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Title of Journal: Soc Psychiat Epidemiol

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Abbravation: Social Psychiatry and Psychiatric Epidemiology

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D. Steinkopff-Verlag

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DOI

10.1002/chin.199016186

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1433-9285

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Attitudes to people with mental disorders a menta

Authors: Michelle Kermode Kathryn Bowen Shoba Arole Soumitra Pathare Anthony F Jorm
Publish Date: 2009/03/21
Volume: 44, Issue: 12, Pages: 1087-1096
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Abstract

People with mental disorders experience discrimination as a consequence of stigmatising attitudes that are largely socioculturally constructed Thus there is a need to understand local contexts in order to develop effective programs to change such attitudes We undertook a mental health literacy survey in rural Maharashtra India prior to developing a mental health training program for village health workers VHWs in a primary health care settingA crosssectional mental health literacy survey was undertaken in late 2007 which involved intervieweradministration of a questionnaire to 240 systematically sampled community members and 60 purposively sampled VHWs Participants were presented with two vignettes describing people experiencing symptoms of mental disorders depression psychosis and were asked about attitudes towards and desired social distance from the people in the vignettes the latter being a proxy measure for stigma Linear regression modelling was undertaken to identify predictors of social distanceAlthough the community was relatively accepting of people with mental disorders false beliefs and negative attitudes were still evident Desired social distance was consistently greater for the person depicted in the psychosis vignette compared to the depression vignette For both vignettes the main predictor of greater social distance was perceiving the person as dangerous and the predictors of reduced social distance were being a VHW and seeing the problem as a sign of personal weakness For depression believing the cause to be family tensions also reduced social distance For psychosis labelling the disorder as a mind/brain problem and believing the cause to be lack of control over life or genetic factors increased social distance The vast majority did not agree that the problems experienced in the vignettes were ‘a real medical illness’Promoting biomedical explanations for mental disorders in this setting may exacerbate discriminatory attitudes Provision of contextually relevant mental health training for the VHWs so that they are able to communicate model and shape more positive attitudes is the next stepWe thank the following people for their contributions to this study Dr Raj Arole for having the vision to incorporate mental health into primary health care Mr Ravi Arole for data management Dr Kaustubh Joag for technical advice Professor Helen Herrman for support and encouragement Mrs Ratna Kamble Ms Shainaj Khudbuddin Sayyad and Ms Shobha Kulkarni for data collection and Dr Ramaswamy Premkumar for assistance with sampling This study was made possible through the award to Michelle Kermode of an Early Career Research grant from the University of Melbourne

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