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Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health.

However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders.

Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Product Details

ISBN-13: 9780309439121
Publisher: National Academies Press
Publication date: 09/03/2016
Pages: 170
Sales rank: 764,725
Product dimensions: 6.00(w) x 9.00(h) x (d)

Table of Contents

Summary 1

1 Introduction 15

Context for the Study 15

Background and Committee Charge 17

Overview 21

Behavioral Health in the U.S. Context 23

The Broader U.S. Context 26

The Committee's Work and the Report 29

2 Understanding Stigma of Mental and Substance Use Disorders 33

Findings from Surveys of Public Knowledge and Norms 33

Factors That Influence Stigma 35

Consequences of Stigma 42

Targets and Interventions to Address Stigma 51

3 The Science of Communication 53

Background 53

Setting Goals for Behavior Change 55

Reaching Target Audiences 55

Choosing a Message Source 60

Message Goals and Designs 61

Making the Most of the Message 63

Choosing the Medium Based on the Target 66

4 Approaches to Reducing Stigma 69

Approaches and Strategies 69

Evidence from Large-Scale Campaigns 79

5 Research Strategies 93

Formative Research 93

Intervention Research 95

Monitoring National Trends 100

Suggested Areas for Future Research 103

6 Conclusions and Recommendations 113

Lessons Learned 113

Conclusions and Recommendations 115

References 123


A Agendas: Public Workshops 145

B Biographical Sketches of Committee Members and Staff 153

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