Study on Mental Health-related Stigma

Study Overview
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Brief Summary
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Mental disorders are currently among the main causes of disability worldwide. For this reason, various national and international organisations include the promotion of mental health among their strategic actions, with special emphasis on the fight against stigma. Evidence shows that stigma has a negative impact on the process of recovery and participation of people with mental disorders. The general aim of this study is to find out about the attitudes of university students at the University of A Coruña towards people with mental disorders and specifically to intervene with students of the Bachelor's Degree in Occupational Therapy to assess whether taking part in a Mental Health Literacy Programme changes these attitudes.

Detailed Description
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In recent years, there has been a growing interest in developing and evaluating anti-stigma plans in the field of mental health. However, stigmatising, coercive or paternalistic attitudes persist in society and have a negative impact on the recovery process of people with mental illness. The Mental Health Spain Confederation proposes tackling stigma through intersectional mental health literacy interventions that incorporate the gender perspective and are focused on the needs identified by people with mental disorders. The New Mental Health Strategy of the National Health System (2021-2026) establishes the need to involve people and their families, as well as the different social agents in the fight against stigma, especially social and health professionals, as well as the media and educational personnel. The aim of this study is to understand the nature of stigma towards people with mental disorders. In order to do so, it is necessary to take into consideration the experiences and experiences of the people themselves in order to develop plans to promote mental health from a participatory and comprehensive perspective. Likewise, it is considered relevant to know the perceptions of future professionals from different areas of knowledge (students of the University of A Coruña), evaluating their attitudes and beliefs regarding mental health. Finally, the aim is to evaluate the impact of incorporating a specific module on mental health and stigmatisation. a specific module on mental health and stigma in the university curriculum of the students of the Occupational Therapy Degree. This research has the following objectives: (1) find out the perception of people with mental disorders in relation to the social stigma of citizens and Health Science professionals; (2) find out how university students perceive people with mental health problems, and (3) evaluate the impact of incorporating a specific module on mental health and stigma in the university curriculum, specifically in the Bachelor's Degree in Occupational Therapy.

Official Title
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Study on Mental Health-related Stigma: Attitudes and Values of University Students Towards People With Mental Disorders

Conditions
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Mental Health Disorder

Intervention / Treatment
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* Other: Mental Health Literacy Programme


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Group I: Be graduated at Occupational Therapy Degree at the University of A Coruña Exclusion Criteria Group I: Have difficulties in understanding and/or communication Not being enrolled in the Mental Health module of the Degree in Occupational Therapy Inclusion Criteria Group II: Student in the University of A Coruña Exclusion Criteria Group II: Have difficulties in understanding and/or communication Inclusion Criteria Group III: Have a mental disorder [according to the Diagnostic Manual Diagnostic Manual] Be a user of the Psychosocial and Labor Rehabilitation Centers of the Health Area of A Coruña Exclusion Criteria Group III: Have difficulties in understanding and/or communication Be in a situation of legal incapacity.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Third year students of the Bachelor's Degree in Occupational Therapy<br>Third-year students of the Bachelor's Degree in Occupational Therapy will receive training on a specific module on mental health and stigma in the university curriculum. | Other: Mental Health Literacy Programme<br>* Mental Health Literacy Program. This program is part of the training of third-year students of the occupational therapy degree at the University of A Coruña. We will follow a mixed method following a sequential explanatory design. The quantitative part corresponds to a quasi-experimental study, where a comparison will be made between the phase before and after the students take the program. The qualitative part will comprise a phenomenological study to collect the knowledge acquired by the students after taking the program.<br>|
| No Intervention: Students of University of A Coruña<br>The students of the University of A Coruña will take part in an online survey to find out the attitudes and beliefs of future professionals from different areas of knowledge regarding mental health. | |
| No Intervention: People with mental health disorder<br>Users of a Psychosocial and Labor Rehabilitation Centers in the A Coruña Health Care Area will take part in interviews to find out their experiences regarding the attributions made towards them by citizens and health professionals. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes on the measurement of the students of third-year of occupational therapy bachelor's degree attitudes and beliefs toward people with mental disorders | It is composed of 40 items, rated on a 5-point Likert scale, ranging from strongly agree to strongly disagree. The scale comprises 4 factors: authoritarianism, benevolence, social restraint, and mental health ideology in the community. Each factor contains 10 statements concerning opinions about the way people with mental disorder are treated. Five of the 10 items are expressed in the positive and the other 5 are worded in the negative. The score for each subscale results from adding the positive items together with the negative items, which are transformed into positive values, with the total score being the sum of all of them. The higher the score, the greater the agreement. The sum of each factor is analyzed with the mean and standard deviation. | One month pre-intervention and one month post-intervention | 
| Changes on the measurement of stigmatizing attitudes towards people with mental health disorders in students of third-year of occupational therapy bachelor's degree | It is a Likert-type scale with 27 items on the situation posed, grouped into 9 factors: responsibility, pity, anger, dangerousness, fear, help, coercion, segregation and avoidance. I sum the items of each factor, obtaining a minimum of 3 and a maximum of 27. | One month pre-intervention and one month post-intervention | 
| Acquired knowledge in students of third-year of occupational therapy bachelor's degree who participated in the intervention programme | The interview is the most used data collection technique in qualitative studies. In this study, a semi-structured interview will be used because it is flexible and dynamic. It's a beginning interview to know the knowledge acquired by the students. | within 1 month after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of the Students of University of A Coruña attitudes and beliefs toward people with mental disorders | It is composed of 40 items, rated on a 5-point Likert scale, ranging from strongly agree to strongly disagree. The scale comprises 4 factors: authoritarianism, benevolence, social restraint and mental health ideology in the community. Each factor contains 10 statements concerning opinions about the way people with mental disorder are treated. Five of the 10 items are expressed in the positive and the other 5 are worded in the negative. The score for each subscale results from adding the positive items together with the negative items, which are transformed into positive values, with the total score being the sum of all of them. | within 1 month after the intervention | 
| Measurement of stigmatizing attitudes towards people with mental health disorders of the Students of University of A Coruña | It is a Likert-type scale with 27 items on the situation posed, grouped into 9 factors: responsibility, pity, anger, dangerousness, fear, help, coercion, segregation and avoidance. I sum the items of each factor, obtaining a minimum of 3 and a maximum of 27. | within 1 month after the intervention | 
| Individual-interviews | The interviews were about the experiences of people with mental disorders in relation to stigma. The following questions composed the interview: the definition of stigma, the influence of society on people with a mental health disorder, experiences about the barriers detected in daily life, and the behavior of the health providers that work with people with a mental health disorder. | within 1 month after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mental health disorder, stigma, university students, occupational therapy, alphabetisation