5062.0: Wednesday, November 15, 2000 - 9:30 AM

Abstract #10836

Dually diagnosed and multiply stigmatized: Missing dimensions of stigma research

Gary Haugland, MA, Center for the Study of Issues in Public Mental Health, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, 914-398-6580, hauglan@nki.rfmh.org

Public mental health approaches to stigma research traditionally have addressed social attitudes toward mental illness and stigma-management strategies employed by consumers of mental health services. This paper will present results of systems-level research on services for persons with co-existing mental illness and chemical abuse problems which reveals how pervasive stigma is within and across the various treatment systems. Persons with dual diagnoses exhibit a broad array of problems leaving them multiply stigmatized: poverty, homelessness, unemployment, incarceration and violence present additional layers of stigma and complicate efforts at stigma-management. The often cited difficulty in engaging dually diagnosed consumers in treatment may be due to stigmatizing features of the mental health, chemical abuse, social services, and criminal justice systems. While government sponsored anti-stigma campaigns have been focused on changing public attitudes through education, consumers argue that culturally competent, consumer-involved treatment systems are needed to reduce stigma. Anti-stigma efforts must therefore take place in medical schools, ERs, clinics and other settings that are training laboratories for mental health professionals; in community-based provider systems that continue to distrust or devalue each other; and in government entities that perpetuate stigma by opposing consumer rights and parity legislation, by promoting welfare-to-work programs that compromise insurance safety nets, and by all but ignoring that the locus of care has shifted to jails. At the federal level, the inability to mitigate differences between mental health and addictions agencies, and the reluctance to introduce blended funding streams that better reflect complex consumer needs must also be addressed.

Learning Objectives: At the conclusion of this presentation, audience members will recognize the importance of assessing the complex effects of multiple stigmas on help seeking behavior, identify key sources of stigma in the mental health and chemical abuse treatment systems and develop approaches for anti-stigma campaigns targeted to these treatment systems

Keywords: Mental Health Services, Substance Abuse

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: NYS Conference of Local Mental Hygiene Directors
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Technical Assistance Project consultation

The 128th Annual Meeting of APHA