A Simple approach for improving the Knowledge and Attitude of Primary Health Workers towards Mental illness in a Rural Community in Southeast Nigeria

Abstract

Background: An adequate knowledge of mental illness causation,
treatment modalities and positive attitude to the mentally ill among health workers is paramount to the development of mental health services in any community. The effects of information
and education intervention on the knowledge and attitude of primary health care workers towards mental disorders were evaluated in this study.
Methods: A parallel experimental study design with an educational
intervention involving a study and control group (50 participants each) was undertaken among primary health care workers in a rural community in Igbo-Etiti Local Government
Area of Enugu State, in southeastern Nigeria. Pre- and post-intervention data was collected using a pre-tested, semi structured and self-administered questionnaire. A 5-point Likert scale ranging from “totally disagree” to “totally agree” (1-5) was used to score attitudinal subscales.
Findings: At baseline only 11 (22.0%) workers each in the study and control groups respectively agreed that mental illness
arose wholly from medical causes while 36 (72.0%) & 35 (70.0%) workers believed in the dual aetiology of traditional and medical factors. The belief in medical aetiological factors rose significantly to 21 (42.0%) in the study group post-intervention. However the preferred mode of treating mental illness for the study and control groups respectively at baseline was orthodox medicine 25 (50.0%) &15 (30.0%), orthodox/alternative medicine
22 (44.0%) & 33 (66.0%) but there was no significant difference
post-intervention. There were no significant difference in the mean attitude subscales of the study and control groups respectively at base line, stereotyping (3.8 & 3.8), separatism (2.8 & 3.0), stigmatisation (2.7 & 3.0) pessimistic prediction (2.6 & 2.8), restrictiveness (2.1 & 2.4) and benevolence (1.3 & 1.4). Post-intervention, a statistically significant change in attitude was observed with P-values of 0.00 in all attitudinal subscales between study and control groups.
Interpretation: The result of this study suggests that information
and education intervention improved health workers knowledge of mental illness causation and attitude towards the mentally ill in the study community. The simple intervention could be replicated in other rural communities in Nigeria and Africa to aid the development of community mental health services.

Keywords: Mental illness; PHC workers; knowledge; attitude; Igbo tribe, Nigeria.

Nigerian Medical Journal Vol. 48 (1) 2007: pp. 4-8