Perceptions of mental health literacy, stigma, empathy, and confidence in managing patients with psychiatric disorders among doctors and nurses working in a Singapore emergency department.

Abstract

In line with the global rise in mental health disorders, Singapore has experienced a notable increase in prevalence, from 13.4% in 2020 to 17% in 2022. Despite strategic efforts to strengthen mental health services, such as expanding the workforce of psychiatrists and psychologists and integrating care into primary healthcare settings, the Emergency Department (ED) faces escalating numbers of patients with psychiatric disorders. This surge leads to heightened workloads, stress, and burnout among healthcare professionals. This study explores the perceptions of mental health literacy, stigma, empathy, and confidence in managing patients with psychiatric disorders among doctors and nurses working in Singapore's EDs. Questionnaires used include the Mental Health Literacy Scale (MHLS) to assess mental health literacy, the Opening Minds Scale for Health Care Providers-15 (OMS-HC-15) to measure attitudes toward mental illness, and the Jefferson Scale of Empathy (JSE) to measure empathy. In the last quarter of 2021, 47 doctors and 63 nurses from the ED at a general restructured hospital in Singapore, who had worked for at least 4 months in the ED, completed the survey. The anonymous survey included the above-validated questionnaires and two original questionnaires that assessed confidence in managing patients with psychiatric disorders and their familiarity with the local Mental Health Care and Treatment Act (MHCTA). Differences between doctors and nurses for all categorical variables, including demographic data and the questionnaire responses of interest, were analysed. Findings reveal that doctors scored higher in mental health literacy (MHLS score of 121.89 to 118.27) and empathy (JSE score of 109.32 to 101.44) and lower in stigma than nurses (OMS-HC-15 score of 41.98 to 43.57). Furthermore, Singaporean ED professionals scored lower on these dimensions than their counterparts in Western countries but outperformed those in East Asia. The unique roles of doctors and nurses, coupled with Singapore's distinct sociocultural context, likely contribute to these variations. Both groups demonstrated moderate confidence in handling patients with psychiatric disorders but emphasised the need for further training. These insights underscore the importance of implementing systemic policies and targeted training programmes to improve mental health care, reduce stigma, and enhance empathy and confidence among ED professionals.