Introduction: Studies of social attitudes towards the mentally ill revealed their down-casting as untrustworthy, ineffective and even dangerous. It is hypothesized that contact with patients is associated with an increase in favourable attitudes towards the mentally ill.
Method: An attitude test was administered to student nurses before and after their psychiatric nurse training rotation.
Results: A significant increase in favourable attitudes was found at the expense of a reduction in undecided and unfavourable attitudes.
Discussion: The social down-casting of the mentally was reflected in student nurse’s initial attitudes towards the mentally ill as dangerous and unreliable or at least unproductive human beings.
Conclusion: Contact with patients during training elicited empathy of trainee nurses and this was reflected in more favourable attitudes towards the mentally ill and the correction of unfavourable or undecided attitude of awe, untrustworthiness, unpredictability and even dangerousness derived from the culture from which the student nurses come.
Keywords: Mental stigma; Student nurses; Psychiatric training
Mental stigma is the social down-casting of the mentally ill. Scales introduced to measure this attitude were adapted to the Arab culture by Kadri  in Morocco and by Sidhom et al.  in Egypt. The present study tests the hypothesis that contact with mentally ill patients is associated with favourable attitude changes among student nurses.
The subjects of this study were student nurses from the high nursing institute in Al-Gouna, Hurgada, Egypt who spent an 8-week psychiatric training rotation in the Behman psychiatric hospital, Cairo (June 2015 to August 2015)
Student nurses completed an attitude questionnaire before and after their rotation in this hospital. The questionnaire used was the Bartlett et al.  scale which was published as exhibit 9-21 in scales for measurement of attitude . The test was presented to students in its original English language after re-wording to apply to the mentally ill rather than the mentally retarded. This test was thought to have facevalidity because most of its items are included in the scales used by Kadri  and Sidhom et al.  For 24 attitude statements nurse students expressed approval, disproval or indecision.
Students included 8 males and 2 females aged 20 years to 22 years. Students and their training supervisors agreed to the study which was considered ethical by the hospital review board. Table 1 shows the total of students’ favourable, unfavourable and undecided attitudes before and after their psychiatric training rotation.
|Attitudes||Before rotation||After rotation||Total|
|2 dfX2=44.0 P<0.001|
Table 1: Attitudes sum totals of student nurses before and after their rotation.
Favourable attitudes were significantly increased after student nurses’ contact with mentally ill patients throughout their psychiatric training rotation. The increase in favourable attitudes was mainly at the expense of reduction of the undecided responses. The study is confirmed.
Students’ initial attitudes reflect the attitudes of the community in general which are based on anecdotal and media information about the myth of mental illness. In the Arab society, mental illness is still attributable to supernatural agents known as jinn (demons) which are alleged to break patient’s contact with reality and break their reasoning.
The social down-casting of the mentally was reflected in student nurse’s initial attitudes towards the mentally ill as dangerous and unreliable or at least unproductive human beings.
Contact with patients not only reduced the awe of students but also demonstrated how treatment restored their pre-morbid selves to varying degrees. Students empathized with patients who had mental suffering that interrupted their social adaptation, productivity and independence. Our findings echo those reviewed by Kadri  in medical students’ before and after their psychiatric rotation.