At home or in hospital: Home treatment and mental health stigma

Abstract

Background: Stigmatized attitudes towards people with mental illness may influence treatment choice for oneself and others. Aim: To gauge the attitudes of the UK general public towards treatment at home for mental illness and to assess the extent to which non-acceptability was related to stigmatized attitudes. Methods: Two hundred and two (101 female) people living in the UK completed an online (vignette) questionnaire in which we asked demographic details and personal experience of mental illness. To measure stigma, we used an adapted version of the Attitudes to Mental Illness Questionnaire (AMIQ) with vignettes asking about treatment at home and using scales for social distance and poor expectations; participants also filled in the Mental Health Knowledge Schedule (MAKS). Results: Participants did not evidence overall agreement with treatment at home for mental illness (i.e. >0; range = −16-to-+16, Mean ( M) = 0.86, 95% confidence interval (CI) = −0.08, 1.80, p = .073), although they showed significant agreement with treatment at home should they experience mental illness themselves (range = −8-to-+8, M = 1.36, CI = 0.82, 1.89, p < .001). Acceptability for treatment at home differed according to specific mental illness considered (range = −4-to-+4); depression ( M = 0.47, CI = 0.13, 0.81, p = .006) and alcohol abuse ( M = 1.46, CI = 1.14,1.77, p < .001) were considered suitable for being treated at home but schizophrenia was not ( M = −0.78, CI = −1.13,−0.43, p < .001). Multivariate analyses revealed that older age and attitudes indicating comfort with less social distance from people with mental illness were independently associated with treatment at home agreeability. Conclusions: Public acceptability of home treatment for mental illness remains ambivalent in the UK, most obviously when considering treatment approaches for individuals other than themselves and for people with schizophrenia. Disagreement with home treatment is particularly evident in younger people and those who prefer less social contact with people with mental illness.