Student Paramedic Stigma towards People with Mental Illness: An International Study

Objective Stigma towards mental illness has been described in many health professions at the undergraduate level, but not in the discipline of paramedicine. The objective of this research was to describe levels of stigma towards people with mental illness as self-reported by undergraduate paramedicine students in Australia, Finland, New Zealand and South Africa. Design Using a cross-sectional design, an online survey was administered consisting of a validated instrument measuring self-reported stigma levels. Setting Four undergraduate paramedicine university programs in Australia, New Zealand, Finland and South Africa. Method The Opening Minds Scale for Health Providers (OMS-HC) is a validated, 20-item instrument measuring self-reported stigma. The 20 OMS-HC items were summed and generalised linear models with log link and Poisson family were used to examine associated factors. Results The overall level of self-reported stigma across students from all countries was 53, on a scale ranging from 20 (‘least stigmatised’) to 100 (‘most stigmatised’). Compared with the Australian cohort, total stigma scores increased significantly by 8% in New Zealand (p=0.01), 15% (p<0.001), and 18% in South Africa (p=0.002). Subscale analysis revealed high scores for social distance as a construct of stigma more broadly. Conclusion The findings provide an important baseline that can be used by paramedicine programs to inform development of mental healthcare curricula seeking to reduce stigma during the formative undergraduate years of professional development. The findings can be applied in a teaching and learning setting as source material to stimulate discussion and promote student self-reflection in a range of teaching activities.