PhD Scientific Days 2023

Mental Health Sciences IV.

The relationship between provider stigma towards people with mental illness and country indicators across Europe

Text of the abstract

Introduction: Mental health-related stigma occurs not only within the public community but also an issue among healthcare professionals. The relationship between national culture and provider stigma remains yet to be empirically attested.

Aims: We performed an observational, cross-sectional multicentre study across 32 European countries to investigate the attitudes of psychiatrists towards patients with mental health problems. We aimed to examine the relationship of attitude with country-specific factors.
Method: We measured stigmatising attitudes using the Opening Minds Stigma Scale for Health Care Providers within an online survey among specialists and trainees in general adult, child and adolescent psychiatry. We investigated the factor structure of the scale by using bifactor exploratory structural equation modeling. Then the total score was correlated with the Human Development Index (HDI), the Democracy Index (DI), the Social Progress Index (SPI), the number of psychiatrists per 100.000 people and the Hofstede dimensions. Latent class analysis was done to find subgroups of countries according to the stigmatising attitudes of psychiatrists and the six Hofstede dimensions.

Results: Altogether, n=4245 participants completed the survey. The bifactor model yielded the best-fitting model. Only 29 of 32 countries with the same factor structure were involved in further analyses. The stigmatising attitude significantly correlated with the long-term orientation (r=0.453, p=0.015) and indulgence dimensions (r=-0.629, p<0.0001) and with the HDI (r=-0.503, p=0.005), DI (r=-0.418, p=0.024), SPI (r=-0.348, p=0.040). The four-class model was the most appropriate in the latent class analysis, separating the high- and low-stigma countries. High stigma was associated with high power distance and uncertainty scores. The two low-stigma countries differed in individualism and uncertainty from each other.

Conclusions: Findings from this study not only expand knowledge of factors related to stigmatising attitudes of healthcare professionals, e.g., psychiatrists but also enlighten the cultural aspects of the stigma that could contribute to the further development of anti-stigma programs.

Funding: National Youth Talent Award 2020, 2021 (Ministry of Human Resources); Prominence Award 2021 (Kerpel-Fronius Talent Support Program); Semmelweis 250+ Excellence PhD Scholarship 2023.