An Examination of the Relationship between Nurses' Attitudes toward Persons with Mental Illness, Prior Training, and Self-Reported Behavioral Health Competencies

Abstract

Many individuals receiving care in general care hospitals have both mental and physical illness. Health care providers in these settings often lack the necessary behavioral health competencies to provide appropriate care to persons with mental illness, typically attributable to lack of education and training. Negative or mixed attitudes of health care providers can also impact the therapeutic relationship and treatment provided, resulting in disparities in care for persons with mental illness in the hospital setting. Nurses provide the most consistent presence with patients in hospitals and possess attitudes similar to all health care providers and the general population. In addition, they often do not believe they possess the knowledge and skills to adequately care for individuals with mental health needs. Formal nursing education and workplace training in behavioral health have been inconsistent and the few specific behavioral health programs for nurses in the literature have not demonstrated a long-term impact on knowledge or attitudes.

This aim of this research study was to identify the relationship between nurses’ attitudes toward person with mental illness and their self-reported behavioral health competencies and to examine whether prior training influences the relationship between attitudes and self-reported competencies. The research questions were answered through a self-administered survey using the Error Choice Test (ECT) to identify attitudes and bias and the Behavioral Health Care Competency (BHCC) tool to determine self-reported competencies. Training focused on whether the participants had clinical experience in their pre-licensure program and/or education in the work setting, including aggression management programs.

The results of this study suggest that there is not a significant relationship between nurses’ attitudes toward persons with mental illness and their self-reported behavioral health care competencies. Prior education and training do not appear to influence attitudes or self-reported competencies. This study highlights the importance of studying strategies that have the potential to reduce disparities in the care of persons with mental illness in acute care hospitals, including evidence-based standardized preparation for nurses and other professionals practicing in these settings.