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Open Access Open Badges Research article

Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

Harry Minas1*, Ruzanna Zamzam2, Marhani Midin2 and Alex Cohen3

Author Affiliations

1 Centre for International Mental Health, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria 3010, Australia

2 Department of Psychiatry, Universiti Kebangsaan Malaysia (National University of Malaysia) Medical Centre, Jalan Yaacob Latiff, Cheras Kuala Lumpur, Malaysia

3 London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E7HT, UK

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BMC Public Health 2011, 11:317  doi:10.1186/1471-2458-11-317

Published: 14 May 2011



The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes.


General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants.


Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298).


Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions.