stigma and barriers to care - Uniformed Services University of the ...

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Stigma and Barriers to Care — Caring for Those Exposed to War, Disaster and Terrorism
DR. URSANO: You will now have about 30 seconds to think about this. We are
going to go around the room and you will be given 10 seconds to say one bullet:
something you liked, something you took away, and something you want people to
remember for tonight because you are going to talk about it more tomorrow. This is
a way to be sure that even those who are silent have an opportunity to educate us.
DR. DIEBOLD: I am the psychiatry consultant and I want to complement all the
presenters today. What I would encourage the group to do is think about continuity
of care with our service members. One of the reasons I bring that up is that I am
stationed in Hawaii, where we have a big Guard and Reserve component. Certainly
they are faced with many barriers and stigma going from their civilian jobs back
into active duty.
We need to keep in mind the family members as well. Again, this was brought
up a great deal today but I would hope tomorrow that we talk about, really, what
I view as the big picture here, both the continuity of care for service members and
not losing contact with the family’s needs.
DR. THOMPSON: I will say these bullets: recovery, social inclusion, and the
health opportunity ladder.
DR. SANTIAGO: I am a Navy psychiatrist in the Department of Psychiatry
at the Uniformed Services University. In my 10 seconds I would like to throw out
there that perhaps society chooses stigma because stigma is cheap, or inexpensive,
relative to our other choices.
DR. BATTEN: First of all, culture change is hard, and if we are talking about
changing stigma, we are talking about changing cultures. I like the idea of focusing
resources where we are likely to get more bang for the buck and have longer-term
impact with younger generations.
DR. BORNEMANN: I would like to do some more thinking about Bernice Pescosolido’s
data. We are doing a great deal of anti-stigma stuff, and I am not confident
that much of it is that effective, so I would like to drill down a little deeper on that.
DR. BELL: Something we learned from the Institute of Medicine suicide report
and Dr. Satcher’s youth violence report is that risk factors are not automatically
predictive due to protective factors. Also, there is apparently a split in the states
about using marijuana to treat PTSD and I think we need to discuss that tomorrow.
DR. CORRIGAN: The question I would like to ask is where are the consumers
today
DR. SHALEV: I have the perspective of a person responsible for delivery of
clinical service. I live in Jerusalem, where for a third of the population, the ultra-
Orthodox, just seeing a psychiatrist is a stigma that may affect your family and your
reputation. We humbly try to alleviate part of that by making our clinical services
effective and known to be effective to that particular community. This is as much
as I think that we can do for them.
DR. RADKE: Stigma and barriers to care exist because society allows it to exist
as an excuse not to do the right thing.
DR. FLYNN: I would like us to take what we have heard today and think about
making some very specific application recommendations in four domains: clinical,
training and education, program design and management, and policy.
DR. URSANO: And research.
DR. HOLLOWAY: I want to hear one or more definitively named variables, and
I want to know what independent variables are likely to influence them.
DR. BATES: I am a clinical psychologist with the Resilience and Prevention