Impact of an Educational Intervention On Nigerian Medical Student's Attitude to Persons with Severe Mental Illness

Introduction Stigma and social distance towards persons with severe mental illness are factors that may significantly limit access to healthcare and prevent optimal delivery of health services by professionals. Little is known about the impact of educational programmes on the attitude of medical students to severe mental illness in developing countries despite emerging evidence of high levels of stigma (Adewuya and Makanjuola, 2008; Lauber and Rossler, 2007). This study aimed to examine the effect of an anti-stigma intervention on medical student's attitude to mental illness. Methods This was a quasi experimental study involving 107 medical students that had completed 4 weeks of psychiatry clerkship. Fifty five students received the intervention consisting of a short video session (Changing minds) and a 1 hour interactive discussion while 52 students served as controls. Both groups completed sociodemographic variables, Modified Bogardus Social distance Scale and two short case vignettes of schizophrenia and depression (Attitude to mental illness questionnaire) were administered before and after the intervention. Pre- and post-mean attitudinal scores were analyzed and significance determined with paired t-test. Results The level of desired social distance towards the mentally ill increased with the level of intimacy required in the relationship, with 8.8% of the participants categorized as having low social distance, 42.1% as having moderate social distance and 49.1% as having high social distance towards the mentally ill. At the end of the intervention, attitude to depression {experimental (t = -4.7; p < 0.001); control (t = -0.069; 0.945)} and schizophrenia {experimental (t = -2.2; p = 0.032); Control (t = -0.19; p < 0. 850)} improved. Attitudinal change was not predicted by age and sex. Conclusion The attitude of future medical professionals towards persons with schizophrenia may improve with tailored educational interventions. It is possible that a complex interplay of factors affect the attitude of medical students to schizophrenia. In overcoming the negative impact of social distance and stigma on mental illness, undergraduate training provides a critical context for early introduction of simple and effective preventive strategies.