Assessment of pharmacy student attitudes and beliefs toward patients with mental illnesses on inpatient psychiatric units

Abstract

Introduction People with mental illness continue to face stigma, despite these illnesses being common. Previous studies have demonstrated reduced stigma in pharmacy students after various exposures and education, although results have been mixed. The primary objective of this study was to evaluate the effects of an advanced pharmacy practice experience (APPE) in psychiatric pharmacy on students' stigma toward patients with mental illness using the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) at 2 psychiatric hospitals. Methods This was a prospective, multicenter survey study of pharmacy students on an APPE rotation at an inpatient psychiatric hospital conducted during 3 academic years. Prior to starting and upon completion of their rotation, participants completed the OMS-HC and provided demographic and rotation information. Results A total of 26 students participated in the prerotation survey, with 88.5% (n = 23) completing the postrotation survey. The primary outcome showed a significant decrease in total OMS-HC score (Z = −2.376, P = .017), indicating a decreased level of stigma at rotation completion. Analysis of the OMS-HC subscales for attitudes toward people with mental illness and attitudes toward self-disclosure of a mental illness also yielded significant decreases (Z = −2.425, P = .015; Z = −2.462, P = .014, respectively). Discussion This study showed that APPE rotations at inpatient psychiatric hospitals may help reduce stigma among pharmacy students. Pharmacy schools should consider increasing access to and encouraging completion of psychiatric pharmacy rotations to help reduce stigma prior to graduation.

Opinions and experiences on the provision of care to people with mental illnesses: a qualitative study with Doctor of Pharmacy graduates after a rotation in psychiatry

“…Similar findings in relation to social stigma has also been reported by pharmacy students in Canada [ 30 ]. Nevertheless, the fact that PharmD graduates in our study recognized and rejected these stigma sources after completing the rotation, including their own internal and implicit biases, is a promising finding and aligns well with the results of other studies which suggest that completion of an inpatient psychiatric APPE decreased stigma among pharmacy students [ 12 ]. Focused stigma-related discussions in rotations may further prepare future pharmacists for pharmaceutical care provision to people with mental illnesses.…”

“…Participants in this study described their PharmD psychiatric-rotation experience as unique, eye opening, and insightful. Observations of the unique presence of interdisciplinary collaboration and holistic pharmaceutical care provision to patients in mental health rotations was also highlighted in other studies and are considered to be an important factor for strengthening pharmacy students’ confidence [ 12 ]. Another unexpected experience that emerged from the interviews was about the use of ECT in mental health practice.…”

“…This study also contributes to the body of literature in regards to stigma surrounding mental health practice among pharmacy graduates. Overall, studies have shown mixed results, with some finding a strong positive effect of psychiatric rotations in reducing pharmacy students’ stigmatizing attitudes towards the provision of care to people with mental illnesses, while others reported an opposite or no significant results [ 11 , 12 , 26 – 28 ]. When discussing their views on mental health stigma, participants in our study recalled their feelings of apprehension, and even fear, before starting the APPE rotation in psychiatry.…”

“…While the authors deemed the rotation to have caused no major change on students’ social distance from patients with mental illness, they reported an overall improvement in the students’ attitudes towards schizophrenia, suicide prevention, and pharmaceutical care provision in this population [ 11 ]. More recently, similar studies conducted in the USA and Nigeria showed mixed findings on the benefits of mental health rotations on the students’ attitudes towards people with mental illnesses [ 12 , 13 ]. However, there is limited qualitative research on PharmD graduates’ opinions and perceived preparedness for the provision of pharmaceutical care to this population after completing a clinical rotation in psychiatry.…”