Exploring Stigmatizing Attitudes Among Community Mental Health Clinicians Working with Clients Who Have a Dual Diagnosis
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Exploring Stigmatizing Attitudes Among Community Mental Health Clinicians Working with Clients Who Have a Dual Diagnosis Michelle Francis 1 & Victoria Manning 1 & Ali Cheetham 1
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Illicit drug use, alcohol use and mental health problems frequently co-occur and are some of the most stigmatised health conditions. This can include stigma from those providing care, although stigmatization by mental health professionals towards dual-diagnosis clients is poorly understood. This study aimed to examine whether clinicians in community managed mental health organisations hold attitudes and beliefs that could be considered stigmatising towards clients with a dual diagnosis (ddx). Using an online survey, mental health clinicians (n = 32) were presented with three vignettes depicting a person with (1) schizophrenia, (2) schizophrenia and alcohol dependence and (3) schizophrenia and methamphetamine use, and two scales measuring stigmatising attitudes. Scores across the vignettes were compared to assess attitudes towards dual diagnosis compared to mental illness. Mental health clinicians' responses suggested greater stigma and a desire for greater social distance towards the methamphetamine case (but not the alcohol case) relative to the schizophrenia alone case. Rates of belief in full recovery were relatively low for all vignettes. It is recommended that training to address negative atttiudes and beliefs towards illicit drug users is implemented in mental health settings. Research indicates that between one-third and three quarters of Australian mental health clients experience comorbid substance use disorders (Adams 2008; Croton 2005; Minkoff and Cline 2004). According to a World Health Organization study (Room et al. 2001), illicit drug use is the most and alcohol the fourth most stigmatised health
* Michelle Francis [email protected] Victoria Manning [email protected] Ali Cheetham [email protected]
1
Turning Point, Eastern Health and Monash University, Melbourne, Australia
International Journal of Mental Health and Addiction
issue in the world, whilst mental health problems are the ninth most stigmatised. Individuals with a dual diagnosis (those experiencing both mental health problems and substance misuse) are therefore likely to face even greater stigma that creates further barriers to engaging in and responding to treatment (Cleary et al. 2009; Room 2005; Schomerus et al. 2011; Wahl and Aroesty-Cohen 2010). In particular, illegal substance use is viewed more negatively, is less socially acceptable and is frequently considered a moral and criminal issue rather than a health issue (Livingston et al. 2012; Room 2003). Alcohol misuse is typically viewed less negatively than use of illegal substances, yet more so than other highly stigmatised disorders (such as schizophrenia) alone (Schomerus et al. 2011). Stigma is a multidimensional construct and has been defined and measured in a variety of ways. One of the mo
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