Background: Community facilitators (CFs), such as pharmacists, policemen, teachers and clergy, may be an important community resource for patients with depression in addition to (mental) health professionals. However, they are ill prepared for such a role and little is known about their attitudes toward depression, which may affect practice.
Aim: To investigate CFs’ attitudes toward depression and compare them to those of (mental) health professionals and nurses.
Method: Attitudes were assessed in participants (n = 2,670) of training programmes about depression in nine countries of the European Alliance Against Depression (EAAD). The EAAD questionnaire included attitudes toward depression and its treatment, perceived causes, preferred treatment options, and knowledge of depression symptoms.
Results: CFs and nurses had a more negative attitude toward patients with depression and toward antidepressants, and more limited knowledge of depression symptoms than (mental) health professionals. CFs more frequently supported non-standard treatment for depression. Nurse assistants clearly differed from registered nurses with their attitudes being among the least favourable and their knowledge the most limited of all groups.
Conclusions: CFs and nurses had less favourable attitudes and more limited knowledge regarding depression when compared to mental health professionals and doctors. This may negatively affect professional collaboration, challenge optimal treatment and stigmatize patients. CFs’ and nurses’ knowledge and attitudes may be similar to those of the general population and be related to a lack of training in mental health issues.
Althaus, D. & Hegerl, U. ( 2003) The evaluation of suicide prevention activities: State of the art. World Journal of Biological Psychiatry, 4, 156-165.
2.
American Psychiatric Association (2000) Practice Guideline for Treatment of Patients with Major Depressive Disorder . Arlington: American Psychiatric Association.
3.
Angermeyer, M.C. & Dietrich, S. ( 2006) Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113, 163-179.
4.
Ayalon, L., Arean, P. & Bornfeld, H. ( 2008) Correlates of knowledge and beliefs about depression among long-term care staff. International Journal of Geriatric Psychiatry , 23, 356-363.
5.
Badger, F., Kingscote-Davies, T. & Nolan, P. ( 2002) The pharmacist’s role in the medicinal management of depression. Nursing Standard, 16, 33-40.
6.
Bell, J.S., Johns, R., Rose, G. & Chen, T. ( 2006) A comparative study of consumer participation in mental health pharmacy education. Annals of Pharmacotherapy , 40, 1759-1765.
7.
Blumner, K.H. & Marcus, S.C.(2009) Changing perceptions of depression: Ten-year trends from the General Social Survey. Psychiatric Services, 60, 306-312.
8.
Botega, N.J., Blizard, R., Wilkinson, D. & Mann, A. ( 1992) General practitioners and depression - First use of the depression attitude questionnaire. International Journal of Methods for Psychiatric Research, 4, 169-180.
9.
Caldwell, T. & Jorm, A.F. ( 2000) Mental health nurses’ beliefs about interventions for schizophrenia and depression: A comparison with psychiatrists and the public. Australian and New Zealand Journal of Psychiatry, 34, 602-611.
10.
Connery, H. & Davidson, K. ( 2006) A survey of attitudes to depression in the general public: A comparison of age and gender differences. Journal of Mental Health, 15, 179-189.
11.
Davidson, T.E., McCabe, M.P., Mellor, D., Karantzas, G. & George, K.(2009) Knowledge of late-life depression: An empirical investigation of aged care staff. Aging & Mental Health, 13, 577-586.
12.
Dowrick, C., Gask, L., Perry, R., Dixon, C. & Usherwood, T. ( 2000) Do general practitioners’ attitudes towards depression predict their clinical behaviour? Psychological Medicine, 30, 413-419.
13.
Eisses, A., Kluiter, H., Jongenelis, K., Pot, A., Beekman, A. & Ormel, J. ( 2005) Care staff training in detection of depression in residential homes for the elderly. British Journal of Psychiatry , 186, 404-409.
14.
Farrell, J. & Goebert, D. ( 2008) Collaboration between psychiatrists and clergy in recognizing and treating serious mental illness. Psychiatric Services , 59, 437-440.
15.
Goldman, L., Nielsen, N. & Champion, H. ( 1999) Awareness, diagnosis and treatment of depression . Journal of General Internal Medicine, 14, 569-580.
16.
Gray, R., Parr, A., Plummer, S., Sandford, T., Ritter, S., Mundt-Leach, R., Goldberg, D. & Gournay, K. ( 1999) A national survey of practice nurse involvement in mental health interventions. Journal of Advanced Nursing , 30, 901-906.
17.
Haddad, M., Plummer, S., Taverner, A., Gray, R., Lee, S., Payne, F. & Knight, D. ( 2005) District nurses’ involvement and attitudes to mental health problems: A three area cross-sectional study. Journal of Clinical Nursing, 14, 976-985.
18.
Haddad, M., Walters, P. & Tylee, A. ( 2007) District nursing staff and depression: A psychometric evaluation of Depression Attitude Questionnaire findings. International Journal of Nursing Studies, 44, 447-456.
19.
Hegerl, U., Althaus, D. & Stefanek, J. ( 2003) Public attitudes towards treatment of depression: Effects of an information campaign. Pharmacopsychiatry, 36, 288-291.
20.
Hegerl, U., Wittenburg, L.& European Alliance Against Depression Consortium (2009) The European Alliance Against Depression: A multilevel approach to the prevention of suicidal behavior. Psychiatric Services, 60, 596-599.
21.
Hegerl, U., Wittmann, M., Arensman, E., Van Audenhove, C., Bouleu, J., van der Feltz-Cornelis, C., Gusmao, R., Kopp, M., Löhr, C., Maxwell, M., Meise, U., Mirjanic, M., Oskarsson, H., Perez Sola, V., Pull, C., Picha, R., Ricka, R., Tuulari, J., Värnik, A. & Pfeiffer-Gerschel, T. ( 2008) The ‘European Alliance Against Depression (EAAD)’: A multifaceted, community-based action programme against depression and suicidality . World Journal of Biological Psychiatry , 9, 51-58.
22.
Hugo, M. ( 2001) Mental health professionals’ attitudes towards people who have experienced a mental health disorder. Journal of Psychiatric and Mental Health Nursing, 8, 419-425.
23.
Jorm, A.F., Christensen, H. & Griffiths, K.M. ( 2005a) Public beliefs about causes and risk factors for mental disorders. Changes in Australia over eight years. Social Psychiatry and Psychiatric Epidemiology, 40, 764-767.
24.
Jorm, A.F., Korten A.E., Jacomb, P.A., Christensen, H., Rodgers, B. & Pollitt, P. ( 1997a) Public beliefs about causes and risk factors for depression and schizophrenia. Social Psychiatry and Psychiatric Epidemiology , 32, 143-148.
25.
Jorm, A.F., Korten A.E., Rodgers, B., Pollitt, P., Jacomb, P.A., Christensen, H. & Jiao, Z. ( 1997b) Belief systems of the general public concerning the appropriate treatments for mental disorders. Social Psychiatry and Psychiatric Epidemiology, 32, 143-148.
26.
Jorm, A.F., Mackinnon, A., Christensen, H. & Griffiths, K.M. ( 2005b) Structure of beliefs about the helpfulness of interventions for depression and schizophrenia: Results from a national survey of theAustralian public. Social Psychiatry and Psychiatric Epidemiology, 40, 877-883.
27.
Kerfoot, M., Harrington, R., Harrington, V., Rogers, J. & Verduyn, C. ( 2004) A step too far? Randomized trial of cognitive-behaviour therapy delivered by social workers to depressed adolescents. European Child & Adolescent Psychiatry, 13, 92-99.
28.
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K., Rush, A., Walters, E. & Wang, P. ( 2003) The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (NCS-R). Journal of the American Medical Association, 289, 3095-3105.
29.
Lamb, H., Weinberger, L. & DeCuir, W. ( 2002) The police and mental health. Psychiatric Services, 53, 1266-1271.
30.
Lauber, C., Falcato, L., Nordt, C. & Rössler, W. ( 2003) Lay beliefs about causes of depression. Acta Psychiatrica Scandinavica, 108, 96-99.
31.
Lauber, C., Nordt, C., Falcato, L. & Rössler, W. ( 2001) Lay recommendations on how to treat mental disorders . Social Psychiatry and Psychiatric Epidemiology, 36, 553-556.
32.
Lauber, C., Nordt, C. & Rössler, W. ( 2005) Recommendations of mental health professionals and the general population on how to treat mental disorders. Social Psychiatry and Psychiatric Epidemiology, 40, 835-843.
33.
Lauber, C., Nordt, C. & Rössler, W. ( 2006) Attitudes and mental illness: Consumers and the general public are on one side of the medal, mental health professionals on the other . Acta Psychiatrica Scandinavica, 114, 145-146.
34.
Leavey, G. & King, M. ( 2007) The devil is in the detail: Partnerships between psychiatry and faith-based organizations. British Journal of Psychiatry , 191, 97-98.
35.
Leavey, G., Loewenthal, K. & King, M. ( 2007) Challenges to sanctuary: The clergy as a resource for mental health care in the community. Social Science and Medicine , 65, 548-559.
36.
Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A. & Pescosolido, B.A. ( 1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. American Journal of Public Health, 89(9), 1328-1333.
37.
Mann, C. & Himelein, M. ( 2004) Factors associated with stigmatization of persons with mental illness. Psychiatric Services, 55, 185-187.
38.
Mann, J.J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., Hegerl, U., Lonnqvist, J., Malone, K., Marusic, A., Mehlum, L., Patton, G., Phillips, M., Rutz, W., Rihmer, Z., Schmidtke, A., Shaffer, D., Silverman, M., Takahashi, Y., Varnik, A., Wasserman, D., Yip, P. & Hendin, H. ( 2005) Suicide prevention strategies: A systematic review . Journal of the American Medical Association, 294, 2064-2074.
39.
McCabe, M.P., Russo, S., Mellor, D., Davidson, T.E. & George, K. ( 2008) Effectiveness of a training program for carers to recognize depression among older people. International Journal of Geriatric Psychiatry, 23, 1290-1296.
40.
McCrae, N., Murray, J., Banerjee, S., Huxley, P., Bhugra, D., Tylee, A. & MacDonald, A. ( 2005) ‘They’re all depressed, aren’t they?’ A qualitative study of social care workers and depression in older adults . Aging and Mental Health, 9, 508-516.
Moses, T. & Kirk, S. ( 2006) Social workers’ attitudes about psychotropic drug treatment with youths. Social Work, 51, 211-222.
43.
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V. & Ustun, B. ( 2007) Depression, chronic diseases and decrements in health: Results from the World Health Surveys. Lancet, 370, 851-858.
44.
O’Hara, M., Gorman, L. & Wright, E. ( 1996) Description and evaluation of the Iowa Depression Awareness, Recognition and Treatment Program. American Journal of Psychiatry , 153, 645-649.
45.
Payne, F., Harvey, K., Jessopp., L., Plummer, S., Tylee, A. & Gourney, K. ( 2002) Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training. Journal of Advanced Nursing, 40, 549-559.
46.
Phokeo, V., Sproule, B. & Raman-Wilms, L. ( 2004) Community pharmacists’ attitudes towards and professional interactions with users of psychiatric medication. Psychiatric Services, 55, 1434-1436.
47.
Pinfold, V., Huxley, P., Thornicroft, G., Farmer, P., Toulmin, H. & Graham, T. ( 2003) Reducing psychiatric stigma and discrimination: Evaluating an educational intervention with the police force in England. Social Psychiatry and Psychiatric Epidemiology, 38, 337-344.
48.
Priest, R., Vize, C., Roberts, A., Roberts, M. & Tylee, A. ( 1996) Lay people’s attitudes to treatment of depression: Results of opinion poll for Defeat Depression Campaign just before its launch . British Medical Journal, 313, 858-859.
49.
Psarra, V., Sestrini, M., Santa, Z., Petsas, D., Gerontas, A., Garnetas, C. & Kontis, K. ( 2006) Greek police officers’ attitudes towards the mentally ill. International Journal of Law and Psychiatry , 31, 77-85.
50.
Ross, S., Moffat, K., McConnachie, A., Gordon, J. & Wilson, P. ( 1999) Sex and attitude: A randomized vignette study of the management of depression by general practitioners. British Journal of General Practice, 49, 17-21.
51.
Schomerus, G., Matschinger, H. & Angermeyer, M.C. ( 2006) Public beliefs about the cause of mental disorders revisited . Psychiatry Research, 144, 233-236.
52.
Sigurdsson, E., Olafsdottir, T. & Gottfredsson, M. ( 2008) Public views on antidepressant treatment: Lessons from a national survey. Nordic Journal of Psychiatry, 62, 374-378.
53.
Stern, S., Williams, T., Dixon, S., Clement, J., Butt, Z., Schwartzbaum, J. & Busch, K. ( 1999) Do health professionals’ attitudes interfere with the treatment of depression? Depression and Anxiety, 9, 151-155.
54.
Stewart, W., Ricci, J., Chee, E., Hahn, S. & Morganstein, D. ( 2003) Cost of lost productive work time among US workers with depression. Journal of the American Medical Association , 289, 3135-3144.
55.
Vermette, H., Pinals, D. & Appelbaum, P. ( 2005) Mental health training for law enforcement professionals . Journal of the American Academy of Psychiatry and Law , 33, 42-46.
56.
Walsh, J., Green, R., Matthews, J. & Bonucelli-Puerto, B. ( 2005) Social workers’ views of the etiology of mental disorders: Results of a national survey. Social Work , 50, 43-52.
57.
Walter, H., Gouze, K. & Lim, K. ( 2006) Teachers’ beliefs about mental health needs of inner city elementary schools. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 61-68.
58.
Wang, J., Fick, G., Adair, C. & Lai, D. ( 2007) Gender-specific correlates of stigma toward depression in a Canadian general population sample. Journal of Affective Disorders, 103, 91-97.
59.
Watson, A., Corrigan, P. & Ottati, V. ( 2004) Police officers’ attitudes toward and decisions about persons with mental illness. Psychiatric Services, 55, 49-53.
60.
Weaver, A., Flannelly, K., Flannelly, L. & Oppenheimer, J. ( 2003) Collaboration between clergy and mental health professionals: A review of professional health care journals from 1980 through 1999. Counseling and Values, 47, 162-171.
61.
Ziervogel, A., Pfeiffer, T. & Hegerl, U. ( 2005) How effective is advanced training concerning depression and suicidality among the elderly? Results of a pilot study. Archives of Suicide Research, 9, 11-17.
