Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

Jie Li; Xiao Ling Duan; Hua Qing Zhong; Wen Chen; Sara Evans‑Lacko; Graham Thornicroft

doi:10.1186/s13033-021-00441-7

Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

Jie Li^*, Xiao Ling Duan, Hua Qing Zhong, Wen Chen, Sara Evans‑Lacko, Graham Thornicroft

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01). Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.

Original language	English
Article number	17
Journal	International Journal of Mental Health Systems
Volume	15
Issue number	1
DOIs	https://doi.org/10.1186/s13033-021-00441-7
Publication status	Published - Dec 2021

Keywords

Care assistant workers
Human rights
Knowledge and attitudes
Low- and middle-income countries
Severe mental disorders
Stigma and discrimination

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s13033-021-00441-7

Cite this

@article{3c1b5aafe79b4bc68677e588bc3b9456,

title = "Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China",

abstract = "Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians{\textquoteright} Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01). Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.",

keywords = "Care assistant workers, Human rights, Knowledge and attitudes, Low- and middle-income countries, Severe mental disorders, Stigma and discrimination",

author = "Jie Li and Duan, {Xiao Ling} and Zhong, {Hua Qing} and Wen Chen and Sara Evans‑Lacko and Graham Thornicroft",

note = "Funding Information: This study was supported by four sources of funds. The first was the programme of randomly control study in intervention of patients with schizophrenia in community (201607010383), which was supported by Guangzhou Science Technology and Innovation Commission. The second was the mental health model research in community of Guangzhou (2016A031002), which was supported by Health and Family Planning Commission of Guangzhou Municipality. The third was the National Institute for Health Research under its Programme Grants for Applied Research scheme (Improving Mental Health Outcomes by Reducing Stigma and Discrimination: RP-PG-0606-1053). The fourth was the Medical Research Council of UK for INDIGO project (MR/R023697/1) lead by the King{\textquoteright}s College London. GT is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London at King{\textquoteright}s College London NHS Foundation Trust, and by the NIHR Asset Global Health Unit award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. GT also receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT is supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. Funding Information: We would like to appreciate participants of CAWs in this study, without whom the study would be difficult to conduct. We also appreciate the contributions of our colleagues such as Yu Fan, Qiao-Mei Zeng and Sheng-Li Huang (The Affiliated Brain Hospital of Guangzhou Medical University) who assisted with data collection. Thanks Xing-Rong Hou, the research assistant of the Community Psychiatry Department of The Affiliated Brain Hospital of Guangzhou Medical University, who assisted with editing and making comments on this manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = dec,

doi = "10.1186/s13033-021-00441-7",

language = "English",

volume = "15",

journal = "International Journal of Mental Health Systems",

issn = "1752-4458",

publisher = "BioMed Central",

number = "1",

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TY - JOUR

T1 - Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

AU - Li, Jie

AU - Duan, Xiao Ling

AU - Zhong, Hua Qing

AU - Chen, Wen

AU - Evans‑Lacko, Sara

AU - Thornicroft, Graham

N1 - Funding Information: This study was supported by four sources of funds. The first was the programme of randomly control study in intervention of patients with schizophrenia in community (201607010383), which was supported by Guangzhou Science Technology and Innovation Commission. The second was the mental health model research in community of Guangzhou (2016A031002), which was supported by Health and Family Planning Commission of Guangzhou Municipality. The third was the National Institute for Health Research under its Programme Grants for Applied Research scheme (Improving Mental Health Outcomes by Reducing Stigma and Discrimination: RP-PG-0606-1053). The fourth was the Medical Research Council of UK for INDIGO project (MR/R023697/1) lead by the King’s College London. GT is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London at King’s College London NHS Foundation Trust, and by the NIHR Asset Global Health Unit award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. GT also receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT is supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. Funding Information: We would like to appreciate participants of CAWs in this study, without whom the study would be difficult to conduct. We also appreciate the contributions of our colleagues such as Yu Fan, Qiao-Mei Zeng and Sheng-Li Huang (The Affiliated Brain Hospital of Guangzhou Medical University) who assisted with data collection. Thanks Xing-Rong Hou, the research assistant of the Community Psychiatry Department of The Affiliated Brain Hospital of Guangzhou Medical University, who assisted with editing and making comments on this manuscript. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01). Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.

AB - Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff, and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA) Scale. Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), and 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care to people with mental illness had significant higher MICA scores when compared with other staff (P < 0.001). Multivariable linear regression showed that after controlling for key variables, care willingness and PDD total score were positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significant negatively with the MICA total score (all P < 0.01). Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of “violent mentally ill” people to all people they deal with who have mental disorders. The results also indicate human rights are being paid some attention to now, but need to be further continually improved in the future. Strategies for improving such negative attitudes and reducing the perceived stigma and discrimination should be carried out towards particular staff groups in an anti-stigma programme in Guangzhou, China.

KW - Care assistant workers

KW - Human rights

KW - Knowledge and attitudes

KW - Low- and middle-income countries

KW - Severe mental disorders

KW - Stigma and discrimination

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U2 - 10.1186/s13033-021-00441-7

DO - 10.1186/s13033-021-00441-7

M3 - Article

AN - SCOPUS:85101379088

SN - 1752-4458

VL - 15

JO - International Journal of Mental Health Systems

JF - International Journal of Mental Health Systems

IS - 1

M1 - 17

ER -

Cross-sectional study of mental health related knowledge and attitudes among care assistant workers in Guangzhou, China

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Keywords

UN SDGs

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