JCPSLP vol 19 no 3 2017 low res. pdf

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JCPSLP Volume 19, Number 3 2017 135
6-week placement and some change in students’ beliefs
and attitudes mostly, though not exclusively, in a positive
direction. However, changes were conservative and more
comprehensive research including qualitative examination
of students’ experiences and responses to mental health
placement is warranted.
Limitations
When considering the findings of this study, it must be
acknowledged that the sample size was small which
inevitably limits the ability to generalise results more broadly
within the speech-language pathology discipline, to other
disciplines within allied health or to other mental health
settings. That said, the students who participated in the
study were representative of disciplines known to be
engaged in the mental health fields, and the findings can
therefore provide a starting point for further research within
allied health broadly and speech-language pathology
specifically. Within this study, there were differences in the
case load accessed by each discipline (e.g., acute vs.
rehabilitation), the style and amount of supervision received,
and the baseline level of theoretical knowledge prior to
commencing placement. These factors likely influenced the
trends seen within each discipline, and therefore the cohort
level findings. As this was a preliminary study with a small
sample size and resource constraints, it was not possible to
analyse the interrelationship between changes in familiarity,
attitudes and beliefs. Future research may be enhanced by
looking at correlations across these three areas.
Conclusion
In this study, beliefs and attitudes towards the area of
mental health and people with mental illness changed
positively in a sample of allied health students. On
commencing clinical placement in a mental health setting,
students from exercise physiology, speech-language
pathology and dietetics demonstrated dominant attitudes
towards people with mental illness consistent with a desire
to assist and support. This is a positive finding. However,
stigmatising beliefs and attitudes around avoidance, anger,
segregation and coercion were also noted along with the
potential for these attitudes to lead to discriminatory actions
or behaviours within personal and professional contexts.
Post-placement, there was a tentative trend across
disciplines towards greater familiarity with mental illness and
improvement of stigmatising beliefs and attitudes. These
findings suggest that there is some potential for clinical
placements in mental health settings to assist with
improving negative attitudes, prejudices and discrimination
towards people with mental illness amongst allied health
students. Further robust research utilising larger sample
sizes and mixed methodologies is required in this area.
References
AIHW. (2014). Australia’s health 2014. Australia’s Health
Series no. 14. Cat. no. AUS 178. Canberra: Author.
Australian Bureau of Statistics. (2009). National survey of
mental health and wellbeing: summary of results . Cat. no.
4326.0. Canberra: Author.
Brenner, A (2014). Stigma about mental illness steers
medical students away from psychiatry. The Conversation,
15 November.
psychiatry
Callaghan, P., Cooper, L., & Gray, R. (2007). Rethinking
clinical placements for mental health nursing students.
Mental Health Practice , 10(5), 18–20.
Questionnaire (AQ-27) for the domains of Help and Pity,
suggested by Corrigan et al. (2003) to correlate with
attitudes and behaviours consistent with assistance and
closeness. However, stigmatising beliefs and attitudes
pertaining to Avoidance, Segregation, Dangerousness and
Coercion were also prevalent pre-placement, suggesting
that while allied health students appear to have a desire to
help and support individuals with a mental illness, they also
possess a degree of reticence and caution.
By post-placement, students across the three
disciplines had demonstrated a positive shift in many
of their attitudes and beliefs about mental illness and
mental health when analysed at the multidisciplinary level.
In particular, improvements in the domains of Anger,
Avoidance and Coercion were noted across the three
disciplines, indicating perhaps that with greater familiarity
and exposure to patients with mental illness can come
greater understanding and positive attribution. This is
consistent with the suggestions of Feeney et al. (2013),
who noted changes in knowledge and skills following
clinical placement in a mental health setting, and Markstrom
et al. (2009), who observed changes in attitudes. For some
domains though, such as Blame and Segregation scores
on the Attribution Questionnaire did increase in one or more
of the disciplines, reflecting greater negative attribution.
Thus, it seems possible that experience of mental illness
can initially challenge students’ perceptions and lead to
reconsideration of previously held beliefs. Six weeks is only
a relatively short time to experience placement and it is
possible that the measures selected did not capture all the
qualitative changes that may have occurred in the students
as a result of their experience. It is important to note when
interpreting these results that no changes in attitudes
or beliefs on the Error Choice Test reached statistical
significance and the scores on the Attribution Questionnaire
were subjected to descriptive analysis only. These findings
should therefore be interpreted cautiously.
Experiential learning is considered to be an effective
method for influencing attitudes and increasing knowledge
across a range of areas within and allied with health
care. Providing opportunities to formalise mental health
placements within tertiary curricula may assist with
addressing this early on. The results obtained through
this study could form a starting point for the speech
pathology profession to review the involvement of
clinicians in this clinical area more holistically, and prepare
students at the undergraduate and postgraduate stages
to ensure that they are equipped with the knowledge and
understanding required to work with people with mental
health conditions in the future. Given ongoing increases in
government funding to mental health services, clinicians
will be encountering this clinical population in all areas of
practice. The refinement of clinical guidelines and position
papers within the profession has assisted speech-language
pathologists to understand and explore their potential role
in mental health contexts. Concurrently, recognition of the
contribution of speech-language pathology in the area of
mental health has burgeoned. Speech-language pathology
students therefore need to be sufficiently prepared prior
to graduation to work with this group of individuals, and
a direct way to address the current gap in knowledge
and experience is for education providers to address and
incorporate teaching and clinical experience in mental
health into undergraduate and graduate entry programs.
In summary, the findings of this study indicate an
increase in familiarity with mental illness following a