1. Homelessness and Mental Illness: The Medical Students’ Viewpoints Charity Pires BS, Sarah Hilton MS, Faneece Embry BS, Anthony Ahmed PhD, Edna Stirewalt BS, Adriana Foster MD Medical College of Georgia at Georgia Health Sciences University CONCLUSIONS DISCUSSION The data suggests that at GHSU, volunteer experience with the homeless is associated with increased empathy in medical students. However, it is unclear whether the volunteer experience leads to increased empathy or whether students who are already more empathetic towards the homeless are more likely to volunteer. In addition, GHSU medical students score higher than a comparable sample in the literature on stigmatizing attitudes towards mental illness. Although it is possible that the cultural and ethnic differences between the two groups contribute to the difference in their attitudes towards mental illness, we conclude that there is a dire need for effective educational approaches that expose medical students to underserved homeless and mentally ill populations. REFERENCES 1. Link BG et al, Public Knowledge, Attitudes and Beliefs about Homeless People: Evidence for Compassion Fatigue. American Journal of Community Psychology 1995, Vol. 23 (4):533-555. 2. Kassam, A. et al, Development and responsiveness of a scale to measure clinicians’ attitudes to people with mental illness (medical student version), Acta Psychiatrica Scandinavica, 2010; 122: 153-161. 3. Henderson, C, Institute of Psychaitry, King’s College, UK, 2012, unpublished report. 4. O’Toole TP, et al, Experiences and Attitudes of residents and students influence voluntary service with homeless populations, J Gen Intern Medicine, 1999; 14:211-216. 5. Doblin BH, Lillian G, and Freeman HE (1992). Patient Care and Professional Staffing Patterns in McKinney Act Clinics Providing Primary Care to the Homeless. The Journal of the American Medical Association. 267:698 -701. This research was sponsored by the American Psychiatric Foundation CPires@georgiahealth.edu PS6-02 1)To evaluate medical students’ attitudes towards the homeless and people with mental illness. 2)To assess whether having volunteered in homeless clinics influenced medical students’ attitudes towards the homeless. OBJECTIVES BACKGROUND Georgia Health Sciences University (GHSU) medical students have been funded by the American Psychiatric Foundation to screen and refer homeless people to mental health treatment and to increase community awareness about mental illness and homelessness. Prior volunteer experience with the homeless has been shown to increase the likelihood for medical students and residents to seek further opportunities to work with such population. Therefore, one of our goals was to evaluate attitudes toward the homeless and about mental illness in the GHSU medical student population. An additional goal was to assess medical students’ perception of the homeless before and after volunteering in shelters and indigent clinics. METHODS After GHSU IRB approval, 1st and 2nd year GHSU medical students (classes of 2014 and 2015) were asked to complete an anonymous survey assessing attitudes about the homeless and about mental illness. The homeless attitudes were assessed with an instrument from Link et al (1) focusing on four areas: willingness to help, emotional responsiveness, empathy, and stigma towards the homeless. The answer choices were based on 4-point Likert-type scale. Medical students’ attitudes about mental illness were measured with the Mental Illness Clinician Attitude Scale ­ medical student version (MICA) (2). MICA¹s 16 items are measured on a 6-point scale. MICA scores range from 16 to 96 with higher scores indicating greater stigmatizing attitudes. We assigned students to 2 groups, an experienced group and a no-experience group, based on having volunteered in homeless or indigent clinics or having not volunteered. We calculated mean and SD for each homeless attitudes scale component or the MICA scale, and used Fisher¹s Exact test, Person¹s Chi-squared test with Yates continuity correction and Welch¹s two sample t-test to compare the means in the experienced vs. no-experience groups. We then compared the GHSU students’ MICA scale results with the results reported in the literature on a medical student population at King’s College in London, UK (3). RESULTS Of 380 GHSU students offered, 79 students participated in the survey, and complete data is available from 62 students. Ethnicity in GHSU and King’s College medical student samples is presented in Table 1. Attitudes towards the homeless (Table 2): The students in the experienced group (n=37 students, M = 13.20, SD=2.97) scored higher on the 6-item empathy towards the homeless subscale, than those with no experience (n=25 students, M= 11.49, SD= 3.25), a statistically significant difference [t= 2.15, df= 54.62, p=.036]. Attitudes towards mental illness (Table 3): The mean MICA score for our sample of 1st & 2nd year students (M= 68.44, SD= 7.96) was higher when compared to another medical student sample in the literature, assessed with same scale (3rd years at King¹s College in London, UK, N=125, M= 40.58, SD= 7.22). The mean difference between these samples (95% CI: 25.56-29.63) in mental illness stigma achieved statistical significance [t= 27.09, df= 60, p<.0001) with our GHSU medical student sample demonstrating greater stigmatizing attitudes towards the mentally ill. We were able to demonstrate that empathy towards the homeless is higher in a group of students who volunteer in homeless clinics than in a group who does not volunteer. Our findings are consistent with the literature illustrating that spending time in homeless clinics encourages resident physicians to continue volunteering in similar settings (4, 5). We also showed that the GHSU medical students show some stigma against mental illness, significantly higher than another group of students in the literature who completed the same scale (ref). Given that the frequency distribution of students by ethnicity was substantially different when the small GHSU and King’s college samples were compared (with higher proportion of White students at GHSU and of Asian students at King’s College), these differences could contribute to differences in MICA scores. So perhaps cultural differences between the medical students in the USA and UK, as well as differences in the curriculum in the two schools may explain the difference in theirs attitudes towards mental illness. Limitations: the number of GHSU students who completed our survey was small when compared to the total number of students who were offered participation (79 of 380). Homeless Experienced groupNon-Experienced group Number of participants (n)3725 Mean empathy score13.2011.49 Standard deviation (SD)2.973.25 Statistical significancet = 2.15; df = 54.62; p = 0.036 Mental illness GHSU studentsKing’s College students Number of participants (n)62125 Mean68.4440.58 Standard deviation (SD)7.967.22 Statistical significance t = 27.09; df = 60; p < 0.0001 Table 2. Medical students’ attitudes toward the homeless based on volunteer experience in homeless or indigent clinics. Table 3. Comparison of medical students’ attitudes toward mental illness at Georgia Health Sciences University, USA and King’s College, UK. WhiteAsianBlackOther GHSU, Augusta, GA, USA71.1 %17.7%4.8%6.4% King’s college, London, UK51.733..6%4.4%10.3% Yates two-way Chi-Square = χ 2 (df=3) = 7.63, p =.054 Table 1. Ethnicity in GHSU and King’s College medical student samples