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Attitudes Toward Individuals With Mental Illness and Substance Use Disorders Among Resident Physicians

Jonathan D. Avery, MD; Katherine E. Taylor, MD; Kristopher A. Kast, MD; Jessica Kattan, MD, MPH; Janna Gordon-Elliot, MD; Elizabeth Mauer, MS; Joseph J. Avery, JD; and Julie B. Penzner, MD

Published: January 3, 2019

Article Abstract

Objective: Resident physicians frequently provide care for individuals diagnosed with mental illness and substance use disorders (SUDs). Clinicians—including psychiatrists and addiction professionals—have been shown to possess negative attitudes toward these individuals, which is concerning since negative attitudes may have an adverse impact on patient engagement, treatment, and outcomes. However, little is known about resident physicians’ attitudes toward individuals with mental illness and SUDs. The objective of this study was to examine the attitudes of emergency medicine, internal medicine, and obstetrics-gynecology residents toward individuals with diagnoses of schizophrenia, multiple SUDs, co-occurring schizophrenia and SUDs, and major depressive disorder.

Methods: A web-based questionnaire, including demographic information, level of training, and the 11-item Medical Condition Regard Scale (MCRS) for individuals with 4 different diagnoses, which assesses the degree to which clinicians find individuals with a given medical condition to be enjoyable, treatable, and worthy of medical resources, was sent to residents across the United States from May 2016 to April 2017.

Results: A total of 411 resident physicians completed the questionnaire. Respondents had more negative attitudes toward individuals with diagnoses of SUDs with and without schizophrenia than toward those individuals with diagnoses of schizophrenia or major depressive disorder alone. Senior residents possessed more negative attitudes toward individuals with SUDs than did junior residents. Emergency medicine residents had more negative attitudes than the other resident physician groups.

Conclusions: The attitudes of resident physicians toward individuals with SUDs with and without schizophrenia were negative and were worse among emergency medicine residents and senior residents. Additional research and programmatic work are needed to understand the reasons for these negative attitudes and to develop interventions during residency training to improve them.

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