Skip to main content

Advertisement

SpringerLink
Log in

Exploring Stigmatizing Attitudes Among Community Mental Health Clinicians Working with Clients Who Have a Dual Diagnosis

  • Brief Report
  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Adams, M. (2008). Comorbidity of mental health and substance misuse problems: a review of workers’ reported attitudes and perceptions. Journal of Psychiatric and Mental Health Nursing, 15(2), 101–108.

    Article  CAS  Google Scholar 

  • Ahern, J.., Stuber, J., & Galea, S. (2007). Stigma, discrimination, and the health of illicit drug users. Disability support services: services provided under the National Disability Agreement 2014-2015. AIHW Bulletin, Canberra, Australian Institute of Health and Welfare.

  • Best, D., & Lubman, D. (2012). The recovery paradigm: a model of hope and change for alcohol and drug addiction. Australian Family Physician, 41(8), 593–597.

    PubMed  Google Scholar 

  • Cleary, M., Hunt, G. E., Matheson, S., & Walter, G. (2009). Views of Australian mental health stakeholders on clients’ problematic drug and alcohol use. Drug and Alcohol Review, 28(2), 122–128. https://doi.org/10.1111/j.1465-3362.2008.00041.x.

    Article  PubMed  Google Scholar 

  • Crapanzano, K., Vath, R. J., & Fisher, D. (2014). Reducing stigma towards substance users through an educational intervention: harder than it looks. Academic Psychiatry, 38(4), 420–425. https://doi.org/10.1007/s40596-014-0067-1.

    Article  PubMed  Google Scholar 

  • Croton, G. (2005). Senate Mental Health Inquiry Submission: Australian treatment system’s recognition of and response to co-occurring mental health & substance use disorders.

  • Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. The British Journal of Psychiatry, 185, 342–349.

    Article  Google Scholar 

  • Griffiths, K. M., Nakane, Y., Christensen, H., Yoshioka, K., Jorm, A. F., & Nakane, H. (2006). Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry, 6(1), 21.

    Article  Google Scholar 

  • Jorm, A. F., & Griffiths, K. M. (2008). The public’s stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations? Acta Psychiatrica Scandinavica, 118(4), 315–321.

    Article  CAS  Google Scholar 

  • Jorm, A. F., & Oh, E. (2009). Desire for social distance from people with mental disorders. Australian and New Zealand Journal of Psychiatry, 43(3), 183–200.

    Article  Google Scholar 

  • Link, B., Yang, L., Phelan, J., & Collins, P. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511–541.

    Article  Google Scholar 

  • Livingston, J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction, 107(1), 39–50. https://doi.org/10.1111/j.1360-0443.2011.03601.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mason, R. J., Hart, L. M., Rossetto, A., & Jorm, A. F. (2015). Quality and predictors of adolescents′ first aid intentions and actions towards a peer with a mental health problem. Psychiatry Research, 228(1), 31–38.

    Article  Google Scholar 

  • Minkoff, K., & Cline, C. (2004). Changing the world: The design and implementation of comprehensive continuous integrated systems of care for individuals with co-occurring disorders. Psychiatric Clinics of North America, 27(4), 727–743.

    Article  Google Scholar 

  • Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167(11), 1321–1330.

    Article  Google Scholar 

  • Ralley, C., Allott, R., Hare, D. J., & Wittkowski, A. (2009). The use of the repertory grid technique to examine staff beliefs about clients with dual diagnosis. Clinical Psychology & Psychotherapy, 16(2), 148–158. https://doi.org/10.1002/cpp.606.

    Article  Google Scholar 

  • Reavley, N. J., Mackinnon, A. J., Morgan, A. J., & Jorm, A. F. (2014). Stigmatising attitudes towards people with mental disorders: a comparison of Australian health professionals with the general community. Australian and New Zealand Journal of Psychiatry, 48(5), 433–441.

    Article  Google Scholar 

  • Roberts, B.M., & Mayberry, D. (2014). Dual diagnosis discourse in Victoria, Australia: the responsiveness of mental health services. Journal of Dual Diagnosis, 10(3), 139-144

  • Room, R. (2003). The Cultural Framing of Addiciton1. Janus Head, 6(2), 221–234.

    Google Scholar 

  • Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review, 24(2), 143–155. https://doi.org/10.1080/09595230500102434.

    Article  PubMed  Google Scholar 

  • Room, R., Rehm, J., Trotter, I.I., Robert, T., Paglia A., & Ustun, T.B. (2001). Cross-cultural views on stigma, valuation, parity, and societal values on disability. In: Disability and Culture: Universalism and Diversity. Eds. T Bedirhan Ustun, Somnath Chatterji, Jerome E. Bickenbach, Robert T. Trotter II, Robin Room, Jurgen Rehm, Shekhar Saxena. Seattle: Hogrefe & Huber Publishers, pp. 247-297

  • Rossetto, A., Jorm, A. F., & Reavley, N. J. (2014). Examining predictors of help giving toward people with a mental illness: results from a national survey of Australian adults. SAGE Open, 4(2), 2158244014537502.

    Article  Google Scholar 

  • Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M. G., & Angermeyer, M. C. (2011). The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol and Alcoholism, 46(2), 105–112.

    Article  CAS  Google Scholar 

  • Skinner, N., Roche, A. M., Freeman, T., & McKinnon, A. (2009). Health professionals’ attitudes towards AOD-related work: moving the traditional focus from education and training to organizational culture. Drugs: Education, Prevention and Policy, 16(3), 232–249. https://doi.org/10.1080/09687630902876338.

    Article  Google Scholar 

  • van Boekel, L. C., Brouwers, E. P., van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug and Alcohol Dependence, 131(1-2), 23–35. https://doi.org/10.1016/j.drugalcdep.2013.02.018.

    Article  PubMed  Google Scholar 

  • Viet Cuong, P., Casswell, S., Parker, K., Callinan, S., Chaiyasong, S., Kazantseva, E., et al. (2018). Cross-country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study. Drug and Alcohol Review, 37, S45–S52.

    Article  Google Scholar 

  • White, W. (2001). Addiction disease concept: Advocates and critics. The Counselor, 2(1), 42-46.

  • Wahl, O., & Aroesty-Cohen, E. (2010). Attitudes of mental health professionals about mental illness: a review of the recent literature. Journal of Community Psychology, 38(1), 49–62. https://doi.org/10.1002/jcop.20351.

    Article  Google Scholar 

  • Yap, M. B. H., & Jorm, A. F. (2011). The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth. Journal of Affective Disorders, 134(1-3), 473–477.

    Article  Google Scholar 

  • Yap, M. B., Wright, A., & Jorm, A. F. (2011). The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1257–1265.

    Article  Google Scholar 

  • Yap, M. B. H., Reavley, N. J., & Jorm, A. F. (2013). Associations between stigma and help-seeking intentions and beliefs: findings from an Australian national survey of young people. Psychiatry Research, 210(3), 1154–1160.

    Article  Google Scholar 

  • Yap, M. B., Mackinnon, A., Reavley, N., & Jorm, A. F. (2014). The measurement properties of stigmatizing attitudes towards mental disorders: results from two community surveys. International Journal of Methods in Psychiatric Research, 23(1), 49–61.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Turning Point, Eastern Health and Monash University, Melbourne, Australia

    Michelle Francis, Victoria Manning & Ali Cheetham

Authors
  1. Michelle Francis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Victoria Manning
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ali Cheetham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michelle Francis.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Francis, M., Manning, V. & Cheetham, A. Exploring Stigmatizing Attitudes Among Community Mental Health Clinicians Working with Clients Who Have a Dual Diagnosis. Int J Ment Health Addiction 18, 1437–1445 (2020). https://doi.org/10.1007/s11469-019-00171-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-019-00171-5

Search

Navigation