DIGEST-Volume-10-Issue-2-FULL ISSUE

12 TPC Digest Daniel Gutierrez, Allison Crowe, Patrick R. Mullen, Laura Pignato, Shuhui Fan M illions of people living in the United States struggle with alcohol or substance use disorders. However, only 1 in 5 of those that need addictions treatment actually receive any treatment. The reasons for the disparity between the need for treatment and the rate at which treatment is accessed are multifaceted and complex. Many people experience barriers to treatment, including lack of finances, availability of treatment, family impact, and fear. One barrier that is arguably the most complex and the least understood is stigma. Individuals with alcohol and other drug (AOD) use concerns experience a high level of stigma. Research on stigma indicates two forms: public stigma and self-stigma. Public stigma is stigma that emits from society. Self-stigma occurs when an individual internalizes that stigma. Self-stigma often leads to low self-esteem, maladaptive coping, and avoidance behaviors. Stigma often is associated with negative labeling, discrimination, and experiencing prejudice from others. There is stigma around most mental health concerns but with regards to substance use, stigma is highly prevalent and oftentimes related to a public belief that individuals are just weak-willed and need to take greater responsibility. Those with substance use concerns experience judgement, mockery, inappropriate comments, overprotection, and hostility from the public. We proposed that the experience of stigma, both self-stigma and public stigma, would influence an individual’s attitude toward help seeking and their drug and alcohol use. Specifically, we tested three hypotheses: 1. Self-stigma toward mental health concerns will have a negative direct effect on attitudes toward help seeking and a positive indirect effect on drug and alcohol use as mediated by attitudes toward help seeking. 2. Self-stigma of help seeking will have a negative direct effect on attitudes toward help seeking and a positive indirect effect on drug and alcohol use as mediated by attitudes toward help seeking. 3. Attitudes toward help seeking will have a negative direct effect on drug and alcohol use. To test our hypotheses, we conducted a cross-sectional study with a community sample of 406 individuals who reported using alcohol and other substances. The sample was gathered using Amazon’s MTurk crowdsourcing platform. These individuals completed a battery of assessments, which included measures of drug use, alcohol use, self-stigma, help seeking, and a demographic profile form. We then utilized path analysis to examine the relationships between the variables and test our mediation model. Findings indicated that self-stigma of help seeking contributed to AOD use and was mediated by help-seeking attitudes. We also found a strong relationship between self-stigma of help seeking and self-stigma of mental illness. These data demonstrate the negative impact that self-stigma has on one’s attitude toward help seeking and demonstrates how that attitude has a subsequent impact on AOD use. We propose that counselors working with individuals who struggle with AOD use disorders consider using interventions that specifically target stigma and especially consider countering the public messages that those who seek help are weak, that addiction is a moral failing, and that those that are addicted simply have a character flaw. Furthermore, we encourage greater professional advocacy around the topic of addiction stigma. Daniel Gutierrez, PhD, NCC, LPC, CSAC, is an assistant professor at the College of William & Mary. Allison Crowe, PhD, NCC, LPCS, is an associate professor at East Carolina University. Patrick R. Mullen, PhD, NCC, is an assistant professor at the College of William & Mary. Laura Pignato is a doctoral student at the College of William & Mary. Shuhui Fan, NCC, is a doctoral student at the College of William & Mary. Correspondence may be addressed to William & Mary, Daniel Gutierrez, School of Education, P.O. Box 8795, Williamsburg, VA 23187-8795, dgutierrez@wm.edu. Stigma, Help Seeking, and Substance Use |