Self-perceptions of aging, physical activity, and depressive symptoms in older community residents with varied neighborhood walkability in Taiwan.

BACKGROUND: Prior research has identified the mediating effect of physical activity in the relationship between self-perceptions of aging and physical health. However, this impact on mental health is unknown, and the influence of environmental contexts proposed by ecological models in this regard remains largely unexplored. Therefore, this study aimed to investigate the role of physical activity in the relationship between self-perceptions of aging and depressive symptoms in older adults, and compare the impact across four levels of neighborhood walkability. METHODS: A sample of 1,055 community-dwelling older adults aged 65 or above was obtained through random-digit-dialing computer-assisted telephone interviewing. The individual's neighborhood walkability was calculated using Walk Score®, and categorized into four levels: car-dependent, somewhat walkable, very walkable, and walker's paradise. Partial least squares structural equation modelling was employed. RESULTS: We found that more positive self-perceptions of aging were associated with fewer depressive symptoms and a mediation effect of physical activity in this relationship. Among the four levels of neighborhood walkability, the mediation effect of physical activity was only statistically significant in the lowest level (car-dependent). The findings supported our hypotheses regarding the mediating effect of self-perceptions of aging on depressive symptoms via physical activity. Neighborhood walkability might potentially influence the mediating role of physical activity. CONCLUSIONS: This study emphasizes key areas on intervention programs and policy formulation to promote mental health in older adults.

The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia.

Impaired quality of life (QoL) is a common and clinically relevant feature of schizophrenia. In the present study, we attempted to formulate a model of QoL in the chronic stage of schizophrenia by including key variables-namely cognitive insight, self-stigma, insight into treatment, and medication compliance-that were proposed as its significant predictors in previous studies. We employed structural equation modeling (SEM) to simultaneously test the associations between these variables. A total of 170 community-dwelling patients with schizophrenia participated in this study. Cognitive insight, self-stigma, insight into treatment, medication compliance, and QoL were assessed through self-reporting. Symptoms were rated by interviewers. The influences of cognitive insight, stigma, insight into treatment, and medication compliance on QoL were supported using SEM. Our findings indicated that cognitive insight had a significant, positive, and direct effect on both self-stigma and insight into treatment; in contrast, it had a negative and direct effect on medication compliance. Notably, no evidence indicated a direct effect of cognitive insight on QoL. Thus, individuals with high cognitive insight reported low QoL because of stigma, low medication compliance, and their increased insight into treatment. In contrast, cognitive insight might indirectly ameliorate QoL mediated by the effect of insight into treatment on medication compliance. The findings provide additional support of the links between cognitive and clinical insight, self-stigma, medication compliance, and QoL in those with schizophrenia and suggest the need for screening and intervention services appropriate for this high-risk population.

Stigma Resistance in Stable Schizophrenia: The Relative Contributions of Stereotype Endorsement, Self-Reflection, Self-Esteem, and Coping Styles.

OBJECTIVE: Stigma resistance (SR) has recently emerged as a prominent aspect of research on recovery from schizophrenia, partly because studies have suggested that the development of stigma-resisting beliefs may help individuals lead a fulfilling life and recover from their mental illness. The present study assessed the relationship between personal SR ability and prediction variables such as self-stigma, self-esteem, self-reflection, coping styles, and psychotic symptomatology. METHOD: We performed an exploratory cross-sectional study of 170 community-dwelling patients with schizophrenia. Self-stigma, self-esteem, self-reflection, coping skills, and SR were assessed through self-report. Psychotic symptom severity was rated by the interviewers. Factors showing significant association in univariate analyses were included in a stepwise backward regression model. RESULTS: Stepwise regressions revealed that acceptance of stereotypes of mental illness, self-esteem, self-reflection, and only 2 adaptive coping strategies (positive reinterpretation and religious coping) were significant predictors of SR. The prediction model accounted for 27.1% of the variance in the SR subscale score in our sample. CONCLUSIONS: Greater reflective capacity, greater self-esteem, greater preferences for positive reinterpretation and religious coping, and fewer endorsements of the stereotypes of mental illness may be key factors that relate to higher levels of SR. These factors are potentially modifiable in tailored interventions, and such modification may produce considerable improvements in the SR of the investigated population. This study has implications for psychosocial rehabilitation and emerging views of recovery from mental illness.

Relationships of perceived public stigma of mental illness and psychosis-like experiences in a non-clinical population sample.

PURPOSE: Studies on the association between psychopathology, perceived public stigma, and labeling in mental illness have focused primarily on severe but rare mental disorders, especially schizophrenia, or other clinically defined psychotic disorders. Although evidence is mounting that psychosis-like experiences show high prevalence in the general population and lead to an increased risk of psychotic disorders, little is known about how psychosis-like experiences independently affect perceived public stigma in the non-clinical population. The aim of the present study was to examine the relationship between psychosis-like experiences and perceived public stigma in a non-clinical sample. METHODS: For this cross-sectional study, we recruited 524 individuals (239 male, 285 female) who had no lifetime history of psychiatric disorder. Participants completed questionnaires that asked for sociodemographic and clinical information, a measure of perceived public stigma (Perceived Psychiatric Stigma Scale [PPSS]), and two measures of psychosis-like experiences (Peters et al. Delusions Inventory [PDI]; Cardiff Anomalous Perceptions Scale [CAPS]). RESULTS: Of the sociodemographic characteristics analyzed in this study-gender, age, education level, marital status, and religion-only age simultaneously influenced PPSS, PDI, and CAPS scores. As hypothesized, perceived public stigma was positively correlated with measures of psychosis-like experiences, even after controlling for age. Furthermore, the perceived stigma was more strongly associated with delusion proneness than with anomalous perceptual experiences. CONCLUSION: The association between psychopathology and perceived public stigma appears to extend beyond clinically defined psychosis to more common psychosis-like experiences in a sample drawn from the general Han Chinese population.

Estimation of heritability for varied indexes of handedness.

Inconsistent results of the molecular studies for handedness have been reported. One of the key issues involved could be ways of assessing handedness. The current study aimed to identify the index of handedness better reveal the genetic component, which showed higher heritability. We measured handedness using the Annett's handedness questionnaire. The college students participating in this study filled the questionnaire in the class while their first-degree relatives returned questionnaires one to two weeks later. A total of 1,968 subjects returned their questionnaires, including 640 college students and 1,328 first-degree relatives. Among the 449 college students returning at least one handedness questionnaire for their parents, a total of 449 fathers, 440 mothers, and 425 siblings participated in the study. The index of mixed-handedness (e.g., Degree of Handedness) showed highest heritability (0.67), followed by the Hand Preference Index (0.52), and then the Direction of Handedness (0.39). Using an index of mixed-handedness for future molecular studies was suggested.

Internalized stigma and stigma resistance among patients with mental illness in Han Chinese population.

Research suggests that accurate measurement is essential in evaluating internalized stigma and abilities to combat with stigma for treatment compliances and outcomes in individuals with mental illness. The purpose of this study was to assess the reliability and validity of the Chinese version of the Internalized Stigma of Mental Illness Scale (ISMIS-C), which is one of the few tools available to measure internalized stigma and stigma resistance (SR) simultaneously. A total of 160 outpatients with (n = 103) and without (n = 57) psychotic disorders were administrated with the ISMIS-C, and measures of self-esteem, self-efficacy, depression, and hopelessness. Overall, the 29-item ISMIS-C was presented to be internal reliable (Cronbach's alpha = 0.90), and reliable over time (intraclass correlation coefficients = 0.36-0.73). The construct validity of the ISMIS-C derived from the factor analysis was nearly identical to the original version. ISMIS-C dimension scores were well correlated with each other and measures of self-esteem, self-efficacy, depression, and hopelessness. Our data also demonstrated that psychotic patients experienced higher internalized stigma scores than those without psychotic diagnoses, but endorsed indifferently on SR scores. This scale can be used as an informative device when investigating "internalized stigma" and "SR" among individuals with or without psychotic disorders.

The power of knowledge: How mental health literacy can overcome barriers to seeking help.

Mental health literacy (MHL) predicts help-seeking attitudes. However, the relationship between components of MHL and help-seeking attitudes has not been thoroughly examined. This study aims to examine whether mental illness stigma, help-seeking efficacy, and maintenance of positive mental health mediated the relationship between recognition of mental disorders and help-seeking attitudes, using a meta-analytic structural equation modeling (MASEM) approach. A comprehensive literature search was conducted to gather relevant studies (111 articles with 118 independent samples), and their data (k = 185) were analyzed using MASEM. Reducing mental illness stigma or increasing help-seeking efficacy may be effective strategies for promoting help-seeking behaviors among individuals who recognize mental disorders, while the maintenance of positive mental health did not significantly mediate the relationship between recognition of mental disorders and help-seeking attitudes. These findings suggest that reducing stigma or increasing help-seeking efficacy may be an effective strategy for promoting help-seeking behaviors among individuals who can identify mental disorders. The use of MASEM in this study highlights the importance of integrating multiple studies to understand the complex relationship between MHL components and help-seeking attitudes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effectiveness of health checkup with depression screening on depression treatment and outcomes in middle-aged and older adults: a target trial emulation study.

Background: Adult preventive health checkups with depression screening were launched in August 2011 in Taiwan; however, its impact has not yet been evaluated. This study aimed to use real-world data to assess the effectiveness of depression screening among middle-aged and older adults. Methods: A total of 4,972,228 adults aged 40 years and above who participated in a health checkup with depression screening between 2013 and 2019 and the same number of unscreened counterparts were included. The target trial emulation study was conducted to estimate the hazard ratios (HRs) for newly treated depression, psychiatric hospitalisation, and suicide. The changes in HRs during the study period were assessed using interval Cox models. Findings: The screening group had a higher rate of newly treated depression (HR 1.63 [95% CI 1.62, 1.64]) and a lower risk of psychiatric hospitalisation (HR 0.93 [95% CI 0.91, 0.95]). There was a null association between depression screening and suicide; however, a higher suicide risk was found in screened older adults aged 65 years and above. Only 10.8% received depression treatment during the study period among the screen-positive individuals. Interpretation: Health checkups with depression screening could potentially promote depression treatment and reduce the risk of psychiatric hospitalisation; however, there was no effect on suicide. The treatment rate for depression remained low after screening for depression. Further attention to enhance referral and treatment is required. Funding: The study was funded by the National Health Research Institutes, Taiwan.

Changes in employment status and income before and after newly diagnosed depressive disorders in Taiwan: a matched cohort study using controlled interrupted time series analysis.

AIMS: We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan. METHODS: Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year. RESULTS: A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups. CONCLUSIONS: The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.

Associations between antenatal education program and mental health outcomes in Taiwan: A population-based cohort study.

Universal antenatal education has been offered to expectant mothers in Taiwan since 2014. Depression screening is included in the offered education sessions. This study aimed to examine the association of antennal education and depression screening with mental health outcomes, including perinatal depression diagnosis and psychiatrist visits. Data was obtained from the antenatal education records and Taiwan's National Health Insurance claims database. A total of 789,763 eligible pregnant women were included in the current study. The psychiatric-related outcomes were measured between antenatal education and the six-month after delivery. It was found that the antenatal education was widely used in Taiwan, and the attendance rate has increased to 82.6% since its launch. The attenders were more likely to be from disadvantaged backgrounds, and 5.3% of them were screened positive for depressive symptoms. They were also more likely to visit a psychiatrist but less likely to be diagnosed with depression than the non-attenders. Factors including young age, high healthcare utilization, and comorbid psychiatric disorder history were consistently associated with depression symptoms, perinatal depression diagnoses and psychiatrist visits. Further research is needed to understand the reasons for the nonattendance at antenatal education programmes and the barriers to utilizing mental health services.

Treatment beyond progression in non-small cell lung cancer: A systematic review and meta-analysis.

Objectives: Treatment beyond progression (TBP) is defined as treatment continuing in spite of disease progression, according to the Response Evaluation Criteria In Solid Tumors. We performed a systematic review and meta-analysis to provide evidence for the effects of TBP on lung cancer survival. Materials and methods: This study has been conducted following the PRISMA guidelines. A systematic review of PubMed, MEDLINE, Embase, and Cochrane Collaboration Central Register of Controlled Clinical Trials from the inception of each database to December 2021 was conducted. Two authors independently reviewed articles for inclusion and extract data from all the retrieved articles. Random-effects meta-analysis was performed using Comprehensive Meta-Analysis software, version 3 (Biostat, Englewood, NJ, USA). Hazard ratios (HRs) with the corresponding 95% confidence intervals (CI) were used for survival outcomes. Results: We identified five (15.6%) prospective randomized trials and twenty-seven (84.4%) retrospective observational studies of a total of 9,631 patients for the meta-analysis. 3,941 patients (40.9%) were in a TBP group and 5,690 patients (59.1%) were in a non-TBP group. There is a statistically significant advantage for patients who received TBP compared with those who did not in post progression progression-free survival (ppPFS), post progression overall survival (ppOS), and overall survival (OS) from initiation of drugs (ppPFS: HR, 0.746; 95% CI, 0.644-0.865; P<0.001; ppOS: HR, 0.689; 95% CI, 0.596-0.797; P<0.001; OS from initiation of drugs: HR, 0.515; 95% CI, 0.387-0.685; P<0.001). Conclusion: This study provides further evidence in support of TBP for NSCLC, however, these results require cautious interpretation. Large, randomized, controlled trials investigating the efficacy of TBP in lung cancer treatment are warranted. Systemic Review Registration: https://www.crd.york.ac.uk/PROSPERO/ identifier CRD42021285147.

The Effectiveness of Mental Health Literacy Curriculum among Undergraduate Public Health Students.

Mental health literacy (MHL) plays an important role in public health. Improving MHL can promote mental health at the individual and public levels. To date, no published studies have assessed the effectiveness of MHL curriculum interventions among undergraduate public health students. The participants in this study were undergraduate public health students (n = 48) who were enrolled in an 18-week MHL curriculum for 100 min per week. MHL was assessed using the Mental Health Literacy Scale for Healthcare Students. A paired sample t-test was performed to examine the immediate and delayed effects of the MHL curriculum. The total MHL score significantly improved, and a moderate effect size was found directly after the intervention and six weeks later. There were significant differences in the recognition of mental illness (p < 0.01), help-seeking efficacy (p < 0.05), and help-seeking attitude (p < 0.05) in the five components of MHL between pre- and post-test. Furthermore, significant improvements were obtained for the maintenance of positive mental health (p < 0.05) and reduction of mental illness stigma (p < 0.001) between the pre-test and follow-up. Our findings provide evidence for the development and implementation of an MHL curriculum for public health education.

Relation of perseverative tendency and life events to depressive symptoms: findings from a prospective study in non-referred adolescents in Taiwan.

This study aimed to explore the role of perseveration in the relations between life events and depression in a 2-year prospective study of non-referred adolescents. Participants were 400 middle school students randomly selected in Taipei. Baseline perseveration was measured using Perseverative Errors on the Wisconsin Card Sorting Test and psychological distress was measured using Anxious/Depressed syndrome on the Child Behavior Checklist. These individuals also completed the Life Event Checklist and the Center for Epidemiologic Studies Depression Scales at follow-up. With adjustment for initial psychological distress and demographic features, the results of multiple regression analyses showed that more perseveration at baseline was associated with greater influence of negative life events on the subsequent depressive symptoms. Perseveration might act as a moderator on the relations of life events to depressive symptoms and lowering perseveration may be a plausible way to decrease the impact of negative life events on adolescent depressive symptoms.

A Structural Equation Modeling of Mental Health Literacy in Healthcare Students.

Background: There is a high prevalence of mental illness among healthcare students, and most students with mental health problems are reluctant to seek help from mental health professionals. Help-seeking is a component of mental health literacy (MHL). Although MHL is conceptualized as multi-dimensional, a theory-based multi-construct of MHL is still lacking. We aimed to build a theory-based multi-construct of MHL to explore the pathways of help-seeking. Methods: The data were obtained from a survey on MHL among healthcare students in 2018 (n = 1294). The Mental Health Literacy Scale for Healthcare Students was used to measure the maintenance of positive mental health, recognition of mental illness, mental illness stigma attitudes, help-seeking efficacy, and help-seeking attitudes. Descriptive analysis and structural equation modeling (SEM) were conducted. Results: The findings of the SEM model indicated recognition of mental illness had a positive direct effect on both help-seeking efficacy and maintenance of positive mental health. Additionally, help-seeking efficacy fully mediated the relationship between recognition of mental illness and help-seeking attitudes. Conclusions: Help-seeking efficacy plays a significant role in healthcare students' willingness to seek professional help when mental health care is needed. Accordingly, improving help-seeking efficacy strategies would increase the use of mental health services and contribute to the prevention of mental health problems.

Challenging mental illness stigma in healthcare professionals and students: a systematic review and network meta-analysis.

OBJECTIVE: Stigma among healthcare professionals may lead to poor quality of healthcare services for patients with mental illness. This study conducts a network meta-analysis to estimate the relative efficacy between different types of anti-stigma interventions for healthcare professionals. DESIGN: Network meta-analysis. MAIN OUTCOME MEASURES: The attitudes and behavior intension of healthcare professionals toward mental illness. RESULTS: A total of 18 studies (22 trials) from 9 countries are included in the analysis. In the network meta-analysis, rank probabilities show interventions with indirect contact plus lecture (SUCRA = 81.5%), direct contact plus problem-based learning workshop (SUCRA = 77.4%), and indirect contact (SUCRA = 72.2%) having the highest probability of being ranked first, second, and third, respectively. CONCLUSION: Our findings suggest that education combining social contact is the most effective anti-stigma intervention, which can be implemented in clinical practices to help reduce this stigma and improve healthcare services for patients with mental illness.

The multidimensionality of schizotypy in nonpsychotic relatives of patients with schizophrenia and its applications in ordered subsets linkage analysis of schizophrenia.

This study aimed to examine the multidimensionality of schizotypy and validate the structure using ordered subset linkage analyses on information from both relatives' schizotypy and probands' schizophrenia symptoms. A total of 203 and 1,310 nonpsychotic first-degree relatives from simplex and multiplex schizophrenia families, respectively, were interviewed with the Diagnostic Interview for Genetic Studies, which contains a modified Structured Interview for Schizotypy. Using Mplus program with categorical factor indicators, a four-factor model (Negative Schizotypy, Positive Schizotypy, Interpersonal Sensitivity, and Social Isolation/Introversion) was extracted by exploratory factor analysis from relatives of simplex families and was confirmed in relatives of multiplex families. The validity of each factor was supported by distinct linkage findings resulting from ordered subset analysis based on different combinations of schizophrenia-schizotypy factors. Six chromosomal regions with significant increase in nonparametric linkage z score (NPL-Z) were found as follows: 15q21.1 (NPL-Z = 3.60) for Negative Schizophrenia-Negative Schizotypy, 10q22.3 (NPL-Z = 3.83) and 15q21.3 (NPL-Z = 3.36) for Negative Schizophrenia-Social Isolation/Introversion, 5q14.2 (NPL-Z = 3.20) and 11q23.3 (NPL-Z = 3.31) for Positive Schizophrenia-Positive Schizotypy, and 4q32.1 (NPL-Z = 3.31) for Positive Schizophrenia-Interpersonal Sensitivity. The greatest NPL-Z of 3.83 on 10q22.3 in the subset was significantly higher than the greatest one of 2.88 in the whole sample (empirical P-value = 0.04). We concluded that a consistent four-factor model of schizotypy could be derived in nonpsychotic relatives across families of patients with different genetic loadings in schizophrenia. Their differential relations to linkage signals have etiological implications and provide further evidence for their validity.

The Relationship between Individual-Level and Context-Level Factors and Social Distancing from Patients with Depression in Taiwan: A Multilevel Analysis of National Surveys.

Background: Research on social distancing from patients with depression has primarily focused on individual-level factors rather than context-level factors. This study aimed to investigate the relationship between individual-level and context-level factors and social distancing from depressive patients. Methods: Sample data were collected via computer-assisted telephone interviews with 800 Taiwanese adults aged 20 to 65 years in 2016. All effects were tested using multilevel analysis. Results: With regard to individual-level variables, male sex, older age, people with more perceived dangerousness and those with more emotional reaction of fear were associated with greater social distancing from depressive patients. After controlling for individual-level variables, a positive association was found between the degree of urbanization and social distancing. We also found the interaction between the density of psychiatric rehabilitation services and perceived dangerousness to be associated with social distance. This finding revealed that persons with more perceived dangerousness and living in a region with higher density of psychiatric rehabilitation services were associated with greater social distance. Conclusions: We found that social distancing from depressive patients is not only determined by individual-level factors but influenced by the surroundings. This study provides useful directions for the implementation of optimal anti-stigma interventions for patients with depression.

Mental Health Literacy in Healthcare Students: An Expansion of the Mental Health Literacy Scale.

OBJECTIVE: Although the recently developed mental health literacy scale showed significant score differences between general population and mental health professionals, to this date there is no published scale intended to specifically assess mental health literacy (MHL) in healthcare students. This study constructed a 26-item scale-based measure to assess multiple components of MHL and associated psychometric properties in a sample of medical and public health students of 11 universities in Taiwan. METHODS: The development and validation of the scale comprised three phases: measure development, pilot testing (n = 32), and psychometric properties examination (n = 1294). RESULTS: 26 items were generated for five factors: maintenance of positive mental health, recognition of mental illness, attitude to mental illness stigma, help-seeking efficacy, and help-seeking attitude. The scale demonstrated good content validity, internal consistency, and construct validity (factorial validity, convergent validity, discriminant validity, and known groups validity). CONCLUSIONS: The findings suggest that the Mental Health Literacy Scale for Healthcare Students (MHLS-HS) is a valid, reliable, and practical tool for identifying MHL gaps in medical and public health students. It has the potential to inform remedial curricular interventions for educators and evaluate intervention effectiveness.

Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey.

Beliefs about and attitudes toward mental illness may be influenced by cultural- or country-specific contexts. Through a national survey, the current study investigated beliefs and attitudes toward people with schizophrenia and depression among the general public in Taiwan. A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese adults aged 20-64 years (n = 1600). The data were analyzed through binary logistic regressions to test for differences between these disorders in causal beliefs, stereotypes, emotional reactions, desire for social distance, and help-seeking behavior. The results revealed that respondents were more concerned with biogenetic causal explanations for people with schizophrenia than for those with depression. Significantly more respondents perceived people with schizophrenia as more likely to be unpredictable and violent toward others. A similar trend was observed for the desire for social distance. For both disorders, respondents were significantly more likely to express compassion than to express anger toward the person described in the vignette. Respondents also expressed more desire for social distance from someone like the vignette who have received psychiatric treatment. These findings provide useful directions for the implementation of optimal psychoeducation among such communities. .

Changes in Attitudes toward Mental Illness in Healthcare Professionals and Students.

Mental-illness-related stigma not only exists in the public but also in healthcare systems. Healthcare providers (HCPs) who have stigmatizing attitudes or behaviors might be thought of as a key barrier to mental health service use, and influence the quality of healthcare. Although cumulative projects have been conducted to reduce stigma related to mental illness among HCPs around the world, little is known about whether the attitudes of HCPs toward mental illness have changed over time. Research on this topic is mixed with respect to whether attitudes of HCPs toward mental illness have become more or less positive. The aim of the current study was to help clarify this issue using a cross-temporal meta-analysis of scores on the Social Distance Scale (SDS), Opinions about Mental Illness (OMI), and Community Attitudes towards Mental Illness (CAMI) measures among health care professionals and students (N = 15,653) from 1966 to 2016. Our results indicated that both social distance (ß = -0.32, p < 0.001) and attitudes (ß = 0.43, p = 0.007) of HCPs toward mental illness have become increasingly positive over time. These findings provide empirical evidence to support that the anti-stigma programs and courses have positive effects on HCPs and can inform future anti-stigma programs focusing on improving the attitudes of HCPs toward mental illness, thereby improving the quality of healthcare provided.