Plusieurs études ont montré que les étudiants en médecine ont tendance à présenter des attitudes de plus en plus défavorables au cours de leurs études à l’égard des personnes souffrant d’un trouble mental, mais peu de données existent sur l’efficacité de programmes visant à améliorer ces attitudes.

L’objectif de notre étude était d’évaluer les effets d’un programme type brevet de secourisme en santé mentale (BSSM) sur les attitudes d’étudiants en médecine français à l’égard des personnes souffrant d’un trouble mental.

Nous avons réalisé une méthodologie mixte impliquant une mesure comparée de l’évolution de la distance sociale à l’égard des personnes atteintes d’un trouble mental entre un groupe contrôle et un groupe intervention ayant reçu le BSSM, ainsi que des entretiens semi-structurés avec des étudiants en médecine français.

Le BSSM a significativement diminué la distance sociale et la stigmatisation envers les personnes souffrant d’un trouble psychique (dépression : p<0,001 et p<.01 ; psychose : p<0,01 et p<.01). De plus, il a permis une augmentation de la confiance à venir en aide auprès de cette population pour le groupe d’étudiants ayant reçu l’intervention (p<.001). Les étudiants en médecine ont rapporté une très bonne satisfaction vis-à-vis de la formation ainsi qu’un intérêt certain concernant la santé mentale. Les entretiens semi-dirigés ont permis de mettre en avant les trois thématiques suivantes : a) les apports de l’enseignement, b) la perception de l’enseignement et c) l’intérêt pour la santé mentale. Au travers de celles-ci les représentations sociales ont un rôle prépondérant sur la stigmatisation des troubles mentaux qui diffère en fonction des pathologies.

Notre étude démontre l’intérêt d’une formation brève sur les attitudes des étudiants en médecine à l’égard des personnes atteintes de troubles mentaux. La réplication de ces résultats dans d’autres contextes est nécessaire.

Several studies have shown that medical students tend to have increasingly unfavorable attitudes towards people with mental disorders during their education, but there is little data on the effectiveness of programs aimed at improving these attitudes. Mental Health First Aid (MHFA) programs have been shown to bring mental health knowledge to the general population and to reduce stigmatizing attitudes towards individuals with mental disorders. In addition, it increases confidence in one's abilities and self-confidence to help an individual with a mental disorder. It therefore seems essential to evaluate the effects of MHFA-type programs in medical students.

The aim of our study was to evaluate the effects of a MHFA-type program implemented in a French medical school on the attitudes of second-year medical students towards people with mental disorders.

We used a mixed methodology including the collection of quantitative and qualitative data, involving comparative measurement of changes in social distance and stigma towards people with mental disorders between a control group and an intervention group that received the MHFA-type program. The quantitative data were collected using a self-administered questionnaire written, translated and adapted from English. This questionnaire is used to assess the impact of MHFA programs, using a Likert scale from 1 to 5 and open-ended questions. The questionnaire was divided into four parts: 1) sociodemographic characteristics, 2) self-confidence in the ability to help someone with mental health problems, 3) social distance and personal stigma toward people with mental disorders, and 4) satisfaction toward the MHFA program. The qualitative part of the study comprised semi-structured interviews with second-year medical students who received the MHFA program.

Our MHFA-type program significantly reduced social distance and stigmatization towards people with mental disorders (depression: P<0.001 and P<.01; psychosis: P<0.01 and P<.01). It also led to a significant increase in the confidence of students who received the intervention in providing help to this population (P<.001). Medical students reported a high level of satisfaction with the training and a greater interest in mental health. The semi-structured interviews highlighted the three following themes: a) the benefits of the program, b) perception of the program and c) interest in mental health. Through these themes, social representations were found to play a predominant role in the stigmatization of people with mental disorders by medical students, which differs depending on mental disorders.

Our study demonstrated the positive impact of a MHFA program on French second-year medical students’ attitudes towards people with mental disorders. Our results are consistent with the international literature on MHFA programs showing positive effects on social distance and stigma toward people with mental disorders. According to our results, implementing MHFA programs in the early stage of medical education could be helpful to reduce stigmatization and unfavorable attitudes toward people with mental disorders in medical students. However, our monocentric study was performed in France and used a non-randomized design. Thus, our results need to be replicated in other contexts, including assessment of the long-term effects of MHFA programs.