Psychometric evaluation of the German version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC).

BACKGROUND: Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the German language version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC), a self-report measure of stigmatizing attitudes. METHODS: Staff (n = 392) on general psychiatric inpatient wards (excluding child, forensic and geriatric psychiatry) at five psychiatric hospitals in Switzerland (n = 3) and Germany (n = 2) participated in the study. The internal consistency of the OMS-HC was examined as well as its factor structure using exploratory and confirmatory factor analyses. To assess the scale's concurrent validity, we used the Social Distance Scale. RESULTS: Internal consistency for the OMS-HC total score was good (α = 0.74), acceptable for the subscales Attitudes (α = 0.62) and Social Distance (α = 0.69), and poor for the Disclosure subscale (α = 0.55). The original three-factor structure fit our data well. The OMS-HC total score and the Social Distance subscale score were significantly correlated with the Social Distance Scale, supporting concurrent validity. CONCLUSION: The German version of the OMS-HC demonstrated satisfactory psychometric properties and can be recommended for future research and intervention evaluation.

Embracing Psychosis: A Cognitive Insight Intervention Improves Personal Narratives and Meaning-Making in Patients With Schizophrenia.

Schizophrenia is a complex psychiatric disorder with unknown and presumably heterogeneous etiology. While the disorder can have various outcomes, research is predominantly "deficit-oriented" emphasizing the hardship that the disorder inflicts on sufferers as well as their families and society. Beyond symptom reduction, imparting patients with hope and meaning in life is increasingly considered an important treatment target, which may raise self-esteem, and reduce self-stigma and suicidal ideation. The present study compared a psychotherapeutic treatment aimed at improving cognitive insight, individualized metacognitive intervention (MCT+), with an active control in order to elucidate if personal meaning-making and hope can be improved in patients with psychosis across time. A total of 92 patients were randomized to either individualized metacognitive therapy (MCT+) or CogPack (neuropsychological training) and followed up for up to 6 months. The "Subjective Sense in Psychosis Questionnaire" (SUSE) was administered which covers different salutogenetic vs pathogenetic views of the disorder, valence of symptom experiences and the consequences of psychosis. Patients in the MCT+ group showed a significant positive shift in attitudes towards the consequences of their illness over time relative to patients in the active control condition. There was some evidence that MCT+ also enhanced meaning-making. The perceived negative consequences of psychosis were highly correlated with depression and low self-esteem, as well as suicidality. The study shows that a cognitive insight training can improve meaning-making in patients and help them come to terms with their diagnosis.

Peer support in mental health services.

PURPOSE OF REVIEW: Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services. RECENT FINDINGS: Current issues include benefits of peer support, its efficacy and effectiveness. The value of peer support in formal and informal settings is discussed, and organizational change processes and the challenges in peer support implementation are discussed. Recent studies have identified the need for a clarification of roles, competencies and job structure and for adequate training and supervision. Along with reported benefits for consumer and PSW involvement in care revealed by mixed method studies, destigmatization at the personal and system level is a crucial PSW component. SUMMARY: Various types of peer support merit further evaluation. Assessing the impact of peer support on service users, peer providers and organizations require complex intervention studies, using mixed methods designs with qualitative exploration of underlying processes and experiences to complement high-quality controlled trials.