Mental illness: diagnostic title or derogatory term? (Attitudes towards mental illness) Developing a learning resource for use within a clinical call centre. A systematic literature review on attitudes towards mental illness

South Central Ambulance NHS Trust, UK.
Journal of Psychiatric and Mental Health Nursing (Impact Factor: 0.98). 09/2008; 15(8):684 - 693. DOI: 10.1111/j.1365-2850.2008.01288.x

ABSTRACT With one in three people likely to experience mental health problems during their lifetime, it is paradoxical that stigma and negative attitudes towards mental illness are so prevalent in the UK today. This systematic literature review was completed to investigate what the most common negative attitudes towards mental illness are, and the most common recommendations made to address them. The findings were used to inform teaching resources used in an National Health Service Direct call centre. Guidelines for undertaking a systematic review, produced by the Centre for Reviews and Dissemination, were used. Terms were set and a search of electronic databases and peer-reviewed academic journals was completed, from which 16 primary research papers (from the UK) were obtained and used. These were assessed, using evidence-based critical appraisal tools, to obtain data pertinent to the original question. This paper describes the process, including a detailed account of the methodologies employed to gather and analyse relevant data. Put into context, alongside key drivers (e.g. government papers), the findings are presented and discussed, along with underlying theories, where appropriate. Recommendations for professional practice are then presented.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Interactions between police and individuals suffering from mental illness are very frequent. Police forces are regularly first responders to those with mental illness. Unfortunately, on occasion interactions are violent and sometimes fatal. Despite this, training police how to best interact with individuals who have a mental illness is poorly studied. The research in this thesis primarily examines a newly developed training program, which used professional actors in a roleplay based training approach. Training was a one-day, 8-hour session, with feedback from senior officers, mental health specialists and actors. Latter feedback enforced how the officer can best approach and speak to individuals when they interact. Explicit goals were to improve officer empathy, communication skills, and ability to de-escalate stressful situations. This unique training program led to improvements in police officer behaviour which were still present 6- months after completion. More specifically, after training officers had (1) more confidence (23%) in interacting with those suffering from mental illness; (2) demonstrated behavioural improvements in empathy, communication and de-escalation strategies (determined by their supervising sergeant); (3) increased their ability to recognize mental illness, shown through increases in mental health call numbers as well as (4) increased efficiency in the time it required officers to begin and finish a mental health call. These changes led to cost savings of over $80,000 over 6 months. In contrast to changes in behaviour, attitudes did not change 6-months after training. We then conducted a 2.5 year follow up of police attitudes in officers who took training and found that officer confidence continued to increase up to 2.5 years after training (32%), however, longitudinal changes in attitudes were mixed with the majority of attitudes not changing. Thesefindings illustrate that the link between attitudes and behaviours is complex, and one that requires further research to fully explain. Another topic of study was how demographic factors affected police attitudes. Initially older officers had increased stigma towards the mentally ill, but after training this changed with younger officers exhibiting higher levels of stigma. In keeping with studies from a range of other areas, female officers were found to show decreases in authoritarian attitudes, and increases in compassion and empathy towards those with mental illness when compared to their male colleagues. In regards to officer location, officers in high crime areas, namely North and Downtown Division were found to have increases in social distance towards individuals with depression compared to Southeast Division (lower crime area). Of importance, North Division officers who received the mental health training had stronger attitudes of compassion and empathy towards individuals suffering from mental illness compared to those that did not take part in the mental health training. This latter finding is supportive of the overall success of this training program, and implies the existence of subtle factors that influence attitudes. The final research piece examined attitudes of the homeless community in Edmonton, since they have frequent interactions with police. Homeless members were surveyed to determine how police interactions affected their attitudes towards police. Interestingly, individuals arrested or handcuffed had significantly greater negative views towards police than if they were not arrested or handcuffed. This novel finding may allow police policy to change in this population. Additionally, it was clear that many individuals in the homeless population do not believe police treat them with an appropriate level of fairness and respect. These findings allow us to conclude that more training is necessary for police officers in this area. Key findings for future police training relate to the benefits of training utilizing realistic “hands-on” scenarios, focusing primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. We recommend organizations provide training that is properly measured for effectiveness and urge training to focus on changing behaviours and not attitudes, because there is little evidence to demonstrate that changing attitudes relates directly to positive behavioural changes. Lastly, we believe that mental health training programs need to be implemented on a repeated basis over the longer-term to maximize its impacts. It is likely that a training program given on a single occasion is not sufficient to improve interactions over the career of a police officer. Future police training needs to address these issues.
    12/2014, Degree: PhD in Psychiatry, Supervisor: Dr. Peter Silverstone
  • Source
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined unmet needs for home- and community-based services (HCBS) among frail older Americans. Using population-based sample from the National Long-Term Care Survey, a hierarchical logistic regression analysis was conducted to examine the predictors of unmet needs for seven types of HCBS. Lack of awareness, reluctance, unavailability, and affordability of services were the main reasons for unmet needs for HCBS. Factors that were associated with unmet needs included Black race/ethnicity, greater care needs (functional limitations and behavioral problems), and less informal support (substitute help and family agreement). It is important to identify risk factors that may lead to older adults' unmet needs for HCBS. The findings of this study charge researchers to look beyond service utilization and give more attention to service needs among those who did or could not access the services.
    Journal of Aging and Health 11/2010; 23(3):529-53. DOI:10.1177/0898264310387132 · 1.56 Impact Factor


Available from