{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:12:30Z","timestamp":1784729550100,"version":"3.55.0"},"reference-count":58,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Individuals diagnosed with Severe Mental Illness (SMI) often perceive negative attitudes from health professionals, acting as a barrier to effective treatment. The present study explores healthcare students\u2019 attitudes toward SMI to identify potential areas of stigma. Methods: A descriptive analytical qualitative approach was employed. Twenty-seven students from six different healthcare programs at the University of Malaga participated in semi-structured interviews, which were subsequently analyzed using thematic content analysis with the assistance of NVivo 12 software. Results: Three main themes emerged from the data: ideals, experiences with SMI, and views on hospitalization and coercive measures. Students acknowledge the importance of empathy but often feel unprepared due to limited knowledge, leading to avoidance and negative interactions. Although stigmatizing beliefs regarding dangerousness and inabilities persist, students generally reject segregation and advocate for equal rights. Positive contact experiences with mental illness can modify negative attitudes and enhance empathy, particularly among individuals with their own personal experiences. Participants generally oppose coercive measures, except for safety concerns and lack of illness awareness, advocating for alternatives to preserve autonomy. Conclusions: The study highlights that insecurity and feeling unprepared could be linked to stigmatizing and negative experiences with individuals with SMI. Therefore, we underline the need for the anti-stigma education of healthcare students focusing on contact experiences and promoting confidence in their knowledge and skills.<\/jats:p>","DOI":"10.3390\/ijerph22030333","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T10:04:28Z","timestamp":1740391468000},"page":"333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Stigma Toward Severe Mental Illness Among Healthcare Students: A Qualitative Study"],"prefix":"10.3390","volume":"22","author":[{"given":"Ana Isabel","family":"Masedo Guti\u00e9rrez","sequence":"first","affiliation":[{"name":"Department of Personality, Evaluation and Psychological Treatment, University of Malaga, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine Cede\u00f1o","family":"Martinez","sequence":"additional","affiliation":[{"name":"Master Program of General Health Psychology, University of Malaga, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"ref_1","first-page":"4","article-title":"\u00bfQu\u00e9 es el trastorno mental grave y duradero?","volume":"16","year":"2019","journal-title":"Edupsykh\u00e9 Rev. Psicol. Educ."},{"key":"ref_2","first-page":"15","article-title":"Attitude and knowledge of nursing students toward mental health issues","volume":"2","author":"Ali","year":"2022","journal-title":"J. Nurses Midwives Pak."},{"key":"ref_3","first-page":"23","article-title":"Social Stigma Towards Mental Health Problems in Spain: A Systematic Review","volume":"34","author":"Zamorano","year":"2023","journal-title":"Clin. Salud"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ruiz, J.C., Fuentes-Dur\u00e1, I., L\u00f3pez-Gilberte, M., Das\u00ed, C., Pardo-Garc\u00eda, C., Fuentes-Dur\u00e1n, M.C., P\u00e9rez-Gonz\u00e1lez, F., Salmeron, L., Soldevila-Mat\u00edas, P., and Vila-Franc\u00e9s, J. (2022). Public stigma profile toward mental disorders across different university degrees in the University of Valencia (Spain). Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.951894"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e3145","DOI":"10.1590\/2526-8910.ctoao24103145","article-title":"Estigma hacia personas con enfermedad mental en estudiantes y profesores de terapia ocupacional","volume":"30","author":"Gajardo","year":"2022","journal-title":"Cad. Bras. Ter. Ocup."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/schbul\/sbj065","article-title":"Attitudes of Mental Health Professionals Toward People With Schizophrenia and Major Depression","volume":"32","author":"Nordt","year":"2005","journal-title":"Schizophr. Bull."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/acps.12611","article-title":"Qualitative analysis of mental health service users\u2019 reported experiences of discrimination","volume":"134","author":"Hamilton","year":"2016","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/0020764013490263","article-title":"Stigma and discrimination against people with schizophrenia related to medical services","volume":"60","author":"Harangozo","year":"2013","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Koschorke, M., Oexle, N., Ouali, U., Cherian, A.V., Deepika, V., Mendon, G.B., Gurung, D., Kondratova, L., Muller, M., and Lanfredi, M. (2021). Perspectives of healthcare providers, service users, and family members about mental illness stigma in primary care settings: A multi-site qualitative study of seven countries in Africa, Asia, and Europe. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258729"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1370\/afm.2924","article-title":"Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations","volume":"21","author":"Phelan","year":"2023","journal-title":"Ann. Fam. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/0840470416679413","article-title":"Mental illness-related stigma in healthcare","volume":"30","author":"Knaak","year":"2017","journal-title":"Health Manag. Forum"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00127-013-0729-4","article-title":"Stigma in patients with schizophrenia receiving community mental health care: A review of qualitative studies","volume":"49","author":"Mestdagh","year":"2013","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1108\/JMHTEP-09-2021-0112","article-title":"Health-care undergraduate student\u2019s attitudes towards mental illness following anti-stigma education: A critical review of the literature","volume":"18","author":"Pursehouse","year":"2022","journal-title":"J. Ment. Health Train. Educ. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105","DOI":"10.17711\/SM.0185-3325.2023.014","article-title":"Mental illness attitudes in medical education: Assessing the stigma in medical students","volume":"46","year":"2023","journal-title":"Salud Ment."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105","DOI":"10.6018\/eglobal.525701","article-title":"Evoluci\u00f3n del estigma hacia salud mental en especialistas sanitarios en formaci\u00f3n en Asturias","volume":"22","author":"Llorca","year":"2023","journal-title":"Enferm. Glob."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1007\/s40596-023-01829-y","article-title":"Evaluation of US Medical Student Bias Toward Mental Health Before and After First-Year Pre-clinical Psychiatry Education","volume":"47","author":"Smith","year":"2023","journal-title":"Acad. Psychiatry"},{"key":"ref_17","unstructured":"En Ediciones Morata, S.L. (1986). Hacia una superaci\u00f3n del enfrentamiento entre los m\u00e9todos cualitativos y los cu-antitativos. M\u00e9todos Cualitativos y Cuantitativos en Investigaci\u00f3n Evaluative, Sage Publications."},{"key":"ref_18","unstructured":"Creswell, J.W., and Poth, C.N. (2016). Qualitative Inquiry and Research Design: Choosing Among Five Approaches, Sage Publications."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1007\/s11126-020-09809-3","article-title":"Stigma in Healthcare? Exploring the Knowledge, Attitudes, and Behavioural Responses of Healthcare Professionals and Students toward Individuals with Mental Illnesses","volume":"91","author":"Riffel","year":"2020","journal-title":"Psychiatr. Q."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Almagro, J., Hern\u00e1ndez-Mart\u00ednez, A., Rodr\u00edguez-Almagro, D., Quiros-Garc\u00eda, J.M., Solano-Ruiz, M.D.C., and G\u00f3mez-Salgado, J. (2019). Level of stigma among spanish nursing students toward mental illness and associated factors: A Mixed-Methods study. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16234870"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Riffel, T., and Chen, S.-P. (2019). Exploring the Knowledge, Attitudes, and Behavioural Responses of Healthcare Students towards Mental Illnesses\u2014A Qualitative Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17010025"},{"key":"ref_22","unstructured":"QSR International (2025, January 19). NVivo (Versi\u00f3n 14.23.1) [Software de An\u00e1lisis Cualitativo de Datos]. 2019\u20132023. Available online: https:\/\/www.qsrinternational.com\/nvivo-qualitative-data-analysis-software\/home."},{"key":"ref_23","first-page":"143","article-title":"El an\u00e1lisis de contenido tem\u00e1tico: Una mirada a sus etapas desde Nvivo12\u00a9","volume":"10","author":"Castro","year":"2022","journal-title":"Rev. Int. Cienc. Soc. Interdiscip."},{"key":"ref_24","first-page":"187","article-title":"La investigaci\u00f3n cualitativa a trav\u00e9s de entrevistas: Su an\u00e1lisis mediante la teor\u00eda funda-mentada","volume":"23","year":"2014","journal-title":"Cuest. Pedag\u00f3gicas"},{"key":"ref_25","unstructured":"Glaser, B.G., and Strauss, A.L. (1967). The Discovery of Grounded Theory, Aldine."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mhp.2018.11.006","article-title":"Positive mental health and mental health stigma: A qualitative study assessing student attitudes","volume":"13","author":"Vidourek","year":"2018","journal-title":"Ment. Health Prev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1007\/s10597-019-00521-6","article-title":"Mental Health Professionals\u2019 Attitudes to Severe Mental Illness and Its Correlates in Psychiatric Hospitals of Attica: The Role of Workers\u2019 Empathy","volume":"56","author":"Economou","year":"2019","journal-title":"Community Ment. Health J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11144\/Javeriana.upsy20.epsm","article-title":"Estigma p\u00fablico en salud mental en la universidad","volume":"20","author":"Saavedra","year":"2022","journal-title":"Univ. Psychol."},{"key":"ref_29","unstructured":"Lee, P. (2024, May 10). Public Stigma and Self-Stigma of Depression in College Students [DNP Scholarly Projects]. Available online: https:\/\/repository.belmont.edu\/dnpscholarlyprojects\/39."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1600-0447.2005.00699.x","article-title":"Public beliefs about and attitudes towards people with mental illness: A review of population studies","volume":"113","author":"Angermeyer","year":"2005","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1037\/h0095282","article-title":"Citizenship rights and psychiatric disability","volume":"21","author":"Chamberlin","year":"1998","journal-title":"Psychiatr. Rehabil. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1017\/S0033291714000129","article-title":"What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies","volume":"45","author":"Clement","year":"2015","journal-title":"Psychol. Med."},{"key":"ref_33","first-page":"106","article-title":"Effectiveness and types of interventions to reduce mental illness-related stigma among medical university students: A literature review (1997\u20132020)","volume":"50","author":"Gervas","year":"2022","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Moudatsou, M., Stavropoulou, A., Philalithis, A., and Koukouli, S. (2020). The role of empathy in health and social care professionals. Healthcare, 8.","DOI":"10.3390\/healthcare8010026"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Bazzari, A.H., and Bazzari, F.H. (2023). Assessing Stigma towards Mental Illness in Relation to Demographics Attitudes and Past Experiences among Pharmacy Students in a Jordanian University Sample. Behav. Sci., 13.","DOI":"10.3390\/bs13110884"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Oliveira, A.M., Machado, D., Fonseca, J.B., Palha, F., Silva Moreira, P., Sousa, N., Cerqueira, J.J., and Morgado, P. (2020). Stigmatizing attitudes toward patients with psychiatric disorders among medical students and professionals. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00326"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Stuart, H. (2016). What has proven effective in anti-stigma programming. The Stigma of Mental Illness\u2014End of the Story?, Springer.","DOI":"10.1007\/978-3-319-27839-1_27"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"114409","DOI":"10.1016\/j.psychres.2022.114409","article-title":"Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries","volume":"309","author":"Munir","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/09638237.2017.1322184","article-title":"Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: A qualitative study","volume":"26","author":"Waugh","year":"2017","journal-title":"J. Ment. Health"},{"key":"ref_40","first-page":"363","article-title":"Attitudes towards disclosing a mental illness: Impact on quality of life and recovery","volume":"57","author":"Mayer","year":"2021","journal-title":"Chest"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13033-021-00502-x","article-title":"Types of stigma experienced by patients with mental illness and mental health nurses in Indonesia: A qualitative content analysis","volume":"15","author":"Subu","year":"2021","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref_42","first-page":"7","article-title":"Detr\u00e1s del estigma. Un an\u00e1lisis cualitativo del impacto en las familias de personas con trastorno mental grave","volume":"4","author":"Carbonell","year":"2024","journal-title":"Itiner. Trab. Soc. Univ. Barc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/ajcp.12516","article-title":"Systematic Review of Cultural Aspects of Stigma and Mental Illness among Racial and Ethnic Minority Groups in the United States: Implications for Interventions","volume":"68","author":"Misra","year":"2021","journal-title":"Am. J. Community Psychol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1093\/schbul\/sbaa181","article-title":"Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences","volume":"47","author":"Dubreucq","year":"2021","journal-title":"Schizophr. Bull."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gunasekaran, S., Tan, G.T.H., Shahwan, S., Goh, C.M.J., Ong, W.J., and Subramaniam, M. (2022). The perspectives of healthcare professionals in mental health settings on stigma and recovery\u2014A qualitative inquiry. BMC Health Serv. Res., 22.","DOI":"10.1186\/s12913-022-08248-z"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5463\/sra.v1i1.9","article-title":"Prevalence of Internalized Stigma among Persons with Severe Mental Illness","volume":"1","author":"West","year":"2011","journal-title":"Stigma Res. Action"},{"key":"ref_47","first-page":"16","article-title":"Estigma en personas con enfermedad mental desde el punto de vista de estudiantes de Grado de Enfermer\u00eda y Fisioterapia","volume":"22","year":"2019","journal-title":"Metas Enf."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1037\/ort0000499","article-title":"Mental health professionals with mental illnesses: A qualitative interview study","volume":"90","author":"Elliott","year":"2020","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1111\/jpm.12921","article-title":"Experience of coercion among nursing professionals in a medium-stay mental health unit: A qualitative study in Spain","volume":"30","year":"2023","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"101665","DOI":"10.1016\/j.ijlp.2020.101665","article-title":"Mental health professionals\u2019 feelings and attitudes towards coercion","volume":"74","author":"Morandi","year":"2021","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_51","first-page":"151","article-title":"Clinician attitude and perspective on the use of coercive measures in clinical practice from tertiary care mental health establishment\u2014A cross-sectional study","volume":"61","author":"Gowda","year":"2019","journal-title":"Indian J. Psychiatry"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/jpm.12586","article-title":"Influence of nursing staff attitudes and characteristics on the use of coercive measures in acute mental health services\u2014A systematic review","volume":"27","author":"Doedens","year":"2019","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1192\/bjp.177.1.4","article-title":"Stigmatisation of people with mental illnesses","volume":"177","author":"Crisp","year":"2000","journal-title":"Br. J. Psychiatry"},{"key":"ref_54","first-page":"1","article-title":"Mental health stigma among college students: Test of an interactive online in-tervention","volume":"70","author":"Kirschner","year":"2020","journal-title":"J. Am. Coll. Health"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1176\/appi.ps.20230215","article-title":"Stigma Reduction Via Brief Video Interventions: Comparing Presentations by an Actor Versus a Person With Lived Experience","volume":"75","author":"Amsalem","year":"2023","journal-title":"Psychiatr. Serv."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"114356","DOI":"10.1016\/j.psychres.2021.114356","article-title":"The effects of a video-based randomized controlled trial intervention on depression stigma and help-seeking attitudes in university students","volume":"308","author":"Rothes","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Masedo, A., Grand\u00f3n, P., Saldivia, S., Vielma-Aguilera, A., Castro-Alzate, E.S., Bustos, C., Romero-L\u00f3pez-Alberca, C., Pena-Andreu, J.M., Xavier, M., and Moreno-K\u00fcstner, B. (2021). A multicentric study on stigma towards people with mental illness in health sciences students. BMC Med. Educ., 21.","DOI":"10.1186\/s12909-021-02695-8"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1177\/1049732319889354","article-title":"\u201cEverything Is perfect, and We Have No problems\u201d: Detecting and limiting social desirability bias in qualitative research","volume":"30","author":"Bergen","year":"2020","journal-title":"Qual. Health Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/3\/333\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:41:36Z","timestamp":1760028096000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/3\/333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":58,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["ijerph22030333"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22030333","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}