Attitude towards mental illness and seeking professional help among pharmacy students in Yemen
DOI:
https://doi.org/10.46542/pe.2023.231.7888Keywords:
Attitude, Help-seeking, Knowledge, Logistic regression, Mental illness, YemenAbstract
Background: People with mental illnesses (MIs) often encounter stigmatising attitudes. The main aim of this study was to assess pharmacy students’ attitudes toward MIs, people with MIs, seeking help for mental health, and knowledge of the causes of MIs.
Methods: A cross-sectional survey was conducted from May 2021 to July 2021 in Yemen. Logistic regression, chi-square test, and student's t-test were used for statistical analyses.
Results: Multivariate logistic regression analysis showed that female gender was independently associated with a positive attitude towards MIs (adjusted odds ratio, aOR 1.85, 95% confidence interval, CI 1.14–2.99) and knowledge (aOR 3.04, 95% CI 1.85–5.02). Also, having a patient with MI in family was associated with knowledge (aOR 2.69, 95% CI 1.03–6.99).
Conclusion: The current study revealed negative attitudes and stigma towards MIs and seeking professional help. Campaigns should be carried out among pharmacy students to reduce stigma.
References
Abi Doumit, C., Haddad, C., Sacre, H., Salameh, P., Akel, M., Obeid, S., Akiki, M., Mattar, E., Hilal, N., Hallit, S. and Soufia, M. (2019). Knowledge, attitude and behaviors towards patients with mental illness: Results from a national Lebanese study. PloS one, 14(9), p.e0222172. https://doi.org/10.1371/journal.pone.0222172
Abolfotouh, M. A., Almutairi, A. F., Almutairi, Z., Salam, M., Alhashem, A., Adlan, A. A., & Modayfer, O. (2019). Attitudes toward mental illness, mentally ill persons, and help-seeking among the Saudi public and sociodemographic correlates. Psychology research and behavior management, 12, 45–54. https://doi.org/10.2147/PRBM.S191676
Ahmed, E., Merga, H. and Alemseged, F. (2019). Knowledge, attitude, and practice towards mental illness service provision and associated factors among health extension professionals in Addis Ababa, Ethiopia. International journal of mental health systems, 13(1), pp.1-9. https://doi.org/10.1186/s13033-019-0261-3
Al-Darmaki, F., Thomas, J., & Yaaqeib, S. (2016). Mental Health Beliefs Amongst Emirati Female College Students. Community mental health journal, 52(2), 233–238. https://doi.org/10.1007/s10597-015-9918-9
Aljedaani, S.M. (2019). Adults’ knowledge, attitudes, and willingness to interact with patients suffering from mental illness in Jeddah City. Journal of the American Psychiatric Nurses Association, 25(5), pp.360-375. https://doi.org/10.1177/1078390318792610
Almusma, A. S., Sharifi, A. Y., & Alshahrani, J. A. (2020). Mental health awareness among adult attendees of Armed Forces Hospital Southern Region family and community center. Journal of family medicine and primary care, 9(11), 5678–5683. https://doi.org/10.4103/jfmpc.jfmpc_1321_20
Alsahali S. (2021). Knowledge and Attitude of Pharmacy Students toward People with Mental Illnesses and Help-Seeking: A Cross-Sectional Study from Saudi Arabia. Pharmacy (Basel, Switzerland), 9(2), 82. https://doi.org/10.3390/pharmacy9020082
Bagchi, A., Sarkar, P., Basu, R. (2020). Knowledge, attitude and practice towards mental health illnesses in an urban community in West Bengal: a community based study. International Journal Of Community Medicine And Public Health, 7(3), pp.1078-83. http://dx.doi.org/10.18203/2394-6040.ijcmph20200970
Benti, M., Ebrahim, J., Awoke, T., Yohannis, Z., Bedaso, A.. (2016). Community perception towards mental illness among residents of Gimbi town, Western Ethiopia. Psychiatry journal, 2016:1-8. https://doi.org/10.1155/2016/6740346
Bland, J.M., Altman, D.G. (1997). Statistics notes: Cronbach's alpha. British Medical Journal, 314(7080), p.572. https://doi.org/10.1136/bmj.314.7080.572
Byrne, P. (2000). Stigma of mental illness and ways of diminishing it. Advances in Psychiatric treatment, 6(1), 65-72. https://doi.org/10.1192/apt.6.1.65
Chan, C. S., Fabb, W. E., & Hazlett, C. B. (2002). Validation of an instrument to assess patient attitudes towards prescribing of pharmaceuticals by doctors. Journal of clinical pharmacy and therapeutics, 27(4), 249–256. https://doi.org/10.1046/j.1365-2710.2002.00417.x
Chen, J., Xu, D., & Wu, X. (2019). Seeking Help for Mental Health Problems in Hong Kong: The Role of Family. Administration and policy in mental health, 46(2), 220–237. https://doi.org/10.1007/s10488-018-0906-6
Corker, E. A., Beldie, A., Brain, C., Jakovljevic, M., Jarema, M., Karamustafalioglu, O., Marksteiner, J., Mohr, P., Prelipceanu, D., Vasilache, A., Waern, M., Sartorius, N., Thornicroft, G., & FEDORA Study Group (2015). Experience of stigma and discrimination reported by people experiencing the first episode of schizophrenia and those with a first episode of depression: The FEDORA project. The International journal of social psychiatry, 61(5), 438–445. https://doi.org/10.1177/0020764014551941
Corrigan, P. W., & Watson, A. C. (2002). Understanding the impact of stigma on people with mental illness. World psychiatry, 1(1), 16–20
Crabb, J., Stewart, R. C., Kokota, D., Masson, N., Chabunya, S., & Krishnadas, R. (2012). Attitudes towards mental illness in Malawi: a cross-sectional survey. BMC public health, 12, 541. https://doi.org/10.1186/1471-2458-12-541
Dahlberg, K. M., Waern, M., & Runeson, B. (2008). Mental health literacy and attitudes in a Swedish community sample - investigating the role of personal experience of mental health care. BMC public health, 8, 8. https://doi.org/10.1186/1471-2458-8-8
Duckworth, K. (2013). Mental illness: what you need to know. Arlington VA: National Alliance on Mental Illness
Effiong, H., Idung, A. U., & Iyanam, V. E. (2019). Knowledge, Attitudes and Perceptions about Mental Illness in Ekom Iman Community in Akwa Ibom. Asian Journal of Medicine and Health, 17(3), 1-9. https://doi.org/10.9734/ajmah/2019/v17i330164
Farrer, L., Leach, L., Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008). Age differences in mental health literacy. BMC public health, 8, 125. https://doi.org/10.1186/1471-2458-8-125
Gaebel, W., Baumann, A., Witte, A. M., & Zaeske, H. (2002). Public attitudes towards people with mental illness in six German cities: results of a public survey under special consideration of schizophrenia. European archives of psychiatry and clinical neuroscience, 252(6), 278–287. https://doi.org/10.1007/s00406-002-0393-2
Girma, E., & Tesfaye, M. (2011). Patterns of treatment seeking behavior for mental illnesses in Southwest Ethiopia: a hospital based study. BMC psychiatry, 11, 138. https://doi.org/10.1186/1471-244X-11-138
Gureje, O., Lasebikan, V. O., Ephraim-Oluwanuga, O., Olley, B. O., & Kola, L. (2005). Community study of knowledge of and attitude to mental illness in Nigeria. The British journal of psychiatry : the journal of mental science, 186, 436–441. https://doi.org/10.1192/bjp.186.5.436
Gureje, O., Abdulmalik, J., Kola, L., Musa, E., Yasamy, M. T., & Adebayo, K. (2015). Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. BMC health services research, 15, 242. https://doi.org/10.1186/s12913-015-0911-3
Gurung, G. (2014). Knowledge and attitude of nurses regarding mental illness. Journal of Chitwan Medical College, 4(2), 40-43. https://doi.org/10.3126/jcmc.v4i2.10863
Hammoudi Halat, D., Younes, S., Safwan, J., Akiki, Z., Akel, M., & Rahal, M. (2022). Pharmacy Students' Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education. European journal of investigation in health, psychology and education, 12(8), 1082–1107. https://doi.org/10.3390/ejihpe12080077
Hirai, M., & Clum, G. A. (2000). Development, reliability, and validity of the Beliefs Toward Mental Illness Scale. Journal of Psychopathology and Behavioral Assessment, 22(3), 221–236. https://doi.org/10.1023/A:1007548432472
Javed, Z., Naeem, F., Kingdon, D., Irfan, M., Izhar, N., & Ayub, M. (2006). Attitude of the university students and teachers towards mentally ill, in Lahore, Pakistan. Journal of Ayub Medical College, Abbottabad, 18(3), 55–58
Jyothi, N. U., Bollu, M., Ali, S. F., Chaitanya, D. S., & Mounika, S. (2015). A questionnaire survey on student's attitudes towards individuals with mental illness. Journal of Pharmaceutical Sciences and Research, 7(7), 393
Kohls, E., Coppens, E., Hug, J., Wittevrongel, E., Van Audenhove, C., Koburger, N., Arensman, E., Székely, A., Gusmão, R., & Hegerl, U. (2017). Public attitudes toward depression and help-seeking: Impact of the OSPI-Europe depression awareness campaign in four European regions. Journal of affective disorders, 217, 252–259. https://doi.org/10.1016/j.jad.2017.04.006
Larson, J. E., & Corrigan, P. (2008). The stigma of families with mental illness. Academic psychiatry, 32(2), 87–91. https://doi.org/10.1176/appi.ap.32.2.87
Leung, P., Cheung, M., & Tsui, V. (2012). Help-seeking behaviors among Chinese Americans with depressive symptoms. Social work, 57(1), 61–71. https://doi.org/10.1093/sw/swr009
Longkumer, I., & Borooah, I. P. (2013). Knowledge about and attitudes toward mental disorders among Nagas in North East India. IOSR Journal of humanities and social science, 15(4), 41-47. https://doi.org/10.9790/0837-1544147
Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. (2006). Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging & mental health, 10(6), 574–582. https://doi.org/10.1080/13607860600641200
Mariam, M. G., Bedaso, A., Ayano, G., & Ebrahim, J. (2016). Knowledge, attitude and factors associated with mental illness among nurses working in public hospitals, Addis Ababa, Ethiopia. Journal of mental disorders and treatment, 2(108), 2
Mojiminiyi, I. O., Balogun, M. R., & Ogunnowo, B. E. (2020). Knowledge and attitude towards mental disorders among adults in an urban community in south-west Nigeria. Malawi medical journal : the journal of Medical Association of Malawi, 32(2), 87–94. https://doi.org/10.4314/mmj.v32i2.6
Morgan, C., & Fearon, P. (2007). Social experience and psychosis insights from studies of migrant and ethnic minority groups. Epidemiologia e psichiatria sociale, 16(2), 118–123. https://doi.org/10.1017/s1121189x00004723
National Institutes of Health (2007). Biological Sciences Curriculum Study; NIH Curriculum Supplement Series; Information about Mental Illness and the Brain; National Institutes of Health (US): Bethesda, MD, USA, 2007. Available online: https: //www.ncbi.nlm.nih.gov/books/NBK20364/ (accessed on 16 November 2020)
Ndetei, D. M., Khasakhala, L. I., Mutiso, V., & Mbwayo, A. W. (2011). Knowledge, attitude and practice (KAP) of mental illness among staff in general medical facilities in Kenya: practice and policy implications. African journal of psychiatry, 14(3), 225–235. https://doi.org/10.4314/ajpsy.v14i3.6
Nepal, S., Rayamajhi, A., Shrestha, M., & Aryal, N. (2020). Attitude of Senior Secondary Level Students towards Mental Illness. Journal of Psychiatrists' Association of Nepal, 9(1), 47-52. https://doi.org/10.3126/jpan.v9i1.31337
Oexle, N., Müller, M., Kawohl, W., Xu, Z., Viering, S., Wyss, C., Vetter, S., & Rüsch, N. (2018). Self-stigma as a barrier to recovery: a longitudinal study. European archives of psychiatry and clinical neuroscience, 268(2), 209–212. https://doi.org/10.1007/s00406-017-0773-2
Ohaeri, J. U., & Fido, A. A. (2001). The opinion of caregivers on aspects of schizophrenia and major affective disorders in a Nigerian setting. Social psychiatry and psychiatric epidemiology, 36(10), 493–499. https://doi.org/10.1007/s001270170014
Patel, V., Maj, M., Flisher, A. J., De Silva, M. J., Koschorke, M., Prince, M., & WPA Zonal and Member Society Representatives (2010). Reducing the treatment gap for mental disorders: a WPA survey. World psychiatry, 9(3), 169–176. https://doi.org/10.1002/j.2051-5545.2010.tb00305.x
Robb, C., Haley, W. E., Becker, M. A., Polivka, L. A., & Chwa, H. J. (2003). Attitudes towards mental health care in younger and older adults: similarities and differences. Aging & mental health, 7(2), 142–152. https://doi.org/10.1080/1360786031000072321
Sadik, S., Bradley, M., Al-Hasoon, S., & Jenkins, R. (2010). Public perception of mental health in Iraq. International journal of mental health systems, 4, 26. https://doi.org/10.1186/1752-4458-4-26
Shibre, T., Negash, A., Kullgren, G., Kebede, D., Alem, A., Fekadu, A., Fekadu, D., Madhin, G., & Jacobsson, L. (2001). Perception of stigma among family members of individuals with schizophrenia and major affective disorders in rural Ethiopia. Social psychiatry and psychiatric epidemiology, 36(6), 299–303. https://doi.org/10.1007/s001270170048
Smith, L. D., Peck, P. L., & McGovern, R. J. (2002). Comparison of medical students, medical school faculty, primary care physicians, and the general population on attitudes toward psychological help-seeking. Psychological reports, 91(3 Pt 2), 1268–1272. https://doi.org/10.2466/pr0.2002.91.3f.1268
Stuart H. (2008). Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World psychiatry : official journal of the World Psychiatric Association (WPA), 7(3), 185–188. https://doi.org/10.1002/j.2051-5545.2008.tb00194.x
Stuart, H., & Arboleda-Flórez, J. (2001). Community attitudes toward people with schizophrenia. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 46(3), 245–252. https://doi.org/10.1177/070674370104600304
Tang, A. C. (2015). Cross-sectional survey: public attitude toward mental illness in China. International archives of nursing health care, 1(1). http://doi.org/10.23937/2469-5823/1510025
Tawiah, P. E., Adongo, P. B., & Aikins, M. (2015). Mental Health-Related Stigma and Discrimination in Ghana: Experience of Patients and Their Caregivers. Ghana medical journal, 49(1), 30–36. https://doi.org/10.4314/gmj.v49i1.6
ten Have, M., de Graaf, R., Ormel, J., Vilagut, G., Kovess, V., Alonso, J., & ESEMeD/MHEDEA 2000 Investigators (2010). Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders. Social psychiatry and psychiatric epidemiology, 45(2), 153–163. https://doi.org/10.1007/s00127-009-0050-4
Tesfamariam, E. H., Tekie, M. M., Tesfa, A. Y., Hadgu, D. H., Awalom, E. A., Ghebremedhin, E. B., & Tquabo, N. A. (2018). Attitude towards Mental Illness among Secondary School Students in Asmara, Eritrea: A Cross-Sectional Study. Psychiatry journal, 2018, 4578721. https://doi.org/10.1155/2018/4578721
Tesfaye, Y., Agenagnew, L., Terefe Tucho, G., Anand, S., Birhanu, Z., Ahmed, G., Getenet, M., & Yitbarek, K. (2020). Attitude and help-seeking behavior of the community towards mental health problems. PloS one, 15(11), e0242160. https://doi.org/10.1371/journal.pone.0242160
Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007). Stigma: ignorance, prejudice or discrimination?. The British journal of psychiatry : the journal of mental science, 190, 192–193. https://doi.org/10.1192/bjp.bp.106.025791
Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., Leese, M., & INDIGO Study Group (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet (London, England), 373(9661), 408–415. https://doi.org/10.1016/S0140-6736(08)61817-6
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 603–613. https://doi.org/10.1001/archpsyc.62.6.603
Webber, M., Corker, E., Hamilton, S., Weeks, C., Pinfold, V., Rose, D., Thornicroft, G., & Henderson, C. (2014). Discrimination against people with severe mental illness and their access to social capital: findings from the Viewpoint survey. Epidemiology and psychiatric sciences, 23(2), 155–165. https://doi.org/10.1017/S2045796013000243
World Health Organization. (2005). Mental Health Declaration for Europe: Facing the Challenges, Building Solutions: Report from the WHO European Ministerial Conference. Copenhagen: WHO Regional Office for Europe
World Health Organization. (2011). Mental Health Atlas 2011. Geneva: World Health Organization; 2011:82
World Health Organization. (2013). WHO Mental Health Gap Action Programme (mhGAP). Geneva: World Health Organization
Zever, I. S. Y. (2017). Assessment of Relatives Beliefs and Attitude on Mental Illness and Treatment in Kano, Nigeria. Annals of Medical and Health Sciences Research, 7(7)
