RT Journal Article
SR Electronic
T1 Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP S56
OP S60
DO 10.1370/afm.2924
VO 21
IS Suppl 2
A1 Sean M. Phelan
A1 Manisha Salinas
A1 Tyson Pankey
A1 Gabrielle Cummings
A1 Jay-Sheree P. Allen
A1 Anne Waniger
A1 Nathaniel E. Miller
A1 Jocelyn Lebow
A1 John F. Dovidio
A1 Michelle van Ryn
A1 Chyke A. Doubeni
YR 2023
UL http://www.annfammed.org/content/21/Suppl_2/S56.abstract
AB 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.