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Anti-stigma training and positive changes in mental illness stigma outcomes in medical students in ten countries: a mediation analysis on pathways via empathy development and anxiety reduction

2022; Springer Science+Business Media; Volume: 57; Issue: 9 Linguagem: Inglês

10.1007/s00127-022-02284-0

1433-9285

Laura Potts, Ioannis Bakolis, Tanya Deb, Heidi Lempp, T Vince, Yasmin Benbow, William Waugh, San Kim, Syed Ahmer Raza, Claire Henderson, Graham Thornicroft, Shuntaro Ando, Shinsuke Kondō, Kayo Ichihashi, Kiyoto Kasai, Sosei Yamaguchi, Asami Matsunaga, Yasutaka Ojio, Makoto Ogawa, Chiyo Fujii, Andrea Candelas, Laura Martín, Andrea Carboni Jiménez, Cristina Castañeda, C Reyes Hernandez, Jesús de la Higuera, José Eduardo Muñoz-Negro, Mercedes Sola, Rocío García, José Miguel Gota, Juan Francisco Mula, Ana María López, Amadeo Oria, Jorge A. Cervilla, A. Hernández Bono, Dolores Franco, Jaime Fernández Gómez, Carmen Jiménez, R Dorado, Evelio Ingunza, I. Fernández Márquez, Diego Vega, Pablo Ga-Cubillana, Uta Ouali, Lamia Jouini, Yosra Zgueb, F. Nacef, Megan Campbell, Dan J. Stein, Judit Harangozó, Andrea Ács, Tünde Bulyáki, Gyöngyi Szabó, Tunde M. Ojo, Adegboyega Ogunwale, Akin Sowunmi, Sewanu Awhangansi, Deji Ogundapo, Olusegun Sodiya, Babatunde Fadipe, Andrew T Olagunju, Adebayo R. Erinfolami, Peter O. Ogunnubi, Catarina Tomás, Miroslava Janoušková, Dzmitry Krupchanka, Simon Vasseur Bacle, A. Colliez, Déborah Sebbane, Amaury C. Mengin, Pierre Vidailhet, Cyril Cazals, Andrea Fiorillo, Gaia Sampogna, Micaela Savorani, Valeria Del Vecchio, Mario Luciano, Giuseppina Borriello, Benedetta Pocai, Patrícia Neves Guimarães, Antônio Prates Caldeira, Pedro Paulo Narciso de Avelar,

Healthcare professionals’ stress and burnout

Abstract Purpose Studies of mental illness stigma reduction interventions have been criticised for failing to evaluate behavioural outcomes and mechanisms of action. This project evaluates training for medical students entitled ‘Responding to Experienced and Anticipated Discrimination’ (READ), developed to focus on skills in addition to attitudes and knowledge. We aimed to (i) evaluate the effectiveness of READ with respect to knowledge, attitudes, and clinical communication skills in responding to mental illness-related discrimination, and (ii) investigate whether its potential effectiveness was mediated via empathy or/and intergroup anxiety. Methods This is an international multisite non-randomised pre- vs post-controlled study. Eligible medical students were currently undertaking their rotational training in psychiatry. Thirteen sites across ten countries ( n = 570) were included in the final analysis. Results READ was associated with positive changes in knowledge (mean difference 1.35; 95% CI 0.87 to 1.82), attitudes (mean difference − 2.50; 95% CI − 3.54 to − 1.46), skills (odds ratio 2.98; 95% CI 1.90 to 4.67), and simulated patient perceived empathy (mean difference 3.05; 95% CI 1.90 to 4.21). The associations of READ with knowledge, attitudes, and communication skills but not with simulated patient perceived empathy were partly mediated through student reported empathy and intergroup anxiety. Conclusion This is the first study to identify mediating effects of reduced intergroup anxiety and increased empathy in an evaluation of anti-stigma training that includes behavioural measures in the form of communication skills and perceived empathy. It shows the importance of both mediators for all of knowledge, skills, and attitudes, and hence of targeting both in future interventions.