Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy

Abstract

Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.

Keywords: Public attitudes about the mentally ill; Public policy issues; stigma.

Figure 1

Public attitudes about persons with mental illness and substance use disorders, 1996–2013 ¹For methodological details, see Pescosolido BA et al. (2010). “A Disease Like Any Other?” A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence. American Journal of Psychiatry, 167, 1321–1330. ²For methodological details, see Barry CL et al. (2014). Stigma, Discrimination, Treatment Effectiveness, and Policy: Public Views about Drug Addiction and Mental Illness. Psychiatric Services, 65, 1269–72. ³For methodological details, see Barry CL et al. (2013). After Newtown – Public Opinion on Gun Policy and Mental Illness. New England Journal of Medicine, 368 (1077–1081). ⁴For methodological details, see Kennedy-Hendricks et al. (2016). How is social stigma toward individuals with prescription opioid use disorder associated with public support for punitive and public health-oriented policies? Psychiatric Services, In Press.