Vol.:(0123456789) 1 3 Community Mental Health Journal https://doi.org/10.1007/s10597-019-00521-6 ORIGINAL PAPER Mental Health Professionals’ Attitudes to Severe Mental Illness and Its Correlates in Psychiatric Hospitals of Attica: The Role of Workers’ Empathy Marina Economou 1,2  · Lily Evangelia Peppou 2  · Konstantinos Kontoangelos 1,2  · Alexandra Palli 2  · Irene Tsaliagkou 2  · Emilia‑Maria Legaki 4  · Rossetos Gournellis 3  · Charalampos Papageorgiou 1 Received: 30 September 2019 / Accepted: 9 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract To describe mental health workers’ attitudes to severe mental illness and to explore its socio-demographic and professional correlates, including the infuence of empathy. A total of 127 mental health staf working on the psychiatric hospitals of Attica participated in the study. Stigma was assessed with the Attitudes to Severe Mental Illness scale (ASMI) and the Greek Social Distance scale; whilst Empathy with the Interpersonal Reactivity Index. Participants’ unfavourable attitudes to severe mental illness were limited to pessimism about recovery, difculty in viewing people with mental illness as similar to other people and desire to keep distance in intimate encounters. Professional group and personal experience with mental illness were found to predict stigma. Only perspective taking was associated with both stigma measures; while Fantasy was positively correlated with social distance. Anti-stigma interventions in mental healthcare should prioritize nurses and psychiatrists and aim at enhancing perspective taking. Keywords Iatrogenic stigma · Mental health workers · Stereotypes · Perspective taking · Social distance Introduction The stigma surrounding mental illness and discriminatory behaviours ensuing from it have been shown to hinder the life opportunities of people with severe mental illness and their access to mental health services (Clement et al. 2015; Schulze and Angermeyer 2003; Thornicroft et al. 2009). Apart from exploring attitudes in the general population, research attention has been shifted to stigma in (mental) health care, the so-called “iatrogenic stigma” (Sartorius 2002). The reasons for investigating mental health profession- als’ attitudes and behaviours are manifold. People with mental illness identify mental health services as notable sources of stigma and discrimination, with more than 38% of them internationally reporting feeling disrespected by mental health staf (Harangozo et al. 2014). This is of out- most importance, in light of evidence indicating that 76% of individuals with chronic mental illness acknowledge their healthcare providers being the most important persons in their lives (Borge et al. 1999). Moreover, mental health staf occupies crucial positions in treatment and rehabilitation of people with mental disorders. Consistent with this, their behaviour and attitudes have been linked to treatment out- come and quality of care (Holmqvist 2000a, b; Thornicroft 2008). Concomitantly, mental health professionals serve as role models and educators, shaping thus beliefs about mental disorders in the general population as well as future health care professionals (Gray 2002; Jorm et al. 2000; Sar- torius 2002). Hence, their attitudes may have a multiplying efect in lay people and other professionals; while they may * Marina Economou antistigma@epipsi.eu 1 First Department of Psychiatry, Medical School, Aigintion Hospital, National and Kapodistrian University of Athens, Athens, Greece 2 Community Mental Health Centre, University Mental Health, Neurosciences and Precision Medicine Research Institute “Costas Stefanis” (U.M.H.R.I.), 2 Soranou toy Efesiou St, 11527 Athens, Greece 3 Second Department of Psychiatry, Medical School, Aigintion Hospital, National and Kapodistrian University of Athens, Athens, Greece 4 Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece