Social distance towards schizophrenia in health professionals

The stigma and prejudice of the public regarding psychiatric disorders are a long-standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self-rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan.

This study used a cross-sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18-item Social Distance Scale for schizophrenia, and the 19-item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self-rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia.

In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (n = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (β ± SE = -0.26 ± 0.14, p = .057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance.

High levels of self-rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and training are imperative to increase familiarity and knowledge of schizophrenia. Appropriate education could be implemented from different perspectives, including communication skills, resources of social support, and topics to reduce stigma and prejudice.