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Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations.

Publication ,  Journal Article
Phelan, SM; Salinas, M; Pankey, T; Cummings, G; Allen, J-SP; Waniger, A; Miller, NE; Lebow, J; Dovidio, JF; van Ryn, M; Doubeni, CA
Published in: Ann Fam Med
February 2023

PURPOSE: Stigma related to mental health is well documented and a major barrier to using mental and physical health care. Integrated behavioral health (IBH) in primary care, in which behavioral/mental health care services are located within a primary care setting, may reduce the experience of stigma. The purpose of this study was to assess the opinions of patients and health care professionals about mental illness stigma as a barrier to engagement with IBH and to gain insight into strategies to reduce stigma, encourage discussion of mental health, and increase uptake of IBH care. METHODS: We conducted semistructured interviews with 16 patients referred to IBH in a prior year and 15 health care professionals (12 primary care physicians and 3 psychologists). Interviews were transcribed and inductively coded separately by 2 coders for common themes and subthemes under the topic headings of barriers, facilitators, and recommendations. RESULTS: We identified 10 converging themes from interviews with patients and the health care professionals, representing important complementary perspectives, with respect to barriers, facilitators, and recommendations. Barriers included professionals, families, and the public as sources of stigma, as well as self-stigma or avoidance, or internalizing negative stereotypes. Facilitators and recommendations included normalizing discussion of mental health and mental health care-seeking action, using patient-centered and empathetic communication strategies, sharing by health care professionals of their own experiences, and tailoring the discussion of mental health to patients' preferred understanding. CONCLUSIONS: Health care professionals can help reduce perceptions of stigma by having conversations with patients that normalize mental health discussion, use patient-centered communication, promote professional self-disclosure, and are tailored to patients' preferred understanding.

Duke Scholars

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Published In

Ann Fam Med

DOI

EISSN

1544-1717

Publication Date

February 2023

Volume

21

Issue

Suppl 2

Start / End Page

S56 / S60

Location

United States

Related Subject Headings

  • Social Stigma
  • Psychiatry
  • Mental Health Services
  • Mental Health
  • Humans
  • Health Personnel
  • General & Internal Medicine
  • 44 Human society
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Phelan, S. M., Salinas, M., Pankey, T., Cummings, G., Allen, J.-S., Waniger, A., … Doubeni, C. A. (2023). Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations. Ann Fam Med, 21(Suppl 2), S56–S60. https://doi.org/10.1370/afm.2924
Phelan, Sean M., Manisha Salinas, Tyson Pankey, Gabrielle Cummings, Jay-Sheree P. Allen, Anne Waniger, Nathaniel E. Miller, et al. “Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations.Ann Fam Med 21, no. Suppl 2 (February 2023): S56–60. https://doi.org/10.1370/afm.2924.
Phelan SM, Salinas M, Pankey T, Cummings G, Allen J-SP, Waniger A, et al. Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations. Ann Fam Med. 2023 Feb;21(Suppl 2):S56–60.
Phelan, Sean M., et al. “Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations.Ann Fam Med, vol. 21, no. Suppl 2, Feb. 2023, pp. S56–60. Pubmed, doi:10.1370/afm.2924.
Phelan SM, Salinas M, Pankey T, Cummings G, Allen J-SP, Waniger A, Miller NE, Lebow J, Dovidio JF, van Ryn M, Doubeni CA. Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations. Ann Fam Med. 2023 Feb;21(Suppl 2):S56–S60.

Published In

Ann Fam Med

DOI

EISSN

1544-1717

Publication Date

February 2023

Volume

21

Issue

Suppl 2

Start / End Page

S56 / S60

Location

United States

Related Subject Headings

  • Social Stigma
  • Psychiatry
  • Mental Health Services
  • Mental Health
  • Humans
  • Health Personnel
  • General & Internal Medicine
  • 44 Human society
  • 42 Health sciences
  • 32 Biomedical and clinical sciences