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Background: There is evidence of negative attitudes among health professionals towards people with mental illness but there is also a knowledge gap on what training must be given to these health professionals during their education. The purpose of this study is to compare the attitudes of students of health sciences: nursing, medical, occupational therapy, and psychology. Methods: A comparative and cross-sectional study in which 927 final-year students from health sciences university programmes were evaluated using the Mental Illness: Clinicians' Attitudes (both MICA-2 and MICA-4) scale. The sample was taken in six universities from Chile and Spain. Results: We found consistent results indicating that stigma varies across university programmes. Medical and nursing students showed more negative attitudes than psychology and occupational therapy students in several stigma-related themes: recovery, dangerousness, uncomfortability, disclosure, and discriminatory behaviour. Conclusions: Our study presents a relevant description of the attitudes of each university programme for education against stigma in the formative years. Results show that the biomedical understanding of mental disorders can have negative effects on attitudes, and that education based on the psychosocial model allows a more holistic view of the person over the diagnosis. [ABSTRACT FROM AUTHOR]

Context: In university programmes preparing students to work with patients with mental illness, clerkship is proposed as a component that may contribute to the battle against stigma, through bringing students into contact with the patients’ reality. Yet, the precise contribution of clerkship remains unclear, perhaps because of the variety of university programmes, clerkship characteristics or types of stigma explored. This is the first systematic meta‐analysis of available evidence determining the precise effect size of the influence of clerkship on stigma and the potential moderators. Methods: We carried out a systematic literature review in Eric, PsycINFO, Pubmed, Scopus, UMI and Proquest dissertations, aiming to identify all the studies exploring health care students’ stigma of mental illness (measured as overall stigma or as attitudes, affect and behavioural intentions) before and after a clerkship from 2000 to 2017. Twenty‐two studies were included in the meta‐analysis, providing data from 22 independent samples. The total sample consisted of 3161 students. The effects of programme (medicine, nursing, occupational therapy, and their combination), study design (paired–unpaired samples), publication year, sex, age and clerkship context, and inclusion of theoretical training and duration, were examined as potential moderators. Results: Our analyses yielded a highly significant medium effect size for overall stigma (Hedge's g = 0.35; p < 0.001; 95% confidence interval [CI], 0.20, 0.42), attitudes (Hedge's g = 0.308; p = 0.003; 95% CI, 0.10, 0.51) and behavioural intentions (Hedge's g = 0.247; p < 0.001; 95% CI, 0.17, 0.33), indicating a considerable change, whereas there was no significant change in the students’ affect. Moderator analyses provided evidence for the distinct nature of each stigma outcome, as they were influenced by different clerkship and student characteristics such as clerkship context, theoretical training, age and sex. Conclusions: The robust effect of clerkship on students’ stigma of mental illness established by the present meta‐analysis highlights its role as a crucial curriculum component for experiential learning and as a necessary agent for the battle against stigma. [ABSTRACT FROM AUTHOR]

People with severe mental illness have multiple and complex needs that often are not addressed. The purpose of this study was to analyse needs and support perceived and the relationship with hospital readmission. We assessed 100 patients with severe mental illness at discharge from an acute inpatient unit in terms of needs (Camberwell Assessment of Needs), clinical status (The Brief Psychiatric Rating Scale), and social functioning (Personal and Social Performance); we also followed up these patients for 1 year. The group of patients who were readmitted had more total needs than did the non-readmitted, in addition to more unmet needs, although the differences were not significant. The highest risk factor for rehospitalisation was the number of previous admissions. In addition, the help of informal carers in alleviating psychological distress was associated with the risk of readmission. The main conclusion concerns the role of the psychological support provided by informal networks in preventing readmission. [ABSTRACT FROM AUTHOR]

Abstract: Background: The List of Threatening Experiences (LTE) questionnaire is frequently used to assess stressful events; however, studies of its psychometric properties are scarce. We examined the LTE's reliability, factorial structure, construct validity and explored the association between LTE scores and psychosocial variables and mental disorders. Method: This study involved interviewing 5442 primary care attendees from Spain. Associations between four different methods of quantifying LTE scores, psychosocial factors, major depression (CIDI), anxiety disorders (PRIME-MD), alcohol misuse and dependence (AUDIT) were measured. Results: The LTE showed high test–retest reliability (Kappa range=0.61–0.87) and low internal consistency (α=0.44). Tetrachoric factorial analysis yielded four factors (spousal and relational problems; employment and financial problems; personal problems; illness and bereavement in close persons). Logistic multilevel regression found a strong association between greater social support and a lower occurrence of stressful events (OR range=0.36–0.79). The association between religious–spiritual beliefs and the LTE, was weaker. The association between mental disorders and LTE scores was greater for depression (OR range=1.64–2.57) than anxiety (OR range=1.35–1.97), though the highest ORs were obtained with alcohol dependence (OR range=2.86–4.80). The ordinal score (ordinal regression) was more sensitive to detect the strength of association with mental disorders. Limitations: We are unable to distinguish the direction of the association between stressful events, psychosocial factors and mental disorders, due to our cross-sectional design of the study. Conclusions: The LTE is a valid and reliable measure of stress in mental health, and the strength of association with mental disorders depends on the method of quantifying LTE scores. [Copyright &y& Elsevier]

Background: Prevention of depression must address multiple risk factors. Estimating overall risk across a range of putative risk factors is fundamental to prevention of depression. However, we lack reliable and valid methods of risk estimation. This protocol paper introduces PREDICT, an international research study to address this risk estimation. Methods/design: This is a prospective study in which consecutive general practice attendees in six European countries are recruited and followed up after six and 12 months. Prevalence of depression is assessed at baseline and each follow-up point. Consecutive attendees between April 2003 and September 2004 who were aged 18 to 75 were asked to take part. The possibility of a depressive episode was assessed using the Depression Section of the Composite International Diagnostic Interview. A selection of presumed risk factors was based on our previous work and a systematic review of the literature. It was necessary to evaluate the test-retest reliability of a number of risk factor questions that were developed specifically, or adapted, for the PREDICT study. In a separate reliability study conducted between January and November 2003, consecutive general practice attendees in the six participating European countries completed the risk factor items on two occasions, two weeks apart. The overall response rate at entry to the study was 69%. We exceeded our expected recruitment rate, achieving a total of 10,048 people in all. Reliability coefficients were generally good to excellent. Discussion: Response rate to follow-up in all countries was uniformly high, which suggests that prediction will be based on almost a full cohort. The results of our reliability analysis are encouraging and suggest that data collected during the course of PREDICT will have a satisfactory level of stability. The development of a multi-factor risk score for depression will lay the foundation for future research on risk reduction in primary care. Our data will also provide the necessary evidence base on which to develop and evaluate interventions to reduce the prevalence of depression. [ABSTRACT FROM AUTHOR]

Background: General practitioners (GPs) play an important role in the physical care of patients with severe mental illness, so our aim was to analyse the relationships between GPs' sociodemographic status and worked-related variables and their perceptions about mental illness. Methods: A descriptive, cross-sectional study was conducted in the Clinical Management Unit of Mental Health (CMU-MH) of the Regional Hospital of Malaga (Spain). The eligible population comprised all GPs working in the 13 primary care centres (PCCs) in the hospital's catchment area during the study period. GPs were interviewed to collect data on their attitudes to and knowledge of mental illness, psychiatry and the local mental health team, as well as their sociodemographic status, professional qualifications and experience. Bivariate analysis was carried out. Results: 145 GPs answered the questionnaire (77%). ANOVA revealed that most of the PCCs with the best relationship with their mental health team and best attitude to mental illness were in the Central Community Mental Health Unit, which operated a collaborative model of care. Conclusions: These results indicated that GPs who worked more closely with their specialist mental health team had a better perception of their relationship with the mental health centre and less stigmatisation in regard to mental illness. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) from COVID-19 pandemic hotspots across the globe have reported mental health problems, including anxiety, depression, or sleep problems. Many studies have focused on identifying modifiable risk factors, such as being afraid of getting infected or reporting shortage of personal protective equipment, but none have explored the role of protective factors. This cross-sectional study used an online survey to describe the association between three potentially protective factors (self-reported resilience, self-perceived social support from colleagues at work, and self-perceived social support from relatives and friends) and three mental health outcomes, namely psychological distress, depression symptoms, and death thoughts in a large sample of Spanish HCWs during the first wave of the COVID-19 pandemic. We recruited 2372 respondents between April 26th and June 22nd, 2020. Resilience and self-perceived social support were inversely associated with mental health problems (psychological distress, depression symptoms, and death thoughts), after adjusting for potential sources of confounding. Resilience and self-perceived social support might protect HCWs against negative mental health outcomes. Public health strategies targeting these modifiable determinants might help to reduce the impact of the pandemic on HCWs' mental health. [ABSTRACT FROM AUTHOR]

Out-of-hospital emergency departments receive multiple types of requests daily. Their management requires a balance to be found between available resources and the actual needs of the requesting party. Those regarding suicidal behaviour, which are resource heavy, are few in number in terms of the bulk of requests, and detecting them correctly is therefore important. Previous research, using machine learning algorithms to analyse suicide, has typically focused on discovering insights to be used by medical personnel. This proposal extends its use in two directions: knowledge that can be used by non-exclusively medical staff, such as telephone operators, and the models that have been incorporated into a software prototype to help in the decision-making of an emergency department. In addition, previous research has often included a range of information from different sources that are not available when processing an emergency call request, for example, data that is only obtained at the end of the intervention. A full-scale data mining process has been performed using data from the out-of-hospital emergency service in Malaga (Spain). Sensitivity has been the primary goal to avoid missing cases requiring special attention, but this objective has been pursued without overlooking a good trade-off with specificity. The best models can offer such a compromise between sensitivity and specificity, and show more than 80% in both metrics simultaneously. The experts validate that the modelling phase showed that the algorithms have automatically identified already known situations. This lays the groundwork for further iterations with a promising outlook. [Display omitted] • Data preparation is key when working with datasets to uncover suicidal behaviour. • Machine learning can identify when the likelihood of suicidal behaviour increases. • Software prototype includes induced knowledge models and allows for easy updates. • The code used in this data mining process is freely available. [ABSTRACT FROM AUTHOR]

University education affects the attitudes of future professionals toward people with mental illness. To evaluate and compare stigmatizing attitudes of university students from nursing, psychology, and occupational therapy careers toward people with severe mental disorder (SMD), a multisite, non-randomized, pre-post-test design was used with evaluations before and after a practicum program in mental health. Evaluation was done on a convenience sample of 520 students. The Mental Illness Clinicians' Attitudes (MIws1CA-4) scale was used to assess attitudes and a mixed linear model was used to compare the pre- and post-test data. Our results show that the practicum was slightly effective at reducing negative attitudes toward people with mental illness. Students' attitudes changed significantly after the training when considering career and country, although the changes were small. Nursing and psychology, but not occupational therapy, showed decreased stigma. Although nursing decreases negative attitudes in the post-test, it achieves higher scores than other careers. Social science's professionals are less stigmatizing than health professionals such as nurses, a result that could be associated with the approach used in the training of students. Although the practicum decreases stigma toward people diagnosed with SMD, its effect is reduced; it would be necessary to incorporate more specific actions in order to decrease the stigma further. The negative attitudes that decreased with professional training, particularly, were those related to behaviors in the workplace. [ABSTRACT FROM AUTHOR]