Advertisement

Using digital storytelling to understand service users' mental health recovery and address stigma among nursing students

Published:April 25, 2022DOI:https://doi.org/10.1016/j.apnu.2022.04.006

      Abstract

      Purpose

      Stigmatized attitudes towards people with mental illness from healthcare providers continues to be a problem affecting recovery in people with mental illness. The process of recovery was explored through digital stories created by service users, with support from nursing students. Stigmatized attitudes in nursing students and stigma resistance in service users were also investigated.

      Design and methods

      A quasi-experimental, mixed-methods, pilot study in which service users/nursing student teams created digital stories. Surveys testing stigmatized attitudes and stigma resistance were employed.

      Findings

      Statistical significance was not found, however, qualitative analysis revealed recovery elements and greater appreciation of individuals with mental illness by the nursing students.

      Practice implications

      Digital story-telling assists service users in doing the internal work of making meaning from experience. Nursing students benefit from involvement in the activity.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Psychiatric Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Allport G.W.
        The nature of prejudice.
        Addison-Wesley, 1954/1988
        • Bailey E.A.
        • Wirtalla C.
        • Sharoky C.E.
        • Kelz R.R.
        Disparities in operative outcomes in patients with comorbid mental illness.
        Surgery. 2018; 163: 667-671https://doi.org/10.1016/j.surg.2017.09.029
        • Ball M.
        • Smith G.
        Analyzing visual data.
        SAGE, 1992
        • Bingham H.
        • O’Brien A.J.
        Educational intervention to decrease stigmatizing attitudes of undergraduate nurses towards people with mental illness.
        International Journal of Mental Health Nursing. 2018; 27: 311-319https://doi.org/10.1111/inm.12322
        • Boydell K.M.
        • Cheng C.
        • Gladstone B.M.
        • Nadin S.
        • Stasiulis E.
        Co-producing narratives on access to care in rural communities: Using digital storytelling to foster social inclusion of young people experiencing psychosis (dispatch).
        Studies in Social Justice. 2017; 11: 298-304https://doi.org/10.26522/ssj.v11i2.1395
        • Bran R.
        Message in a bottle telling stories in a digital world.
        Procedia - Social and Behavioral Sciences. 2010; 2: 1790-1793
        • Brown S.
        • Kim M.
        • Mitchell C.
        • Inskip H.
        Twenty-five year mortality of a community cohort with schizophrenia.
        British Journal of Psychiatry. 2010; 196: 116-121https://doi.org/10.1192/bjp.bp.109.067512
        • Chan C.
        • Sage M.
        A narrative review of digital storytelling for social work practice.
        Journal of Social Work Practice. 2019; 35: 63-77https://doi.org/10.1080/02650533.2019.1692804
        • Chang E.T.
        • Vinzon M.
        • Cohen A.N.
        • Young A.S.
        Effective models urgently needed to improve physical care for people with serious mental illnesses.
        Health Services Insights. 2019; 12 (1178632919837628)https://doi.org/10.1177/1178632919837628
        • Charles J.L.K.
        Mental health provider-based stigma: Understanding the experience of clients and families.
        Social Work in Mental Health. 2013; 11: 360-375https://doi.org/10.1080/15332985.2013.775998
        • Corrigan P.W.
        • Mittal D.
        • Reaves C.M.
        • Haynes T.F.
        • Han X.
        • Morris S.
        • Sullivan G.
        Mental health stigma and primary health care decisions.
        Psychiatry Research. 2014; 21835–338https://doi.org/10.1016/j.psychres.2014.04.028
        • Creswell J.W.
        Qualitative inquiry & research design.
        Sage, 2013
        • Creswell J.W.
        • Clark V.L.P.
        Designing and conducting mixed methods research.
        Sage, 2011
        • Cunningham C.
        • Dixon L.B.
        Health disparities among people with serious mental illness.
        Psychiatric Services. 2020; 71: 412-413https://doi.org/10.1176/appi.ps.71406
        • De Vecchi N.
        • Kenny A.
        • Dickson-Swift V.
        • Kidd S.
        How digital storytelling is used in mental health: A scoping review.
        International Journal Of Mental Health Nursing. 2016; 25 (11p): 183-193https://doi.org/10.1111/inm.12206
        • De Vecchi N.
        • Kenny A.
        • Dickson-Swift V.
        • Kidd S.
        Exploring the process of digital storytelling in mental health research: A process evaluation of consumer and clinician experiences.
        International Journal of Qualitative Methods. 2017; 16 (160940691772929)https://doi.org/10.1177/1609406917729291
        • DiFulvio G.T.
        • Gubrium A.C.
        • Fiddian-Green A.
        • Lowe S.E.
        • Del Toro-Mejias L.M.
        Digital storytelling as a narrative health promotion process: Evaluation of a pilot study.
        International Quarterly of Community Health Education. 2016; 36: 157-164
        • Eksteen H.-C.
        • Becker P.J.
        • Lippi G.
        Stigmatization towards the mentally ill: Perceptions of psychiatrists, pre-clinical and post-clinical rotation medical students.
        International Journal of Social Psychiatry. 2017; 63: 782-791https://doi.org/10.1177/0020764017735865
        • Ferrari M.
        • Rice C.
        • McKenzie K.
        ACE pathways project: Therapeutic catharsis in digital storytelling.
        Psychiatric Services. 2015; 66: 556
        • Firmin R.L.
        • Lysaker P.H.
        • McGrew J.H.
        • Minor K.S.
        • Luther L.
        • Salyers M.P.
        The stigma resistance scale: A multi-sample validation of a new instrument to assess mental illness stigma resistance.
        Psychiatry Research. 2017; 25837–43https://doi.org/10.1016/j.psychres.2017.09.063
        • Fractal Foundation
        What are fractals? Fractal Foundation.
        • Goldman M.L.
        • Spaeth-Rublee B.
        • Pincus H.A.
        The case for severe mental illness as a disparities category.
        Psychiatric Services. 2018; 69: 726-728https://doi.org/10.1176/appi.ps.201700138
        • Goncalves M.M.
        • Matos M.
        • Santos A.
        Narrative therapy and the nature of “innovative moments” in the construction of change.
        Journal of Constructivist Psychology. 2009; 22: 1-23https://doi.org/10.1080/10720530802500748
        • Gubrium A.
        • Harper K.
        Participatory visual and digital methods.
        Left Coast Press, 2013
        • Gubrium A.C.
        • Fiddian-Green A.
        • Lowe S.
        • DiFulvio G.
        • Del Toro-Mejías L.
        Measuring down: Evaluating digital storytelling as a process for narrative health promotion.
        Qualitative Health Research. 2016; 26: 1787-1801https://doi.org/10.1177/1049732316649353
        • Hamilton S.
        • Pinfold V.
        • Cotney J.
        • Couperthwaite L.
        • Matthews J.
        • Barret K.
        • Warren S.
        • Corker E.
        • Rose D.
        • Thornicroft G.
        • Henderson C.
        Qualitative analysis of mental health service users’ reported experiences of discrimination.
        Acta Psychiatrica Scandinavica. 2016; 134: 14-22https://doi.org/10.1111/acps.12611
        • Harper D.
        Talking about pictures: A case for photo elicitation.
        Visual Studies. 2002; 17: 13-26
        • Jocius R.
        Telling unexpected stories: Students as multimodal artists.
        English Journal. 2016; 105: 16
        • Kassam A.
        • Papish A.
        • Modgill G.
        • Patten S.
        The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The opening minds scale for health care providers (OMS-HC).
        BMC Psychiatry. 2012; 12: 62https://doi.org/10.1186/1471-244X-12-62
        • Kidd S.
        • Kenny A.
        • McKinstry C.
        Exploring the meaning of recovery-oriented care: An action-research study.
        International Journal of Mental Health Nursing. 2015; 24: 38-48https://doi.org/10.1111/inm.12095
        • Knaak S.
        • Mantler E.
        • Szeto A.
        Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions.
        Healthcare Management Forum. 2017; 30: 111-116https://doi.org/10.1177/0840470416679413
        • Kopera M.
        • Suszek H.
        • Bonar E.
        • Myszka M.
        • Gmaj B.
        • Ilgen M.
        • Wojnar M.
        Evaluating explicit and implicit stigma of mental illness in mental health professionals and medical students.
        Community Mental Health Journal. 2015; 51: 628-634https://doi.org/10.1007/s10597-014-9796-6
        • Kottler J.
        Stories we've heard, stories we've told: Life-changing narratives in therapy and everyday life.
        Oxford University Press, 2015
        • Lambert J.
        Digital storytelling cookbook.
        Digital Diner Press, California, USA2010
        • Lang M.
        • Laing C.
        • Moules N.
        • Estefan A.
        Words, camera, music, action: A methodology of digital storytelling in a health care setting.
        International Journal of Qualitative Methods. 2019; https://doi.org/10.1177/1609406919863241
        • Laursen T.M.
        • Nordentoft M.
        • Mortensen P.B.
        Excess early mortality in schizophrenia.
        Annual Review of Clinical Psychology. 2014; 10 (PMID: 24313570): 425-448https://doi.org/10.1146/annurev-clinpsy-032813-153657
        • Leamy M.
        • Bird V.
        • Le Boutillier C.
        • et al.
        Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis.
        The British Journal of Psychiatry. 2011; 199: 445-452
        • Link B.
        • Phelan J.C.
        • Bresnahan M.
        • Stueve A.
        • Pescolido B.A.
        Public conceptions of mental illness: Labels, causes, dangerousness, and social distance.
        American Journal of Public Health. 1999; 89: 1328-1333https://doi.org/10.2105/AJPH.89.9.1328
        • Madigan S.
        Narrative therapy.
        2nd ed. American Psychological Association, 2019https://doi.org/10.1037/0000131-000
        • Matthews J.
        Voices from the heart: The use of digital story telling in education.
        Community Practitioner: The Journal Of The Community Practitioners' & Health Visitors' Association. 2014; 87: 28-30
        • Mittal D.
        • Corrigan P.
        • Sherman M.D.
        • Chekuri L.
        • Xiaotong H.
        • Reaves C.
        • Sullivan G.
        Healthcare providers' attitudes toward persons with schizophrenia.
        Psychiatric Rehabilitation Journal. 2014; 37 (7p): 297-303https://doi.org/10.1037/prj0000095
        • Ostrow L.
        • Manderscheid R.
        • Mojtabai R.
        Stigma and difficulty accessing medical care in a sample of adults with serious mental illness.
        Journal of Health Care for the Poor and Underserved. 2014; 25: 1956-1965
        • Patton M.Q.
        Qualitative research & evaluation methods.
        Sage Publications, 2015
        • Rice C.
        • Chandler E.
        • Harrison E.
        • Liddiard K.
        • Ferrari M.
        Project Re•Vision: Disability at the edges of representation.
        Disability and Society. 2015; 30: 513-527
        • Spector R.
        • Smojkis M.
        • Chilton L.
        Service-user involvement in a ward staff training project: Participants' experiences of making digital stories.
        Clinical Psychology Forum. 2011; 220: 49-53
        • Stefanovics E.
        • Rosenheck R.
        • He H.
        • Ofori-Atta A.
        • Cavalcanti M.
        • Neto H.
        • Leddy M.
        Cross-national analysis of beliefs and attitude toward mental illness among medical professionals from five countries.
        Psychiatric Quarterly. 2016; 87: 63-73https://doi.org/10.1007/s11126-015-9363-5
        • Stuart S.R.
        • Tansey L.
        • Quayle E.
        What we talk about when we talk about recovery: A systematic review and best-fit framework synthesis of qualitative literature.
        Journal of Mental Health. 2017; 26: 291-304
        • Thoits P.A.
        • Link B.G.
        Stigma resistance and well-being among people in treatment for psychosis.
        Society and Mental Health. 2016; 6: 1-20https://doi.org/10.1177/2156869315591367
        • Ungar T.
        • Knaak S.
        • Szeto A.
        Theoretical and practical considerations for mental illness stigma in health care.
        Community Mental Health Journal. 2016; 52: 262-271https://doi.org/10.1007/s10597-015-9910-4
        • Vistorte A.O.R.
        • Ribeiro W.S.
        • Jaen D.
        • Jorge M.R.
        • Evans-Lacko S.
        • Mari J.d.J.
        Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review.
        The International Journal of Psychiatry in Medicine. 2018; 53: 317-338https://doi.org/10.1177/0091217418778620
        • Walker E.R.
        • McGee R.E.
        • Druss B.G.
        Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis.
        JAMA Psychiatry. 2015; 72: 334-341https://doi.org/10.1001/jamapsychiatry.2014.2502
        • Wedgeworth M.L.
        • Ford C.D.
        • Tice J.R.
        “I'm scared”: Journaling uncovers student perceptions prior to a psychiatric clinical rotation.
        Journal of the American Psychiatric Nurses Association. 2020; 26: 189-195https://doi.org/10.1177/1078390319844002
        • White M.
        • Epston D.
        Narrative means to therapeutic ends.
        Norton, 1990
        • Wuest J.
        Grounded theory: The method.
        in: Munhall P.L. Nursing research: Aqualitative perspective. 5th ed. Jones & Bartlett Learning, Sudbury, MA2012: 225-256