Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools
Background: Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors’ training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical educ...
| Main Authors: | , , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
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2024
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| Online Access: | https://hdl.handle.net/10356/173780 |
| _version_ | 1826109505996324864 |
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| author | Rees, Annie Cuthbert, Callum Shah, Viraj Rong, Lim Peh, Daniel Baptista, Ana Smith, Susan |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Rees, Annie Cuthbert, Callum Shah, Viraj Rong, Lim Peh, Daniel Baptista, Ana Smith, Susan |
| author_sort | Rees, Annie |
| collection | NTU |
| description | Background: Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors’ training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical education to prevent such attitudes propagating into clinical practice. Thus, this study explores whether stigmatising attitudes are detectable amongst medical students in London and Singapore and examines whether they are ameliorated by specific curricular and welfare features of formal medical education, utilising the Mental Illness Stigma Framework (MISF). Methods: A mixed-methods approach was adopted. Medical students at Imperial College London (UK; n = 211) and Nanyang Technological University (Singapore; n = 141) completed a validated scale (the OMS-HC-15) to assess attitudes towards mental illness. Semi-structured interviews were conducted (Imperial: n = 12, NTU: n = 8) until theoretical saturation was reached. Quantitative data were analysed descriptively and comparatively using SPSS and interview data subjected to inductive thematic analysis. Results: Total OMS-HC-15 scores ranged from 19–51 for Imperial (n = 211) and 16–53 for NTU (n = 141). No significant differences in overall stigma scores were found between the two schools (p = 0.24), nor when comparing year groups within each school. Four themes were identified across interview data: student perceptions, impacts of medical school culture, university support, and curricular impacts on mental illness perceptions. Themes allowed identification of aspects of medical school that were well-received and warranted further emphasis by students, alongside areas for improvement. Conclusion: Mental health stigma was identified in two medical schools, with differing cultures. Mean stigma scores obtained were comparable between both UK and Singaporean medical students. Nuanced differences were identified via subgroup analysis, and the MISF identified both shared and country-specific drivers for this stigma across the qualitative data. Actionable recommendations to mitigate this were hypothesised. Curricular improvements such as earlier psychiatric teaching and sharing of personal stories may improve future stigma scores as students’ progress through the course. Specific welfare-based changes to formal support systems were also deemed to be beneficial by students. The impacts of welfare and curricular redesign in relation to societal influence on students’ attitudes warrants further investigation, as does medical students’ self-stigma. |
| first_indexed | 2024-10-01T02:18:58Z |
| format | Journal Article |
| id | ntu-10356/173780 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T02:18:58Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1737802024-03-03T15:38:06Z Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools Rees, Annie Cuthbert, Callum Shah, Viraj Rong, Lim Peh, Daniel Baptista, Ana Smith, Susan Lee Kong Chian School of Medicine (LKCMedicine) Medicine, Health and Life Sciences Stigma Mental health Background: Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors’ training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical education to prevent such attitudes propagating into clinical practice. Thus, this study explores whether stigmatising attitudes are detectable amongst medical students in London and Singapore and examines whether they are ameliorated by specific curricular and welfare features of formal medical education, utilising the Mental Illness Stigma Framework (MISF). Methods: A mixed-methods approach was adopted. Medical students at Imperial College London (UK; n = 211) and Nanyang Technological University (Singapore; n = 141) completed a validated scale (the OMS-HC-15) to assess attitudes towards mental illness. Semi-structured interviews were conducted (Imperial: n = 12, NTU: n = 8) until theoretical saturation was reached. Quantitative data were analysed descriptively and comparatively using SPSS and interview data subjected to inductive thematic analysis. Results: Total OMS-HC-15 scores ranged from 19–51 for Imperial (n = 211) and 16–53 for NTU (n = 141). No significant differences in overall stigma scores were found between the two schools (p = 0.24), nor when comparing year groups within each school. Four themes were identified across interview data: student perceptions, impacts of medical school culture, university support, and curricular impacts on mental illness perceptions. Themes allowed identification of aspects of medical school that were well-received and warranted further emphasis by students, alongside areas for improvement. Conclusion: Mental health stigma was identified in two medical schools, with differing cultures. Mean stigma scores obtained were comparable between both UK and Singaporean medical students. Nuanced differences were identified via subgroup analysis, and the MISF identified both shared and country-specific drivers for this stigma across the qualitative data. Actionable recommendations to mitigate this were hypothesised. Curricular improvements such as earlier psychiatric teaching and sharing of personal stories may improve future stigma scores as students’ progress through the course. Specific welfare-based changes to formal support systems were also deemed to be beneficial by students. The impacts of welfare and curricular redesign in relation to societal influence on students’ attitudes warrants further investigation, as does medical students’ self-stigma. Published version The Professor Jenny Higham Collaboration Grant was provided by Imperial College London and Nanyang Technological University to purchase 5×NVivo licences and vouchers to incentivise participation for both the questionnaire and interviews. The open access fee was paid from the Imperial College London Open Access Fund. 2024-02-27T02:35:18Z 2024-02-27T02:35:18Z 2023 Journal Article Rees, A., Cuthbert, C., Shah, V., Rong, L., Peh, D., Baptista, A. & Smith, S. (2023). Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools. BMC Medical Education, 23(1), 981-. https://dx.doi.org/10.1186/s12909-023-04962-2 1472-6920 https://hdl.handle.net/10356/173780 10.1186/s12909-023-04962-2 38124141 2-s2.0-85180188801 1 23 981 en BMC Medical Education © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf |
| spellingShingle | Medicine, Health and Life Sciences Stigma Mental health Rees, Annie Cuthbert, Callum Shah, Viraj Rong, Lim Peh, Daniel Baptista, Ana Smith, Susan Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title | Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title_full | Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title_fullStr | Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title_full_unstemmed | Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title_short | Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools |
| title_sort | medical student perceptions of mental illness a cross sectional transnational study in two medical schools |
| topic | Medicine, Health and Life Sciences Stigma Mental health |
| url | https://hdl.handle.net/10356/173780 |
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