Mental health stigma and primary health care decisions.
People with serious mental illness have higher rates of mortality and morbidity due to physical illness. In part, this occurs because primary care and other health providers sometimes make decisions contrary to typical care standards. This might occur because providers endorse mental illness stigma, which seems inversely related to prior personal experience with mental illness and mental health care. In this study, 166 health care providers (42.2% primary care, 57.8% mental health practice) from the Veteran׳s Affairs (VA) medical system completed measures of stigma characteristics, expected adherence, and subsequent health decisions (referral to a specialist and refill pain prescription) about a male patient with schizophrenia who was seeking help for low back pain due to arthritis. Research participants reported comfort with previous mental health interventions. Path analyses showed participants who endorsed stigmatizing characteristics of the patient were more likely to believe he would not adhere to treatment and hence, less likely to refer to a specialist or refill his prescription. Endorsement of stigmatizing characteristics was inversely related to comfort with one׳s previous mental health care. Implications of these findings will inform a program meant to enhance VA provider attitudes about people with mental illness, as well as their health decisions.
Illinois Institute of Technology, Chicago, IL, USA. Electronic address: corrigan@iit.edu.
Patrick W
PW
Corrigan
VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA; Department of Psychiatry Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Dinesh
D
Mittal
VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA; Department of Psychiatry Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Christina M
CM
Reaves
VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA; Department of Psychiatry Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Tiffany F
TF
Haynes
Department of Psychiatry Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Xiaotong
X
Han
Illinois Institute of Technology, Chicago, IL, USA.
Scott
S
Morris
VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA; Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Psychiatry Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Greer
G
Sullivan
D001291:Attitude of Health Personnel; D003657:Decision Making; D006282:Health Personnel; D006801:Humans; D001523:Mental Disorders; D008603:Mental Health; D011320:Primary Health Care; D012017:Referral and Consultation; D012559:Schizophrenia; D057545:Social Stigma
Health decisions; Primary care; Serious mental illness; Stigma