Maltese nurses' and midwives' attitudes towards mental illness: a national comparative study

BACKGROUND: Mental health problems are of serious concern across Europe. A major barrier to the realisation of good mental health and well-being is stigma and discrimination. To date there is limited knowledge or understanding of mental health nurses' attitudes towards mental illness and individuals experiencing mental health problems. No previous study has been conducted in Malta that addresses this aim, and prior to this study the attitudes of nurses and midwives towards mental illness were unknown. This study is the first of its kind to sample the nursing and midwifery population of an entire country. This study is also the first to attempt to compare the attitudes of nurses according to the years within a mental health setting as well as a comparison between attitudes and the different mental health settings. To the researcher's knowledge this study is also the first to include a midwifery population within the comparisons. OBJECTIVES: To identify the attitudes of Maltese nurses and midwives towards mental illness and also the investigation of factors that contribute to the formation of attitudes towards mental illness. DESIGN: A nation-wide cross sectional questionnaire survey. SETTINGS: All Maltese state-owned hospitals, departments, units and clinics employing nurses and midwives. PARTICIPANTS: A total of 1483 nurses and midwives participated in this study, representing all the various nursing and midwifery grades and work settings. METHODS: Data were collected using The Community Attitudes towards the Mentally Ill (CAMI) scale, which is a 40-item self-report questionnaire. Data were analysed using quantitative methods using SPSS ver.21. RESULTS: Maltese nurses and midwives hold a positive attitude towards mental illness. Positive attitudes are also seen for each of the 3 subscales of the CAMI tool, namely Fear and Exclusion, Social Control and Goodwill. This study concurs with existing literature and also identifies the importance of education in the formation of attitudes. Results show that Registered Mental Health nurses hold the highest attitudinal score. Apart from education and professional grade, age, years in service and working specifically within the mental health field also seem to infer on the attitudes of Maltese nurses and midwives towards mental illness. CONCLUSIONS: Understanding the variables influencing nurses' and midwives' attitudes towards mental illness is critical to deliver effective care. Although Education has been identified as the most influential variable in this study, influencing variables only account for 6.9% of the total variation in the responses. This implies that other predictors exist that affect attitudes, thus further research is warranted.