A comparison of substance use stigma and health stigma in a population of veterans with co-occurring mental health and substance use disorders

OBJECTIVE: This pilot study examined whether substance use or mental illness was more stigmatizing among individuals with co-occurring mental health and substance abuse problems. METHODS: This study included 48 individuals with co-occurring substance use and mental health problems enrolled in a Substance Abuse and Mental Health Services funded treatment program. Subjects received a baseline assessment that included addiction, mental health, and stigma measures. RESULTS: The sample consisted primarily of White males with an average age of 38 years. Substance abuse was found to be more stigmatizing than mental illness, F(1, 47) = 14.213, p < .001, and stigma varied across four different levels of stigma (Aware, Agree, Apply, and Harm), F(2.099, 98.675) = 117.883, p < .001. The interaction between type and level of stigma was also significant, F(2.41, 113.284) = 20.250, p < .001, indicating that differences in reported stigma between types varied across levels of stigma. Post hoc tests found a significant difference between all levels of stigma except for the comparison between Apply and Harm. Reported stigma was significantly higher for substance abuse than mental illness at the Aware and Agree levels. In addition, pairwise comparisons found significant differences between all levels of stigma with the exception of the comparison between Apply and Harm, indicating a pattern whereby reported stigma generally decreased from the first level (Aware stage) to subsequent levels. CONCLUSIONS: These results have important implications for treatment, suggesting the need to incorporate anti-stigma interventions for individuals with co-occurring disorders with a greater focus on substance abuse

MISSION Community Re-Entry for Women (MISSION-CREW) Program Development and Implementation [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files below. Describes a study that examined the impact of the MISSION-CREW (Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking Community Re-Entry for Women) model of care on criminal justice outcomes for women released from MCI-Framingham and South Middlesex Correctional Center (SMCC) in Massachusetts. Originally published as: Research in the Works, Issue 5, 2011

MISSION Diversion & Recovery for Traumatized Veterans (MISSION DIRECT VET): Early Findings and Lessons Learned

MISSION DIRECT VET is a SAMHSA- funded, court based diversion program targeting veterans in Massachusetts with trauma-related mental health and substance use problems. MISSION-DIRECT VET seeks to: Reduce criminal justice involvement Treat mental health, substance abuse and other trauma related symptoms Use a systematic wrap-around model Provide care coordination, peer support and trauma informed services Develop interagency partnerships to serve veterans with co-occurring disorder

MISSION Diversion & Recovery for Traumatized Veterans (MISSION DIRECT VET): Early Planning and Development

MISSION DIRECT VET is a SAMHSA- funded, court based diversion program targeting veterans in Massachusetts with trauma-related mental health and substance use problems. MISSION-DIRECT VET seeks to: Reduce criminal justice involvement Treat mental health, substance abuse and other trauma related symptoms Use a systematic wrap-around model Provide care coordination, peer support and trauma informed service

Legal and Ethical Issues in Emergency Psychiatry

Discusses legal and ethical issues of psychiatric emergency care

Commitment Determinations and Definition of Mental Disease

In United States v. Beatty, 642 F.3d 514 (6th Cir. 2011), the United States Court of Appeals for the Sixth Circuit upheld a decision by the U.S. District Court for the Eastern District of Tennessee to recognize antisocial personality disorder (ASPD) as a mental disease for the purposes of conditional release under the civil commitment statute according to Title 18 United States Code Service (18 U.S.C.S.) § 4243 (hospitalization of a person found not guilty by reason of insanity; 1984)

A 20‐year follow‐up survey of police officers’ experience with Tarasoff warnings: How law enforcement reacts to clinicians’ duty to protect

Since the Tarasoff case of 1976, mental health professionals are recognized to have a “duty to protect” third‐party targets from violence‐threatening patients, but little is known about what happens after clinicians warn law enforcement. In 2000, Huber et al. published a study that surveyed Michigan police about “Tarasoff warnings.” We conducted a 20‐year follow‐up study, inviting all Michigan police and sheriff departments to participate. There were no significant differences between studies about knowledge of Tarasoff‐related policies, which was low in both surveys. We found significant decreases in the number of officers who had ever intervened due to warning calls. Of the survey respondents, 83% supported documenting warning calls. For those who received warnings, 96% followed up with at least one intervention. In both studies, notifying other officers was the most common action taken. 56% said they would take action to remove a firearm. We identified opportunities for training law enforcement.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/174795/1/bsl2564.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/174795/2/bsl2564_am.pd