Students' Cultural Beliefs Toward Mental Health

Mental health issues are common. The most recent national survey (Australian Bureau of Statistics, 2007) indicates that, of Australians aged 16-85, one in five (20% or 3.2 million) had experienced a mental disorder over the previous 12-months, and almost half (45% or 7.3 million) will experience a mental disorder during their lifetime. People with mental health problems have significant contact with all types of health services (Mather, Roche, & Duffield, 2014), and nurses need the appropriate knowledge, skills, and attitudes to care for these people regardless of the setting. Studies in Australia and elsewhere have demonstrated that quality educational and clinical experiences can improve attitudes to mental health nursing (Brunero, Jeon, & Foster, 2012; Happell & Gaskin, 2013; Surgenor, Dunn, & Horn, 2005).

One of the foundations of working effectively with people with mental health problems is the development of a therapeutic alliance (Pitkänen, Hätönen, Kuosmanen, & Välimäki, 2008), which itself is influenced by the beliefs and attitudes of the clinician (Albery et al., 2003; Hughes et al., 2008) .

The beliefs and attitudes held by individuals towards mental health problems vary between cultures (Chambers et al., 2010). These beliefs reflect different historical and cultural antecedents. Consequently, these beliefs impact on the understanding of mental health and resultant attitudes, for example by attributing agency to the development of disorder. Findings from an international study on beliefs and attitudes established their impact on how nurses deliver mental health practice (Chambers et al., 2010).

Students undertaking the BN course will provide care for people who experience mental health problems across a range of practice settings. Self-awareness of one’s own beliefs and attitudes concerning mental health influences an individual’s capacity to achieve therapeutic outcomes for people receiving nursing care (Stein-Parbury, 2013). Central to an undergraduate nursing curriculum is its capacity to provide teaching and learning activities which challenge and remedy fallacious beliefs and attitudes held by students on entering the course.

A systematic integrative review of the topic was undertaken (Whittemore & Knafl, 2005). An electronic search was conducted for the period January 2000 to January 2017. Databases searched included CINAHL Complete, PsycINFO, Medline and Informit. Key words used included attitudes to mental illness, cultural beliefs, undergraduate nursing students, religious beliefs, in combination with mental illness and mental disorder, and were informed by checking suggested subject terms. Secondary searches were conducted by hand examining references lists of identified papers. Inclusion criteria included English language, peer reviewed journal articles, and those addressing attitudes towards mental health problems, services and treatments. Exclusion criteria included those papers addressing attitudes and beliefs of established clinicians.

The above search strategy returned numerous papers. However, when these were examined more closely and different key word combinations applied, the number of papers significantly reduced. Further, application of exclusion criteria resulted in few papers meeting the criteria for review. Results were tabulated to facilitate comparison and integration of findings.

Findings reiterated the commonality of negative attitudes and beliefs about people with mental health problems and that these attitudes and beliefs are global in nature. Variation was noted between countries of origin, gender and clinical practice area of encounter during study (Hampton & Zhu, 2011; Linden & Kavanagh, 2012). Personal experience of mental health problems was not a significant predictor of attitudes and beliefs (Schafer, Wood, & Williams, 2011).

This paper addresses in detail the findings and ramifications for mental health nursing education design.