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

Introduction 9
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Introduction
Mark C. Brown, M.D., M.P.H.
Robert J. Ursano, M.D.
DR. BROWN: Good morning and welcome to the Forum on Health and National
Security meeting on “Stigma and Barriers to Care: Caring For Those Exposed to
War, Disaster and Terrorism” working meeting. I stand before you today feeling
as I do prior to many big events — excited, anxious if not afraid, and somewhat
uncertain about what we are getting into. I am a fellow in the Disaster and Preventive
Psychiatry Program at USUHS (Uniformed Services University of the Health Sciences)
and a mid‐career Army psychiatrist. I first became interested in this program
when I met COL Chuck Engel, the architect of the RESPECT‐MIL (Re-Engineering
Systems of Primary Care for PTSD and Depression in the Military) program. COL
Engel encouraged me to see mental health problems through a population-health
lens and inspired me to sign up for the disaster psychiatry fellowship, which has
been a great experience.
Sadly, I am near the end of that journey and want to take a couple of minutes
to thank some important people. First I should comment on the origins of this conference.
The idea was born during a meeting about a year ago when I was waxing
philosophical about my research findings and the secondary analysis of COL Hoge’s
land combat study data. A smile came across Dr. Ursano’s face and he said, “Mark,
you’re going to lead a conference on this topic next year.”
So here we are. Thankfully, when he made that statement, he had also hired a
wonderful woman named Mary Lee Dichtel. Without her, I could not have done
this. Mary Lee is a former ICU and pediatric oncology nurse who is exceptionally
caring and who has a very gentle touch. She was extremely well qualified to help me
orchestrate this meeting. Along with Mary Lee, Julie Grieco did much of the hard
work. Dr. Jamie Naifeh is responsible for the conference website, which some of
you have joined and contributed to. All of the talks will be posted on the website,
which will remain available after the conference.
I want to thank COL Chuck Engel for his mentorship and friendship over the
last couple of years. In addition, I want to personally thank Dr. Alisha Creel, who
has a Ph.D. in Public Health, Social and Behavioral Science, and is a great student
of stigma. As my key mentor during the MPH year, she guided me through directed
readings on stigma, most written by people who are in the room today.
Indeed, we have convened the world’s experts on stigma and we will soon hear