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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To explore the possibility that peer influences not only contribute to adolescent substance abuse but shape feelings about being in treatment for substance abuse, forty adolescent inpatients were surveyed. Misconduct, including substance abuse, was predicted best by perceived peer pressure toward misconduct, low opinions of the value of treatment by disposition to conform to antisocial peers, and sense of stigma associated with being treated by perceived peer pressure toward conformity. Concerns over peer acceptance may be one basis for resistance to substance abuse treatment.
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PMID:Conformity, peer pressure, and adolescent receptivity to treatment for substance abuse: a research note. 147 83

Persons with dual diagnoses of psychiatric illness and substance abuse represent a large subpopulation within the mental health system, but mental health service delivery systems typically do not adequately address their special needs. The literature on dual diagnoses is marked by the paucity of information on such persons in rural settings. This paper describes the characteristics of a rural community mental health system, which illustrate the difficulties in treating persons with dual diagnoses in rural communities. These problems include a fragmented system of services, centralized services in a large geographic area, overly restrictive regulations, conceptual differences in treatment approaches, confidentiality and stigma in a rural culture, and the academic and professional isolation of mental health workers, leading to high turnover and a shortage of staff having sufficient training and experience to work with persons with dual diagnoses. Some recommendations to address these problems and to improve the delivery of services to persons with dual diagnoses are suggested.
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PMID:The treatment of persons with dual diagnoses in a rural community. 770 Oct 19

A discussion of adolescent high-risk behavior and associated stigma is presented from the perspective of teenagers confined in juvenile detention. Data contributing to this discussion originate from a qualitative research study designed to discover the meaning detained adolescents associate with substance use/abuse and to describe how they make substance-related decisions while in juvenile detention. This pilot study was part of a program of ongoing ethnographic research in the setting of a large metropolitan juvenile detention facility (JDF). Twenty teenagers participated in the study during interviews and focus group discussions. A major theme among all six focus groups involved resolutions to quit drugs and alcohol after release. The trajectory of substance abuse interwoven in these discussions most frequently began with problems at home, progressed to substance abuse and other high-risk behaviors, and culminated in detention. All of the groups gave suggestions for the kind of help teenagers need most: someone to listen and to care.
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PMID:Resolutions and risk-taking in juvenile detention. 770 65

Private insurance coverage has historically been and continues to be discriminatory toward patients requiring treatment for mental illness and substance abuse disorders in comparison with those in need of general medical care. Factors contributing to this disparity include stigma, relatively low overt consumer demand for psychiatric care, lack of knowledge about psychiatric illness and treatment on the part of insurers, a historical reliance on public sector psychiatry, and the assumption that more liberal psychiatric benefits result in unnecessary and excessive use. Strategies aimed at eliminating discriminatory insurance practices against those in need of mental health care must be implemented. Recommended approaches include further research on the cost effectiveness of mental health care, public education regarding the nature of mental illness and its treatment, patient/family advocacy, and the marketing of services by mental health professionals.
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PMID:Private insurance coverage for the treatment of mental illness versus general medical care: a policy of inequity. 820 46

Visitors (N = 579) to a science center read selected scenarios and evaluated the most likely outcome for a hypothetical substance abuser. Respondents were randomly assigned to one of six scenario conditions: a person with one of three different substance abuse problems (alcohol, tobacco, or cocaine) was crossed with two labels reflecting high or low substance dependence. Results indicated that: (1) cigarettes were viewed as a less serious substance abuse problem than were alcohol or cocaine (a person who smoked cigarettes was rated as more likely to recover from his problem, self-change was regarded as more appropriate and less stigma was associated with smoking than with the other two drugs); (2) non-abstinent recoveries of all types were greeted with skepticism; and (3) recovery was rated as more likely to occur from treatment than from self-change.
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PMID:What's in a label? The effects of substance types and labels on treatment considerations and stigma. 827 5

1. There is still a strong stigma attached to mental illness, and surprisingly many psychiatric nurses reinforce that stigma. Although some professionals may go into therapy to improve self-esteem and become better professionals, they may run the risk of destroying their career. 2. The experience as a patient in a mental health facility can result in nightmares and flashbacks, and damage due to restraints. Because "coming out" can destroy one's career, the safest place for a nurse with a history of hospitalization or substance abuse may be "in the closet." 3. If the stigma of mental illness is going to be changed, then it must start with the changing of the attitudes and perceptions of mental health professionals.
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PMID:Coming out. My experience as a mental patient. 835 27

An exploratory study was conducted with 27 injecting drug users (IDUs) on psychosocial factors (stress, coping reactions, and attitudes toward HIV illness and treatment) which are relevant to treatment acceptance and adherence. A semi-structured interview was used to collect qualitative data in a sample of 13 seropositive and 14 seronegative subjects. The results indicated a range of HIV-specific stressors such as social stigma, uncertainty about the future, disclosure of seropositive status, and monitoring of HIV illness. Seeking of social support, relapse to substance abuse, and mental disengagement were the most common coping reactions reported by the sample; there was a lack of behavioral, problem-focused responses. The study also provided descriptive information on attitudes toward HIV treatment, including fatalism, optimism (hope and control), and ambivalence regarding treatment efficacy. Clinical implications and suggestions for future research are discussed.
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PMID:Stress, coping, and attitudes toward HIV treatment in injecting drug users: a qualitative study. 867 95

Substance abuse is known to be our nation's number one public health problem. Physicians and other health providers can develop chemical dependency problems that create significant quality assurance and risk management dilemmas. Not all of society understands drug dependence to be a treatable medical disease and behavioral problem. Sometimes impaired providers are ignored or punished rather than treated and rehabilitated. This results in an enormous waste of human and monetary resources. In the last 10 years, impaired physician programs have developed focus and credibility. But certain difficulties exist in these programs: namely, that such programs are affected by tensions between medical societies and state licensing boards; that substance-dependent providers escape detection by moving to other states; that existing impaired provider programs have limited practical application within the federal health care system; and that liability risks are incurred if institutions rely on impaired provider policies that do not include all members of the medical staff. Hence, we argue that existing impaired provider policies might be worth rethinking. To promote that dialogue, we offer a sample policy for consideration and review. It includes specific actions and procedures for the identification, referral, and reentry of impaired providers and allows for National Practitioner Data Bank reporting in that process. The Data Bank has been in place for only a few years and offers society and the health community a new opportunity to better control chemically dependent, licensed medical staff without dismantling existing impaired provider programs. The policies for managing chemically dependent health professionals are changing from a focus on stigma and prosecution to one of early identification, rehabilitation, and reentry. We hope to advance that process.
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PMID:Quality improvement and substance abuse: rethinking impaired provider policies. 870 3

This article reviews the history, growth, and evolution of managed care in mental health and substance abuse treatment. Specific issues described are stigma, the important social dimensions and chronicity of some types of mental illness and chemical dependency, and reliance on the public sector for care. Opportunities and challenges for occupational therapists in the rapidly changing mental health system are discussed, including the use of interdisciplinary teams, the importance of measuring functional outcomes of interventions, the need to develop clinical guidelines, the importance of the community setting and a continuum of services, ethical dilemmas, and the importance of assertive occupational therapy advocacy and involvement in health care reform.
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PMID:Managed mental health care: reflections in a time of turmoil. 872 77

Dual diagnosis refers to the co-occurrence of substance abuse and mental illness, which may take many forms. Women who abuse alcohol or drugs are more likely than men to be diagnosed with a psychiatric disorder, particularly depression or personality disorder. The interaction of pregnancy, addiction, and mental illness creates complex needs that often go unrecognized by treatment providers. Clinical issues concern adequate prenatal care, use of medications while pregnant and/or nursing, maternal bonding, and coordinated treatment planning among medical, addiction, and mental health treatment providers. Barriers to service delivery to perinatal substance-abusing women with a mental illness include the difficulty in diagnosing a dual disorder, child care and custody concerns, lack of health insurance or funds to pay for treatment, and the stigma associated with mental illness and addiction. Services currently available for the dually diagnosed are typically fragmented and uncoordinated and provision of those services is often hampered by philosophical differences, categorical funding, competition for scarce resources, inadequate staff training, and lack of a central administrative authority or mandate. Several models have been suggested that coordinate services for the dually diagnosed. Awareness of the service needs of dually-diagnosed perinatal women must be included within these models and integrated at all levels of the treatment system.
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PMID:Services for perinatal women with substance abuse and mental health disorders: the unmet need. 911 Feb 67


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