Detecting mental health stigma in medical education: a cross-sectional study of differences in medical students' knowledge, attitudes, and behaviors across six years of training

Background: Medical students often face psychological distress, worsened by mental health stigma. Aims: This study examines how stigma-related knowledge, attitudes, and behaviors evolve over six years of medical education and explores socio-demographic and psychosocial predictors of these changes. Methods: A cross-sectional study conducted during the 2022/2023 academic year involved 969 medical students, with 527 participants. Tools included the Mental Health Knowledge Schedule (MAKS-I), Community Attitudes to Mental Illness Scale (CAMI-I), and Reported and Intended Behavior Scale (RIBS-I), alongside socio-demographic data. Results: Findings showed a steady improvement in students’ mental health knowledge, attitudes, and behaviors, especially in the final two years. Academic and clinical experiences played a key role in shaping these views. However, a notable increase in mental health issues was observed in the later years. Positive changes were predicted by factors such as personal or family experiences with mental health issues, being older, and being female. Conclusions: The study emphasizes the need for integrating mental health education and stigma-reduction strategies throughout medical training. Although attitudes and knowledge improved, the rise in mental health issues underscores the importance of continued support and tailored interventions to enhance the well-being of medical students. (www.actabiomedica.it).