Download Ending Discrimination Against People with Mental and Substance Use Disorders PDF

TitleEnding Discrimination Against People with Mental and Substance Use Disorders
File Size2.0 MB
Total Pages171
Table of Contents
1 Introduction
2 Understanding Stigma of Mental and Substance Use Disorders
3 The Science of Communication
4 Approaches to Reducing Stigma
5 Research Strategies
6 Conclusions and Recommendations
Appendix A: Agendas: Public Workshops
Appendix B: Biographical Sketches of Committee Members and Staff
Document Text Contents
Page 1


Distribution, posting, or copying of this PDF is strictly prohibited without written permission of the National Academies Press.
(Request Permission) Unless otherwise indicated, all materials in this PDF are copyrighted by the National Academy of Sciences.

Copyright © National Academy of Sciences. All rights reserved.


Visit the National Academies Press at and login or register to get:

– Access to free PDF downloads of thousands of scientific reports

– 10% off the price of print titles

– Email or social media notifications of new titles related to your interests

– Special offers and discounts



This PDF is available at SHARE


   

Ending Discrimination Against People with Mental and
Substance Use Disorders: The Evidence for Stigma Change

170 pages | 6 x 9 | PAPERBACK
ISBN 978-0-309-43912-1 | DOI 10.17226/23442

Committee on the Science of Changing Behavioral Health Social Norms; Board on
Behavioral, Cognitive, and Sensory Sciences; Division of Behavioral and Social
Sciences and Education; National Academies of Sciences, Engineering, and

Page 2

Committee on the Science of Changing Behavioral Health Social Norms

Board on Behavioral, Cognitive, and Sensory Sciences

Division of Behavioral and Social Sciences and Education

Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma ...

Copyright National Academy of Sciences. All rights reserved.

Page 85


tion, biogenetic messages may unintentionally trigger a message of hope-
lessness in people with mental illness, which can reinforce self-stigma and
inhibit the pursuit of wellness goals (Kvaale et al., 2013a). Although these
historical efforts were successful in decreasing attributional stigma, they
are no longer considered effective or sufficient stigma change strategies
by themselves (Corrigan et al., 2012).

Social media can also perpetuate negative stereotypes about mental
and substance use disorders. In a 2015 study, Joseph and colleagues ana-
lyzed tweets about diabetes and schizophrenia, to compare the attitudes
toward and perceptions of these chronic illnesses in informal online con-
versations. They found that tweets about schizophrenia were significantly
less likely to be medically accurate and more likely to be sarcastic and
negative in tone than tweets about diabetes (Joseph et al., 2015).

Mental Health Literacy Campaigns

Mental health literacy programs are a common educational strategy.
Educators, health professionals, and policy makers have recognized the
important role of schools in addressing the mental health needs of young
people and have endorsed the implementation of school mental health
programs (Wei et al., 2013). There is evidence that some in-school mental
health literacy programs improve knowledge, attitudes, and help-seeking
behavior, but more research is needed before decisions to scale-up men-
tal health literacy campaigns to the national level. There is also some
evidence that basic health education to improve mental health literacy
may be effective in reducing stigma for school-age children; however, to
improve public attitudes without negatively impacting self-stigma, the
curricula need to be recovery focused and developmentally and cogni-
tively tailored to different age groups (Wei et al., 2013). One such program
is mental health first-aid, in-person training that teaches participants to
respond to developing mental health problems and crises.2

Mental health literacy campaigns have also focused on how to encour-
age individuals and families to seek needed services (Jorm, 2012). This is
an important goal because early diagnosis and treatment are predictive
of improved outcomes, but high-quality, culturally informed treatment
is not widely available, especially to racial and ethnic minority groups
(Pescosolido et al., 2008a). The behavioral model of health service use,
which was first used to identify factors that influenced families’ utiliza-
tion of health care services (Andersen, 1995), has been expanded for use in
examining health-seeking behaviors for many different groups including

2 For more information on mental health first aid, see http://www.mentalhealthfirstaid.
org [March 2016].

Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma ...

Copyright National Academy of Sciences. All rights reserved.

Page 86


minorities and children and adolescents. Eiraldi and colleagues (2006)
used the original model to develop a help-seeking model for mental
health service use among ethnic minority families. They identified four
stages in the process of deciding to seek care for a child with symptoms
of attention deficit hyperactivity disorder: problem recognition, the deci-
sion to seek help, service selection, and service utilization. The researchers
noted that the problem-recognition stage is particularly important as it is
the first step in access to care. Families are more likely to seek treatment
for symptoms attributed to illness than for symptoms attributed to family
relations or personality factors (Yeh et al., 2005).

Although campaigns that promote biogenic explanations of men-
tal and substance use disorders are not generally effective in reducing
perceptions of dangerousness and desire for social distance among the
general public, there is evidence that biogenic cause attributions reduce
blame (Kvaale et al., 2013a, 2013b). Biogenic explanations may help coun-
ter culturally specific negative attitudes about mental disorders (Anger-
meyer et al., 2011; Yang et al., 2013) and promote parental help-seeking
behaviors for children’s mental health problems. Efforts to close the treat-
ment gap in access to mental health care between whites and ethnic
minorities might include campaigns that target ethnic minority parents,
as well as trusted community figures with messages about the biological
underpinnings of mental illnesses.


Across a wide range of stigmatizing conditions, people without the
stigmatized conditions have little meaningful contact with those who
have these conditions. Lack of contact fosters discomfort, distrust, and
fear (Cook et al., 2014). Contact interventions aim to overcome this inter-
personal divide and facilitate positive interaction and connection between
these groups (Shera, 1996). In contact-based behavioral health anti-stigma
interventions, people with lived experience of mental illness or substance
use disorders interact with the public describing their challenges and sto-
ries of success. These strategies are aimed at reducing public stigma on
a person-to-person basis but have also been shown to benefit self-stigma
by creating a sense of empowerment and boosting self-esteem (Corrigan
et al., 2013).

Historically, contact with people with mental and substance use disor-
ders occurred in person and through video, but now contact increasingly
occurs over the internet. A Norwegian survey conducted in 2002 found
that almost 75 percent of participants found it easier to discuss personal
problems online rather than face to face, and almost 50 percent said they
discuss problems online that they do not discuss face to face. Many com-

Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma ...

Copyright National Academy of Sciences. All rights reserved.

Page 170


in the media. She has an M.S. in community counseling from Georgia
State University.

Lisa M. Vandemark (Study Director) is a senior program officer at the
National Academies of Sciences, Engineering, and Medicine. She is also a
psychiatric nurse practitioner in the District of Columbia, working with
children and families and adjunct faculty in the Department of Acute
and Chronic Care at Johns Hopkins University School of Nursing. Her
previous studies focused primarily on social and environment influences
on health and health outcomes in the United States and in developing
countries. Previously, she was on the faculty at the Medical University of
South Carolina, where she taught in the psychiatric nurse practitioner and
global health programs. She has a master’s degree in psychiatric nursing
from Rush University and a Ph.D. in geography from Rutgers University.

Eric R. Wright is professor of sociology and public health at Georgia State
University and a Second Century Initiative faculty in the university’s
Atlanta Census Research Data-Health Policy and Risky Behaviors Clus-
ter. Previously, he was a professor and chair of the Department of Health
Policy and Management and director of the Center for Health Policy at
the Richard M. Fairbanks School of Public Health at Indiana University-
Purdue University Indianapolis. As a medical sociologist, his research
interests center on social and public policy responses to mental health and
illness, substance use and addictions, sexual health, and HIV/STI pre-
vention. His research focuses on understanding and ameliorating health
problems and disparities in minority and other vulnerable communities,
including lesbian, gay, bisexual, and transgender people. He also works
with community organizations and local and state governments to better
understand community health needs and improve the effectiveness of
health- and health care-related programs and policies. He has an M.A.
and a Ph.D. in sociology from Indiana University, Bloomington.

Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma ...

Copyright National Academy of Sciences. All rights reserved.

Similer Documents