Attitudes towards people with depression and schizophrenia among social service workers in Denmark.

BACKGROUND: Mental health-related stigma is a major public health issue, and is an obstacle to the possibility for successful treatment, recovery, and reintegration. AIM: To examine attitudes towards mental illness among employees in the social services. METHODS: The study design was part of a large randomized trial, and data presented in this study are baseline data from this trial. Respondents completed a baseline questionnaire to assess the respondents' attitudes. RESULTS: A significant difference was found between employees' personal attitudes towards depression and schizophrenia. The same significant difference was found in the employees' perceived attitudes. Furthermore, a significant difference was found between the employees' personal and perceived attitudes. A significant difference was found between the respondents wish for social distance towards depression and schizophrenia in all cases, except regarding the willingness to provide a job at one's own workplace. CONCLUSION: Employees in the social services are comparable to the general public concerning attitudes towards mental illness. IMPLICATIONS: The results indicate that the employees in social services could have great use of gaining more knowledge about mental illness and ways in which to recognize a mental illness, in order to be able to offer the right kind of help and reduce the treatment gap concerning people suffering from mental illness.

Effectiveness of Mental Health First Aid training in Denmark: a randomized trial in waitlist design.

PURPOSE: To examine the effect of the Australian educational intervention Mental Health First Aid (MHFA) in a Danish context. Primary outcome was improvement concerning confidence in help-giving behavior towards people suffering from mental illness. Secondary outcomes were increased knowledge and ability to recognize mental illness and improved positive attitudes towards people suffering from mental health problems. METHOD: Study design was a randomized trial with a waitlist control group. The intervention group was compared with the control group at 6-month follow-up. Both groups completed at baseline and at 6-month follow-up. RESULTS: A significant difference was found between employees trained in the intervention group compared to the control group at 6-month follow-up on the items of confidence in making contact to (Cohen's d 0.17), talking to (Cohen's d 0.18) and providing help to (Cohen's d 0.31) people suffering from a mental health illness. Further, participants improved in knowledge (Cohen's d depression vignette 0.40/Cohen's d schizophrenia vignette 0.32) and in the ability to recognize schizophrenia OR = 1.75 (95 % CI 1.00-3.05), p = 0.05. A significant difference between the intervention group and control group at follow-up concerning actual help offered was not found. Changes in attitudes were limited. CONCLUSION: The MHFA training was effective in a Danish context.

The effect of the mental health first-aid training course offered employees in Denmark: study protocol for a randomized waitlist-controlled superiority trial mixed with a qualitative study.

BACKGROUND: Studies show a high and growing prevalence of mental disorders in the population worldwide. 25% of the general population in Europe will during their lifetime experience symptoms related to a mental disorder. The Mental Health First Aid concept (MHFA) was founded in 2000 in Australia by Kitchener and Jorm, in order to provide the population with mental health first aid skills. The aim of the concept is, through an educational intervention (course), to increase confidence in how to help people suffering from mental health problems. Further, secondary aims are to increase the mental health literacy of the public by increasing knowledge, reduce stigma and initiate more supportive actions leading towards professional care. An investigation of the effect of MHFA offered a Danish population is needed. METHODS: The design is a randomized waitlist-controlled superiority trial, in which 500 participants will be allocated to either the intervention group or the control group. The control group will attend the course six months later, hence waiting list design. From fall 2013 to spring 2014 participants will be educated to be "mental health first-aiders" following a manualized, two days MHFA course. All the participants will answer a questionnaire at base-line and at 6 months follow-up. The questionnaire is a back-translation of the questionnaire used in Australian trials. The trial will be complemented by a qualitative study, in which focus groups will be carried out. DISCUSSION: Outcomes measured are sensitive to interpretation, hence a challenge to uniform. This trial will add to the use of a mixed-methods design and exemplify how it can strengthen the analysis and take up the challenge of a sensitive outcome. TRIAL REGISTRATION: https://clinicaltrials.gov identifier NCT02334020.

Staff attitudes towards patients with schizophrenia.

INTRODUCTION: Stigmatizing attitudes have been reported in international studies among staff in psychiatry. The authors wanted to investigate if this was the case in Denmark. MATERIAL AND METHODS: A survey of attitudes among staff at two psychiatric units in Copenhagen was performed using the Mental Illness: Clinicians' Attitudes scales. The scales have 16 questions to which another four questions were added by the authors. RESULTS: A total of 548 staff members answered the questions (61 doctors and 487 other professionals). The majority of the respondents believed in the possibility of recovery for patients and only a minority associated a high degree of dangerousness with schizophrenia. The cause of the illness was mainly regarded as being biological, but all agreed to a bio-psycho-social aetiological approach. The majority of the respondents believed that the illness was chronic and agreed on the need for staff to also be aware of patients' somatic illness. The doctors did not question their role as "real doctors" or the scientific basis for psychiatry. The majority would not mind working with a colleague with schizophrenia, but about half would hesitate to disclose if they themselves were diagnosed with the illness. Being a woman working in community psychiatry with long experience and participation in a recovery educational programme was associated with less stigmatizing attitudes. CONCLUSION: The survey showed a relatively low level of stigmatizing attitudes. This runs counter to the results from international investigation. This trend could be interpreted both as a result of a shift towards a more recovery-oriented approach to treatment as well as a reflection of political correctness.

[Stigmatizing of persons with a mental illness]. / Stigmatisering af mennesker med psykisk lidelse.

Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark.