Factors associated with police attitudes towards mentally ill people in Lusaka urban
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Objective: The main objective of the study was to determine factors associated with Police attitudes towards mentally ill persons in the streets and Police Cells of Lusaka urban.Design: This was a case control study involving 220 consenting Police Officers, randomly selected, out of which 110 with negative attitudes constituted cases and the other half with positive attitudes were controls.To be considered a case, an Officer had to score less than 70% on an attitude scale, while any Officer who scored 70% and above was a control.Main Outcome Measure: Police attitudes towards mentally ill persons was the main outcome measure seen as positive or negative.Setting: The study covered all Police Stations and Posts in Lusaka urban where sampled subjects were to be found.Results: Because two analyses were done, instead of considering the 5% significant level, 2.5%) was considered as a cut off point for statistical significance. Thus, a p-value of 0.025 was considered significant at 95% level of confidence. The median (QuQs) ages in years for those with negative attitudes and those with positive attitudes were 30 (27,34) and 29 (26,35) respectively (p=0.014).There was statistically no significant difference in the median length of stay at work for the two groups (p=0.144). Those with positive attitudes had significantly (t-2.330; p=0.021) spent more years in school, than those with negative attitudes. There was an association between sex and attitude (p=0.017) as well as between marital status and attitude (p=0.253). Some significant difference (p<0.001) was noted in marital status between males and females in the total sample. Some association (p=0.026) was observed between handcuffing and Police attitudes towards mentally ill persons. Another significant association (p<0.001) noted was between the conviction that mentally ill people must be locked up in Chainama Hills Hospital and Police attitudes towards mentally ill persons. A listing of signs and symptoms (in category 1: violent, restless, talkative, nakedness or torn clothes) was significantly (p<0.001) higher among Officers with negative attitudes. Suggestion among Police Officers that they needed further training in skills on how to deal with mentally ill persons was significantly (p=0.024 associated with their attitudes towards mentally ill persons. An association between the conviction that breast-feeding mentally ill mothers should be allowed to breastfeed and attitude was observed (p=0.025). After adjusting for confounding factors, breast-feeding was the only factor independently associated with the outcome.Officers who stated that mentally ill breast-feeding mothers should be allowed to continue breast-feeding were 28% (95% CI; 0.55,0.94; p=0.015) less likely to have negative attitudes towards mentally ill persons.conclusion and Recommendations: We conclude that there was an association between socio-cultural belief (e.g. breast-feeding, marrying a person with history of mental illness) related to mental illness stigma, and Police attitude towards mentally ill persons. There was no association between training, education, personal experience in dealing with mentally ill persons and attitude.The report concludes with a recommendation that health education targeting socio-cultural beliefs of the Police regarding mentally ill persons should be introduced quite early in their training and this must be on going even after graduation. This should be augmented by the introduction of a training module/component in their curriculum, which involves visits to practical sites like Chainama Hills College Hospital Board.