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Mitigating Stigma and Barriers to Care 75
versus who I am. I remember what a woman who had been raped said to me as I
was apologizing to her for manhood. She said, “That which happened to me does
not define who I am.” If people can make that subtle distinction it is much easier
to do some things.
But I guess I also struggle with people’s level of understanding and how able
they are to differentiate these subtle differences. Someone said they were impressed
with the American public’s intelligence. I am not one of those people.
DR. PESCOSOLIDO: No, I think that sometimes researchers go into research
thinking, “These people will not do this because they are stupid” or “These people
will not understand what I am saying.” I do not think that is true. People believe
what they believe and we may think what they believe is stupid, but I do not think
that they are unable to answer the questions that we ask or the things we want to
know about.
DR. HOBFOLL: I have several thoughts. One, it has been discussed a number
of times that, if you had the data, you would do it differently. I think that is in part
true. For example, our surgeons ignore psychological stuff entirely except for the
transplant surgeons because they get certified. If you fall below a certain level you
lose certification so all transplant teams have psychologists on them who they listen
to carefully.
DR. ZATZICK: Dr. Hobfoll, I have to take issue with that. The American College
of Surgeons, for the first time in any general medical setting, has mandated brief
motivational interviewing as part of trauma center accreditation. Just like there
has to be a trauma surgeon in house 24 hours, you have to have somebody who is
available to deliver motivational interviews.
DR. HOBFOLL: But every transplant team already has a psychologist involved
with them. The second part is that men are generally more resistant to this than are
women. I would say that for military commanders, if 20% of people are coming
up with PTSD, it is deeply affecting those combatants’ ability to behave in the field.
If you look at the data it would have to be obvious and devastating. So, there is
something about the resistance to facts that is underlying much of this.
DR. HAMMER: I wanted to comment on Dr. Corrigan’s point regarding the
effectiveness of contact. There is a program in San Diego called Kids Included
Together, which encourages kids with disabilities to be included in after school and
summer recreation programs. They implemented this in order to help benefit the
kids that have the disabilities, but what they found was a concurrent benefit with
the kids without disabilities who became much more tolerant, more effective, and
more engaged with the kids with disabilities. The benefit was on both sides.
Kids Included Together counselors come to the YMCA and summer camp programs,
and their mission is to provide the training to the counselors in order to help
them know what to do with kids in wheelchairs and children with autism. It is an
interesting model that might be useful. They may be further ahead in the anti-stigma
campaign for children with disabilities than we are for mental health.
DR. BATTEN: Theater of War is a project that several of us jointly in the Department
of Defense have been spearheading over the past couple of years. Chuck Engel
piloted it, but now we have a large contract across the DoD. In Theater of War we
are presenting two of the works of Sophocles, an ancient Greek general who wrote
several of his plays about the experience of warriors and their families. There is a
translator from New York, Brian Doerries, who translated the ancient Greek text
of two plays, Ajax and Philoctetes, looking at different aspects of the effect of war