A Survey of Psychiatric Undergraduates' Attitude Towards Psychiatry

Abstract

Objective To explore the attitudes of psychiatric undergraduates toward psychiatry.

Methods A total of 434 psychiatric undergraduates in Chongqing medical university were investigated with a questionnaire.

Results Although in general, psychiatric undergraduates showed a positive attitude towards psychiatry, opinions about certain aspects like the reputation of psychiatry and the income were not positive.

Conclusion: There are still some misunderstandings for psychiatry even among psychiatric undergraduates, some of which are based on false beliefs that should be actively targeted for remediation．

Introduction

With the rapid development of society, the spectrum of human diseases has changed from previous infectious diseases to chronic diseases closely related to the mind and body. The medical model has gradually shifted from a single emphasis on biological factors in the past to an emphasis on socio-psychological factors. Therefore, the importance of psychiatry has become increasingly prominent in current society [1]. According to the World Health Organization, the burden of mental illness in China will be 1/4 of the total disease burden by 2020. At the end of 2014, there had registered 5.3 million patients with severe mental disorders in China [2]. However, the current situation is that the mental health service resources are very scarce and unevenly distributed. At the end of 2015, there were 2,936 mental health professional institutions in China, with 433,000 psychiatric beds, but there were only 27,000 psychiatrists, which had only 1/4 of international standards [3], and mainly distributed at the provincial and municipal levels, there is a serious shortage of primary psychiatrists, and there is a huge potential demand for psychiatrists in general hospitals. Most general hospitals lack psychiatrists, while it is difficult for physicians and surgeons to identify the common mental symptoms of outpatients and inpatients early due to the incomplete knowledge structure of psychiatry, resulting in missed, misdiagnosed, and delayed diagnosis, leading to unreasonable waste of medical resources. On the one hand, the burden of mental illness in our country is very serious, and there is a shortage of mental health service resources and psychiatrists. On the other hand, there have been few colleges and universities that trained psychiatric talents in the past, and in the training process, due to insufficient professional ideological training, insufficient love for psychiatry, and difficult institutions, a large number of psychiatric talents were drained, which could not meet the national mental health policy. Based on this, the country has successively introduced policies to ensure the training of psychiatrists. Our school began to recruit psychiatric undergraduates in 2016, and has recruited 5 periods of undergraduates so far. At the same time, undergraduates have been equipped with tutors throughout the course to cultivate interest early, but there are many factors that ultimately affect medical students’ choice of career after graduation. Among them, medical students’ attitudes and views on psychiatry are very important. This will run through the entire course of a student's career and play an important role in career choice. Therefore, this study investigated the attitudes of psychiatric undergraduates from Grade 2016 to Grade 2020 of Chongqing Medical University towards psychiatry, hoping to find problems and improve them in time.

Objects And Methods

Research Objects

The survey subjects are from grade 2016 to grade 2020 psychiatric undergraduates of Chongqing Medical University. The survey was conducted when they were in the freshman year, which could better reflect their first impression and understanding of the subject. The survey received a total of 434 questionnaires, including 140 (32.3%) males and 294 (67.7%) females. Ethical approval was granted by the Chongqing Medical University, informed consent was obtained from all participants.

Survey Method

By consulting relevant literatures, designing questionnaire, discovering problems in time through pre-surveys and optimizing the questionnaire, by means of online questionnaire, the interviewer will immediately check the completeness after the survey. The survey is completed one week after the enrollment of each student. All methods were carried out in accordance with relevant guidelines and regulations.

Results And Analysis

General Condition

There are 434 students in this survey, of which 140 are boys and 294 are girls. Most of them are Han nationality. Nearly half of the students have one or more siblings. They generally believe that their family relationship are harmonious. Salary is the main income, most of the income is concentrated at the level of 2000-20000, most of them live in urban or city (Table 1)

Table 1 General Condition

Views on psychiatric patients

The results of this survey show that most of the students do not have any contact with psychiatric patients (90.1%), and they know little about psychiatric patients. Generally speaking, most students report sympathy towards psychiatric patients (Table 2)

Table 2 Views on psychiatric patients

Attitudes towards becoming a psychiatrist

This survey shows that most students are willing to become psychiatrists after graduation. Their willingness to become psychiatrists is mainly due to their love on psychiatry and good employment prospects. The unwillingness to become psychiatrists is mainly due to the working environment and income, and also, the risk of being beaten and scolded by the patients (Table 3)

Table 3 Attitudes towards becoming a psychiatrist

Attitudes towards the psychiatric profession

This survey shows that most students think that psychiatry is useful in their lives and are willing to continue studying psychiatric postgraduates. However, it is also found that less than 50% of the students who apply for the psychiatric major as their first choice (Table 4)

Table 4 Attitudes towards the psychiatric profession

Views on the future of psychiatry

This survey shows that most students think that the prospects of psychiatry are relatively good, but 18.2% of students still decide to change their major if they have opportunity (Table 5)

Table 5 Views on the future of psychiatry

Discussion

In recent years, due to social transformation and other reasons, mental problems such as anxiety and depression have significantly increased. However, psychiatric professionals in China are obviously insufficient. The psychiatric major aims to train specialists in mental health institutions at all levels and medical research departments who are engaged in clinical prevention, treatment, teaching and research focusing on mental illnesses [4]. In recent years, the government has increased its investment in psychiatry and mental health. It has formulated the "National Mental Health Development Program" and the "Mental Health Law", organized the Xiangshan Conference of Neuroscience, and put the Chinese Brain Project on board, focused on the construction of local psychiatric hospitals. In terms of resources, the Health and Family Planning Commission further improved the professional title evaluation methods for specialists, and implemented the salary policy for mental health personnels; in terms of medical education, encouraging universities to hold undergraduate major in psychiatry, Guaranteeing the teaching hours of psychiatry and medical psychology. All show that the national government attaches greater importance to the cultivation of psychiatric professionals. But in fact, there are still many difficulties in cultivating psychiatric professionals. Xiangya Medical College, the first one which offer psychiatry major, has recruited 28 periods psychiatric undergraduates and 632 graduates since 1988, The psychiatric related employment rate was 57.2%, and nearly half of the students did not provide medical services in their major, while the psychiatric related employment rate of Jining Medical College and Xinxiang Medical College during the same period was not optimistic either. This phenomenon may be related to many factors such as social prejudice, psychiatrist's working environment, income level, discrimination, and identification with psychiatric major.

In our survey, we found that 39.9% of the students occasionally contacted with psychiatric patients, and 50.2% of the students had never contacted with psychiatric patients. Before applying for the psychiatric major, 38.6% Of the students did not understand the psychiatric patients. Among the attitudes towards the psychiatric patients, 47% of the students felt sympathetic, and 28.3% felt that they had no special feelings. In general, students have less contact with psychiatric patients, and more feel that they are pitiful. In this regard, it is very important to create a good social evaluation and correct social prejudice. The government should strengthen the propaganda of general knowledge of mental illness, hold early contact, early clinical activities, help to raise students’ awareness of this group [5].

Regarding the development of psychiatry, most students maintained a relatively optimistic attitude. 37.3% of students said that psychiatry was very useful, 47% of students said it was useful, and 80.6% of students said they were willing or quite willing to continue master degree in psychiatry after they graduated, but 5.7% of students said they were extremely reluctant or unwilling. Generally speaking, most of the students had a positive attitude towards further studies in the field of psychiatry. However, when it came to whether psychiatry was the first choice in the college entrance examination, Only 42.4% of the students said it was the first choice, and 57.6% of the students entered the psychiatric major through major transfer. In terms of the future development of psychiatry, 94.9% of students believed that the future of psychiatry was relatively optimistic, but if there was an opportunity to change major, 18.2% of students would choose to change major. This showed that although students were generally optimistic about the future of psychiatry, there were still many students who were passively chosen psychiatry major, and their recognition of the major was still not stable. On the one hand, it is necessary to continue to strengthen the ideological education of psychiatric students, to stabilize the ideological fluctuations of some students, give students correct and rational guidance, and deepen professional feelings; on the other hand, in teaching and internship, strengthen communication with teachers and hospitals, and take responsibility for teaching skills, and supervise the training of graduates to improve the status quo of graduates switching to non-mental health jobs or applying for clinical medicine majors [6].

Regarding whether they are willing to be a psychiatrist in the future, 78.6% of the students are willing or quite willing. The main reasons for their willingness are their interest on psychiatry (67.7%), good employment prospects (58.3%) and social needs of psychiatric doctors (71.9%) , shows that interests and good employment expectations are still the main reasons for being willing to engage in psychiatry. 21.9% of students believe that easier work is also one of the reasons why they choose. Among the reasons for unwillingness to be a psychiatrist, low income (27.2%), poor working environment (18.0%), and fear of being discriminated against (25.3%) are the main reasons. Regarding the low social status of psychiatrists, work in poor environment and other conditions, previous domestic studies have similar results. Liu Tieqiao et al found that 53.1% of students agreed with this statement partially or completely on the issue of medical students’ recognition of the low social status of psychiatry [7], However, this research mainly focused on non-psychiatric students, and its proportion was higher than our survey results in psychiatric undergraduate major. In terms of the income of psychiatrists, 46.5% of students surveyed by Wang Xuyi et al believed that the income of psychiatrists was lower than that of other doctors [8], which was also higher than the survey conducted in our school. In this article, the first ranked reason why unwilling to be a psychiatrist is because of fear of being beaten and scolded by psychiatric patients. Guo Jing et al investigated the situation of hospital violence experienced by medical staffs in 136 tertiary hospitals in China and found departments of Obstetrics and gynecology and pediatrics were high-incidence departments of violence, and psychiatry was not among the top [9]. Yang Yang conducted a questionnaire of 500 medical staffs in 4 hospitals in Tianjin. Among them, the emergency department had the highest incidence of violence [10]. The psychiatric department is certainly a high-risk department that is prone to violence. However, due to the high vigilance of psychiatric doctors and the constant risk assessment of patients at work, the actual incidents of violence and injury are not at the forefront. In the process of student training, early education should be provided to correct students’ misperceptions.

In summary, students’ impressions of psychiatry, the development prospects of psychiatry, and the employment of psychiatrist are generally good, but there are still some negative opinions. More negative attitudes include the social reputation of psychiatry, low income of psychiatrists, high risk of violence, etc. Due to the existence of these negative opinions, medical students will face resistance from all sides when they choose to become psychiatrists in the future. Some of these negative attitudes need to be improved through targeted medical education, and some are more related to misunderstandings that are common in the whole society, requiring the joint efforts of all psychiatric circles and the whole society.

Declarations

Acknowledgements

The authors would like to thank participating medical school for permission to conduct the study amongst students and the respondents for their participation.

Funding

This research is supported by the Chongqing Higher Education Teaching Reform Research Project,(Grant No.: 171012); Education and Teaching Research Project of Chongqing Medical University, (Grant No.: JY170101).The funding body had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Availability of data and materials

For access to data, please approach Dr. Xiao Li via [email protected]

Authors’ contributions

All authors listed in the manuscript contributed sufficiently to qualify for authorship: Xiao Li conceived the structure of the manuscript, analyzed the data and wrote the manuscript. Ming Ai and Li Kuang critically reviewed the manuscript. All authors have read and approved the final manuscript.

Ethics approval and consent to participate

The study, including the consent procedure, was approved by the ethics committee of the Chongqing Medical University. All student participants have provided online consent to the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests

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