Knowledge, attitude and behaviors towards patients with mental illness: Results from a national Lebanese study
Autoři:
Carla Abi Doumit aff001; Chadia Haddad aff002; Hala Sacre aff003; Pascale Salameh aff004; Marwan Akel aff004; Sahar Obeid aff002; Maria Akiki aff001; Elie Mattar aff001; Najla Hilal aff001; Souheil Hallit aff001; Michel Soufia aff001
Působiště autorů:
Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
aff001; Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
aff002; Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
aff003; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
aff004; Faculty of Medicine, Lebanese University, Beirut, Lebanon
aff005; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
aff006; School of Pharmacy, Lebanese International University, Beirut, Lebanon
aff007; Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
aff008; Faculty of Pedagogy, Lebanese University, Beirut, Lebanon
aff009
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222172
Souhrn
Objectives
Patients with mental health disorders often have to endure the burdens of the condition itself and the stigma that follows. Since no study has been conducted in Lebanon on this topic, our objective was to assess the knowledge, attitude and behaviors towards public stigma of mental health diseases, among a sample of the Lebanese population.
Methods
A cross-sectional study, conducted between November 2017 and May 2018, enrolled 2289 participants. The Mental Health Knowledge Schedule (MAKS), the Community Attitudes toward Mental Illness (CAMI) and the Reported and Intended Behavior Scale (RIBS) were used to assess knowledge, attitude and behaviors toward mental illness respectively. The 25th, 50th and 75th percentile of the MAKS, CAMI and RIBS scales scores were considered as cutoff points for low, medium and high scores respectively.
Results
A high knowledge score was found in 33.0% of the participants, whereas a high attitude score and a higher behavior score were found in 32.2% and 26.9% of the participants respectively. Living in North Lebanon (Beta = 1.331) and being familiar with a non-close person with mental illness (Beta = 0.811) were associated with higher knowledge of mental illness (higher MAKS score), whereas living in Bekaa (Beta = -8.693) and being 70 years old and above (Beta = -5.060) were associated with lower knowledge toward mental illness (lower MAKS score). Higher knowledge of mental illness (higher MAKS score) (Beta = 0.670), having a high level of education (university (Beta = 8.785), secondary (Beta = 6.084) and technical (Beta = 5.677)) were associated with less stigmatizing attitudes (higher CAMI scale). Being familiar with close people with mental illness (Beta = 0.577), less stigmatizing attitudes (higher CAMI scale) (Beta = 0.077) and higher knowledge of mental illness (higher MAKS score) (Beta = 0.115) were associated with higher favorable behaviors (higher RIBS score), whereas knowing a non-close person who have a mental illness (Beta = -0.720) was associated with lower favorable behaviors (lower RIBS score).
Conclusion
A mass media awareness campaigns that could transmit health messages to a wide public audience in the country to fight stigma toward mental illness, seems warranted.
Klíčová slova:
Biology and life sciences – Physical sciences – Research and analysis methods – Psychology – Social sciences – Sociology – People and places – Population groupings – Mathematics – Geographical locations – Medicine and health sciences – Statistics – Mathematical and statistical techniques – Statistical methods – Behavior – Mental health and psychiatry – Emotions – Asia – Ethnicities – Regression analysis – Linear regression analysis – Fear – Psychometrics – Social discrimination – Lebanon – Arabic people
Zdroje
1. Definitions of Stigma and Discrimination. Disability Rights California. Available from: https://www.disabilityrightsca.org/system/files/file-attachments/CM0401.pdf.
2. Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World psychiatry. 2002;1(1):16. 16946807
3. Corrigan PW, Shapiro JR. Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review. 2010;30(8):907–22. doi: 10.1016/j.cpr.2010.06.004 20674114
4. Henderson C, Thornicroft G. Stigma and discrimination in mental illness: Time to Change. The Lancet. 2009;373(9679):1928–30.
5. Vaughan G, Hansen C. ‘Like Minds, Like Mine’: a New Zealand project to counter the stigma and discrimination associated with mental illness. Australasian Psychiatry. 2004;12(2):113–7. doi: 10.1080/j.1039-8562.2004.02083.x 15715752
6. Bratbo J, Vedelsby AK. ONE OF US: The national campaign for anti-stigma in Denmark. The Stigma of Mental Illness-End of the Story?: Springer; 2017. p. 317–38.
7. Stuart H, Chen S-P, Christie R, Dobson K, Kirsh B, Knaak S, et al. Opening minds in Canada: background and rationale. The Canadian Journal of Psychiatry. 2014;59(1_suppl):8–12.
8. Drake RE, Bond GR, Essock SM. Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin. 2009;35(4):704–13. doi: 10.1093/schbul/sbp041 19491315
9. Wei Y, McGrath PJ, Hayden J, Kutcher S. Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC psychiatry. 2015;15(1):291.
10. Henderson C, Robinson E, Evans‐Lacko S, Corker E, Rebollo‐Mesa I, Rose D, et al. Public knowledge, attitudes, social distance and reported contact regarding people with mental illness 2009–2015. Acta Psychiatrica Scandinavica. 2016;134:23–33. doi: 10.1111/acps.12607 27426643
11. Hansson L, Stjernswärd S, Svensson B. Changes in attitudes, intended behaviour, and mental health literacy in the Swedish population 2009–2014: an evaluation of a national antistigma programme. Acta Psychiatrica Scandinavica. 2016;134:71–9. doi: 10.1111/acps.12609 27426648
12. Angermeyer MC, Holzinger A, Carta MG, Schomerus G. Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. The British Journal of Psychiatry. 2011;199(5):367–72. doi: 10.1192/bjp.bp.110.085563 22045945
13. Parra F. Social tolerance of the mentally ill in the Mexican American community. International Journal of Social Psychiatry. 1985;31(1):37–45. doi: 10.1177/002076408503100104 3972491
14. Brockington IF, Hall P, Levings J, Murphy C. The community's tolerance of the mentally ill. The British Journal of Psychiatry. 1993;162(1):93–9.
15. Kobau R, Zack MM, Barile JP, Marshall C, Bornemann T, Otey EM, et al. Attitudes toward mental illness: Results from the behavioral risk factor surveillance system. 2012.
16. Vezzoli R, Archiati L, Buizza C, Pasqualetti P, Rossi G, Pioli R. Attitude towards psychiatric patients: a pilot study in a northern Italian town. European Psychiatry. 2001;16(8):451–8. 11777735
17. Phelan JC, Link BG. Fear of people with mental illnesses: The role of personal and impersonal contact and exposure to threat or harm. Journal of Health and Social Behavior. 2004;45(1):68–80. doi: 10.1177/002214650404500105 15179908
18. Lauber C, Nordt C, Falcato L, Rössler W. Factors influencing social distance toward people with mental illness. Community mental health journal. 2004;40(3):265–74. 15259631
19. Hackler AH. Contact and stigma toward mental illness: Measuring the effectiveness of two video interventions. 2011.
20. Stuber JP, Rocha A, Christian A, Link BG. Conceptions of mental illness: Attitudes of mental health professionals and the general public. Psychiatric services. 2014;65(4):490–7. doi: 10.1176/appi.ps.201300136 24430508
21. Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatrica Scandinavica. 2006;113(3):163–79. doi: 10.1111/j.1600-0447.2005.00699.x 16466402
22. Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. Public conceptions of mental illness: labels, causes, dangerousness, and social distance. American journal of public health. 1999;89(9):1328–33. doi: 10.2105/ajph.89.9.1328 10474548
23. Martin JK, Pescosolido BA, Tuch SA. Of fear and loathing: The role of'disturbing behavior,'labels, and causal attributions in shaping public attitudes toward people with mental illness. Journal of health and social behavior. 2000:208–23.
24. Perry BL, Pescosolido BA, Martin JK, McLeod JD, Jensen PS. Comparison of public attributions, attitudes, and stigma in regard to depression among children and adults. Psychiatric Services. 2007;58(5):632–5. doi: 10.1176/ps.2007.58.5.632 17463343
25. Walker JS, Coleman D, Lee J, Squire PN, Friesen BJ. Children's stigmatization of childhood depression and ADHD: magnitude and demographic variation in a national sample. Journal of the American Academy of Child & Adolescent Psychiatry. 2008;47(8):912–20.
26. Seeman N, Tang S, Brown AD, Ing A. World survey of mental illness stigma. Journal of affective disorders. 2016;190:115–21. doi: 10.1016/j.jad.2015.10.011 26496017
27. Al-Krenawi A. Mental health practice in Arab countries. Current Opinion in Psychiatry. 2005;18(5):560–4. doi: 10.1097/01.yco.0000179498.46182.8b 16639119
28. Dardas L, Simmons LA. The stigma of mental illness in A rab families: a concept analysis. Journal of psychiatric and mental health nursing. 2015;22(9):668–79. doi: 10.1111/jpm.12237 26118332
29. Aloud N, Rathur A. Factors affecting attitudes toward seeking and using formal mental health and psychological services among Arab Muslim populations. Journal of Muslim Mental Health. 2009;4(2):79–103.
30. Youssef J, Deane FP. Factors influencing mental-health help-seeking in Arabic-speaking communities in Sydney, Australia. Mental Health, Religion & Culture. 2006;9(1):43–66.
31. Coker EM. Selfhood and social distance: toward a cultural understanding of psychiatric stigma in Egypt. Social Science & Medicine. 2005;61(5):920–30.
32. Eapen V, Ghubash R. Help-seeking for mental health problems of children: preferences and attitudes in the United Arab Emirates. Psychological reports. 2004;94(2):663–7. doi: 10.2466/pr0.94.2.663-667 15154199
33. Rayan A, Fawaz M. Cultural misconceptions and public stigma against mental illness among Lebanese university students. Perspectives in psychiatric care. 2018;54(2):258–65. doi: 10.1111/ppc.12232 28726343
34. WHO-AIMS report on mental health system in Lebanon. World Health Organization and Ministry of Health. 2010. Retrieved from https://www.who.int/mental_health/who_aims_report_lebanon.pdf?ua=1. Accessed on January 20, 2019.
35. Organization WH. WHO-AIMS report on mental health system in Lebanon. World Health Organization and Ministry of Health Retrieved from http://wwwwhoint/mental_health/who_aims_country_reports/en/indexhtml#L. 2010.
36. Karam EG, Mneimneh ZN, Dimassi H, Fayyad JA, Karam AN, Nasser SC, et al. Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war. Plos medicine. 2008;5(4):e61. doi: 10.1371/journal.pmed.0050061 18384228
37. Aramouny C, Kerbage H, Richa N, Rouhana P, Richa S. Knowledge, Attitudes, and Beliefs of Catholic Clerics’ Regarding Mental Health in Lebanon. Journal of religion and health. 2019:1–20. doi: 10.1007/s10943-018-00739-w
38. Karam G. Vocational and Technical Education in Lebanon: Strategic Issues and Challenges. International Education Journal. 2006;7(3):259–72.
39. Melki I, Beydoun H, Khogali M, Tamim H, Yunis K. Household crowding index: a correlate of socioeconomic status and inter-pregnancy spacing in an urban setting. Journal of Epidemiology & Community Health. 2004;58(6):476–80.
40. Evans-Lacko S, Little K, Meltzer H, Rose D, Rhydderch D, Henderson C, et al. Development and psychometric properties of the mental health knowledge schedule. The Canadian Journal of Psychiatry. 2010;55(7):440–8. doi: 10.1177/070674371005500707 20704771
41. Taylor SM, Dear MJ. Scaling community attitudes toward the mentally ill. Schizophrenia bulletin. 1981;7(2):225. doi: 10.1093/schbul/7.2.225 7280561
42. Evans-Lacko S, Rose D, Little K, Flach C, Rhydderch D, Henderson C, et al. Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure. Epidemiology and Psychiatric Sciences. 2011;20(3):263–71. 21922969
43. Shahrour TM, Rehmani RS. Testing psychiatric stigma in a general hospital in Saudi Arabia. Saudi medical journal. 2009;30(10):1336–9. 19838444
44. Al-Krenawi A, Graham JR, Kandah J. Gendered utilization differences of mental health services in Jordan. Community mental health journal. 2000;36(5):501–11. 10994683
45. Abolfotouh MA, Almutairi AF, Almutairi Z, Salam M, Alhashem A, Adlan AA, et al. Attitudes toward mental illness, mentally ill persons, and help-seeking among the Saudi public and sociodemographic correlates. Psychology research and behavior management. 2019;12:45. doi: 10.2147/PRBM.S191676 30679929
46. Kadri N, Manoudi F, Berrada S, Moussaoui D. Stigma impact on Moroccan families of patients with schizophrenia. The Canadian Journal of Psychiatry. 2004;49(9):625–9. doi: 10.1177/070674370404900909 15503735
47. Mathison LA. Mental health stigma in religious communities: Development of a quantitative measure. 2016.
48. Dalky HF. Perception and coping with stigma of mental illness: Arab families’ perspectives. Issues in mental health nursing. 2012;33(7):486–91. doi: 10.3109/01612840.2012.676720 22757601
49. Dardas LA, Simmons LA. The stigma of mental illness in Arab families: a concept analysis. J Psychiatr Ment Health Nurs. 2015;22(9):668–79. doi: 10.1111/jpm.12237 26118332
50. Dalky HF. Perception and coping with stigma of mental illness: Arab families' perspectives. Issues Ment Health Nurs. 2012;33(7):486–91. doi: 10.3109/01612840.2012.676720 22757601.
51. Pierce ML. Stigma and Knowledge: A Questionnaire and Literature Review: Cleveland State University; 2012.
52. Das S, Phookun HR. Knowledge, attitude, perception and belief (KAPB) of patients’ relatives towards mental illness: A crosssectional study. Delhi Psychiatry Journal. 2014;17:48–59.
53. Ahmed N, Baruah A. Awareness about mental illness among the family members of persons with mental illness in a selected District of Assam. Indian Journal of Social Psychiatry. 2017;33(2):171.
54. Buizza C, Ghilardi A, Ferrari C. Beliefs and Prejudices Versus Knowledge and Awareness: How to Cope Stigma Against Mental Illness. A College Staff E-survey. Community Ment Health J. 2017;53(5):589–97. doi: 10.1007/s10597-017-0116-9 28188389.
55. LORENZAMAGLIANO CDR, FIORILLO A, MALANGONE C, GUARNERP M, MARASCO C, MAJ M. Cause e conseguenze psicosociali della schizofrenia: le opinioni degli italiani. Epidemiologia e Psichiatria Sociale. 2003;12(3):187.
56. Song L-Y, Chang L-Y, Shih C-Y, Lin C-Y, Yang M-J. Community attitudes towards the mentally ill: The results of a national survey of the Taiwanese population. International Journal of Social Psychiatry. 2005;51(2):162–76. doi: 10.1177/0020764005056765 16048245
57. Vibha P, Saddichha S, Kumar R. Attitudes of ward attendants towards mental illness: Comparisons and predictors. International Journal of Social Psychiatry. 2008;54(5):469–78. doi: 10.1177/0020764008092190 18786908
58. Barke A, Nyarko S, Klecha D. The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views. Social psychiatry and psychiatric epidemiology. 2011;46(11):1191–202. doi: 10.1007/s00127-010-0290-3 20872212
59. Pattyn E, Verhaeghe M, Bracke P. Attitudes toward community mental health care: the contact paradox revisited. Community mental health journal. 2013;49(3):292–302. doi: 10.1007/s10597-012-9564-4 23179045
60. Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe H, Carta MG, et al. Evolution of public attitudes about mental illness: a systematic review and meta‐analysis. Acta Psychiatrica Scandinavica. 2012;125(6):440–52. doi: 10.1111/j.1600-0447.2012.01826.x 22242976
61. Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry. 2010;167(11):1321–30. doi: 10.1176/appi.ajp.2010.09121743 20843872
62. Chong SA, Abdin E, Picco L, Pang S, Jeyagurunathan A, Vaingankar JA, et al. Recognition of mental disorders among a multiracial population in Southeast Asia. BMC psychiatry. 2016;16(1):121.
63. Subramaniam M, Vaingankar J, Heng D, Kwok KW, Lim YW, Yap M, et al. The Singapore Mental Health Study: an overview of the methodology. International Journal of Methods in Psychiatric Research. 2012;21(2):149–57. doi: 10.1002/mpr.1351 22331628
64. Ewalds-Kvist B, Högberg T, Lützén K. Impact of gender and age on attitudes towards mental illness in Sweden. Nordic journal of psychiatry. 2013;67(5):360–8. doi: 10.3109/08039488.2012.748827 23241018
65. Subramaniam M, Abdin E, Picco L, Pang S, Shafie S, Vaingankar J, et al. Stigma towards people with mental disorders and its components–a perspective from multi-ethnic Singapore. Epidemiology and psychiatric sciences. 2017;26(4):371–82. doi: 10.1017/S2045796016000159 27018715
66. Ewalds-Kvist B, Hogberg T, Lutzen K. Impact of gender and age on attitudes towards mental illness in Sweden. Nord J Psychiatry. 2013;67(5):360–8. doi: 10.3109/08039488.2012.748827 23241018.
67. Yuan Q, Abdin E, Picco L, Vaingankar JA, Shahwan S, Jeyagurunathan A, et al. Attitudes to mental illness and its demographic correlates among general population in Singapore. PloS one. 2016;11(11):e0167297. doi: 10.1371/journal.pone.0167297 27893796
68. Elkington KS, Hackler D, McKinnon K, Borges C, Wright ER, Wainberg ML. Perceived mental illness stigma among youth in psychiatric outpatient treatment. Journal of Adolescent Research. 2012;27(2):290–317.
69. Arkar H, Eker D. Influence of having a hospitalized mentally ill member in the family on attitudes toward mental patients in Turkey. Social psychiatry and psychiatric epidemiology. 1992;27(3):151–5. 1621141
70. United Nations Office for the Coordination of Humanitarian Affairs. (UNOCHA). Lebanese Population—Central Administration of Statistics (CAS) year 2002 dataset. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/20140811-Beirut%20MountLebanonGovernorateProfile.pdf. [Last accessed Nov7, 2018].
71. National Academies of Sciences E, Medicine. Ending discrimination against people with mental and substance use disorders: The evidence for stigma change: National Academies Press; 2016.
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