Photo by Alachua County via Flickr.
One of the biggest barriers to seeking mental health care is stigma. While I can point to some studies that show this all over the world, the scale of the problem is most evident simply by doing a keyword search in PubMed. Stigma is particularly discouraging for those living with substance use disorders, including alcohol use disorder.
What if training and research related to mental illness involved the people who live with mental health conditions? Could that reduce at least some of the stigma that even many clinicians have, consciously or not, about their patients and the disorders they treat? Could it improve mental health care overall? According to a new pilot study that tested this, it appears it can.
Journalists might find the study’s findings interesting because it’s a rich area for story ideas:
- Do mental health facilities in your area explicitly do training to reduce stigma in clinicians?
- How are people generally trained in local mental health treatment centers in your area?
- Have patients who have been in treatment programs felt as though they were treated with respect and dignity?
- Could patients’ perception of stigma from their clinicians be discouraging them from continuing care?
- Are any local mental health facilities considering including people with mental illness in their training programs?
Any one of those questions or a half dozen others could lead to possible stories to explore on a local or national level. Let’s look at how the researchers conducted this study and what they found.
Robert Califf (Photo by Mark J. Ermarth via Flickr)
President Joe Biden nominated cardiologist Robert Califf for Food and Drug Administration (FDA) commissioner to replace Janet Woodcock, who has been acting commissioner since Biden took office in January. So, who is Califf, and what should journalists know about him? Below is an overview of key facts that journalists may find helpful as a backgrounder as well as some recommended reading for those who have time to learn more.
- Califf was most recently a senior research advisor for Verily, a research organization, and Google Health.
- Califf has served at the FDA previously but is best known for building Duke University’s clinical trials program from the ground up and as an advocate for tobacco control.
- Despite wide bipartisan support in his previous FDA appointment, Congressional reactions to this appointment are mixed, with particular opposition from Sen. Joe Manchin.
Califf isn’t new to the FDA.
- He served as FDA Commissioner under President Barrack Obama from February 2016-January 2017, when President Donald Trump took office.
- Before that, he had been Deputy Commissioner of the FDA’s Office of Medical Products and Tobacco from January 2015 until his nomination and confirmation as commissioner.
- While at the FDA, Califf pushed to require “black box” warnings about the risks of mixing opioids and benzodiazepines.
- Califf pushed for using electronic health data and “real-world evidence” while at the FDA.
- Califf was involved in a controversial decision in 2016 after Commissioner Woodcock granted accelerated approval for eteplirsen, a drug for Duchenne muscular dystrophy, over the objections of agency and external scientists who said there wasn’t adequate evidence that the treatment worked. Califf’s subsequent memo deferred to Woodcock.
- Califf was allegedly considered for FDA Commissioner in 2009 but was considered too tied to the industry.
Photo by Shaheen Lakhan via Flickr.
Journalists already know it’s important to be thoughtful and respectful when including patient stories in our reporting. Where it gets tricky is figuring out what someone might consider disrespectful when they’re identified with their condition. I’ve written before about the difference between identity-first and person-first language, and a new study offers additional insight on the importance of distinguishing between the two.
Identity-first language means the condition precedes the person, such as writing about “autistic people” or “deaf people.” A substantial proportion (but not all) of the autistic and deaf communities prefer identity-first language. Person-first language means, for example, referring to “a person with diabetes” instead of “a diabetic” or “a diabetic person.” Putting the person first — instead of their disease — emphasizes their humanity and can reduce stigma, which is why it’s important when writing about obesity to use “people with obesity” instead of “obese people,” as obesity physician Yoni Freedhoff has encouraged for years.
The new study focuses on the label used for those who live with schizophrenia and provides compelling evidence for why it’s important for clinicians to use “people with schizophrenia” instead of “schizophrenics.” The findings are crucial for journalists because media coverage of mental illness can affect how the public views mental health conditions — especially schizophrenia — which has already suffered from stigma for years in the public eye. The new research also reveals how powerful words are in shaping our perceptions.
Photo by the University of Nottingham via Flickr.
Throughout my reporting of the pandemic, I’ve made an explicit effort to interview many more women than men, especially women of color. I’ve done that because the popular perception of a “doctor” remains a white male, and I believe that one way I can contribute to changing that mindset is to be more inclusive about who I show doing a job.
That’s why a new research letter in JAMA Surgery on representation in medical school faculty caught my eye. In short, it found low diversity overall among surgery faculty and residents and revealed that having more underrepresented minorities among the faculty was correlated with more students from those groups. Neither of those findings is necessarily surprising, but they have two major implications for journalists reporting on a study that requires an expert source in surgery:
- Reporters likely need to work a little harder to find more diverse sources when reporting on surgery research since senior faculty in that field isn’t particularly diverse.
- You must find diverse sources because representation matters. If more faculty from underrepresented groups correlated with more students from those groups, it’s possible that including more diverse sources in your stories will make a difference in who reads your stories and what your readers take away from them. It will also allow you to present perspectives you might not have gotten if you had relied on too many sources who look alike.
Study methodology and key findings
Researchers used data from the American Association of Medical Colleges to assess the race, ethnicity, and sex of medical students and full-time surgical faculty members. (Note: Although the study states that it assessed the sex of faculty members, it seems more likely they were assessing gender, a common conflation that occurs in research.) One interesting aspect of this study is that investigators look specifically at “underrepresented” groups as opposed to “minority” groups. The difference is significant given that certain minority groups are overrepresented in medical subspecialties.
Though liver cancer rates have historically been lower in rural areas, they have recently increased and urban rates have started to slow down, according to a new study. These findings highlight the growing disparities between rural and urban health.
Some of the biggest stories in recent years about urban-rural health disparities have focused on opioid dependence and deaths, but the topic is rich with other story ideas that need public awareness — including ones that are connected to the opioid epidemic. Given what the most common causes of liver cancer are, the results of this new study hint at other upstream health issues that are becoming growing problems in rural areas, especially when other cancer rates, such as breast, lung, and colorectal cancer, have been falling in the same places.
Kali Zhou, M.D., one of the study’s lead authors, and her colleagues looked at trends of hepatocellular carcinoma — one of the nation’s fastest growing cancers — in adults over age 20 during the past two decades (1995-2016). They used the North American Association of Central Cancer Registries database which covers 93% of the U.S., including large swaths of the rural population.