Stigma & Psychiatry?

[prominence]

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I know there is no scientific or objective evidence out there, but since there are some many SDN'ers located in different areas of the country, I'd love to hear opinions on which U.S. cities view the practice of psychiatry and psychotherapy with (relatively) less stigma than the rest of the country?

NYC is the first city that comes to mind for me. Any others?

 

[billypilgrim37]

I know there is no scientific or objective evidence out there, but since there are some many SDN'ers located in different areas of the country, I'd love to hear opinions on which U.S. cities view the practice of psychiatry and psychotherapy with (relatively) less stigma than the rest of the country?

NYC is the first city that comes to mind for me. Any others?

I'd propose there's a pretty significant correlation between cost of living and acceptance of psychiatry. Wherever there is an abundance of rich, white, liberal neurotics, psychiatry will be accepted.

 

[Anasazi23]

Here in NYC, the opposite demographic seems to have absolutely no problem seeing psychiatrist for anything from boyfriend fights which "necessitate" ER visits to a largely minority outpatient clinic population.

 

[OldPsychDoc]

I'm in the upper midwest, the "Land of 10,000 Treatment Centers". Everyone and their brother is in treatment for something here, and that, together with a residual attitude of Scandanavian progressivism, might make this part of the country somewhat less stigma-prone. That said, we have a lot of "minding our own business" conservatism, too--so I'd really hesitate to generalize too much.

 

[whopper]

I haven't noticed anything that shows a regional trend where I can do a head to head comparison. Good question.

What I have noticed-several young African American males, when committed are less trusting of the system. We haldoled a young man and he immediately thought there was some type of gov conspiracy. I don't think it was a psyche DO there, but more of a cultural distrust of the gov from African Americans.

 

[nancysinatra]

I'm in the upper midwest, the "Land of 10,000 Treatment Centers". Everyone and their brother is in treatment for something here, and that, together with a residual attitude of Scandanavian progressivism, might make this part of the country somewhat less stigma-prone. That said, we have a lot of "minding our own business" conservatism, too--so I'd really hesitate to generalize too much.

That's a funny thing about upper midwesterners. There's that Scandinavian "progressivism" where people want to help people and destigmatize things, and then there's that Scandinavian "Strindbergism" as I think of it, that stoical pessimistic type thinking where you're supposed to accept your lot in life and move sullenly on, no questions asked. The treatment centers and self-help beliefs probably represent the overlapping of those two mindsets, I've always kind of thought. However, I probably I shouldn't be generalizing like this either. I don't even live there anymore. And there's a lot of other viewpoints besides mine.

I am a little worried what would happen if I were to say, do a psychoanalytic fellowship. I don't know that I could move back to my hometown and expect to find many eager patients. Here in New York I would not worry though.

 

[golfpropsychguy]

Maybe its just me but I never really thought of psychiatry as having a stigma or being looked at negatively. The bottom line is that there are some really sick people out there that need the help of a psychiatrist and if you love working with that patient population within the entire spectrum than who cares if anyone looks at your field of expertise in a negative way.

just my .02 cents...

 

[daru1]

I haven't noticed anything that shows a regional trend where I can do a head to head comparison. Good question.

What I have noticed-several young African American males, when committed are less trusting of the system. We haldoled a young man and he immediately thought there was some type of gov conspiracy. I don't think it was a psyche DO there, but more of a cultural distrust of the gov from African Americans.

With all due respect, speaking as an African American male, that's the most *****ic stereotype I've heard on this board. However, congratulations on making a verb out of Haldol.

 

[whopper]

You may think its a *****ic stereotype & you are entitled to your opinion. I know several African Americans health practitioners who differ with your opinion.

However its also one that is published in most psychiatric textbooks & has become a topic for research.

2 examples...
http://www.ssc.upenn.edu/soc/People/schnittkerjason.html

Schnittker, Jason. Forthcoming. "Misgivings of Medicine?: African Americans' Skepticism of Psychiatric Medication." Journal of Health and Social Behavior

http://www.soph.uab.edu/paartners/publications/Hamiltonetal2006.pdf


Most psychiatric texts have a chapter concerning ethnicity & psychopharmacology & expectation with psychiatric treatment which echo what I've written. Different cultures have differing perceptions of psychopharmacology.

However good science always demands that people challenge existing studies & try to replicate them to prove/disprove them. If you want to try to change these views, consider going into this field of research.

 

[Chimed]

I am a little worried what would happen if I were to say, do a psychoanalytic fellowship. I don't know that I could move back to my hometown and expect to find many eager patients. Here in New York I would not worry though.

As a generalization, I think the issue would be more a matter of $$$ then acceptence. Sure, I could see some issues with hard core Freudian psychoanalysis. But you might be surprised how many folks would come for general psychotherapy if the price was right, even in a smaller town.

 

[OldPsychDoc]

You may think its a *****ic stereotype & you are entitled to your opinion. I know several African Americans health practitioners who differ with your opinion.

However its also one that is published in most psychiatric textbooks & has become a topic for research.

2 examples...
http://www.ssc.upenn.edu/soc/People/schnittkerjason.html

Schnittker, Jason. Forthcoming. “Misgivings of Medicine?: African Americans’ Skepticism of Psychiatric Medication.” Journal of Health and Social Behavior

http://www.soph.uab.edu/paartners/publications/Hamiltonetal2006.pdf


Most psychiatric texts have a chapter concerning ethnicity & psychopharmacology & expectation with psychiatric treatment which echo what I've written. Different cultures have differing perceptions of psychopharmacology.

However good science always demands that people challenge existing studies & try to replicate them to prove/disprove them. If you want to try to change these views, consider going into this field of research.

I don't believe that it is so much an issue of race as it is justifiable skepticism regarding the "benevolence" of the authoritative majority when one is in the minority. I have seen much the same thing in Asian, Middle-eastern, African, and Eastern European immigrants. One has to acknowledge that, like African-americans, their collective experience with authority figures, including doctors, has not always been favorable.

 

[whopper]

True...

In fact one of my own attendings theorizes that Thomas Szasz's own views may be from what you're mentioning (he's one of the big guys in the anti-psychiatry movement).

Another problem with talking about race & being culture sensitive is doing so with good intentions can also have bad results.

I'm of Asian ethnicity. I've been stuck with Asian patients by well meaning though "turfing" coworkers thinking they were doing their PC part to help society. There was nothing about their race or my race that necessitated that type of racial selection, and the patient can feel singled out because of race.


Race & culture are sticky issues. You for example read about Ataque de Nervios in the psyche textbooks but if you bring it up to coworkers in the culture who supposedly show it--some of them are the first to say "yes its true, we do that" others are offended.

Anyways getting back to my first post, one of the places I worked at was in emergency psychiatry in an inner city in the E.R. Anectdotally that's the experience I had with in that particular area.