Attitudes of healthcare professionals towards psychiatric patients in a general hospital in Hong Kong.

Abstract Objectives: To examine the attitudes of healthcare professionals towards psychiatric patients in a general hospital in Hong Kong, and explore what contributions these attitudes may have on their management. Participants and Methods: A survey was carried out on healthcare professionals working in a general hospital in Hong Kong. A newly devised questionnaire with a case vignette was used. Each subject received a case depicting either a psychiatric patient (case group) or a diabetes mellitus patient (control group) randomly. Results: A total of 1200 questionnaires were distributed with a response rate of 36.1 %. A case vignette depicting a psychiatric patient elicited responses that reveal a statistical significant contribution towards the expression of negative opinions; about two-thirds of the statements contained negative connotations. Increase in social exposure to psychiatric patients led to a decrease in negative attitude, whilst negative experience with psychiatric patients led to an increase in negative attitude. Conclusion: Stigma towards psychiatric patients exists to a certain degree among the healthcare professionals in the general hospital we investigated. More clinical research is needed in this area to have a more in-depth understanding of the issue. Key words: Attitude of health personnel; Mental disorders; Mentally ill persons; Stereotyping [TEXT NOT REPRODUCIBLE IN ASCII. ] Introduction Mental health is recognised to be a major global health issue in the past century. The associated stigma is a distressing problem for persons suffering from mental illness and could have deleterious effects on all aspects of life. (1-3) It lowered their self-esteem and affected their ability to socialise. (4) On the other hand, attitudes of healthcare professionals may also affect the physical care psychiatric patients receive. People with mental illnesses were found to receive fewer medical services than the others. (5) With a psychiatric history, family physicians were less likely to take physical complaints seriously. (6) It was also noted that people who had been served by the mental health services had a mean of 8.8 years shorter life expectancy than controls. (7) In another study, it was found that the presence of a substance use disorder significantly reduced the likelihood of beta-blocker use after myocardial infarction. (8) Furthermore, people with mental illnesses had also had their chance of organ transplantation negated, merely on the grounds of their mental illnesses. (9) Stigma could be a contributing factor underlying these various observations. The presence of stigma among healthcare professionals may impede the care-seeking of psychiatric patients. (10) Different methodologies have been employed to ascertain attitudes towards people with mental illness. A literature review of 123 empirical articles (11) found that nearly two-thirds were non-experimental surveys. Through the years, different standards for scales to study attitude have been devised. (12-15) None was designed specifically to measure the attitude of healthcare professionals towards psychiatric patients. In general, previous studies revealed that negative attitudes towards psychiatric patients exist in the community. Among the various contributions explored, knowledge of mental illness and personal contact with psychiatric patients were the most widely investigated. (16-18) Evidence related to the contribution of personal contact with psychiatric patients was conflicting. Increasing personal contact with psychiatric patients was found to either increase or decrease the negative attitude. (19-21) In Hong Kong, increasing contact with psychiatric patients evidently decreased negative attitudes. Older persons and those with a lower education levels held more negative attitudes. (22,23) Regarding healthcare professionals, junior nurses and those in training tended to be more pessimistic about the extent to which psychiatric patients were able to participate in treatment. …