TPC Journal-Vol 10- Issue 2-FULL ISSUE

The Professional Counselor | Volume 10, Issue 2 221 People who perceive this stigma from their health or mental health professionals show a higher treatment attrition rate, less treatment satisfaction, and less perceived access to care (Barry et al., 2014). People with substance use concerns may also experience perceived stigma from the impressions they receive from society and through their own and others’ past experiences (Smith et al., 2016). Perceived stigma is also related to low self-esteem, high levels of depression and anxiety, and sleep issues (Birtel et al., 2017). Individuals who experience public stigma can develop self-stigma (i.e., stigma that is internalized), which impacts help-seeking attitudes (Vogel et al., 2007). For example, an individual could see a person struggling with alcohol use disorder portrayed in the media as being malicious, selfish, and incompetent and begin to believe those stereotypes about themselves. Additionally, researchers have demonstrated that public stigma is a predictor of self-stigma over time (Vogel et al., 2013). Self-stigma initially develops from stereotype awareness, resulting in stereotype agreement and self-concurrence, which lead to self-esteem decrement (Schomerus et al., 2011). Self-stigma can increase maladaptive coping strategies such as avoidance that can deter seeking treatment, applying for jobs, and interacting with others in social settings (da Silveira et al., 2018). Luoma et al. (2014) also suggested that people with a higher level of self-stigma have lower levels of self-efficacy and tend to remain longer in residential substance abuse treatment. Role of Stigma and Help Seeking in Relationship to SUDs The role of public stigma on seeking and receiving psychological help for substance use treatment has been well established by researchers (Birtel et al., 2017; Smith et al., 2016), but the influence of negative perceptions remains less understood (Center for Behavioral Health Statistics and Quality, 2018). Researchers have asserted the importance of examining negative public attitudes toward seeking psychological help; such attitudes act as a catalyst for the development of self-stigma incurred by individuals struggling with SUDs (Vogel et al., 2013). Also, recent reports indicate that the self-stigma of seeking psychological help may be a major contributor to the treatment utilization gap (i.e., the dearth of individuals receiving substance use treatment despite substance misuse and use disorders becoming a public health crisis). The U.S. Department of Health and Human Services, Office of the Surgeon General (2018) reported that ingrained public attitudes have hindered the delivery of medications used to treat SUDs, such as methadone and buprenorphine, because of misconceptions and prejudices surrounding these medications. Other factors they found contributing to the treatment gap include the view of substance use as a moral failing rather than a disease and the belief that the person simply has a “character flaw” (p. 12). Consequently, policymakers and researchers have emphasized the importance of understanding the effect of negative public attitudes on the delivery of substance use treatment and the decision to seek psychological help for mental health concerns involving AOD (Bose et al., 2018; Corrigan, 2011). To illustrate, the Substance Abuse and Mental Health Services Administration (SAMHSA; Bose et al., 2018) recently stated that 1.0 million (5.7%) of the 18.2 million individuals aged 12 years or older who reported experiencing an SUD perceived a need for treatment for their illicit drug or alcohol use. However, these respondents reported not seeking specialty substance use treatment because they believed getting treatment would have a negative impact on their job (20.5%) and cause their neighbors or community to have a negative opinion of them (17.2%). Additionally, out of the 4.9 million adults aged 18 or older that reported an unmet mental health service need for a serious mental illness, over a third had not received any mental health services in the previous year. Respondents gave the following reasons for avoiding seeking help: concern about being committed or having to take medicine (20.6%); the risk of it having a negative effect on their jobs (16.4%); the belief that treatment would not help