Changing the Stigma Associated With Mental Health Disorders

EP: 1.Overview of Treatment-Resistant Depression

EP: 2.Prevalence of Treatment-Resistant Depression

EP: 3.Risk Factors Associated with TRD

EP: 4.Treatment Landscape Surrounding TRD

EP: 5.Current TRD Treatment Model: Part 1

EP: 6.Current TRD Treatment Model: Part 2

EP: 7.Evaluating Response to TRD Treatment

EP: 8.Barriers Impacting Access to Care in TRD

EP: 9.Examining the Patient Journey in TRD

EP: 10.Clinical and Economic Burdens Impacting Patients with TRD

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EP: 11.Changing the Stigma Associated With Mental Health Disorders

EP: 12.Key Takeaways Surrounding TRD Treatment Strategies

Megan Maroney, PharmD, BCPP: How can payers and providers help change the stigma associated with mental health disorders?

Eric Cannon, PharmD, FAMCP: There’s a stigma, and we’ve touched on it. My parents and my in-laws are a different generation. Frankly, they’re probably tougher than I am. But they don’t want to admit it, so we need to help individuals understand. Some of this is being more vulnerable and more open and letting patients have the opportunity to communicate what’s going on. As a society, we’re doing a much better job of that. But we need to spend more time with different ethnic backgrounds. I mentioned the growing Hispanic population where I am. That requires individuals who are of their culture and understand it. [Someone] they feel they can trust. Somebody who speaks their language. As a [health] plan, that’s something we’ve invested in. Have we invested enough? Probably not. But meeting patients in their community, and meeting them on their level, is critical. That eliminates some of the stigma. That eliminates some of the barriers. I hate to admit it, but being a little vulnerable helps individuals understand that it’s OK to express where I am and how I feel.

Neil Skolnik, MD: I’ll follow up on that because that’s critically important. We’re often proudest of our successes, and I’ve written about this: it’s not our successes but our struggles that let us relate to others. We all have struggles. They’re in different areas, but we all have them. A lot of stigma can be addressed in a lot of areas. It’s been wonderfully addressed from a public health point of view. Individuals [have these struggles], including movie stars and ballplayers. Recently a politician from Pennsylvania was courageous enough to come forward about his struggles with depression after a stroke. All of that helps the issue of stigma and embarrassment by acknowledging to us, as professionals, what’s going on.

Within our office setting, we do our part, and that has to do with listening in a nonjudgmental way. Being introspective about our own vulnerabilities and our own struggles that we’ve all had in different areas. [Ralph Waldo] Emerson said, “What you are speaks so loud I cannot hear what you say.” When we have an attitude of acceptance that comes through and allows patients to share with us. I take care of a lot of middle-aged and older patients with chronic diseases—COPD [chronic obstructive pulmonary disease], diabetes, etc. That’s group has twice the instances of depression than the population at large. We should have an ear for that. If someone is not taking their medicines, it might not be that they’re forgetting. They might not have the oomph to take it. We should have an ear out, ask the right questions, and listen.

Transcript edited for clarity.