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JCPSLP
Volume 19, Number 3 2017
Journal of Clinical Practice in Speech-Language Pathology
with mental illness, as well as providing students with the
knowledge, skills and awareness to advocate for ongoing
services for patients throughout their professional allied
health careers.
This main aim of this research study was to explore the
understanding, beliefs and attitudes of exercise physiology
(EP), speech-language pathology (SLP) and dietetic (DTn)
students towards mental health and mental illness prior to
commencing a 6–8 week clinical placement within a mental
health setting, and examine the nature and degree of any
changes seen post placement.
Method
The hypothesis of this study arose from the idea that
through providing clinical experience with patients who
have a mental health concern, allied health students,
including speech-language pathology students, will gain a
greater understanding about their professional role with this
clinical group and experience positive change in previously
held beliefs and attitudes. A convenience sample (Teddie &
Yu, 2007) of students from the disciplines of exercise
physiology, speech-language pathology and dietetics was
recruited. These professions were selected as they
represent the allied health professions that are playing an
increasingly important role in the care of people with mental
health concerns. Students were invited to participate in the
study by the primary author, who was associated with the
research though not responsible for the clinical education of
two of the included disciplines (exercise physiology and
dietetics). The invitation occurred in the first week of the
students’ placement. Students interested in participating in
the study responded directly to their clinical supervisor in
their respective discipline.
The research was overseen by two academics from two
universities in Australia. This study received ethics clearance
from the University of Melbourne Department of Medical
Education Health Advisory Group Ethics Committee
(#1543866) and the NSW Health Northern Sydney Local
Health District Human Research Ethics Committee
(#LNR/15/HAWKE/102 & #LNRSSA/15/HAWKE/122).
Participants
A total of 26 students were recruited for this study. Ten
students from exercise physiology, 10 students from
speech-language pathology and 6 students from dietetics
participated. All students were from the same university
undertaking clinical placement within a multidisciplinary
team located within a psychiatric inpatient metropolitan
mental health facility for a period of between six to eight
weeks. The university was responsible for allocation of
students to this site as per standard university procedure.
As part of the recruitment process students were provided
with a plain English description of what participation in the
study would entail. It was made clear that participation was
voluntary and the decision to participate would not impact
their clinical placement assessment or influence current or
future relationships with their university or the placement
organisation.
Data collection
Students’ beliefs and attitudes towards mental health were
explored pre-placement and again post-placement using
the following three validated questionnaires.
•
Level of Familiarity Survey (LOF) (Corrigan, Edwards
et al., 2001; Michaels & Corrigan, 2013) – examining
experience and familiarity with mental illness
latter action an example of discrimination. Discrimination
refers the behavioural reaction to the stereotypes and
prejudices held about a particular group and may manifest
in the health care sector as exclusion from, withholding of
or redirecting of services. Stereotypes (beliefs), prejudices
(attitudes) and discrimination (behaviours) are important to
examine and understand within health care settings, as
negative views can interfere with efficient patient care and
hinder a truly person-centred approach to service provision.
The role of education and
experience in changing attitudes
Emerging literature highlights some evidence about the
positive effect of dedicated clinical experience and/or
education about mental health in shifting students’ attitudes
and understanding about mental health. For example,
exposure to people with mental health conditions, through
clinical placements, has been shown to afford several
benefits for students and health professions more generally
in the areas of skills and knowledge (Feeney, Jordan, &
McCarron, 2013), as well as beliefs and attitudes
(Markstrom et al., 2009). Students may demonstrate a
reduction in their fears and anxieties about working in
mental health through exposure to and involvement in this
setting (Thomas & Bhattacharya, 2012) and increase
intentions to pursue careers in this area of clinical practice
as a result of greater familiarity and understanding (Happell
& Gaskin, 2012). As the need for services to support
patients with mental health concerns increases, so too
does the relevance and recognised role for allied health
clinicians (NSW Health, 2015). Therefore it is essential that
allied health students, including speech-language pathology
students, receive adequate preparation for work in a
diverse range of clinical areas, prior to graduation.
Information about how training programs and clinical
placements influence medical students’ attitudes towards
mental illness is most prevalent within the research
literature; however, outcomes of studies are mixed
(Happell & Gaskin, 2012; Stubbs, 2014). Some low-level
studies (utilising pre-post evaluation methods) suggest
training results in little or no change in attitudes, although
knowledge and understanding of mental health may
increase (Happell & Gaskin, 2012; Stubbs 2014). Yet
other studies have found positive changes in the attitudes
of health care students in connection with a clinical
placement in mental health (Corrigan, Druss, & Perlick,
2011; Corrigan, Edwards, Green, Diwan, & Penn, 2001;
Corrigan, Green, Lundin, Kubiak, & Penn, 2001; Corrigan,
Markowitz, Watson, Rowan, & Kubiak, 2003). To date,
there has been a paucity of literature exploring the benefits
of clinical placements and education programs within the
area of mental health for allied health students, relative
to medical or nursing literature. As the role and profile of
allied health professionals within this area increases and is
further acknowledged, a focus on high-quality methods to
adequately prepare graduates is warranted.
Exposure, discussion and explicit instruction regarding
mental illness is assumed to play an important role in
determining and reforming attitudes, both of professionals
and students. Clinical placements within mental health
are a unique and rich opportunity to influence students’
skills, knowledge and understanding of a potential area of
specialisation (Callaghan, Cooper, & Gray, 2007). Exposure
to mental health contexts as students may also assist
with identifying, challenging and addressing any negative
or inaccurate beliefs and attitudes held towards patients