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

Conference Recommendations 105
helpfulness, and that is a protective factor. We sort of understand from this 2009
IOM Prevention Report that we just did, that there are things that you can do to
prevent these problems. The difficulty is in the implementation, so some research
on implementation and effective ways of doing this would be helpful. There is the
Internet-based Depression Prevention intervention we have been doing. It seems to
be very helpful in terms of coaching people, building resiliency, and helping people
learn how to flourish.
Richard Bryant talked about catastrophizing as a risk factor for developing
PTSD and how the notion of self-efficacy was a protective factor. The more of those
things that can be cultivated, the better off we could be.
The thing that I struggle with in terms of information is all the garbage that
is on the Internet. Apparently people who frequent the internet have much more
difficulty understanding truisms that are actually real, authentic, and genuine. Part
of the challenge is directing people to the right internet sources. Maybe some sort
of Good Housekeeping Seal of Approval might be helpful; because I think the
Depression Prevention studies we have been doing show that is a very efficacious
way to reach large populations. You do not have to worry about fidelity and you
do not have to worry about dissemination. You push a button and you are there.
The problem is all the garbage.
DR. CORRIGAN: Every English-speaking country in the world has an antistigma
program. In the United States it is run by SAMHSA. It is called the Center
to Address Discrimination Stigma. Ken Thompson would be a wonderful resource
on that. The person running it is a gentleman named Chris Marshall. I have the
website here. They talk about all sorts of important groups of people. They talk
about employers, landlords, politicians and the like. Under employers and under
employment is the military. They have had webinars on military issues and stigma.
One webinar was done by a series of veterans groups, including a veterans group
that represents OEF, OIF, Iraq and Afghanistan Veterans of America. Also, we talked
about marketing as having some work based on the research here on marketing to
employers.
One of the first priorities is to help them further develop their research agenda
and their focus on the military. The Ad Center is one excellent start, keeping in mind
whatever sort of stuff you use, the unique culture of the military is going to spin
that in a way that is very important to them. For example, we talked about contact.
Contact with whom in the military With the General, the NCO, the soldier Probably
with all three groups. We can look for existing research. One is the Ad Center,
the other one is NIMH. There are several people in the room that have received
NIMH grants on stigma.
One of the concerns I have is that NIMH may be losing its sense of priority
in that regard. It had its own portfolio defined as stigma. I am not sure if it is an
explicit or implicit agenda, but Director Insel may be decreasing the concern and
interest in stigma research. I think we want to really promote this group, promote
and encourage more work in that area, especially with a military flair. I am also
aware that the VA is starting to pick up on this concern. I am aware of small projects
around the country. Rediscovering research agendas at SAMHSA Ad Center, the
NIMH portfolio, and the local VA work coming out of some of the minor places
into bigger places are all important.
DR. SHALEV: I endorse the idea that we need effective therapy. The product
that we package must be effective. There is quite a bit of work to do in that regard.