JCPSLP November 2017

latter action an example of discrimination. Discrimination refers the behavioural reaction to the stereotypes and prejudices held about a particular group and may manifest in the health care sector as exclusion from, withholding of or redirecting of services. Stereotypes (beliefs), prejudices (attitudes) and discrimination (behaviours) are important to examine and understand within health care settings, as negative views can interfere with efficient patient care and hinder a truly person-centred approach to service provision. The role of education and experience in changing attitudes Emerging literature highlights some evidence about the positive effect of dedicated clinical experience and/or education about mental health in shifting students’ attitudes and understanding about mental health. For example, exposure to people with mental health conditions, through clinical placements, has been shown to afford several benefits for students and health professions more generally in the areas of skills and knowledge (Feeney, Jordan, & McCarron, 2013), as well as beliefs and attitudes (Markstrom et al., 2009). Students may demonstrate a reduction in their fears and anxieties about working in mental health through exposure to and involvement in this setting (Thomas & Bhattacharya, 2012) and increase intentions to pursue careers in this area of clinical practice as a result of greater familiarity and understanding (Happell & Gaskin, 2012). As the need for services to support patients with mental health concerns increases, so too does the relevance and recognised role for allied health clinicians (NSW Health, 2015). Therefore it is essential that allied health students, including speech-language pathology students, receive adequate preparation for work in a diverse range of clinical areas, prior to graduation. Information about how training programs and clinical placements influence medical students’ attitudes towards mental illness is most prevalent within the research literature; however, outcomes of studies are mixed (Happell & Gaskin, 2012; Stubbs, 2014). Some low-level studies (utilising pre-post evaluation methods) suggest training results in little or no change in attitudes, although knowledge and understanding of mental health may increase (Happell & Gaskin, 2012; Stubbs 2014). Yet other studies have found positive changes in the attitudes of health care students in connection with a clinical placement in mental health (Corrigan, Druss, & Perlick, 2011; Corrigan, Edwards, Green, Diwan, & Penn, 2001; Corrigan, Green, Lundin, Kubiak, & Penn, 2001; Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003). To date, there has been a paucity of literature exploring the benefits of clinical placements and education programs within the area of mental health for allied health students, relative to medical or nursing literature. As the role and profile of allied health professionals within this area increases and is further acknowledged, a focus on high-quality methods to adequately prepare graduates is warranted. Exposure, discussion and explicit instruction regarding mental illness is assumed to play an important role in determining and reforming attitudes, both of professionals and students. Clinical placements within mental health are a unique and rich opportunity to influence students’ skills, knowledge and understanding of a potential area of specialisation (Callaghan, Cooper, & Gray, 2007). Exposure to mental health contexts as students may also assist with identifying, challenging and addressing any negative or inaccurate beliefs and attitudes held towards patients

with mental illness, as well as providing students with the knowledge, skills and awareness to advocate for ongoing services for patients throughout their professional allied health careers. This main aim of this research study was to explore the understanding, beliefs and attitudes of exercise physiology (EP), speech-language pathology (SLP) and dietetic (DTn) students towards mental health and mental illness prior to commencing a 6–8 week clinical placement within a mental health setting, and examine the nature and degree of any changes seen post placement. Method The hypothesis of this study arose from the idea that through providing clinical experience with patients who have a mental health concern, allied health students, including speech-language pathology students, will gain a greater understanding about their professional role with this clinical group and experience positive change in previously held beliefs and attitudes. A convenience sample (Teddie & Yu, 2007) of students from the disciplines of exercise physiology, speech-language pathology and dietetics was recruited. These professions were selected as they represent the allied health professions that are playing an increasingly important role in the care of people with mental health concerns. Students were invited to participate in the study by the primary author, who was associated with the research though not responsible for the clinical education of two of the included disciplines (exercise physiology and dietetics). The invitation occurred in the first week of the students’ placement. Students interested in participating in the study responded directly to their clinical supervisor in their respective discipline. The research was overseen by two academics from two universities in Australia. This study received ethics clearance from the University of Melbourne Department of Medical Education Health Advisory Group Ethics Committee (#1543866) and the NSW Health Northern Sydney Local Health District Human Research Ethics Committee (#LNR/15/HAWKE/102 & #LNRSSA/15/HAWKE/122). Participants A total of 26 students were recruited for this study. Ten students from exercise physiology, 10 students from speech-language pathology and 6 students from dietetics participated. All students were from the same university undertaking clinical placement within a multidisciplinary team located within a psychiatric inpatient metropolitan mental health facility for a period of between six to eight weeks. The university was responsible for allocation of students to this site as per standard university procedure. As part of the recruitment process students were provided with a plain English description of what participation in the study would entail. It was made clear that participation was voluntary and the decision to participate would not impact their clinical placement assessment or influence current or future relationships with their university or the placement organisation. Data collection Students’ beliefs and attitudes towards mental health were explored pre-placement and again post-placement using the following three validated questionnaires. • Level of Familiarity Survey (LOF) (Corrigan, Edwards et al., 2001; Michaels & Corrigan, 2013) – examining experience and familiarity with mental illness

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology

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