5-point Likert scale, ranging from strongly agree to strongly disagree. The scale comprises 4 factors: authoritarianism, benevolence, social restraint, and mental health ideology in the community. Each factor contains 10 statements concerning opinions about the way people with mental disorder are treated. Five of the 10 items are expressed in the positive and the other 5 are worded in the negative. The score for each subscale results from adding the positive items together with the negative items, which are transformed into positive values, with the total score being the sum of all of them. The higher the score, the greater the agreement. The sum of each factor is analyzed with the mean and standard deviation.	One month pre-intervention and one month post-intervention
Changes on the measurement of stigmatizing attitudes towards people with mental health disorders in students of third-year of occupational therapy bachelor's degree	It is a Likert-type scale with 27 items on the situation posed, grouped into 9 factors: responsibility, pity, anger, dangerousness, fear, help, coercion, segregation and avoidance. I sum the items of each factor, obtaining a minimum of 3 and a maximum of 27.	One month pre-intervention and one month post-intervention
Acquired knowledge in students of third-year of occupational therapy bachelor's degree who participated in the intervention programme	The interview is the most used data collection technique in qualitative studies. In this study, a semi-structured interview will be used because it is flexible and dynamic. It's a beginning interview to know the knowledge acquired by the students.	within 1 month after the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Measurement of the Students of University of A Coruña attitudes and beliefs toward people with mental disorders	It is composed of 40 items, rated on a 5-point Likert scale, ranging from strongly agree to strongly disagree. The scale comprises 4 factors: authoritarianism, benevolence, social restraint and mental health ideology in the community. Each factor contains 10 statements concerning opinions about the way people with mental disorder are treated. Five of the 10 items are expressed in the positive and the other 5 are worded in the negative. The score for each subscale results from adding the positive items together with the negative items, which are transformed into positive values, with the total score being the sum of all of them.	within 1 month after the intervention
Measurement of stigmatizing attitudes towards people with mental health disorders of the Students of University of A Coruña	It is a Likert-type scale with 27 items on the situation posed, grouped into 9 factors: responsibility, pity, anger, dangerousness, fear, help, coercion, segregation and avoidance. I sum the items of each factor, obtaining a minimum of 3 and a maximum of 27.	within 1 month after the intervention
Individual-interviews	The interviews were about the experiences of people with mental disorders in relation to stigma. The following questions composed the interview: the definition of stigma, the influence of society on people with a mental health disorder, experiences about the barriers detected in daily life, and the behavior of the health providers that work with people with a mental health disorder.	within 1 month after the intervention

Collaborators and Investigators

• Sponsor: Nereida Canosa Rodríguez
• Investigators: Principal Investigator: Nereida Canosa Domínguez, Master, Universidade da Coruña

Publications and helpful links

General Publications

• Hankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students. BMJ Case Rep. 2014 Sep 2;2014:bcr2014205226. doi: 10.1136/bcr-2014-205226.
• Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JS, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015 Jan;45(1):11-27. doi: 10.1017/S0033291714000129. Epub 2014 Feb 26.
• Corrigan PW, Mittal D, Reaves CM, Haynes TF, Han X, Morris S, Sullivan G. Mental health stigma and primary health care decisions. Psychiatry Res. 2014 Aug 15;218(1-2):35-8. doi: 10.1016/j.psychres.2014.04.028. Epub 2014 Apr 18.
• Lanfredi M, Macis A, Ferrari C, Rillosi L, Ughi EC, Fanetti A, Younis N, Cadei L, Gallizioli C, Uggeri G, Rossi R. Effects of education and social contact on mental health-related stigma among high-school students. Psychiatry Res. 2019 Nov;281:112581. doi: 10.1016/j.psychres.2019.112581. Epub 2019 Sep 27.
• Mejia-Lancheros C, Lachaud J, O'Campo P, Wiens K, Nisenbaum R, Wang R, Hwang SW, Stergiopoulos V. Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness. PLoS One. 2020 Feb 27;15(2):e0229385. doi: 10.1371/journal.pone.0229385. eCollection 2020.
• Milin R, Kutcher S, Lewis SP, Walker S, Wei Y, Ferrill N, Armstrong MA. Impact of a Mental Health Curriculum on Knowledge and Stigma Among High School Students: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2016 May;55(5):383-391.e1. doi: 10.1016/j.jaac.2016.02.018. Epub 2016 Mar 8.
• Mahmoudi H, Saffari M, Movahedi M, Sanaeinasab H, Rashidi-Jahan H, Pourgholami M, Poorebrahim A, Barshan J, Ghiami M, Khoshmanesh S, Potenza MN, Lin CY, Pakpour AH. A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19. Brain Behav. 2021 May;11(5):e02138. doi: 10.1002/brb3.2138. Epub 2021 Apr 3.
• Adu J, Oudshoorn A, Anderson K, Marshall CA, Stuart H, Stanley M. Policies and Interventions to Reduce Familial Mental Illness Stigma: A Scoping Review of Empirical Literature. Issues Ment Health Nurs. 2021 Dec;42(12):1123-1137. doi: 10.1080/01612840.2021.1936710. Epub 2021 Jul 28.
• Ma HI, Hsieh CE. An Anti-Stigma Course for Occupational Therapy Students in Taiwan: Development and Pilot Testing. Int J Environ Res Public Health. 2020 Aug 3;17(15):5599. doi: 10.3390/ijerph17155599.
• Tomar N, Ghezzi MA, Brinkley-Rubinstein L, Wilson AB, Van Deinse TB, Burgin S, Cuddeback GS. Statewide mental health training for probation officers: improving knowledge and decreasing stigma. Health Justice. 2017 Nov 15;5(1):11. doi: 10.1186/s40352-017-0057-y.

Study record dates

Study Major Dates

• Study Start (Actual): September 5, 2021
• Primary Completion (Anticipated): June 30, 2023
• Study Completion (Anticipated): June 30, 2023

Study Registration Dates

• First Submitted: November 13, 2022
• First Submitted That Met QC Criteria: December 2, 2022
• First Posted (Estimate): December 6, 2022

Study Record Updates

• Last Update Posted (Estimate): December 6, 2022
• Last Update Submitted That Met QC Criteria: December 2, 2022
• Last Verified: December 1, 2022

More Information

Terms related to this study

• Keywords: mental health disorder; stigma; university students; occupational therapy; alphabetisation
• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: 2021/028

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: The IPD sharing plan contains the collection of the variables of the present study.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No