The Effect of Clinical Psychiatric Training on Medical Students' Belief and Attitude towards People with Mental Illness

Abstract

Background to the study: Medical student's attitude towards people with mental illness (PWMI) is very important for the future care of psychiatric patients. It has been postulated that psychiatric education could lead to a reduction in negative attitude towards PWMI.
Objective: To assess the effect of clinical psychiatric training on medical student's belief and attitudes towards PWMI
Methods: A pre-posttest design study carried out among final year medical students of the University of Benin, Nigeria. One hundred and seventy one medical students and randomly selected 55 students of biochemistry, who served as controls, participated in the study. A modified version of the questionnaire developed for the World psychiatric Association program to reduce stigma and discrimination because of Schizophrenia was used to collect data. Some socio-demographic information was also obtained. Data were analyzed using the 16th version of SPSS; level of significance was set at 0.05
Results: Majority (95.9%) of the pre-training subjects (P1) and control group (85.5%) had good knowledge of genetic causes of mental illness. However substantial proportions of P1 (65.5%) and control group (81.8%) believed in spiritual causation of mental illness. Among post-training subjects (P2), there was a significant shift in favour of more accurate belief about causes of mental illness. Although majority of P1 and controls (78.4% and 83.6% respectively) believed that PWMI can be treated outside the hospital, this belief co-existed with discriminatory views such as, being dangerous and being nuisance to the public. Among P2, views were largely less discriminatory on all items. Large percentages of P1 and control (80.79% and 98.27% respectively believed that PWMI can be treated and be normal again but a substantial proportion of them did not believe that orthodox medical care is the best form of treatment. Majority (85.8%) of P2, however, believed that orthodox care is the best form of care. Larger percentage of P2 (90.0%) than P1 (60.2%) would be able to maintain friendship with PWMI (P= 0.00). Overall, P2 expressed more tolerant attitudes than P1 and control groups. Male and female respondents did not differ significantly on any of the items that assessed their attitudes towards PWMI (P= 0.07, 0.52, 0.26)
Conclusion: Negative views and attitudes towards PWMI were found among our sample of medical students before exposure to psychiatric training. The eight weeks of clinical psychiatric training considerably altered this, as it positively influenced their knowledge, belief, views and attitudes towards PWMI. In order to enhance and sustain this trend a periodic review of the psychiatric training curriculum to accommodate adequate exposure of the students to PWMI is advocated.