Instruments to assess mental health‐related stigma among health professionals and students in health sciences: A systematic psychometric review

Sastre-Rus, Meritxell; García-Lorenzo, Alejandro; Lluch‐Canut, Teresa; Tomás–Sábado, Joaquín; Zabaleta‐del‐Olmo, Edurne

doi:10.1111/jan.13960

Cited by 27 publications

(28 citation statements)

References 51 publications

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“…Neither the ATP-30 nor the AMI were included in a recent systematic review of the psychometric properties of instruments to assess stigma related to mental illness among professionals and students in the health sciences. 46 That study found the Opening Minds Scale for Health Care Providers (OMS-HC) 47 to be the most widely used instrument across published studies. Importantly, we did not include a metric for self-stigma and help-seeking behaviors and intervening barriers, such as the validated Self-Stigma of Seeking Help (SSOSH) questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

Martin

Chilton

Gothelf

et al. 2020

Journal of Medical Education and Curricular Development

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Introduction: Depression and suicidal ideation are common among medical students, a group at higher risk for suicide completion than their age-normed peers. Medical students have health-seeking behaviors that are not commensurate with their mental health needs, a discrepancy likely related to stigma and to limited role-modeling provided by physicians. Methods: We surveyed second-year medical students using the Attitudes to Psychiatry (ATP-30) and Attitudes to Mental Illness (AMI) instruments. In addition, we asked questions about role-modeling and help-seeking attitudes at baseline. We then conducted a randomized trial of an intervention consisting of 2 components: (a) a panel of 2 physicians with personal histories of mental illness speaking about their diagnosis, treatment, and recovery to the students, immediately followed by (b) small-group facilitated discussions. We repeated the ATP-30 and AMI after the active/early group was exposed to the panel, but before the control/late group was similarly exposed. Results: Forty-three medical students participated (53% women). The majority of students (91%) agreed that knowing physicians further along in their careers who struggled with mental health issues, got treatment, and were now doing well would make them more likely to access care if they needed it. Students in the active group (n = 22) had more favorable attitudes on ATP-30 ( P = .01) and AMI ( P = .02) scores, as compared with the control group (n = 21). Conclusion: Medical students can benefit from the availability of, and exposure to physicians with self-disclosed histories of having overcome mental illnesses. Such exposures can favorably improve stigmatized views about psychiatry, or of patients or colleagues affected by psychopathology. This intervention has the potential to enhance medical students’ mental health and their health-seeking behaviors.

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Section: Discussionmentioning

confidence: 99%

Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

Martin

Chilton

Gothelf

et al. 2020

Journal of Medical Education and Curricular Development

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“… 24 – 26 For this study we used the OMS-HC as outcome measure, rather than the similarly well-validated Attitudes to Psychiatry (ATP-30) 27 and Attitudes to Mental Illness (AMI) 28 we had relied on for our previous study. Our rationale was twofold: first, the OMS-HC captures not just attitudes and their degree of stigmatization, but also the key constructs of social distance and disclosure/help-seeking; second, the OMS-HC is broadly used, 17 efficient, and short (15 total items, compared to 30 for the ATP and 20 for the AMI).…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of the psychometric properties of instruments to assess mental health-related stigma among health professionals and students in the health sciences found the OMS-HC to be the most widely used instrument across published studies. 17 …”

Section: Methodsmentioning

confidence: 99%

Shared Living Experiences by Physicians have a Positive Impact on Mental Health Attitudes and Stigma among Medical Students: A Mixed-Methods Study

Martin

Chilton

Paasche

et al. 2020

Journal of Medical Education and Curricular Development

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Introduction: Medical culture can make trainees feel like there is neither room for mistakes, nor space for personal shortcomings in the makeup of physicians. A dearth of role models who can exemplify that it is acceptable to need support compounds barriers to help-seeking once students struggle. We conducted a mixed-methods study to assess the impact of physicians sharing their living experiences with medical students. Methods: Second-year medical students participated, through synchronized videoconferencing, in an intervention consisting of 3 physicians who shared personal histories of vulnerability (e.g. failure on high-stakes exams; immigration and acculturation stress; and personal psychopathology, including treatment and recovery), followed by facilitated, small-group discussions. For the quantitative component, students completed the Opening Minds to Stigma Scale for Health Care Providers (OMS-HC) before and after the intervention. For the qualitative component, we conducted focus groups to explore the study intervention. We analyzed anonymized transcripts using thematic analysis aided by NVivo software. Results: We invited all students in the class (n = 61, 46% women) to participate in the research component. Among the 53 participants (87% of the class), OMS-HC scores improved after the intervention ( P = .002), driven by the Attitudes ( P = .003) and Disclosure ( P < .001) subscales. We conducted 4 focus groups, each with a median of 6 participants (range, 5-7). We identified, through iterative thematic analysis of focus group transcripts, active components before, during, and after the intervention, with unexpected vulnerability and unarmored mutuality as particularly salient. Conclusions: Sharing histories of personal vulnerability by senior physicians can lessen stigmatized views of mental health and normalize help-seeking among medical students. Synchronous videoconferencing proved to be an effective delivery mechanism for the intervention in a ‘virtual wellness’ format. Candid sharing by physicians has the potential to enhance students’ ability to recognize, address, and seek help for their own mental health needs.

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“…Each item of this scale has scores ranging from 1 to 5, and the full 15-item OMS-HC score can range from 15 (least stigmatizing) to 75 (most stigmatizing) [4]. A recent systematic review of all available instruments that assess mental health related stigma among health care professionals concluded there is no “gold standard” tool; however, the 15-item OMS-HC was identified as the strongest available tool supported by evidence [67]. However, another recent multi-center study published online which investigated the validity of this scale, utilizing Rasch modeling, with undergraduate nursing students did not support its use as a global estimate of stigma [68].…”

Section: Methodsmentioning

confidence: 99%

Association between attitudes of stigma toward mental illness and attitudes toward adoption of evidence-based practice within health care providers in Bahrain

et al. 2019

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The health care system is one of the key areas where people with mental illnesses could experience stigma. Clinicians can hold stigma attitudes during their interactions with patients with mental illness. To improve the quality of mental health services and primary care, evidence-based practices should be disseminated and implemented. In this study, we evaluated the attitudes of health care providers in Bahrain toward people with mental illness and adoption of evidence-based practice using the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) and Evidence-Based Practice Attitude Scale (EBPAS). We conducted a cross-sectional study across 12 primary health care centers and a psychiatric hospital (the country’s main mental health care facility). A self-report questionnaire was distributed among all health care providers. A total of 547 health care providers participated, with 274 from mental health services and 273 from primary care services. Results of the OMS-HC indicated differences between both main groups and subgroups. Regression model analysis reported significant outcomes. There was no statistical difference found between both groups in EBPAS scores. A weak but statistically significant negative association was reported between both scales. Participants showed varying stigma attitudes across different working environments, with less stigma shown in mental health services than in primary care services. Providers who were more open to adopting evidence-based practices showed less stigma toward people with mental illness. Comparing our findings with previous research showed that health care providers in Bahrain hold more stigma attitudes than other groups studied. We hope that this study serves as an initial step toward future campaigns against the stigma of mental illness in Bahrain and across the region.

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Instruments to assess mental health‐related stigma among health professionals and students in health sciences: A systematic psychometric review

Cited by 27 publications

References 51 publications

Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

Shared Living Experiences by Physicians have a Positive Impact on Mental Health Attitudes and Stigma among Medical Students: A Mixed-Methods Study

Association between attitudes of stigma toward mental illness and attitudes toward adoption of evidence-based practice within health care providers in Bahrain

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