Available online 1 November 2022

Abstract

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.

Section snippetsRelevance Summary

Problem or Issue: Little is known about Bachelor of Nursing student attitudes toward people with mental illness on program entry, or students’ personal experience with mental illness.

What Is Already Known: Research suggests students can hold stigmatizing attitudes toward people with mental illness. Early intervention for young people experiencing mental health concerns is pivotal in improving their outcomes.

What This Paper Adds: Bachelor of Nursing students were found to hold some negative

Review of Literature

Mental health is an unpopular career choice for most pre-registration nursing students, and the majority will not work in mental health following graduation (Happell et al., 2018). All nurses, regardless of the healthcare setting, need mental health knowledge, skills and accepting attitudes to provide effective holistic patient care. Globally, the lifetime prevalence of mental illness is 29% (Nochaiwong et al., 2021), and in Australia, the lifetime prevalence is 46% (AIHW, 2022). Entincott et

Purpose of the Study

The study aims were to describe Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement, and to explore the relationship between demographic characteristics and prior experience with mental illness.

Research Design

A cross-sectional survey design was used. The findings are reported using the STROBE recommendations for cross-sectional studies (Vandenbroucke et al., 2007). Ethics approval was obtained from the relevant

Findings

There were n = 378 participants who commenced the survey and n = 311 students completed it, with a final response rate of 19%. There were n = 271 females and n = 40 males. Almost 78% (n = 242) of students were between 18 and 23 years, the mean age was 19.2 years, and the range 18-20. A further 22.2% (n = 69) of participants were over 24 years. This age range is generally representative of Australian university students (Department of Education, Skills and Employment, 2016).

Attitudes across the

Discussion

The aim of this study was to describe Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness at commencement of their tertiary program. Despite the high number of female participants, the sample in this study approximates the distribution of males and females currently employed in nursing in Australia. Over 87% of participants in this study were female and this is broadly representative of registered nurses in Australia, where only

Limitations

The participants were students enrolled in a nursing program at one university in Australia, and the findings may not be generalizable to other programs or settings. There was a relatively low response rate (19%) which is consistent with online university survey recruitment rates (Nulty, 2008) with a potential for atypical responses that may not be representative of the target population. As noted by Sakshaug et al. (2010), however, the lower response rate in this study may be because topics

Conclusion

This study explored the attitudes toward individuals, and prior experience with, people with mental illness in a cohort of preregistration nursing students at commencement of their program. Overall, student attitudes were mostly positive. Some rejecting attitudes were noted on the need for social restrictions and perceptions of dangerousness toward people with mental illness. There is a need for education and stigma reduction for nursing students which targets perceptions of dangerousness in

Authorship Statement

All authors listed in this manuscript meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors. All authors agree with the content in this manuscript.

Declaration of Competing Interest

The authors report no conflict of interest.

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