Loading...
Intersectional Stigma and Discrimination among Justice-Involved Adults with Co-Occurring Opioid Use and Mental Health Disorder
Citations
Altmetric:
Genre
Thesis/Dissertation
Date
2024-05
Advisor
Committee member
Group
Department
Public Health
Permanent link to this record
Collections
Research Projects
Organizational Units
Journal Issue
DOI
http://dx.doi.org/10.34944/dspace/10285
Abstract
Background. Justice-involved adults with co-occurring opioid use disorder (OUD) and mental health disorder (MHD) have complex health needs and underutilize healthcare services and evidence-based interventions to decrease fatal overdose risk, improve mental health symptoms and functioning, and reduce recidivism rates. Stigma and discrimination are commonly cited obstacles to healthcare access and community participation. Combined experiences of criminal-legal system involvements and co-occurring disorders are additionally influenced by other facets of identity and social group memberships, justifying use of an intersectional lens in understanding stigma and discrimination experiences and impacts in this population. However, valid and reliable instruments of intersectional stigma and discrimination have not yet been developed and psychometrically tested among justice-involved adults with co-occurring OUD and MHD. Objective. The objectives of this study were threefold and are presented as three manuscripts. First, a multidimensional measure of intersectional internalized stigma was developed and evaluated among justice-involved adults with co-occurring OUD and MHD (Manuscript 1). Next, the study psychometrically evaluated a recently created measure of intersectional discrimination and examined related health impacts, including psychological distress, active concealment/intentional non-disclosure, and health-related quality of life (Manuscript 2). Finally, internalized stigma, social support, and recovery capital were investigated as potential mediators and moderators of associations between intersectional discrimination and health impacts (Manuscript 3).
Methods. Using a cross-sectional survey design, N=213 participants were recruited from community-based settings (e.g., street outreach, harm reduction organizations, treatment clinics, re-entry programs, community resource fairs) from August 2023 to January 2024. Eligible participants completed thirteen survey modules on sociodemographic characteristics, intersectional stigma and discrimination, personal and interpersonal support mechanisms, and health impacts (i.e., psychological distress, active concealment/intentional non-disclosure, and health-related quality of life). Analytic methods included item reduction techniques, structural equation modeling, and mediation/moderation analyses.
Conclusion. Results help advance the field of intersectional quantitative stigma and discrimination measurement sciences, elucidate health impacts of intersectional stigma and discrimination among justice-involved people with co-occurring disorders, and identify specific opportunities for empowerment-based resources and interventions to help mitigate the negative health impacts of intersectional stigma and discrimination – such as programs to promote recovery capital and social support (e.g., peer recovery programs and recovery-friendly workplaces).
Description
Citation
Citation to related work
Has part
ADA compliance
For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu