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Rural Health: Stigma is an unnecessary barrier to mental health care

Several years back, I was conducting a community health assessment of a small, rural community in South Alabama to identify its greatest health issues and needs. My first job after finishing college was with the Alabama Department of Mental Health. Because of this experience, mental health care and needs have always been of special concern to me.

As a part of this health assessment, I visited the local outpatient mental health center to meet with the clinical director to discuss mental health-related issues, trends, and needs in the community. I was surprised when he refused to discuss such general topics until I received permission from his supervisor. This experience started me thinking about the stigma attached to certain mental health and other sensitive health conditions as a very real barrier to health care.

Keeping health conditions and issues in the closet is greatly contributing to establishing and increasing stigmas that are actually creating barriers to health care. The question must be asked:  Could this unnecessary stigma be a contributing factor in the horrible school violence in this country?  This director should have been required to get out and speak with civic organizations, churches, etc. to inform the community about local mental health.

A large portion of our population does not understand mental health. What is depression? What are the symptoms of depression? What is schizophrenia? What treatments and other options are available for persons with mental health needs? Bringing such conditions out of the closet and openly discussing them may help identify many of the undiagnosed who need assistance. It may also increase local awareness and concern to the point of producing more local buy-in and support for mental health care.

Such open and public conversation can also remove much of the stigma associated with sensitive health conditions, like mental health, HIV/AIDS, and drug abuse or dependency. Open discussion can enable many sensitive health conditions to become recognized as normal conditions that involve normal people and for which successful treatments are available.

Attempts are being made to care for patients with more sensitive conditions together with other general health care, rather than having such care provided in separate facilities. Seeing someone walking into a mental health clinic or a facility dedicated to the treatment of other sensitive conditions would virtually be an announcement that they have that condition. This integrative care model holds promise in decreasing the stigma attached to certain health conditions.

If you are a member of a civic organization, church, or other source that provides programs, I encourage you to have programs on topics that can diminish the stigmas attached to sensitive health conditions to enhance access to such health care.

Dale Quinney is executive director of the Alabama Rural Health Association, 1414 Elba Highway, Troy, 36081.