Public attitudes toward psychiatric treatment

Abstract

Aim

In order to examine whether there is a relationship between the state of mental health care and the acceptance of psychiatry, public attitudes toward psychiatric treatment in three countries where the reform of mental health care has progressed to a different degree will be compared.

Methods

Population surveys on public beliefs about mental illness and attitudes toward psychiatric treatment were conducted in Bratislava, Slovak Republic, and Novosibirsk, Russia. The data were compared with those from a population survey that had recently been carried out in Germany. In all three surveys, the same sampling procedure and fully structured interview were applied.

Results

Although respondents from all three countries were equally inclined to seek help from mental health professionals, those from Bratislava and Novosibirsk tended to recommend more frequently to address other medical or nonmedical professionals or members of the lay support system. In all three countries, psychotherapy was the most favored treatment modality, followed by psychotropic medication. Although natural remedies were more frequently recommended in Bratislava and Novosibirsk, meditation/yoga was more popular among the German public. Across all three countries, the endorsement of a brain disease as cause was associated with a greater willingness to seek help from medical professionals (psychiatrist, GP). Respondents who adopted biological causes tended to recommend psychotropic medication more frequently.

Conclusion

In countries with less developed mental health care systems, there appears to be a tendency of the public toward more frequently relying on helping sources outside the mental health sector and on traditional “alternative” treatment methods. However, it is our prognosis that with the progress of reforms observed, differences may further decrease.

Appendix

Vignette schizophrenia

Imagine that you hear the following about an acquaintance with whom you occasionally spend your leisure time:

Within the past months, your acquaintance appears to have changed. More and more, he retreated from his friends and colleagues, up to the point of avoiding them. If someone managed to involve him in a conversation, he would address only one single topic: the question as to whether some people had the natural gift of reading other people's thoughts. This question became his sole concern. In contrast with his previous habits, he stopped taking care of his appearance and looked increasingly untidy. At work, he seemed absent-minded and frequently made mistakes. As a consequence, he has already been summoned to his boss.

Finally, your acquaintance stayed away from work for an entire week without an excuse. Upon his return, he seemed anxious and harassed. He reports that he is now absolutely certain that people cannot only read other people's thoughts, but that they also directly influence them. He was, however, unsure who would steer his thoughts. He also said that when thinking, he was continually interrupted. Frequently, he would even hear those people talk to him, and they would give him instructions. Sometimes, they would also talk to each other and make fun of whatever he was doing at the time. The situation was particularly bad at his apartment, he claimed. At home, he would really feel threatened and would be terribly scared. Hence, he had not spent the night at his place for the past week, but rather, he had hidden in hotel rooms and hardly dared to go out.

Vignette major depressive disorder

Imagine that you hear the following about an acquaintance with whom you occasionally spend your leisure time:

Within the past 2 months, your acquaintance has changed in his nature. As opposed to previously, he is down and sad without being able to make out a concrete reason for his feeling low. He appears serious and worried. There is nothing anymore that will make him laugh. He hardly ever talks, and if he says something, he speaks in a low tone of voice about the worries he has with regard to his future. Your acquaintance feels useless and has the impression to do everything wrong. All attempts to cheer him up have failed. He lost all interest in things and is not motivated to do anything. He complains of often waking up in the middle of the night and not being able to get back to sleep. Already in the morning, he feels exhausted and without energy. He says that he encounters difficulty in concentrating on his job. In contrast with previous times, everything takes him very long. He hardly manages his workload. As a consequence, he has already been summoned to his boss.