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The stigmatisation of psychiatric illness: the attitudes of medical students and doctors in a London teaching hospital

  • Raja Mukherjee (a1), Antonio Fialho (a1), Aruna Wijetunge (a1), Ken Checinski (a2) and Tammy Surgenor (a3)...
Extract
AIMS AND METHOD

To study the attitudes and opinions of doctors and medical students with regard to psychiatric illness a questionnaire was sent to all medical students (832) and all doctors of all grades (441) at a London teaching hospital.

RESULTS

A total of 520 questionnaires were returned. More than 50% felt that people with schizophrenia and drug and alcohol addiction were dangerous and unpredictable. It was felt by the majority that people were not to blame for their conditions and there were low negative responses towards lack of treatability for a majority of conditions.

CLINICAL IMPLICATIONS

There were more optimistic views with regard to treatment than the general population. There appeared to be a lessening in stigma as experience increased. This would suggest that early improved education and exposure in the future may lead to a greater decline in stigmatised attitudes.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Bhugra, D. (1989) Attitudes towards mental illness; a review of the literature. Acta Psychiatrica Scandinavica, 80, 112.
Cowan, C. & Hart, D. (1998) Changing minds: every family in the land. A new challenge for the future. Psychiatric Bulletin, 22, 593594.
Crisp, A. H. (1999) The stigmatisation of sufferers with mental disorders. British Journal of General Practice, 49, 34.
Crisp, A. H., Gelder, M. G., Rix, S., et al (2000) The stigmatisation of people with mental illness. British Journal of Psychiatry, 177, 47.
Singh, S., Baxter, H., Standen, P., et al (1998) Changing the attitudes of ‘tomorrow's doctors’ towards mental illness and psychiatry: a comparison of two teaching methods. Medical Education, 32, 115–20.
Sivakumar, K., Wilkinson, G., Toone, B. K., et al (1986) Attitudes to psychiatry at the end of their first postgraduate year: two-year follow-up of a cohort of medical students. Psychological Medicine, 16(2), 457460.
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The stigmatisation of psychiatric illness: the attitudes of medical students and doctors in a London teaching hospital

  • Raja Mukherjee (a1), Antonio Fialho (a1), Aruna Wijetunge (a1), Ken Checinski (a2) and Tammy Surgenor (a3)...
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eLetters

Psychiatric stigma among medical teachers

Ravi Jayawardana, Lecturer
28 April 2005

We welcome the article 'The stigmatization of psychiatric illness: the attitudes of medical students and doctors in a London teaching hospital', (1) providing information and stimulating debate on psychiatric stigma among medical professionals and medical students. A similar study was conducted at the Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka to assess the diverse aspects of psychiatric stigma amongst the medical teachers. Medical teachers were defined as all the members of the Faculty academic staff who holds MBBS or an equivalent medical degree, currently involved in teaching medical students. A pre-tested, self-administered questionnaire was distributed among all the medical teachers (192) of the Faculty. A total of 168 questionnaires were returned.

The results were, in many ways could be interpreted as desirable though certain attitudes were notably discriminatory. Not surprisingly allthe respondents were well aware of the fact that psychiatric illness has an aetiological basis. All of them were also familiar with the common treatment strategies deployed in the management of such patients.

77.3%(130/168) and 92.8%(156/168) of the staff indicated that people with psychotic and neurotic illnesses could be employed respectively when they make a complete recovery.But when they were asked whether they would like to work with a person whohas completely recovered from psychiatric illness their willingness plummeted to 42/168(25.0%) and 79/168(47.0%) respectively for psychotic and neurotic illnesses.

Likewise an overwhelming majority of the medical teachers indicated that those who made a complete recovery is fit enough to marry and to reproduce. The figures were 73.8 %( 124/168) for people with psychotic illnesses and 91.0%(153/168) for people with neurotic illnesses.However when they were asked whether they were willing to choose a partnerwho has had a past history of a mental illness, there was a dramatic decline with regard to the interest. The figures were 56/168(33.3%) for psychotic illnesses and 70/168(41.6%) for neurotic illnesses respectively.

Even though the factual knowledge with regard to psychiatric illnesses is comparatively better among the medical teachers, the attitudes towards 'mentally ill' were no way near to be called idealistic. This reflects a profound reality. Knowledge is one of the manyaspects which will facilitate to develop anti-stigmatizing attitudes. The belief that stigma will disappear eventually with the expansion of medicalknowledge is only partially correct. This has been further demonstrated bya study conducted among psychiatrists which revealed that stigmatizing attitudes exists even among psychiatrists(2). There are many other social,cultural, psychological etc. issues as yet unknown and hence they are currently not being addressed.

Successful identification and subsequent manipulation of these anti-stigmatizing elements will no doubt help to improve the overall quality oflife of the people with psychiatric illness. In future we hope that the Royal College will launch a more result oriented Changing Minds campaign whilst making full use of those unaddressed issues.

References1.Raja Mukherjee, Antonio Fialho, Aruna Wijetunge, Ken Checinski, and Tammy Surgenor The stigmatisation of psychiatric illness: the attitudes of medical students and doctors in a London teaching hospitalPsychiatr Bull 2002; 26: 178-1812.David Kingdon, Tonmoy Sharma, Deborah Hart The Schizophrenia Subgroup ofThe Royal College of Psychiatrists' Changing Minds CampaignWhat attitudes do psychiatrists hold towards people with mental illness?Psychiatr. Bull., Nov 2004; 28: 401 - 406.
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