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The Impact of Indigenous Identity and Treatment Seeking Intention on the Stigmatization of Substance Use

  • Emily Winters
  • Nick HarrisEmail author
Original Article
  • 30 Downloads

Abstract

Substance use disorders (SUDs) are one of the most stigmatized mental health issues. There is a disproportionate burden of SUDs and related harms on Indigenous peoples in Canada. This study examined public stigma toward SUDs and if the degree of stigma would change as a result of Indigenous identity and treatment seeking intention. Participants (N = 711) were randomly assigned to read one of four vignettes depicting a person living with a SUD and then completed an online survey. Vignettes differed on the character’s ethnicity (Caucasian vs. First Nations) and their treatment seeking intention (seeking treatment vs. not seeking treatment). Participants then completed a series of questionnaires to assess stigma. Significant main effects of both ethnicity and treatment seeking were found on all three outcome measures of stigma. Specifically, participants assigned a vignette depicting a First Nations person responded with more stigmatizing attitudes and participants assigned a vignette of a person not seeking treatment responded with more stigmatizing attitudes. Implications for these findings are discussed.

Keywords

Substance use Indigenous Treatment seeking Stigma 

Notes

Compliance with Ethical Standards

Ethics approval for this study was obtained from the Memorial University Research Ethics Board.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing.Google Scholar
  2. Angermeyer, M. C., & Matschinger, H. (2004). The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: results from a representative survey in Germany. Schizophrenia Bulletin, 30, 1049.CrossRefGoogle Scholar
  3. Beauvais, F. (1998). American Indians and alcohol. Alcohol Health and Research World, 22, 253–259.PubMedPubMedCentralGoogle Scholar
  4. Bombay, A., Matheson, K., & Anisman, H. (2014). The intergenerational effects of Indian Residential Schools: implications for the concept of historical trauma. Transcultural Psychiatry, 51, 320–338.CrossRefGoogle Scholar
  5. Canadian Psychological Association. (2018). Psychology’s response to the truth and reconciliation Commission of Canada’s report. Retrieved from: https://cpa.ca/aboutcpa/committees/cpataskforces/
  6. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11–27.CrossRefGoogle Scholar
  7. Coffey, S. F., Read, J. P., & Norberg, M. M. (2008). Posttraumatic stress disorder and substance use disorder: neuroimaging, neuroendocrine, and psychophysiological findings, In Anxiety and SUDs (pp. 37-57). Boston, MA: Springer.Google Scholar
  8. Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625.CrossRefGoogle Scholar
  9. Corrigan, P. W., Kuwabara, S. A., & O'Shaughnessy, J. (2009). The public stigma of mental illness and drug addiction: findings from a stratified random sample. Journal of Social Work, 9, 139–147.CrossRefGoogle Scholar
  10. Crisp, A. H., Gelder, M. G., Rix, S., Meltzer, H. I., & Rowlands, O. J. (2000). Stigmatisation of people with mental illnesses. The British Journal of Psychiatry, 177, 4–7.CrossRefGoogle Scholar
  11. Downey, R. G., & King, C. V. (1998). Missing data in Likert ratings: a comparison of replacement methods. The Journal of General Psychology, 125, 175–191.CrossRefGoogle Scholar
  12. Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111, 564–572.CrossRefGoogle Scholar
  13. Egeland, G. M., Pacey, A., Cao, Z., & Sobol, I. (2010). Food insecurity among Inuit preschoolers: Nunavut Inuit child health survey, 2007–2008. Canadian Medical Association Journal, 182, 243–248.CrossRefGoogle Scholar
  14. Firestone, M., Tyndall, M., & Fischer, B. (2015). Substance use and related harms among Aboriginal people in Canada: a comprehensive review. Journal of Health Care for the Poor and Underserved, 26, 1110–1131.CrossRefGoogle Scholar
  15. Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., Pickering, R. P., Ruan, W. J., Smith, S. M., Huang, B., & Hasin, D. S. (2015). Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions III. Journal of the American Medical Association Psychiatry, 72, 757–766.PubMedGoogle Scholar
  16. Harding, R. (2006). Historical representations of Aboriginal people in the Canadian news media. Discourse & Society, 17, 205–235.CrossRefGoogle Scholar
  17. Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: a review of the literature. The American Journal of Psychiatry, 158, 1184–1190.CrossRefGoogle Scholar
  18. Joinson, A. (1999). Social desirability, anonymity, and Internet-based questionnaires. Behavior Research Methods, Instruments, & Computers, 31, 433–438.CrossRefGoogle Scholar
  19. Kulesza, M., Pedersen, E. R., Corrigan, P. W., & Marshall, G. N. (2015). Help-seeking stigma and mental health treatment seeking among young adult veterans. Military Behavioral Health, 3, 230–239.CrossRefGoogle Scholar
  20. Lang, B., & Rosenberg, H. (2017). Public perceptions of behavioral and substance addictions. Psychology of Addictive Behaviors, 31, 79–84.CrossRefGoogle Scholar
  21. Li, X., Sun, H., Marsh, D. C., & Anis, A. H. (2013). Factors associated with pretreatment and treatment dropouts: comparisons between Aboriginal and non-Aboriginal clients admitted to medical withdrawal management. Harm Reduction Journal, 10, 38–45.CrossRefGoogle Scholar
  22. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.CrossRefGoogle Scholar
  23. Loppie-Reading, C. (2014). Policies, programs and strategies to address Aboriginal racism: a Canadian perspective. Prince George, BC: National Collaborating Centre for Aboriginal Health.Google Scholar
  24. Loppie-Reading, C. L., & Wien, F. (2009). Health inequalities and the social determinants of Aboriginal peoples’ health. Prince George, BC: National Collaborating Centre for Aboriginal Health.Google Scholar
  25. Louden, J. L. E. (2009). Effect of mental disorder and substance abuse stigma on probation officers' case management decisions. (Doctoral dissertation) University of California, Irvine.Google Scholar
  26. Mannarini, S., & Boffo, M. (2015). Anxiety, bulimia, drug and alcohol addiction, depression, and schizophrenia: what do you think about their aetiology, dangerousness, social distance, and treatment? A latent class analysis approach. Social Psychiatry and Psychiatric Epidemiology, 50, 27–37.CrossRefGoogle Scholar
  27. Marsh, T. N., Coholic, D., Cote-Meek, S., & Najavits, L. M. (2015). Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada. Harm Reduction Journal, 12, 14–26.CrossRefGoogle Scholar
  28. McGinty, E. E., Goldman, H. H., Pescosolido, B., & Barry, C. L. (2015). Portraying mental illness and drug addiction as treatable health conditions: effects of a randomized experiment on stigma and discrimination. Social Science & Medicine, 126, 73–85.CrossRefGoogle Scholar
  29. McPherson, K., & Wakefield, P. (2015). The perfect colonizer: understanding alcoholism and its treatments in Native America through humanistic inquiry. Journal of Student Research, 4, 174–179.Google Scholar
  30. Merskin, D. (2001). Winnebagos, Cherokees, Apaches, and Dakotas: the persistence of stereotyping of American Indians in American advertising brands. Howard Journal of Communications, 12, 159–169.CrossRefGoogle Scholar
  31. Minich, K., Saudny, H., Lennie, C., Wood, M., Williamson-Bathory, L., Cao, Z., & Egeland, G. M. (2011). Inuit housing and homelessness: results from the international polar year Inuit health survey 2007–2008. International Journal of Circumpolar Health, 70, 520–531.CrossRefGoogle Scholar
  32. Paulhus, D. L. (1984). Two-component models of socially desirable responding. Journal of Personality and Social Psychology, 46, 598–609.CrossRefGoogle Scholar
  33. Penn, D. L., Guynan, K., Daily, T., Spaulding, W. D., Garbin, C. P., & Sullivan, M. (1994). Dispelling the stigma of schizophrenia: what sort of information is best? Schizophrenia Bulletin, 20, 567–578.  https://doi.org/10.1093/schbul/20.3.567.CrossRefPubMedGoogle Scholar
  34. Possemato, K., Funderburk, J., Spinola, S., Hutchison, D., Maisto, S. A., Lantinga, L. J., & Oslin, D. W. (2016). Reliability and validity of a treatment barriers scale for individuals with alcohol use disorder. Substance Use and Misuse, 51, 383–394.CrossRefGoogle Scholar
  35. Roshanafshar, S., & Hawkins, E. (2015). Food insecurity in Canada. Statistics Canada.Google Scholar
  36. Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M. G., & Angermeyer, M. C. (2010). The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol and Alcoholism, 46, 105–112.CrossRefGoogle Scholar
  37. Sorsdahl, K., Stein, D. J., & Myers, B. (2012). Negative attributions towards people with SUDs in South Africa: variation across substances and by gender. BMC Psychiatry, 12, 101–109.CrossRefGoogle Scholar
  38. Tippin, G. K. (2016). Audience response to photovoice as a mental illness antistigma intervention (Doctoral dissertation). Thunder Bay: Lakehead University.Google Scholar
  39. Truth and Reconciliation Commission of Canada (2015). Honouring the truth, reconciling for the future: summary of the final report of the truth and reconciliation commission of Canada. Retrieved from http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Exec_Summary_201 5_05_31_web_o.pdf
  40. Urbanoski, K., Inglis, D., & Veldhuizen, S. (2017). Service use and unmet needs for substance use and mental disorders in Canada. The Canadian Journal of Psychiatry, 62, 551–559.CrossRefGoogle Scholar
  41. van Boekel, L. C., Brouwers, E. P., van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug and Alcohol Dependence, 131, 23–35.CrossRefGoogle Scholar
  42. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54, 40–50.CrossRefGoogle Scholar
  43. von Hippel, C., Brener, L., & Horwitz, R. (2018). Implicit and explicit internalized stigma: relationship with risky behaviors, psychosocial functioning and healthcare access among people who inject drugs. Addictive Behaviors, 76, 305–311.CrossRefGoogle Scholar
  44. Weine, E. R., Kim, N. S., & Lincoln, A. K. (2015). Understanding lay assessments of alcohol use disorder: need for treatment and associated stigma. Alcohol and Alcoholism, 51, 98–105.CrossRefGoogle Scholar
  45. Wilson, D., & Macdonald, D. (2010). The income gap between Aboriginal peoples and the rest of Canada. Ottawa: Canadian Centre for Policy Alternatives.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyMemorial University of NewfoundlandSt. John’sCanada

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