Psychiatrists' Attitudes Toward Individuals With Substance Use Disorders and Serious Mental Illness

Objective: The attitudes of psychiatrists toward individuals with highly stigmatized conditions such as substance use disorders and serious mental illness may influence treatment effectiveness. These attitudes may be influenced by factors including previous specialty training and current practice patterns. This study examined the attitudes of addiction and community psychiatrists toward individuals with diagnosed schizophrenia, polysubstance dependence, comorbid schizophrenia and polysubstance dependence, and depression. Methods: A web-based survey link was sent to the electronic mailing lists of addiction and community psychiatry associations. Results: A total of 84 respondents identified themselves as either addiction (n = 54) or community (n = 30) psychiatrists. The majority were male (70% of addiction and 57% of community psychiatrists) with an average age of 56.0 (SD = 11.86) and 52.7 (SD = 11.8), respectively. Addiction psychiatrists had less stigmatizing attitudes than community psychiatrists for individuals with polysubstance dependence (p < .0001), while community psychiatrists had less stigmatizing attitudes than addiction psychiatrists for those with schizophrenia (p < .0001). Attitudes toward individuals with dual diagnosis did not vary significantly by psychiatrist group, but both addiction and community psychiatrists had more stigmatizing attitudes for individuals with dual diagnosis (p < .0001). Conclusions: These findings suggest that even psychiatrists working with highly stigmatized groups of individuals may continue to hold stigmatizing attitudes toward people with other diseases. Future work is needed to further assess stigmatizing attitudes among psychiatrists and the impact of these attitudes on quality of care, as well as interventions such as specialized education and training to reduce such stigma among psychiatrists.