Stigmatization of Mathare mental hospital nursing staff caring for the mentally ill
Background: Over the years, mental illness has been associated with stigma and negative attitudes. Most research has been on stigma of mentally ill and few on their relatives. Staff members caring for the mentally ill are at risk of stigma by association due to regular interaction with mentally ill. In the local setting, majority of the staff members working for the mentally ill patients in the hospital institutions are the nurses. In view of this the current study aimed to establish the prevalence of stigmatization of Mathare mental hospital nursing staff caring for the mentally ill. Objectives: To determine the prevalence of stigmatization of Mathare mental hospital nursing staff caring for the mentally ill patients and their social demographic characteristics. DESIGN: Cross-Sectional descriptive study involving nursing staff members caring for the mentally ill at Mathare Mental Hospital who fulfilled the inclusion criteria. Study objective: Mathare Mental Hospital situated along Thika Road, 4km North of Nairobi City. METHOD: Participants were interviewed using a researcher designed social demographic questionnaire and Adopted Researcher designed stigma questionnaire assessing discrimination, disclosure and positive attitude. Statistical analysis included descriptive analysis of nurse's demographic characteristics and associations between stigma and demographics using chi square tests conducted using SPSS version 17. Results: One hundred and twenty (n = 120) nurses met the inclusion criteria and were recruited in the study. The age of nurses in the study ranged from18 years to 60 years with a mean age of 42 (SD 7.7) years. There were 108 (90 %) female nurses and 12 (10%) male nurses. Married participants constituted 80 % (n=96) of the population while 12.5% (n=15) were single. Majority of the nurses, 97.5 %( n= 117) were Christians. Approximately 56% nurses had worked in the nursing field for 15 years, while 26.7% (n=32) nurses and 15% (n=18) nurses had worked for 10 -15 and 5 -10 years respectively. Only 1.7% (n = 2) of nurses had worked for less than five years. Enrolled community psychiatric nurses accounted for 45% (n=53), followed by Kenya registered community psychiatric nurses with 24%(, n=28) and registered community health nurses with 18%( n=21) while enrolled community nurses accounted for 14%.Most nurses lived in rented premises(54%), while 46% (n = 55) lived in their own houses. The main significance of the study found a moderate level of stigma among the nursing staff caring for the mentally ill at a mean overall score of 35.2(SD=14.4) with a range of 4 to 56.The mean stigma score for the 9 discrimination items was 22(SD=8.3), 11.7(SD=5.9) mean score for 5 items on disclosure items while mean score for the 2 positive attitude items was 1.5(SD=1.5). The multivariate analysis showed significant association with nursing experience where a longer working experience was associated with lower stigma score. Conclusion: There is a moderate level of stigma at among nursing staff caring for the mentally ill in Mathare Mental Hospital. Nurses with longer exposure to mental health practice reported lower level of stigma related caring for the mentally ill. Recommendations: Mental health education needs to be introduced early at various levels in the education curriculum to help reduce level of stigma associated with mentally ill patients.