'Not in my backyard' : Public attitudes towards mental illness and people with mental illness living in sweden

摘要

BACKGROUND Several studies reveal that inadequate knowledge existregarding mental illness among the general population as well asstigmatizing attitudes towards persons suffering from a mental illness.The public s attitudes towards mental illness and people with mentalillness can be summarised with the inference that the majority considerpeople with mental illness are in need of help and entitled to receivesupport; thus support the idea of social integration of individuals withmental illness. However, negative and stigmatizing attitudes towardspersons with serious mental illness still present one main obstacle toovercome in order to facilitate social integration.AIM The overall aims of this thesis were 1) to explore, analyze anddescribe the public s opinions and attitudes towards mental illness ingeneral and towards persons with a serious mental illness in particular,2) to analyze the respondents attitudes in relation to theirsocio-economic background. An additional aim was to evaluate thereliability of an existing questionnaire; Community Attitudes TowardsMental Illness (CAMI), and subsequently adapt and develop thequestionnaire in accordance with Swedish conditions.MATERIALS AND METHODSIn sub-study I, nine psychiatric nurses were interviewed. Two men andseven women participated in the study. The method of interviewing andanalysis was inspired by the constant comparative method of groundedtheory .In sub-study II, nine psychiatric nurses were interviewed. Two men andseven women participated in the study and a qualitative content analysiswas used for the analysis.In sub-study III, the English version of CAMI was translated intoSwedish, renamed CAMI-S , and distributed to all nursing students whowere in their second year of studies at three universities situatedwithin large to mid-size cities in Sweden (n = 421).In sub-study IV, the CAMI-S questionnaire was supplemented with 9 itemsconcerning the respondents intention to interact with a person with amental illness and then renamed New CAMI-S . 5.000 questionnaires weresent out. The population consisted of a sample of Swedish residents aged18-85 years. The sampling frame was based on the Register of TotalPopulation (RTP) and consisted of all registered residents in Sweden aged18-85 years. The number of individuals within the sampling frame included7.055 235 people. An independent random sample, consisting of 5.000people was extracted from the sampling frame; 2.391 (47.9%) of the 5.000distributed questionnaires, were returned and analyzed.SUMMARY OF FINDINGS FROM EACH SUB-STUDYIn sub-study I, the process of behaving as a nurse or not wasidentified as a core category. Four subcategories were identified: receiving involuntary information , to take action or not , behavingas a mediator in the neighbourhood and the freedom of choice . Thefindings show that psychiatric nurses with professional knowledge aboutmental illness have moral concerns about their role as nurses duringtheir leisure time.In sub-study II, the nurses perceived that personal contact between theneighbour and the mentally ill person was one essential way to reducefear of the mentally ill person. They viewed themselves as a link betweenthe mentally ill person and other neighbours. Without the personalcontact between the mentally ill person and the neighbours, there may bea risk that integration will fail, no matter how excellent the supporteddwelling is framed.In sub-study III, a corrected inter-item-total correlation including allthe 40 original statements, revealed a weak loading on 20 items andtherefore was excluded. A factor analysis of the 20 items showed moderateto high loading, revealing the collected data could be adequatelyrepresented by extraction of three factors identified and labelled as;Open-minded and Pro-Integration, Fear and Avoidance and Community MentalHealth Ideology.In sub-study IV, a majority of the respondents displayed moderatelypositive attitudes. Respondents within the age group 31-50 years, appearto have increased sympathetic attitudes towards persons with mentalillness. Additionally; it is worth noting, that in contrary to previousresearch, results showed that persons with a lower level of education,tend to be more sympathetic towards persons with mental illness thanpersons with a high level of education.CONCLUSIONS A summary interpretation of the main findings containedwithin this thesis, reinforces the assumption that negative attitudestowards people with mental illness living in Sweden exists. This suggeststhat persons with mental illness frequently encounter stigmatizingattitudes in their surroundings as well as from mental healthprofessionals. The present thesis also demonstrates that additionalknowledge is not the only way to eliminate prejudices against mentalillness and mentally ill people. Mental health professionals withknowledge also display stigmatizing attitudes, which implies that they,as well as other citizens, must examine their own moral attitudes,improve their ability to interact with persons with mental illness andbecome more tolerant in order to prevent alienation.