Longitudinal evaluation of the impact of an integrated psychiatry course on medical students as a tool to combat mental health stigma

Background and aim: This study seeks to investigate if the involvement of fifth-year medical school students in the Integrated Course in Psychiatry within the curriculum leads to enhanced understanding of mental health, improved attitudes towards individuals facing mental health distress, and intended behavior and/or contact with those experiencing mental health issues. Additionally, the study aims to identify potential predictors linked to changes over time in the three mentioned variables (knowledge, attitudes, and behaviors). Methods: All participating students were requested to complete a socio-demographic questionnaire and the Italian versions of three psychometric instruments: Mental Health Knowledge Schedule (MAKS-I), Community Attitudes to Mental Illness (CAMI-I), and the Reported and Intended Behavior Scale (RIBS-I). Each student was assigned a code which was used to match the questionnaires when re-administered at 3 months and 6 months. Results: Of 150 eligible students, 87 (58%) participated at baseline; 41 (27%) completed the 6-month follow-up. The results showed an improvement in attitudes (CAMI-I mean score from 113.13 to 115.88; p=.02) and behaviors (RIBS-I from 16.74 to 17.08; p=.05) toward individuals with mental distress. However, knowledge decreased (MAKS-I from 23.24 to 19.88; p<.001). Following people on social media who discuss mental health was significantly associated with improved attitudes over time (β =-6.47; p=.004), while having experienced mental health challenges was linked to higher intended behavior (β =-2.35; p=.03). Conclusions: The results obtained demonstrated that participation in a curricular course in psychiatry can-not be equated with participation in an anti-stigma activity. To hypothesize further improvement in the training activity, it could be useful to involve peer-workers as well, aiming to provide a perspective that is not solely doc-tor centered. (www.actabiomedica.it).