Reducing Stigma Associated with Behavioral Health: Findings from the Paso Del Norte Health Foundation Situational Analysis

Introduction - Stigma associated with mental illness or substance abuse is a common reason cited by people for not seeking behavioral health or other services (Aromaa et al., 2011).   Stigma has been amplified by inaccurate media portrayals depicting behavioral health patients as unpredictable, dangerous and violent (Corrigan, 2004). This study examined community and cultural definitions of stigma and opportunities for stigma reduction along the United States Mexico Border.

Methods - Key informant interviews with behavioral health providers and focus groups with consumers of behavioral health conducted. N=25 provider interviews were conducted as well as focus group of consumers N=125. Qualitative analyses using QSR NVivo qualitative software was conducted.

Results - findings related to stigma definitions and personal experiences included; Stigma defined as “discrimination”, “prejudice”, a “condition that people should control”, associated with “violence”, based on “negative media” portrayals, results in “fear”, “social isolation and rejection from family”.

Persistent themes related to Stigma reduction included ; a) Increase local and regional behavioral health training for health professionals and community leaders, b) Increase local and regional basic behavioral health education through training and workshops, c) Promote the dissemination of accurate information about behavioral health and emotional well-being, d) Increase and expand education programs for parents and children, e) Increase public education about behavioral health through media, f) Implement media messaging away from the negative connotations associated with terms such as “mental,” and “mental illness,”  g)  Increase and training of Promotoras and other lay health workers to assist with basic behavioral health screening and referral for children and families, h) Increase campus-based behavioral health education,  i) Explore innovative approaches to screening and treating military personnel including web based, telehealth strategies that avoid on base self disclosure.

Responses from consumers clustered around themes related to; a) the need for better trained and qualified behavioral health professionals, b) the need for more funding and support for behavioral health services, c) improvements in the school system to reduce stigma and foster earlier prevention, early intervention services for youth, d) greater sensitivity among law enforcement and finally e) increased education for family members.

Conclusions - Results are consistent with the Corrigan (2004) model of stigma reduction where respondents highlighted a number of challenges and opportunities related to education and increased contact (social inclusion) strategies. Future research is needed to implement, test and evaluate community based strategies for stigma reduction to promote early prevention and interventions.