Somatic health care professionals’ stigmatization of patients with mental disorder: a scoping review

Abstract

Background Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals’ stigmatization toward patients with mental disorders. Methods We conducted a scoping review using Arksey and O’Malley’s framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May-June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008–2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. Results A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. Conclusions The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.

‘What's she doing here?’ Overcoming barriers to the implementation of Expert by Experience positions in academia

“…Notably, nursing students were more likely to agree that they would not admit to having a mental health diagnosis to their friends than other students and were almost as likely as medical students to agree they would not admit it to their work colleagues (Masedo et al, 2021). These stigmatising attitudes, if not addressed, are likely to remain when students graduate and enter the health workforce (Riffel & Chen, 2020; Sølvhøj et al, 2021). Given stigmatising attitudes impact the quality of care provided (Sølvhøj et al, 2021), universities have a moral imperative to take necessary action to address them.…”

“…These stigmatising attitudes, if not addressed, are likely to remain when students graduate and enter the health workforce (Riffel & Chen, 2020; Sølvhøj et al, 2021). Given stigmatising attitudes impact the quality of care provided (Sølvhøj et al, 2021), universities have a moral imperative to take necessary action to address them. Furthermore, due to the accreditation requirements for EBE involvement for some health professions, universities are responsible for ensuring curricula meets these requirements.…”

Accompagnement des soins ­somatiques des adultes avec un diagnostic psychiatrique connu

“…Les patient•e•s atteint•e•s de maladies psychiatriques perdent en moyenne 15-20 ans de vie, en raison de troubles somatiques, par rapport à la population générale [1]. La littérature indique que les stigmates qui entourent ces maladies entraînent des comportements différents chez les professionnel•le•s de santé somatique vis-à-vis des patient•e•s avec un diagnostic psychiatrique [2,3]. Ceci résulte en des disparités dans les soins somatiques, entraînant un sentiment de négligence ainsi qu'une morbidité et une mortalité accrues de causes somatiques chez ces patient•e•s [2][3][4].…”

“…La littérature indique que les stigmates qui entourent ces maladies entraînent des comportements différents chez les professionnel•le•s de santé somatique vis-à-vis des patient•e•s avec un diagnostic psychiatrique [2,3]. Ceci résulte en des disparités dans les soins somatiques, entraînant un sentiment de négligence ainsi qu'une morbidité et une mortalité accrues de causes somatiques chez ces patient•e•s [2][3][4]. La présence de cette discrimination est établie comme un défi mondial dans la littérature [2].…”

“…Ceci résulte en des disparités dans les soins somatiques, entraînant un sentiment de négligence ainsi qu'une morbidité et une mortalité accrues de causes somatiques chez ces patient•e•s [2][3][4]. La présence de cette discrimination est établie comme un défi mondial dans la littérature [2]. Cependant, il y a peu de documentation concernant le développement de programmes visant à réduire la stigmatisation dans les milieux de santé [5].…”