Study: Public Feels More Negative Toward People With Drug Addiction Than Those With Mental Illness
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October 1, 2014
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People are significantly more ly to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don’t support insurance, housing, and employment policies that benefit those dependent on drugs, new Johns Hopkins Bloomberg School of Public Health research suggests.
A report on the findings, which appears in the October issue of the journal Psychiatric Services, suggests that society seems not to know whether to regard substance abuse as a treatable medical condition akin to diabetes or heart disease, or as a personal failing to be overcome.
“While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more ly to think of addiction as a moral failing than a medical condition,” says study leader Colleen L.
Barry, PhD, MPP, an associate professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “In recent years, it has become more socially acceptable to talk publicly about one’s struggles with mental illness.
But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal.”
Between Oct. 30 and Dec. 2, 2013, Barry and her colleagues surveyed a nationally representative sample of 709 participants about their attitudes toward either mental illness or drug addition. The questions centered on stigma, discrimination, treatment and public policy.
Not only did they find that respondents had significantly more negative opinions about those with drug addiction than those with mental illness, the researchers found much higher levels of public opposition to policies that might help drug addicts in their recovery.
Only 22 percent of respondents said they would be willing to work closely on a job with a person with drug addiction compared to 62 percent who said they would be willing to work with someone with mental illness.
Sixty-four percent said that employers should be able to deny employment to people with a drug addiction compared to 25 percent with a mental illness.
Forty-three percent were opposed to giving individuals addicted to drugs equivalent health insurance benefits to the public at-large, while only 21 percent were opposed to giving the same benefits to those with mental illness.
Respondents agreed on one question: Roughly three in 10 believe that recovery from either mental illness or drug addiction is impossible.
The researchers say that the stories of drug addiction portrayed in the media are often of street drug users in bad economic conditions rather than of those in the suburbs who have become addicted to prescription painkillers after struggling with chronic pain.
Drug addicts who fail treatment are seen as “falling off the wagon,” as opposed to people grappling with a chronic health condition that is hard to bring under control, they say.
Missing, they say, are inspiring stories of people who, with effective treatment, are able to overcome addiction and live drug-free for many years.
Barry says once it would have been taboo for people to casually discuss the antidepressants they are taking, which is often the norm today. That kind of frank talk can do wonders in shaping public opinion, she says.
“The more shame associated with drug addiction, the less ly we as a community will be in a position to change attitudes and get people the help they need,” says another study author, Beth McGinty, PhD, MS, an assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction.”
“Stigma, Discrimination, Treatment Effectiveness, and Policy: Public Views About Drug Addiction and Mental Illness” was written by Colleen L. Barry, PhD, MPP; Emma E. McGinty, PHD, MS; Bernice A. Pescosolido, PhD; and Howard H. Goldman, MD, PhD.
The study was supported by grants from AIG Inc.; the National Institutes of Health’s National Institute on Drug Abuse (R01 DA026414); the NIH’s National Institute of Mental Health (1R01MH093414-01A1); the National Science Foundation and the College of Arts and Sciences, Indiana University.
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Media contacts for Johns Hopkins Bloomberg School of Public Health: Stephanie Desmon at 410-955-7619 or firstname.lastname@example.org and Susan Murrow at 410-955-7624 or email@example.com.
Hospitals starting to address sexual harassment by patients – STAT
At Mayo Clinic last year, a male patient groped a female doctor in the presence of several other staff members. She immediately notified hospital administrators using a new reporting system, and the patient was terminated from the physician’s practice within 48 hours.
Before this reporting process was created in 2017, the renowned Rochester, Minn., hospital had no procedures for how to deal with patients who harass staff — or even language addressing the issue in hospital guidelines.
The patient’s “behavior was egregious,” but if the incident occurred before 2017 and the physician “complained about it, the patient would have reported her,” said Dr.
Sharonne Hayes, a cardiologist and medical director of the hospital’s Office of Diversity and Inclusion, who helped create the new policies.
“Now our employees feel much more confident about their role in sexual harassment incidents, what they should and should not do, and that Mayo has their back.”
Mayo’s program — and similar initiatives at other hospitals — reflects growing awareness that it’s not just bosses and colleagues who sexually harass health care workers. Often, it’s the patients who are doing the harassing.
More often, in fact, according to a survey last year by Medscape.
Of more than 6,000 doctors surveyed, 27% reported sexual harassment by patients within the past three years, whereas only 7% reported harassment from clinicians, medical personnel, or administrators.
The majority of those who experienced incidents were women. Another survey of 822 doctors, conducted by STAT and Medscape in 2017, found that almost 60% had to deal with offensive remarks from a patient over the previous five years.
Yet only recently have hospitals begun grappling with the problem. “Most health care programs had 20 policies in place that protect patients, but not one that had a policy to protect staff from patients,” said Hayes, who also is a founder of Time’s Up Healthcare, a nonprofit launched this year to tackle harassment and gender bias.
The new program at Mayo includes a policy to address patient behavior, a reporting structure for providers to use following incidents, protocols for dealing with patients who behave improperly, and training for staff and students.
Hayes said that more and more hospitals are adopting similar policies to combat harassment by patients, driven in part by concern about skyrocketing rates of physician burnout and mental illness, particularly in women.
“These two issues often result from the accumulation of multiple factors including stress, anxiety, and a loss of control of one’s work and environment.
Since harassment contributes to all of these factors, I have no doubt that being harassed or poorly treated by patients is additive to all the other challenges faced by doctors, nurses and other members of the health care team.”
In the absence of hospital policies, doctors can find it difficult to deal with patients who act inappropriately toward them.
They try to empathize with patients who may feel angry, frustrated, or powerless when interacting with the sometimes inefficient and bureaucratic health care system.
They know patients are often stressed and frightened, and most physicians feel they have a duty to provide care, even when patients are difficult. So when doctors feel harassed, they often just laugh it off in an attempt to diffuse the situation and avoid offending the patient.
They may also not want to risk a patient complaint to hospital administrators, or a poor rating on customer satisfaction surveys or online review sites. Doctors also worry that reporting such incidents to colleagues could result in embarrassment, or at the very least, an awkward encounter with the patient on morning rounds.
Dr. Elizabeth Viglianti, an associate professor in pulmonary and critical care at the University of Michigan, said that when she asks other providers about sexual harassment and discrimination from patients, she commonly gets the reply, “It’s just part of the job.”
She recalled an encounter a couple years ago with a male patient who was verbally harassing her when they were alone in the clinic.
She felt uncomfortable and unsafe, but later, when she went to her fellowship director and hospital administration, she was surprised to find that no system existed to report and deal with these incidents in an adequate and confidential manner. She said, “We didn’t know where to go next.”
That experience motivated her to create an algorithm in August 2018 to guide doctors and medical trainees at her hospital when they experience harassment or discrimination. It instructs doctors that if the harassment continues, they should transfer the patient to another provider and consider placing a warning in the patient’s medical chart, visible only to providers.
Viglianti said progress is slow, as there still is no reporting system in place for harassment events by patients. But the hospital is now working on a policy to change the patient bill of rights to address issues of sexual harassment by patients.