Reducing Mental Illness Stigma through Unconscious Bias-Informed Education

Abstract

Mental illness stigma can have disastrous consequences for patients, families and healthcare organizations. Unconscious bias informed education seeks a systematic approach to addressing implicit biases in healthcare providers by promoting awareness and understanding in order to promote compassion and empathy. After a 1 hour intervention, third year medical students who were enrolled in the third year psychiatry clerkship rotation completed a demographic form, (pre/post) a shortened mental illness implicit association test (IAT) and the Brief Mental Illness Attitudes Scale (BMIAS). For the IAT, the majority (51.4%) of participants demonstrated a bias that mental illness was associated with dangerousness. A paired samples t test of BMIAS scores found no significant change in pre and post scores on Responsibility subscale. There was a statistically significant improvement in the in the Traits subscale from pre (n=87, m=5.15, sd=0.87) and post (n=87, m=5.62, sd=0.71), t(86)=5.16 p<0.001. Our brief seminar had a statistically significant impact on student attitudes towards patients with traits of individuals with psychiatric illness. These findings indicate that mental illness stigma is an important issue in medical education and that unconscious bias-informed education may provide an effective method to reduce stigma.

An Anti-Stigma Course for Occupational Therapy Students in Taiwan: Development and Pilot Testing

“…These findings suggest that, although a strong stigmatising attitude may at first appear negative and harsh, it may actually indicate amenability. It is therefore necessary to understand that mere protest against stigma can have adverse effects, including rebound behaviours that result in increased bias [ 19 , 20 ]. It is thus important to provide a safe and non-threatening environment so that students can share their experiences and thoughts without being criticised.…”

“…Given this provision, students are likely to become critically aware of implicit and explicit stigma in society. This enables them to reformulate their assumptions in order to adopt more inclusive and integrative perspectives, which ultimately leads to corrective action based on better understanding [ 19 , 20 ].…”

Mental illness-related stigma in healthcare

“…Another issue is a lack of awareness and unconscious biases, which acknowledge the power of hidden beliefs and attitudes that can underlie stigma-related behaviour. 14 , 25 – 28 Qualitative research has found that for many healthcare providers, it is only through the experience of receiving anti-stigma training that they become aware of the subtle and unintended ways certain beliefs and behaviours may have been contributing to stigmatizing experiences among their patients (Knaak et al 14 see also Sukhera et al 25 and Horsfall et al 28 )…”

Functional linguistics: the lens and the looking glass

“…11 Medical learning environments are plagued by numerous biases, including mental health stigma, racism and gender discrimination. [12][13][14][15] Osseo-Asare and colleagues found that minority residents face 'a daily barrage of microagressions and bias' in their educational environments. 13 Meyerson et al showed that even when controlling for level of training and procedural difficulty, female residents still receive less operative autonomy than their male counterparts.…”

“…Implicit bias in medical education is pervasive and under‐explored . Medical learning environments are plagued by numerous biases, including mental health stigma, racism and gender discrimination . Osseo‐Asare and colleagues found that minority residents face ‘a daily barrage of microagressions and bias’ in their educational environments .…”