Evidence map›Paper›PMID 36849477›Full record

ArticleAnnals of family medicine2023

Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations.

Sean M Phelan, Manisha Salinas, Tyson Pankey, Gabrielle Cummings, Jay-Sheree P Allen, Anne Waniger, Nathaniel E Miller, Jocelyn Lebow, John F Dovidio, Michelle van Ryn and 1 more

Open access · diamondAbstract read
In one paragraph

Article in Annals of family medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
12.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Design and implementation of a stratified care model for refugee women's behavioral health in an obstetrical care setting.Families, systems & health : the journal of collaborative family healthcare · 2026
    Article
  3. Article
  4. Turning to Service Users for the Understanding of Current and Future Mental Health Services in the Development Process of Research and Practice: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Stigma Toward Severe Mental Illness Among Healthcare Students: A Qualitative Study.International journal of environmental research and public health · 2025
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 1 country.

Sean M PhelanDepartment of Family Medicine, Division of Health Care Delivery Research, Robert D. & Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota Phelan.sean@mayo.edu.
Manisha SalinasCenter for Health Equity and Community Engaged Research, Mayo Clinic, Jacksonville, Florida.
Tyson PankeyDepartment of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
Gabrielle CummingsAlix School of Medicine, Mayo Clinic, Rochester, Minnesota.
Jay-Sheree P AllenDepartment of Family Medicine, Mayo Clinic, Rochester, Minnesota.
Anne WanigerDepartment of Psychiatry, Mayo Clinic, Rochester, Minnesota.
Nathaniel E MillerDepartment of Family Medicine, Mayo Clinic, Rochester, Minnesota.
Jocelyn LebowDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
John F DovidioDepartment of Psychology, Yale University, New Haven, Connecticut.
Michelle van RynDiversity Science, Inc, Portland, Oregon.
Chyke A DoubeniDepartment of Family Medicine, Center for Health Equity and Community Engaged Research, Mayo Clinic, Phoenix, Arizona.
Mayo Clinic · USMayo Clinic in Florida · USDuke University · USMayo Clinic in Arizona · USOffice of Diversity and Inclusion · USWinnMed · USYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStigma related to mental health is well documented and a major barrier to using mental and physical health care. Integrated behavioral health (IBH) in primary care, in which behavioral/mental health care services are located within a primary care setting, may reduce the experience of stigma. The purpose of this study was to assess the opinions of patients and health care professionals about mental illness stigma as a barrier to engagement with IBH and to gain insight into strategies to reduce stigma, encourage discussion of mental health, and increase uptake of IBH care.

methodsWe conducted semistructured interviews with 16 patients referred to IBH in a prior year and 15 health care professionals (12 primary care physicians and 3 psychologists). Interviews were transcribed and inductively coded separately by 2 coders for common themes and subthemes under the topic headings of barriers, facilitators, and recommendations.

resultsWe identified 10 converging themes from interviews with patients and the health care professionals, representing important complementary perspectives, with respect to barriers, facilitators, and recommendations. Barriers included professionals, families, and the public as sources of stigma, as well as self-stigma or avoidance, or internalizing negative stereotypes. Facilitators and recommendations included normalizing discussion of mental health and mental health care-seeking action, using patient-centered and empathetic communication strategies, sharing by health care professionals of their own experiences, and tailoring the discussion of mental health to patients' preferred understanding.

conclusionsHealth care professionals can help reduce perceptions of stigma by having conversations with patients that normalize mental health discussion, use patient-centered communication, promote professional self-disclosure, and are tailored to patients' preferred understanding.

Indexed as

Mental Health ServicesPsychiatryHealth PersonnelHumansMental HealthSocial Stigmaattitude of health personnelbarrierscommunicationhealth services accessibilityintegrated behavioral healthmental healthmental health services deliverypatient acceptance of health carepatient-centered carephysician-patient relationsprimary carestigma

Identifiers

PMID36849477
PMCPMC9970680
OpenAlexW4322489775

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.