ON STIGMA AND ITS CONSEQUENCES - EVIDENCE FROM A LONGITUDINAL-STUDY OF MEN WITH DUAL DIAGNOSES OF MENTAL-ILLNESS AND SUBSTANCE-ABUSE

Numerous studies have demonstrated a strong connection between the exp erience of stigma and the well-being of the stigmatized. But in the ar ea of mental illness there has been controversy surrounding the magnit ude and duration of the effects of labeling and stigma. One of the arg uments that has been used to downplay the importance of these factors is the substantial body, of evidence suggesting that labeling leads to positive effects through mental health treatment. However as Rosenfie ld (1997) points out, labeling can simultaneously induce both positive consequences through treatment and negative consequences through stig ma. In this study we test whether stigma has enduring effects on well- being by interviewing 84 men with dual diagnoses of mental disorder an d substance abuse at two points in time-at entry into treatment, when they were addicted to drugs and had many psychiatric symptoms and then again after a year of treatment, when they were far less symptomatic and largely drug- and alcohol-free. We found a relatively strong and e nduring effect of stigma on well-being. This finding indicates that st igma continues to complicate the lives of the stigmatized even as trea tment improves their symptoms and functioning. It follows that if heal th professionals want to maximize the well-being of the people they tr eat, they must address stigma as a separate and important factor in it s own right.