Impact of a Mental Health Support Program on of Medical Residents' Stigmatization Towards People With Lived Experience

NCT05057026 | Terminated

• 1 other identifier: Version1, July 29, 2021
• Study Type: observational
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

The program, called the Mental Health Practice Support Program, is designed to teach new tools and skills for working with patients with mental health concerns in a family practice setting. The program is also being evaluated for effectiveness.

Conditions

Depression, Anxiety Disorders

Outcome Measures

Primary Outcomes (2)

• Opening Minds Scale for Health Providers (OMS-HC)

  Stigma changes will be measured using the 15 item Opening Minds Scale for Health Providers (OMS-HC), which captures providers' overall mental health related stigma as well as three main dimensions of stigma: negative attitudes, health professionals' own willingness to disclose/seek help for a mental illness, and preference for greater social distance. Total scores can range from 15 to 75, with lower scores indicating less stigma. This scale has been widely validated and used in evaluations of anti-stigma interventions in Canada. In 2014, a rigorous examination of the psychometric properties and responsiveness of the OMS-HC scale was conducted by Modgill G, et al. Results from this evaluation showed internal consistency as acceptable for all versions of the OMS scale (α = 0.74 to 0.79) and corresponding subscales (α = 0.67 to 0.68), further depicting the OMS-HC as an accurate and reliable instrument

  Pre-training, post-training, 6 , 12 and 18 months post -training

• PSP resident study_survey v1F Comfort in Managing Mental Health Conditions

  Confidence in managing depression will be assessed using adaptations of measures used in previous evaluations of this program with practicing primary care physicians. Modified versions of three ad hoc scales developed for a randomized controlled evaluation study in Nova Scotia were used to collect demographic information. The scales were also used to assess levels of confidence on a number of statements pertaining to their ability to diagnose, treat, and otherwise manage patients' mental health concerns using a 7-point Likert scale (not at all, very low, low, moderate, high, very high), with higher scores indicating higher levels of confidence, comfort, and familiarity.

  Pre-training, post-training, 6 , 12 and 18 months post -training

Secondary Outcomes (2)

• Emotion Scale

  Pre-training, post-training, 6 , 12 and 18 months post -training

• PSP resident study_survey v1F Use of and Comfort in Use of Tools and Strategies of the Program

  Pre-training, post-training, 6 , 12 and 18 months post -training

Other Outcomes (1)

• Correlation between changes in Physician Confidence and Stigma Scores.

  Pre-training, post-training, 6 , 12 and 18 months post -training

Study Arms (1)

Adult mental health support program

The investigators will evaluate the Impact of an Adult mental health support program on stigmatization and confidence of medical residents working with people with mental health concerns. The intervention will be delivered to approximately 30 residents from the University of Dalhousie family medicine residency program from the 2021-2022 academic year. The training will be delivered by resident groups. The first group will receive the PSP training October - November 2022. The second will receive the training November 2021 to February 2022. The third will take the training March to May 2022. Each group will include approximately 10 residents.

Other: Training Program Adult Mental Health Practice Support Program

Interventions

Training Program Adult Mental Health Practice Support Program OTHER

The Adult Mental Health Practice Support Program (PSP) was designed in 2009 by the General Practice Services Committee (GPSC) to address needs expressed by the province's family physicians to improve patient care in British Colombia. Its content and delivery model has been designed using evidence-based key ingredients and implication factors understood to be important for effective stigma reduction. These include the following: * the use of contact-based education, * skills-building to increase confidence and provide another management option with or without drugs particularly if access to mental health support services is difficult or absent * tools - using the principles of cognitive behavioural theory The training will be delivered virtually over a total of 4 sessions two weeks apart, covering an 8-week period. A two hour virtually delivered booster session will be provided to students approximately one year after the delivery of the initial training.

Adult mental health support program

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Residents from the University of Dalhousie family medicine residency program providing care for people with mental health conditions

You may qualify if:

• Family Medicine residency program students in the1st year of their program.
• Provision of informed consent In good standing in their program.

You may not qualify if:

• Medical Students who are not enrolled in Dalhousie University Family Medicine residency program

Sponsors & Collaborators

• Bianca Horner: lead
• University of Calgary: collaborator

Study Sites (1)

Dalhousie University Department of Psychiatry

Halifax, Nova Scotia, B3H2E2, Canada

Location

Related Publications (24)

• Adshead, Gwen. 2005. Healing ourselves: ethical issues in the care of sick doctors. Advances in Psychiatric Treatment 11 (5): 330-37. https://doi.org/10.1192/apt.11.5.330.

  RESULT

• Azrin ST. Integrated care: High-impact mental health-primary care research for patients with multiple comorbidities. Psychiatr Serv. 2014 Apr 1;65(4):406-9. doi: 10.1176/appi.ps.201300537.

  PMID: 24534819 RESULT

• Beaulieu T, Patten S, Knaak S, Weinerman R, Campbell H, Lauria-Horner B. Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: Results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial. Can J Psychiatry. 2017 May;62(5):327-335. doi: 10.1177/0706743716686919. Epub 2017 Jan 17.

  PMID: 28095259 RESULT

• Caldwell TM, Jorm AF. Mental health nurses' beliefs about likely outcomes for people with schizophrenia or depression: a comparison with the public and other healthcare professionals. Aust N Z J Ment Health Nurs. 2001 Mar;10(1):42-54. doi: 10.1046/j.1440-0979.2001.00190.x.

  PMID: 11421972 RESULT

• Health Nursing 10 (1): 42-54. https://doi.org/10.1046/j.1440-0979.2001.00190.x. College of Family Physicians of Canada, Canadian Psychiatric Association, and Canadian Psychological Association. (2020). Integrating Mental Health Services in Primary Care. Ontario: College of Family Physicians of Canada, Canadian Psychiatric Association, and Canadian Psychological Association.

  RESULT

• Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004 Oct;59(7):614-625. doi: 10.1037/0003-066X.59.7.614.

  PMID: 15491256 RESULT

• Emrich K, Thompson TC, Moore G. Positive attitude. An essential element for effective care of people with mental illnesses. J Psychosoc Nurs Ment Health Serv. 2003 May;41(5):18-25. doi: 10.3928/0279-3695-20030501-09.

  PMID: 12743963 RESULT

• Jones S, Howard L, Thornicroft G. 'Diagnostic overshadowing': worse physical health care for people with mental illness. Acta Psychiatr Scand. 2008 Sep;118(3):169-71. doi: 10.1111/j.1600-0447.2008.01211.x. No abstract available.

  PMID: 18699951 RESULT

• Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum. 2017 Mar;30(2):111-116. doi: 10.1177/0840470416679413. Epub 2017 Feb 16.

  PMID: 28929889 RESULT

• Knaak S, Modgill G, Patten SB. Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Can J Psychiatry. 2014 Oct;59(10 Suppl 1):S19-26. doi: 10.1177/070674371405901s06.

  PMID: 25565698 RESULT

• Knaak S, Patten S. A grounded theory model for reducing stigma in health professionals in Canada. Acta Psychiatr Scand. 2016 Aug;134 Suppl 446:53-62. doi: 10.1111/acps.12612.

  PMID: 27426646 RESULT

• Kopera M, Suszek H, Bonar E, Myszka M, Gmaj B, Ilgen M, Wojnar M. Evaluating Explicit and Implicit Stigma of Mental Illness in Mental Health Professionals and Medical Students. Community Ment Health J. 2015 Jul;51(5):628-34. doi: 10.1007/s10597-014-9796-6. Epub 2014 Dec 23.

  PMID: 25535045 RESULT

• Lauria-Horner B, Beaulieu T, Knaak S, Weinerman R, Campbell H, Patten S. Controlled trial of the impact of a BC adult mental health practice support program (AMHPSP) on primary health care professionals' management of depression. BMC Fam Pract. 2018 Nov 28;19(1):183. doi: 10.1186/s12875-018-0862-y.

  PMID: 30486799 RESULT

• Lukovic JA, Miletic V, Pekmezovic T, Trajkovic G, Ratkovic N, Aleksic D, Grgurevic A. Self-medication practices and risk factors for self-medication among medical students in Belgrade, Serbia. PLoS One. 2014 Dec 11;9(12):e114644. doi: 10.1371/journal.pone.0114644. eCollection 2014.

  PMID: 25503967 RESULT

• MacCarthy D, Weinerman R, Kallstrom L, Kadlec H, Hollander MJ, Patten S. Mental health practice and attitudes of family physicians can be changed! Perm J. 2013 Summer;17(3):14-7. doi: 10.7812/TPP/13-033.

  PMID: 24355885 RESULT

• Modgill G, Patten SB, Knaak S, Kassam A, Szeto AC. Opening Minds Stigma Scale for Health Care Providers (OMS-HC): examination of psychometric properties and responsiveness. BMC Psychiatry. 2014 Apr 23;14:120. doi: 10.1186/1471-244X-14-120.

  PMID: 24758158 RESULT

• Nyblade L, Stockton MA, Giger K, Bond V, Ekstrand ML, Lean RM, Mitchell EMH, Nelson RE, Sapag JC, Siraprapasiri T, Turan J, Wouters E. Stigma in health facilities: why it matters and how we can change it. BMC Med. 2019 Feb 15;17(1):25. doi: 10.1186/s12916-019-1256-2.

  PMID: 30764806 RESULT

• Patten SB, Remillard A, Phillips L, Modgill G, Szeto ACh, Kassam A, Gardner DM. Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students. BMC Med Educ. 2012 Dec 5;12:120. doi: 10.1186/1472-6920-12-120.

  PMID: 23216787 RESULT

• Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010 Sep 15;304(11):1181-90. doi: 10.1001/jama.2010.1300.

  PMID: 20841531 RESULT

• Sullivan GM, Feinn R. Using Effect Size-or Why the P Value Is Not Enough. J Grad Med Educ. 2012 Sep;4(3):279-82. doi: 10.4300/JGME-D-12-00156.1. No abstract available.

  PMID: 23997866 RESULT

• Ungar T, Knaak S, Szeto AC. Theoretical and Practical Considerations for Combating Mental Illness Stigma in Health Care. Community Ment Health J. 2016 Apr;52(3):262-71. doi: 10.1007/s10597-015-9910-4. Epub 2015 Jul 15.

  PMID: 26173403 RESULT

• Wallace JE. Mental health and stigma in the medical profession. Health (London). 2012 Jan;16(1):3-18. doi: 10.1177/1363459310371080. Epub 2010 Dec 22.

  PMID: 21177717 RESULT

• Weinerman R, Campbell H, Miller M, Stretch J, Kallstrom L, Kadlec H, Hollander M. Improving mental healthcare by primary care physicians in British Columbia. Healthc Q. 2011;14(1):36-8. doi: 10.12927/hcq.2011.22146.

  PMID: 21301237 RESULT

• MacCarthy D, Kallstrom L, Kadlec H, Hollander M. Improving primary care in British Columbia, Canada: evaluation of a peer-to-peer continuing education program for family physicians. BMC Med Educ. 2012 Nov 9;12:110. doi: 10.1186/1472-6920-12-110.

  PMID: 23140230 RESULT

MeSH Terms

Conditions

Depression; Anxiety Disorders

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Mental Disorders

Study Officials

• Bianca Lauria-Horner, MD

  Dalhousie University Department of Psychiatry

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Psychiatrist

Study Record Dates

• First Submitted: September 10, 2021
• First Posted: September 27, 2021
• Study Start: October 5, 2021
• Primary Completion: June 10, 2022
• Study Completion: June 10, 2022
• Last Updated: August 30, 2023

Record last verified: 2023-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: 36 Months

Locations

CA (1)