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Mental health care in the community reduces stigma, UL study shows

University of Limerick living bridge
Wed, 21 Nov 2018

Research carried out at University of Limerick has offered the first evidence that community-based mental health services have a positive impact on local attitudes to mental health.

An article in this month’s Journal of Mental Health, based on studies of two Pieta House centres, shows that where services are delivered within the community rather than in an institutional setting, the stigma of mental health in that community is reduced.

“This work is amongst the first to offer evidence in support of the World Health Organisation’s recommendation that community-based services are more effective and lessen social exclusion of those affected by mental ill-health,” says Dr Michelle Kearns, lead author of the study.

“A community-based approach can be viewed as a welcome addition to hospital-based alternatives. Not only do such services have the benefits of accessibility and allow for treatment in a familiar environment, they also appear to impact the stigma of help-seeking and mental health issues,” she stated.

The research, titled ‘The Impact of Community-based Mental Health Service Provision on Stigma and Attitudes Towards Professional Help-seeking’ was conducted in collaboration with Pieta House mental health services, an advocate and practitioner of community-based mental healthcare. The group supports movement away from traditional, hospital-based treatment models towards integrated, community-based services that are accessed on an outpatient basis.

“This new model of healthcare was speculated to lessen the stigma around mental ill-health and help-seeking, as it provides distance from the stereotyped, historical, “insane asylum” rhetoric,” says Dr Kearns. “Until now, however, there was little or no evidence available to support such claims.”

At UL Dr Kearns, who is now based in UCD, examined the impact of Pieta House Suicide Prevention Centres opening in two towns in Ireland.

This study formed part of an ongoing collaboration between the UL Centre for Social Issues Research and Pieta House for Dr Kearns’ PhD research, which was supervised by Professor Orla Muldoon and Professor Rachel Msetfi in UL. The research was funded by an Irish Research Council Enterprise Partnership award, with Dr Paul Surgenor representing Pieta House as enterprise mentor on the project.

It was found that, amongst local residents, mental health-related stigma was significantly lower and attitudes towards seeking professional help significantly more positive after Pieta House’s community-based mental health services had been introduced in each locality. This suggests that the presence of local, community-based services can serve to reduce the stigma surrounding mental ill-health and positively impact help-seeking by initiating a normalising effect.

“The visibility of mental health services within a given area may result in community members viewing help-seeking behaviour as something that is not unusual or something to be ashamed of, but rather part of the everyday fabric of maintaining health and well-being, in the same way as visiting a doctor or a dentist,” Dr Kearns suggests.

Co-author Professor Orla Muldoon adds that “Local, community-based, accessible services such as Pieta House thus play an important role in facilitating help-seeking behaviour and the uptake of mental health support services, as this research suggests that their reach extends beyond the direct therapeutic effect of those receiving individual counselling, by positively impacting attitudes and stigma towards mental ill-health amongst those residing in the surrounding area.”

Brian Higgins, CEO of Pieta House, said, "Pieta House would like to sincerely thank Dr Michelle Kearns and Professor Orla Muldoon on the in-depth research carried out which studied the impact at local level of the establishment of a Pieta House centre in an area. The findings highlight that the presence of Pieta House, accessible mental health services in two localities have a positive impact on people seeking help by reducing the mental health stigma, changing norms and attitudes towards seeking professional help”.

“Our vision at Pieta House is a world where suicide, self-harm, and stigma have been replaced by hope, self-care, and acceptance. Stigma is frequently what brings people to the doors of Pieta House, often adding to stresses on youth and adult mental health. Thank you to the Irish Research Council Enterprise Partnership Scheme for the funding to facilitate the publication,” Mr Higgins added.