3 Early Psychosis Service, Metro South Mental Health, Australia, Macgregor, ... Mental health literacy (MHL) comprises awareness of how to access mental.
The relationship between mental health literacy regarding schizophrenia and psychiatric stigma in the Republic of Ireland Donal O’Keeffe1, Niall Turner2, Sharon Foley3, Elizabeth Lawlor1, Anthony Kinsella4, Eadbhard O’Callaghan1, and Mary Clarke1 1 DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland, 2 Cluain Mhuire Family Centre, Blackrock, Dublin, Ireland, 3 Early Psychosis Service, Metro South Mental Health, Australia, Macgregor, Australia, and 4 Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland, Dublin, Ireland
INTRODUCTION
DISCUSSION
Mental health literacy (MHL) comprises awareness of how to access mental
We found a low schizophrenia recognition rate among Irish residents surveyed.
health information; the ability to recognise disorders; attitudes which aid
Higher age, higher socioeconomic status, and an urban geographic location
recognition and appropriate help seeking; knowledge and beliefs about risk
predicted the correct identification of schizophrenia. This may be the result of (i)
factors and causes of mental disorders; and awareness of the range of treatments
individuals with these characteristics being more exposed to education on
available. Low levels of MHL can be a barrier to seeking treatment for mental
schizophrenia, (ii) adolescents lacking life experience, and (iii) people aged over
illness and MHL is a prerequisite for early recognition and intervention. 1
65 not having access to school mental health education programmes or certain media such as the internet. Participants living in urban regions are likely to
People with mental illness are frequently the target of stigma; viewed as in need
experience higher levels of exposure to schizophrenia (as incidence of
of help, dependent on others, unpredictable, violent, and dangerous; those
schizophrenia is associated with urbanicity); exposure which may not be
diagnosed with schizophrenia and alcoholism being seen as the most dangerous. 2
representative of the heterogeneity in schizophrenia outcomes.
There is an unclear relationship between MHL and psychiatric stigma; the
Participants who correctly recognised schizophrenia (i.e. people with high MHL)
literature is conflicting. MHL interventions can reduce stigma, and those with
displayed more negative attitudes to schizophrenia and mental illness
more knowledge of mental illness are less likely to hold stigmatising attitudes. 3
generally. If these individuals are more educated about schizophrenia than the
However having the knowledge to be able to label someone as mentally ill is
rest of the population, it may be the nature of this education that is
associated with increased
inadvertently enhancing stigma.5 Moreover, the literature indicates that there
stigma. 4
is a positive relationship between education and media consumption. 6 If the
OBJECTIVES To assess and examine the relationship between MHL regarding schizophrenia and the degree of psychiatric stigma displayed by the general public in the Republic of Ireland.
mental health literate, highly educated individual is more exposed to the media, then they may be more likely to receive the message that people with schizophrenia are unpredictable and violent.
METHODS
IMPLICATIONS
A quantitative cross-sectional omnibus survey design was used. In 2007, a
MHL and anti-stigma campaigns might consider giving particular attention to
market research company was commissioned to conduct a face-to-face in-home
schizophrenia as it is not easily recognised by the public and particularly
national omnibus survey. Participants were a representative sample of residents
stigmatised. Increasing the attention given to the biopsychosocial model and the
of the Republic of Ireland aged >15 (N=1001); its capital Dublin and four
stress-vulnerability model in education programmes may be advantageous.
provinces. Data was analysed using SPSS 21. A waiver for the study was granted
Future anti-stigma campaigns may benefit from promoting recovery optimism
by the Saint John of God Hospitaller Ministries Provincial Ethics Committee.
and challenging stereotypes by disseminating statistics on recovery and the
RESULTS
likelihood of harm or violence in schizophrenia. It may be beneficial for mental
Among the participants, 34.1% correctly identified schizophrenia. Higher age,
health professionals (and those involved in their training and education) to be
higher socioeconomic status, and an urban geographic location predicted
cognizant of the stigma enhancing impact of emphasising biology and genetics
schizophrenia recognition. Those who correctly identifed schizophrenia were
in isolation when communicating information on the etiology of schizophrenia.
significantly less optimistic about recovery and perceived people with schizophrenia as more dangerous.
REFERENCES 1. Jorm AF, Christensen H, Griffiths KM. (2006b). The public’s ability to recognize mental disorders and their
Table 1 Comparisons of stigma scores by schizophrenia recognition group.
beliefs about treatment: Changes in Australia over 8 years. Austr NZ J Psychiatry, 40, 36–41. 2. Angermeyer MC, Dietrich S. (2006). Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scand, 113, 163–79.
Scale Recovery Optimism, M (SD) Anticipated Propensity for Harm / Violence, M (SD) Stigma, M (SD)
Correct Recognition of Schizophrenia
11.12 (4.08)
5.59 (2.04)
19.33 (3.91)
Incorrect Recognition
11.72 (4.16)
6.03 (1.99)
19.40 (3.36)
Mann-Whitney U/ Independent Samples T-Test P = 0.04 r = 0.08 n = 780 P = 0.01 r = 0.10 n = 798 P = 0.78 d = 0.02 n = 745
3. Thornton J, Wahl OF. (1996). Impact of a newspaper article on attitudes toward mental illness. J Commun Psychol, 24, 17–25. 4. Angermeyer MC, Matschinger H. (2004). The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: Results from a representative survey in Germany. Schizophrenia Bull, 30, 1049–61. 5. Read J, Haslam N, Sayce L, Davies E. (2006). Prejudice and schizophrenia: A review of the ‘mental illness is an illness like any other’ approach. Acta Psychiatrica Scand, 114, 303–18. 6. Roe K. (2000). Socio-economic status and children’s television use. Communications, 25, 3–18.
Funding This study was supported by a grant from the Mental Health Commission. Conflict of interest The authors have no conflict of interest to declare.