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Impact of work experience placements on school students' attitude towards mental illness

  • Vanathi Kennedy (a1) and Ravindra B. Belgamwar (a2)
Abstract
Aims and method

Research shows that 16- to 19-year-olds express the greatest level of negative attitudes towards people with mental illness. Our aim was to assess the effectiveness of work experience placements in influencing secondary-school students' attitudes towards mental illness and career choices. The Adolescent Attitude Towards Mental Illness questionnaire measured and assessed the adolescents' attitude changes. Pre- and post-evaluation questionnaires assessed changes in their career choices.

Results

There was a statistically significant change in the adolescents' attitudes, especially regarding categorical thinking and perceptions that people with mental illness are violent and out of control. There was also a positive shift in their career choices towards options in the field of mental health.

Clinical implications

Work experience placements can have a positive impact on secondary-school students' attitudes towards mental illness and may improve the level of student recruitment into the field of psychiatry.

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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.
Corresponding author
Vanathi Kennedy (vanathikennedy@gmail.com)
Footnotes
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Declaration of interest

None.

Footnotes
References
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Impact of work experience placements on school students' attitude towards mental illness

  • Vanathi Kennedy (a1) and Ravindra B. Belgamwar (a2)
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eLetters

The contact hypothesis - an answer to a recruitment crisis?

Helen M Henfrey, FY2 Doctor
05 October 2014

I thank Kennedy & Belgamwar for their very interesting and thought provoking article. Their research provides clear evidence as to the benefits of the 'contact hypothesis' to reduce stigma towards people with mental illness. I am particularly interested, however, in the potential significance of this in terms of increasing recruitment from foundation training.

The UK foundation training scheme states that "rotating through different specialties provides a foundation doctor with a broad-based beginning to their training" (1). In 2012, 7613 Foundation Year (FY)1 and 7701 FY2 doctors passed through the foundation training scheme, 67% of FY2 doctors going onto join specialty training schemes in the UK at the end of their FY2 year. In all, 4% of FY1 doctors and 12% of FY2 doctors undertook ajob in psychiatry. This is in comparison with 82% of FY1s having jobs ingeneral surgery and 44% of FY2s having a job in general practice. Foundation doctors are also given time to undertake 'tasters' in differentspecialties. In 2012 3% of FY1 taster days and 6% of FY2 taster days were taken in psychiatry. In comparison 23% of FY1 and 23% of FY2 tasters were taken in medical specialties (1).

Relating this to the data from Kennedy & Belgamwar, more must be done to increase the number of jobs and tasters in psychiatry to allow the 'contact hypothesis' to be tested. This is echoed by the RCPsych five-yearstrategy to increase the number of foundation posts and taster days, in addition to their support of 'broad-based' training, which includes time spent in psychiatry (2). In conclusion, the evidence presented by Kennedy & Belgamwar supports the RCPsych five-year plan, yet time will tell whether this has a noticeable effect on recruitment to the specialty.

References:

1. Foundation Programme Annual Report 2012. [Accessed online 03/09/14 - www.foundationprogramme.nhs.uk/].

2. Brown, T. Recruitment Strategy 2011-2016. Royal College Psychiatrists 2012. [Accessed online 03/09/14 - http://www.rcpsych.ac.uk/pdf/Recruitment%20Strategy%20-%2010092013.pdf]

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Conflict of interest: None declared

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More support from mental health trusts needed to enable exposure for students to psychiatry

Elizabeth Ewins, Clinical Teaching Fellow
22 September 2014

The article by Kennedy and Belgamwar (1) nicely illustrates the importance of work experience in psychiatry for school students. Unfortunately, this can be difficult to arrange in mental health trusts despite recent guidance by the Royal College of Psychiatrists (2).

Avon and Wiltshire Mental Health Partnership Trust (AWP) Medical Education department and Bristol University recently joined forces to provide a week-long Summer School event for local sixth-formers. This programme included 2 days of work experience with Consultant Psychiatristsand their teams as well as half a day with local GPs. This followed extensive work by AWP to change their work experience policy to allow 17 year olds to participate.

Our event consisted of taught sessions, similar to the programme detailed by Kennedy and Belgamwar, to help the sixth-formers explore what it might be like to be a medical student and doctor, as well as a session entitled 'What is mental health?'. Our aim was to additionally support sixth-formers in their application to medical school and so we also provided sessions for personal statement advice and interview practice. Weheld an evening social event with an opportunity for parents and guardiansto attend a question and answer session whilst students watched and discussed a film related to psychiatry. A Summer School competition was held encouraging students to write a reflective piece on their experiencesof the week, for which the students produced some excellent and thoughtfulpieces of work. All students were allocated a mentor, either a medical student or trainee in psychiatry, to provide support before, during, and following the event.

Feedback from students, parents and teachers has been very positive following our event, with students particularly valuing work experience, personal statement advice, interview practice sessions, and being allocated a mentor. It was fantastic to hear the students talking about their positive experiences of psychiatry during mock interview practice sessions. Encouragingly, 67% of our students said that they would considera career in psychiatry (strongly agree or agree) following the event.

Kennedy and Belgamwar's piece gives some excellent ideas for work experience programmes for school students, and I hope that more work experience and Summer School programmes such as ours can be developed across the country, with the success and positive outcomes shown encouraging mental health trusts to lower their age limits for work experience to enable this.

References: 1. Kennedy V, Belgamwar R. Impact of work experience placements on school students' attitude towards mental illness. Psychiatr Bull 2014; 38:159-163.

2. Royal College of Psychiatry. College Position Statement on Work Experience in Psychiatry. Royal College of Psychiatry, 2012.

(http://www.rcpsych.ac.uk/pdf/Position%20Statement%20on%20Work%20Experience20in%20Psychiatry2012.pdf).

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Conflict of interest: None declared

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Volunteering in sixth form with people with mental health problems

Maria C Lobo, Final Year Medical Student
22 September 2014

At sixth form we were required to do some kind of volunteering in the community. I knew I wanted to do something medically related, but my options were running out. The elderly lady I was meant to visit as a 'befriender' moved house; the gentleman I was meant to take out in his wheelchair bought an electric one. Halfheartedly, I signed up to help run a social club for people with mental health problems.

Every week I would meet twenty men and women who came to the community hall to drink tea and play board games. I was terrified to startwith. Everyone seemed unpredictable and I didn't understand why they were acting strangely. I thought it was safest to stay in the corner, out of the way. Gradually, I started to get to know the members, and realised that joining in with the chatting and board games was a lot less boring than sitting in the corner.

Over the two years I volunteered there, I began to really look forward to Thursday evenings. Once I'd spoken to someone a few times, theydidn't seem strange anymore- everyone was just an individual and any quirks were part of them too. It was touching to see how members would look out for each other. When my friends joked about the crazy people I was spending time with, I would try to explain that they weren't so different really.

I would agree with the authors that education is important for lessening the stigma of mental illness as I feel much more confident beingaround psychiatric patients as a medical student. I strongly feel that knowing what symptoms a patient may have allows a much better understanding of their behaviour, and means that you can be more sympathetic to what they are going through. I would also stress that efforts are made to ensure that students (on school or medical school placements) feel supported, as the world of mental health can be quite intimidating initially. I had a difficult encounter with a member of the club making racist comments, and would probably have never brought this upwith the team unless we had time specifically set aside every month to talk about our concerns with a psychiatric nurse.

Looking back on my time at the social club, I can see there are many lessons I learned without realising it. I know that volunteering gave me abig head start for my psychiatry placement at medical school. Some of my peers found the first few days difficult and wanted to leave the ward because they did not feel comfortable, while I'd already been through feeling like this. As a medical student, the patients that I saw fitted into neat diagnostic boxes in my memory. I hope that in the future I will try to see patients more as I did when I was a volunteer- as individuals, not just diagnoses.
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Conflict of interest: None Declared

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Work experience placements in psychiatry for school students

Ann Maria Albert, 4th year medical student
22 September 2014

We congratulate Kennedy and Belgamwar (1) for adding to the evidence base for the beneficial effects of Work Experience Placements (WEPs) for school students on stigma and recruitment, the two major problems facing psychiatry.

We searched the websites of all 54 Mental Health Trusts (MHTs) in England and Wales for information regarding WEPs in clinical settings for 16-18 year olds. Only 11 out of the 54 MHT websites mentioned WEPs. Of them two confirmed that WEP was not available and one offered WEPs only innon-clinical areas. We then contacted all the 54 MHTs under the Freedom of Information Act and inquired whether they offered WEPs in clinical settings to 16-18 year olds. The National Research Ethics Service confirmed that this study does not need ethical approval. 25 of the 54 MHTs either did not respond to our inquiry or did not offer WEPs. Amongst the 29 MHTs that offer WEPs 9 offer WEPs only in non-clinical areas. Responses of 12 MHTs were ambiguous e.g. they would offer WEPs on an ad hoc basis, on a limited basis, possibly non-frontline, in low risk areas etc. Only 8 MHTs offer WEPs in clinical areas for sixth form students aged 16-18 years.

Our findings suggest that the WEP, the key initiative to solve the twinproblems of stigma and recruitment is not working. Sixth formers often struggle to get WEPs in psychiatry. Most MHTs websites often offer littleor no information on WEPs. On the other hand many mental health professionals state that they are keen to offer WEPs, but have no guidance. The few students who manage to get WEPs in psychiatry do so because 'they know someone who knows someone'. Many consultants offer informal WEPs on their own initiative andat their own risk because their employer MHTs do not have the relevant policies.

We urge the College to develop a 'Policy template for MHTs for WEPs for school students', and to support MHTs to improve access to clinical WEPs and ensure that information is readily available online.

References:

1.Kennedy V, Belgamwar, RB. Impact of work experience placements on school students' attitude towards mental illness. Psychiatr Bull 2014; 38:159 - 163.

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Conflict of interest: None declared

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