Our Stigmatized American Heroes: Examining How Veterans with PTSD Communicatively Manage Stigma

Mental health conditions are arguably the most prominent disabling medical condition that military service members endure. Veterans with combat-related PTSD often refrain from seeking mental health treatment due to the stigma attached. Concealing PTSD or attempting to cope without professional help can lead to extreme and lifethreatening consequences including depression, substance abuse, and suicide. Attaining a better understanding of stigma management strategies is important because it has the ability to help veterans better manage stigma in the future. Thus, the current study uses stigma management communication theory (Meisenbach, 2010) to uncover the ways in which veterans with PTSD communicatively manage their stigmatized identity. In addition, this study uses Smith’s (2007) stigma communication framework to evaluate the military discourse and public discourse surrounding veterans with PTSD. In-depth one-on-one interviews were conducted with 10 United States veterans to dig deep into the personal experiences of those who have developed combat-related PTSD and learn more about how veterans communicatively manage mental health stigma. The results show that veterans with PTSD manage stigma using all six major strategies of stigma management communication. Further, all elements of stigma communication were represented in military and public discourse. Interestingly, veterans sometimes managed stigma by blending contradictory strategies together. In addition, three new stigma management communication strategies appeared. Not only do these results offer advancement for communication theory, but they could aid in the development of military training, military policy, mental health assessments, interventions, and destigmatizing campaigns

Employees' descriptions and management of power-laden stigma in sexual and reproductive healthcare at Planned Parenthood

Despite providing vital sexual and reproductive healthcare for over 100 years, the U.S. Planned Parenthood (PP) organization has remained highly contested, making it difficult for the organization to attain its mission of providing "care, no matter what." The current study took a critical-interpretive health communication approach to examine how healthcare employees experienced and managed power-laden stigma related to working in a core stigmatized organization -- PP. Data was collected through in-depth interviews with 27 U.S. PP employees approximately one month after the fall of Roe v. Wade and analyzed using the phronetic iterative approach. Ultimately, PP employees described four stigmatizing constructions of the organization that impacted employees and patients: 1) PP as abortion provider, 2) PP as white supremacist, 3) PP as covert capitalist, and 4) PP as shallow activist. PP employees' management of multiple power-laden stigmas depended on whether their stigmatized identity was discredited or discreditable (Goffman, 1963), that is, known or unknown. Employees were discredited in the workplace, where their stigma management responses were often impacted by organizational policy or the need to remain professional in patient-provider interactions. Employees were discreditable outside of the workplace. In this case, employees engaged in a stigma appraisal process, a new concept where a stigmatized individual considers several internal and external factors in deciding whether to disclose their stigmatized identity. In addition, employees managed stigmatizing discourses and structural stigma. This study contributes to communication scholarship by advancing stigma management theorizing and developing new stigma concepts, including stigma appraisal, synecdochical stigma, and the abortion stigma hierarchy. Further, the results have the ability to inform destigmatizing campaigns, organizational practices, and employee training that can improve conditions for employees working in stigmatized organizations and improve patient-provider communication surrounding stigmatized healthcare. Ideally, these contributions can ensure that PP not only provides "care, no matter what" but effective care.Includes bibliographical references

Civilian and Veteran Perceptions of Communicated Stigma about Veterans with PTSD

Mental health problems are considered some of the most common and disabling medical conditions that affect military service members. Veterans with PTSD need mental health services but are often reluctant to seek them due to perceived stigma. In this study, we used Smith’s (2007) stigma communication framework to analyze veterans’ and civilians’ perceptions of combat-related PTSD. Findings from our study indicate that, although participants were exposed to stigma communication about veterans with PTSD, most stigmatizing labels were considered inaccurate. Further, participants perceived that discourse about veterans infrequently implied that veterans were personally responsible for developing and overcoming PTSD. These findings indicate that perhaps efforts to destigmatize mental health issues, and PTSD among veterans specifically, have been successful

Text messages exchanged between individuals with opioid use disorder and their mHealth e-coaches: Content analysis study

BACKGROUND: Opioid use disorder (OUD) has affected 2.2 million people in the United States. About 7.2 million people reported using illicit drugs in 2019, which contributed to over 70,000 overdose deaths. SMS text messaging interventions have been shown to be effective in OUD recovery. However, the interpersonal communication between individuals in OUD treatment and a support team on digital platforms has not been well examined. OBJECTIVE: This study aims to understand the communication between participants undergoing OUD recovery and their e-coaches by examining the SMS text messages exchanged from the lens of social support and the issues related to OUD treatment. METHODS: A content analysis of messages exchanged between individuals recovering from OUD and members of a support team was conducted. Participants were enrolled in a mobile health intervention titled uMAT-R, a primary feature of which is the ability for patients to instantly connect with a recovery support staff or an e-coach via in-app messaging. Our team analyzed dyadic text-based messages of over 12 months. In total, 70 participants\u27 messages and 1196 unique messages were analyzed using a social support framework and OUD recovery topics. RESULTS: Out of 70 participants, 44 (63%) were between the ages of 31 and 50 years, 47 (67%) were female, 41 (59%) were Caucasian, and 42 (60%) reported living in unstable housing conditions. An average of 17 (SD 16.05) messages were exchanged between each participant and their e-coach. Out of 1196 messages, 64% (n=766) messages were sent by e-coaches and 36% (n=430) by participants. Messages of emotional support occurred the most, with 196 occurrences (n=9, 0.8%) and e-coaches (n=187, 15.6%). Messages of material support had 110 occurrences (participants: n=8, 0.7%; e-coaches: n=102, 8.5%). With OUD recovery topics, opioid use risk factors appeared in most (n=72) occurrences (patient: n=66, 5.5%; e-coach: n=6, 0.5%), followed by a message of avoidance of drug use 3.9% (n=47), which occurred mainly from participants. Depression was correlated with messages of social support (r=0.27; P=.02). CONCLUSIONS: Individuals with OUD who had mobile health needs tended to engage in instant messaging with the recovery support staff. Participants who are engaged in messaging often engage in conversations around risk factors and avoidance of drug use. Instant messaging services can be instrumental in providing the social and educational support needs of individuals recovering from OUD

Data_Sheet_1_Understanding mobile use behavior, stigma and associated needs among female sex workers in Nepal: a qualitative study.PDF

Female sex workers (FSWs) in Nepal continue to disproportionately experience increased HIV risk alongside individual, social, and structural barriers to accessing and using health services. Innovative methods are needed to provide improved HIV prevention information and other health services for FSWs. Mobile health (mHealth) is a mechanism that can overcome structural and social barriers. Studies show that FSWs are increasingly using mobile phones to solicit clients. Hence, this exploratory study using the Uses and Gratifications (U&G) framework aimed to understand Nepali FSWs' mobile use behavior, including the purposes they use it for. We conducted four focus group discussions. Results showed that FSWs in Nepal used mobile phones to gratify their needs to: (1) manage their profession, (2) maintain social connection, (3) to keep their sex work information hidden (4) have access to information in a stigma-free environment. The study's findings can be instrumental in developing and designing innovative health interventions to reduce HIV and STI incidents in this population.</p