The attitudes of doctors in South Africa teaching hospitals towards mental illness and psychiatry

Abstract

Introduction. Mental illnesses are highly prevalent worldwide. The majority of mentally ill individuals are reintegrated into society where they often encounter stigma and discrimination. Stigmatisation by the community is a well-known and highly researched phenomenon. However, fewer studies have investigated the attitudes of medical doctors towards mental illness and as yet no such study has been done in South Africa. On reviewing the literature it is evident that negative attitudes also exist towards psychiatry as a profession, however to date there is limited data available on this topic. The aim of this study was to determine the attitudes of a group of psychiatric and non-psychiatric doctors towards people with mental illness and towards psychiatry as a profession. Methods. This was a cross-sectional study in the form of a self-administered questionnaire, which was distributed to medical doctors at five teaching hospitals in Gauteng, South Africa. All qualified doctors working at the selected institutions were eligible to participate in the study, regardless of their level of experience or specialist field. The questionnaire investigated their attitudes towards three mental illnesses namely; depression, schizophrenia and borderline personality disorder, and towards psychiatry as a profession. A convenience sampling method was used and two different questionnaires were distributed, one to the psychiatric and the other to the non-psychiatric doctor group. Results. A total of 531 doctors (16.4% psychiatric & 83.6% non-psychiatric) completed the questionnaire. Overall, the doctors’ attitudes were more negative towards persons with schizophrenia and borderline personality disorder than towards those with depression. For all three of the mental illnesses in question more than 50% of the doctors felt that persons would improve with treatment, however less than one third felt that they would ever recover fully. The non psychiatric doctors’ attitudes were more negative towards persons with schizophrenia and depression than the psychiatric doctors, with significantly more non-psychiatrists agreeing that such persons are unpredictable, dangerous and hard to talk to. More than 70% of the psychiatric group felt that non-psychiatric doctors considered psychiatrists to know less than other doctors and psychiatry to be an unimportant specialty. However, less than 11% of the non-psychiatric doctors actually held these negative views. Conclusion. Overall, the doctors in this inquiry did hold negative attitudes towards mental illness. However, the psychiatric doctor group were noted in a number of instances to be significantly more positive in their attitudes towards mental illness than their non-psychiatric colleagues. In addition, a large proportion of the psychiatric doctor group had encountered stigma towards their profession, but it was clear that they have incorrect perceptions with regards to the extent of the non-psychiatric doctors’ negative attitudes towards them and their profession.