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Perspectives of healthcare providers, service users, and family members about mental illness stigma in primary care settings: A multi-site qualitative study of seven countries in Africa, Asia, and Europe
- Source :
- PLoS ONE, Vol 16, Iss 10, p e0258729 (2021), PLoS ONE, PLOS ONE, vol. 16, no. 10, pp. e0258729, PLoS ONE, Vol 16, Iss 10 (2021), Koschorke, M, Oexle, N, Ouali, U, Cherian, A V, Deepika, V, Mendon, G B, Gurung, D, Kondratova, L, Muller, M, Lanfredi, M, Lasalvia, A, Bodrogi, A, Nyulászi, A, Tomasini, M, El Chammay, R, Hana, R A, Zgueb, Y, Nacef, F, Heim, E, Aeschlimann, A, Souraya, S, Milenova, M, Van Ginneken, N, Thornicroft, G & Kohrt, B A 2021, ' Perspectives of healthcare providers, service users, and family members about mental illness stigma in primary care settings : A multisite qualitative study of seven countries in Africa, Asia, and Europe ', PLoS ONE, vol. 16, no. 10, e0258729, pp. 1-29 . https://doi.org/10.1371/journal.pone.0258729
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- Background Stigma among healthcare providers is a barrier to the effective delivery of mental health services in primary care. Few studies have been conducted in primary care settings comparing the attitudes of healthcare providers and experiences of people with mental illness who are service users in those facilities. Such research is necessary across diverse global settings to characterize stigma and inform effective stigma reduction. Methods Qualitative research was conducted on mental illness stigma in primary care settings in one low-income country (Nepal), two lower-middle income countries (India, Tunisia), one upper-middle-income country (Lebanon), and three high-income countries (Czech Republic, Hungary, Italy). Qualitative interviews were conducted with 248 participants: 64 primary care providers, 11 primary care facility managers, 111 people with mental illness, and 60 family members of people with mental illness. Data were analyzed using framework analysis. Results Primary care providers endorsed some willingness to help persons with mental illness but reported not having appropriate training and supervision to deliver mental healthcare. They expressed that people with mental illness are aggressive and unpredictable. Some reported that mental illness is incurable, and mental healthcare is burdensome and leads to burnout. They preferred mental healthcare to be delivered by specialists. Service users did not report high levels of discrimination from primary care providers; however, they had limited expectations of support from primary care providers. Service users reported internalized stigma and discrimination from family and community members. Providers and service users reported unreliable psychiatric medication supply and lack of facilities for confidential consultations. Limitations of the study include conducting qualitative interviews in clinical settings and reliance on clinician-researchers in some sites to conduct interviews, which potentially biases respondents to present attitudes and experiences about primary care services in a positive manner. Conclusions Primary care providers’ willingness to interact with people with mental illness and receive more training presents an opportunity to address stigmatizing beliefs and stereotypes. This study also raises important methodological questions about the most appropriate strategies to accurately understand attitudes and experiences of people with mental illness. Recommendations are provided for future qualitative research about stigma, such as qualitative interviewing by non-clinical personnel, involving non-clinical staff for recruitment of participants, conducting interviews in non-clinical settings, and partnering with people with mental illness to facilitate qualitative data collection and analysis.
- Subjects :
- Male
Social Stigma
Social Sciences
Nurses
Burnout
Sociology
Medicine and Health Sciences
Mental health and psychiatry
Confidentiality
Medical Personnel
Lebanon
Human Families
Qualitative Research
Czech Republic
Multidisciplinary
10093 Institute of Psychology
Mental Disorders
Mental health therapies
Primary care
Justice and Strong Institutions
Professions
Italy
Medicine
Female
Psychology
Research Article
Adult
Mental Health Services
SDG 16 - Peace
Tunisia
Health Personnel
Science
India
Stigma (botany)
Qualitative property
Interviews as Topic
Nepal
Nursing
Physicians
Psychiatric medication
medicine
Humans
Family
Health care providers
1000 Multidisciplinary
Hungary
Primary Health Care
SDG 16 - Peace, Justice and Strong Institutions
Health care facilities
Mental illness
medicine.disease
Mental health
Health Care
People and Places
Population Groupings
150 Psychology
Qualitative research
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....cf09f1841ea633651fd9302d9342d887