Non-traditional mental health clinical placements : An effective means for reducing self-stigma in pre-registration nursing students

Accessible Summary

What Is Known on the Subject

• Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues.
• Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students.

What the Paper Adds to Existing Knowledge
• There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma.

Implications for Practice
• The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses.
• There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours.

Introduction
Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour.

Aim
The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness.

Methods
Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking.

Results
Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001,
= .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001,
= 0.09, Social Distance: p < .001,
= 0.07, Disclosure/Help-seeking: p < .001,
= 0.04).

Discussion
These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma.

Limitations
Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking.

Implications
These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain.

Recommendations
Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.

© 2024 The Author(s). Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.