Association between stigmatisation and experiences of evidence-based practice by psychiatric rehabilitation staff in Japan: a cross-sectional survey

Mental health professionals are one of the groups holding harmful stigmatisation towards people with mental illness.To investigate the association between the performance of evidence-based practice (EBP) and the staff's level of stigmatisation in Japan.The study enrolled 179 staff members in psychiatric day-care, psychiatric community outreach teams, and psychiatric rehabilitation teams at 14 psychiatric hospitals. The Positive Attitudes Scale (PAS), the Japanese-language version of the Social Distance Scale (SDSJ) and the Recovery Attitude Questionnaire (RAQ) were employed as outcome measures. Scores on each scale were compared between participants who performed EBPs and those who had never performed EBPs.Approximately 40% of the staff engaged in at least assertive community treatment, supported employment or family psychoeducation. The staff who performed EBPs had significantly higher scores on PAS (MD, 7.09; 95% CIs, 4.09-10.09) and RAQ (MD, 1.30; 95% CIs, 0.36-2.25) but lower scores on SDSJ (MD, -2.41; 95% CIs, -3.50 to -1.32) than those who never performed EBPs. Multivariate analyses found that EBP experience was associated with a low level of staff stigmatisation after controlling for confounders.The findings suggest that an individual EBP experience is associated with their reduced stigmatisation.