1. Examining Mental Illness and Stigma Among Medical Students
Statement of the Problem:
Mental Illness and Stigma
Stigma: “mark of disgrace associated with a quality, or person”1
1 in 4 Americans suffer from mental illness (MI); 1 in 17 from serious mental illness (SMI): major depressive disorder, schizophrenia, or bipolar disorder2
Stigma of MI has tangible effects: discrimination in insurance, housing, employment, social lives
Mass shooting tragedies: perception of MI as a risk factor for violence
A small subset of those with SMI are prone to violence3
Reality: socioeconomic status, substance abuse are the major determinants of violence, while people with MI are more likely to be victims4
Laws like the NYS SAFE Act perpetuate this stigma, override HIPAA, and may deter treatment-seeking
The Mental Health
Community: A Complex Structure
Acknowledgements
Thank you to my mentors at CDPC, the NYS Office of Mental Health, and AMC.
Thank you to my family and friends, for your enthusiasm and curiosity about this project.
Thank you to artist Martin O’Neill of Debut Art for the header art.
Examining Mental Illness and Stigma Among Medical Students
2014 AAFP
Jency Daniel, MSIII – Siena College/Albany Medical College Program in Science, Humanities, and Medicine Kathleen Young, PhD, MPH, Ann Rutter, MD, Katherine Wagner, MD – Albany Medical College
Summary
Anticipated Results: Diminishing Stigma
Examine relationships between survey variables
Do medical students carry stigma about MI?
Do factors such as personal familiarity with MI, completion of the psychiatry clerkship, political beliefs, etc. correlate with attitudes about MI?
Develop a stigma reduction workshop for 2nd-year medical students
Evidence-based curriculum structured around survey responses
Pre- and post-test evaluations
30-40% of patients seek mental health care via primary care, not psychiatry7
Medical professionals carry stigma towards MI
A survey will illuminate to what degree this is true among Albany Medical College (AMC) students
An evidence-based workshop prior to the psychiatry clerkship may prove beneficial in reducing stigma among medical students
Materials & Methods: Evaluating Stigma
A literature review was conducted
Medical students, professionals carry equal or greater stigma towards MI than general population5
A 4-part online survey was developed
To assess medical student attitudes towards MI
To illuminate need for education, curriculum intervention on this topic
Future Directions: Stigma Reduction Workshop
Assessment of class knowledge base
Pretest
Didactic
Intro to stigma
Illustrate patient experiences of MI
Multimedia
Small groups
Clinical vignettes
Comments, personal experiences
Discussion
Evaluate workshop effectiveness
Post-test
Project Timeline
June 2013 to present
Psychiatry patient focus groups
Literature review on MI and stigma
Nov to Spring 2015
Stigma assessment survey development
Survey data collection
Survey results analysis
Fall 2015 to Fall 2016
Development and implementation of stigma reduction workshop
Patients and families
Advocacy groups
Social workers
Federal and state law
Federal and state agencies
Psychiatry
Primary care
Social support
“We have a mental health system in this country that has completely and totally collapsed. We have no national database of these lunatics…We have a completely cracked mentally ill system that's got these monsters walking the streets.”
- Wayne LaPierre, Executive V.P. of the NRA (NBC’s Meet the Press)6
“Having mental illness is like diabetes or heart disease. Having diabetes doesn’t make you who you are.”
- A patient at the Capital District Psychiatric Center
References available upon request.