Genetic counselors' attitudes toward and practice related to psychiatric genetic counseling.

Booke S1, Austin J2, Calderwood L3, Campion M1.

Author information

1: Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
2: Departments of Psychiatry and Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
3: Department of Pediatrics, Division of Medical Genetics, Stanford University School of Medicine, Stanford, CA, USA.

Abstract

Despite the high demand for psychiatric genetic counseling among people with psychiatric conditions (>90%), surveys show that genetic counselors rarely receive primary referrals for psychiatric cases. The purpose of this study was to further investigate potential barriers to the provision of psychiatric genetic counseling services, focusing specifically on the prevalence and impact of psychiatric stigmatization among genetic counselors. Board-certified, practicing genetic counselors were invited to participate in an anonymous survey via the National Society of Genetic Counselors. Survey measures included a validated psychiatric stigmatization scale (OMS-HC) and questions assaying genetic counselors' experiences with and opinions of psychiatric genetic counseling. Associations between psychiatric stigmatization and attitudes toward and practice related to psychiatric genetic counseling were computed using Pearson's correlation. The majority of respondents believed that psychiatric genetic counseling is of value to families (94%) and that it is indicated if there is a relevant personal or family history (90.3%), but only 44.6% reported providing this service. On average, respondents scored neutrally on psychiatric stigma scales; however, higher stigma levels were associated with less frequent psychiatric discussions (p = .05), less counselor comfort and perceived qualification (p = .003) and perceptions of having insufficient psychiatric genetic data (p < .02), resources (p < .02) and time (p < .03). This study suggests that the limits of psychiatric genetics research and unavailability of genetic testing lead many genetic counselors to doubt the utility of psychiatric genetic counseling. Should this mindset persist, without the intervention of psychiatric education and training, the field of genetic counseling risks continuing to inadequately serve a historically underserved population.

KEYWORDS:

attitudes; family history; genetic counseling; genetic testing; mental health; mental illness; psychiatric disorders; psychiatric genetic counseling; stigma; stigmatization