Stigma About Mental Illness Among Multidisciplinary Health Care Providers in the Dominican Republic

Abstract

Few studies have examined the attitudes of multidisciplinary health care providers toward mental illness, particularly in Latin America. The present study explored the attitudes of health care providers in the Dominican Republic (DR) toward persons with mental illness. Five Spanish-language focus groups were conducted in different regions of the DR with a purposive sample of 37 multidisciplinary health care providers and administrators. We found that among Dominican health care professionals mental illness was primarily defined as schizophrenia. Stigma was pervasive, but differed based on level of experience with persons with mental illness. People with mental illness were perceived as out of control and unable to conform to societal norms, resulting in fear and a lack of empathy among care providers. General practitioners felt unprepared to manage mental illness and unsupported by families and communities that also held stigmatizing attitudes. Providers considered government investment in mental health services imperative to improve access to treatment. Currently there are few options for intervention or rehabilitation for persons with severe mental illness. Strategies to reduce stigma among nonmental health care providers include governmental prioritization of mental health care, as well as formal training and clinical exposure to persons with mental illness in recovery.

Factors associated with visits to general practitioners in patients with schizophrenia in Malaga

“…However communication between PCC and CMHCs was negatively associated with number of GP visits. This may be because good communication between the team resulted in community mental health professionals assuming some of the functions that would otherwise have been performed by the GP, such as monitoring physical health problems, and this could be because GPs feel unprepared and with low confidence in treating patients with severe mental health problems [ 22 , 23 ], even if it is about their physical health problems. In the CMHU of the Regional Hospital in Malaga specialist mental health care has been coordinated with primary care for more than 20 years.…”

Perceptions about mental illness among general practitioners

“…A recent systematic review concluded that older general practitioners (GPs) had a more negative attitude to patients with schizophrenia [10]. It has been shown that GPs’ stigmatisation of patients with mental illness depends on their level of experience of such patients, so that the more experience they have, the less stigmatisation they exhibit [11]. Comparisons of the attitudes of different categories of health professional have shown that GPs stigmatise mental illness more than psychiatrists do [12–14].…”

“…A recent study carried out in the United States showed that GPs faced significant barriers to providing good care to patients with mental illness: lack of time and resources and lack of confidence [11, 17].…”

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

“…This perception could influence their decisions in daily practice [17], which can be detected by patients [18]. In addition, feeling unprepared, having low confidence, and a lack of resources to manage mental illness from GPs [19,20] could encourage GPs to transfer these patients to specialised care [21]. Both factors could explain the low contact of patients with SRDs with primary care services [16,21,22].…”