Skip to main content
Top
Published in: Community Mental Health Journal 4/2018

01-05-2018 | Original Paper

Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants

Authors: Larry R. Martinez, Shi Xu, Michelle Hebl

Published in: Community Mental Health Journal | Issue 4/2018

Login to get access

Abstract

The incidence of depression has been increasing. One of the best interventions for depression is taking antidepressant medications. However, the stigma of taking antidepressants has been shown to be a barrier not only to seeking an antidepressant regimen but also adhering to it. This may have negative consequences for people who suffer from depression. Thus, in two studies, we investigate the incidence of felt stigma of taking antidepressants among clinically depressed individuals who take antidepressants and the effectiveness of two possible interventions to reduce this stigma among others. Study 1 revealed that stigma toward individuals who take antidepressants is a reality, either because people were not educated about depression and antidepressants, or because they did not show empathy or did not take on perspectives from the victim’s point-of-view. Based on these results, we used an experimental design in Study 2 to investigate the effects of education and perspective-taking interventions in diminishing the stigma of taking antidepressants. These results suggest that participant gender played a moderating role in the effectiveness of education and perspective taking, such that a combination of the two interventions resulted in lower stigma for men but not for women. These results suggest that people can be trained (using a simple, low-fidelity intervention) to be more accepting of antidepressant use among their friends, family members, and colleagues, resulting in better outcomes for those who benefit from taking antidepressants.
Literature
go back to reference Altindag, A., Yanik, M., Ucok, A., Alptekin, K., & Ozkan, M. (2006). Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia. Psychiatry and Clinical Neurosciences, 60, 283–288.CrossRefPubMed Altindag, A., Yanik, M., Ucok, A., Alptekin, K., & Ozkan, M. (2006). Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia. Psychiatry and Clinical Neurosciences, 60, 283–288.CrossRefPubMed
go back to reference Batson, C. D., Polycarpou, M. P., Harmon-Jones, E., Imhoff, J. H., Mitchener, E. C., Bednar, L. L., & Highberger, L. (1997). Empathy and attitudes: Can feeling for a member of a stigmatized group improve feelings toward the group? Journal of Personality and Social Psychology, 72, 105–118.CrossRefPubMed Batson, C. D., Polycarpou, M. P., Harmon-Jones, E., Imhoff, J. H., Mitchener, E. C., Bednar, L. L., & Highberger, L. (1997). Empathy and attitudes: Can feeling for a member of a stigmatized group improve feelings toward the group? Journal of Personality and Social Psychology, 72, 105–118.CrossRefPubMed
go back to reference Bultman, D. C., & Svarstad, B. L. (2000). Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling, 40, 173–185.CrossRefPubMed Bultman, D. C., & Svarstad, B. L. (2000). Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling, 40, 173–185.CrossRefPubMed
go back to reference Button, K. S., Ioannidis, J. P., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S., & Munafò, M. R. (2013). Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience, 14, 365–376.CrossRefPubMed Button, K. S., Ioannidis, J. P., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S., & Munafò, M. R. (2013). Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience, 14, 365–376.CrossRefPubMed
go back to reference Buus, N., Johannessen, H., & Stage, K. B. (2012). Explanatory models of depression and treatment adherence to antidepressant medication: a qualitative interview study. International Journal of Nursing Studies, 49, 1220–1229.CrossRefPubMed Buus, N., Johannessen, H., & Stage, K. B. (2012). Explanatory models of depression and treatment adherence to antidepressant medication: a qualitative interview study. International Journal of Nursing Studies, 49, 1220–1229.CrossRefPubMed
go back to reference Cassano, P., & Fava, M. (2002). Depression and public health: An overview. Journal of Psychosomatic Research, 53(4), 849–857.CrossRefPubMed Cassano, P., & Fava, M. (2002). Depression and public health: An overview. Journal of Psychosomatic Research, 53(4), 849–857.CrossRefPubMed
go back to reference Cohen, J. (1992). Statistics a power primer. Psychology Bulletin, 112, 155–159.CrossRef Cohen, J. (1992). Statistics a power primer. Psychology Bulletin, 112, 155–159.CrossRef
go back to reference Collado, A., Loya, J. M., & Yi, R. (2015). The interaction of HIV knowledge, perceived risk, and sex differences on risky sex. International Journal of Sexual Health, 27, 418–428.CrossRef Collado, A., Loya, J. M., & Yi, R. (2015). The interaction of HIV knowledge, perceived risk, and sex differences on risky sex. International Journal of Sexual Health, 27, 418–428.CrossRef
go back to reference Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625.CrossRefPubMed Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625.CrossRefPubMed
go back to reference Corrigan, P. W., River, L. P., Lundin, R. K., Penn, D. L., Uphoff-Wasowski, K., Campion, J., et al. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27, 187–195.CrossRefPubMed Corrigan, P. W., River, L. P., Lundin, R. K., Penn, D. L., Uphoff-Wasowski, K., Campion, J., et al. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27, 187–195.CrossRefPubMed
go back to reference Dalky, H. F. (2012). Mental illness stigma reduction interventions: Review of intervention trials. Western Journal of Nursing Research, 34, 520–547.CrossRefPubMed Dalky, H. F. (2012). Mental illness stigma reduction interventions: Review of intervention trials. Western Journal of Nursing Research, 34, 520–547.CrossRefPubMed
go back to reference DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., et al. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409–416.CrossRefPubMed DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., et al. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409–416.CrossRefPubMed
go back to reference Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.CrossRefPubMed Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.CrossRefPubMed
go back to reference Dovidio, J. F., ten Vergert, M., Stewart, T. L., Gaertner, S. L., Johnson, J. D., Esses, V., et al. (2004). Perspective and prejudice: Antecedents and mediating mechanisms. Personality and Social Psychology Bulletin, 30, 1537–1549.CrossRefPubMed Dovidio, J. F., ten Vergert, M., Stewart, T. L., Gaertner, S. L., Johnson, J. D., Esses, V., et al. (2004). Perspective and prejudice: Antecedents and mediating mechanisms. Personality and Social Psychology Bulletin, 30, 1537–1549.CrossRefPubMed
go back to reference Eisenberg, N., & Lennon, R. (1983). Sex differences in empathy and related capacities. Psychological Bulletin, 94, 100–131.CrossRef Eisenberg, N., & Lennon, R. (1983). Sex differences in empathy and related capacities. Psychological Bulletin, 94, 100–131.CrossRef
go back to reference Fortney, J. C., Pyne, J. M., Edlund, M. J., Stecker, T., Mittal, D., Robinson, D. E., & Henderson, K. L. (2011). Reasons for nonadherence among veterans treated in primary care clinics. Journal of Clinical Psychiatry, 72, 827–834.CrossRefPubMed Fortney, J. C., Pyne, J. M., Edlund, M. J., Stecker, T., Mittal, D., Robinson, D. E., & Henderson, K. L. (2011). Reasons for nonadherence among veterans treated in primary care clinics. Journal of Clinical Psychiatry, 72, 827–834.CrossRefPubMed
go back to reference Frasure-Smith, N., Lesperance, F., Juneau, M., Talajic, M., & Bourassa, M. G. (1999). Gender, depression, and one-year prognosis after myocardial infarction. Psychosomatic Medicine, 61, 26–37.CrossRefPubMed Frasure-Smith, N., Lesperance, F., Juneau, M., Talajic, M., & Bourassa, M. G. (1999). Gender, depression, and one-year prognosis after myocardial infarction. Psychosomatic Medicine, 61, 26–37.CrossRefPubMed
go back to reference Galinsky, A. D., & Ku, G. (2004). The effects of perspective-taking on prejudice: The moderating role of self-evaluation. Personality and Social Psychology Bulletin, 30, 594–604.CrossRefPubMed Galinsky, A. D., & Ku, G. (2004). The effects of perspective-taking on prejudice: The moderating role of self-evaluation. Personality and Social Psychology Bulletin, 30, 594–604.CrossRefPubMed
go back to reference Galinsky, A. D., & Moskowitz, G. B. (2000). Perspective-taking: Decreasing stereotype expression, stereotype accessibility, and ingroup favoritism. Journal of Personality and Social Psychology, 78, 708–724.CrossRefPubMed Galinsky, A. D., & Moskowitz, G. B. (2000). Perspective-taking: Decreasing stereotype expression, stereotype accessibility, and ingroup favoritism. Journal of Personality and Social Psychology, 78, 708–724.CrossRefPubMed
go back to reference Geddes, J. R., Carney, S. M., Davies, C., Furukawa, T. A., Kupfer, D. J., Frank, E., & Goodwin, G. M. (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: A systematic review. Lancet, 361, 653–661.CrossRefPubMed Geddes, J. R., Carney, S. M., Davies, C., Furukawa, T. A., Kupfer, D. J., Frank, E., & Goodwin, G. M. (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: A systematic review. Lancet, 361, 653–661.CrossRefPubMed
go back to reference Gottlieb, S. S., Khatta, M., Friedmann, E., Einbinder, L., Katzen, S., Baker, B., … Potenza, M. (2004). The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology, 43, 1542–1549.CrossRefPubMed Gottlieb, S. S., Khatta, M., Friedmann, E., Einbinder, L., Katzen, S., Baker, B., … Potenza, M. (2004). The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology, 43, 1542–1549.CrossRefPubMed
go back to reference Helweg-Larsen, M., & Collins, B. E. (1997). A social psychological perspective on the role of knowledge about AIDS in AIDS prevention. Current Directions in Psychological Science, 6, 23–26.CrossRef Helweg-Larsen, M., & Collins, B. E. (1997). A social psychological perspective on the role of knowledge about AIDS in AIDS prevention. Current Directions in Psychological Science, 6, 23–26.CrossRef
go back to reference Keller, M. B., Hirschfield, R. M. A., Demyttenaere, K., & Baldwin, D. S. (2002). Optimizing outcomes in depression: Focus on antidepressant compliance. International Clinical Psychopharmacology, 17, 65–71.CrossRef Keller, M. B., Hirschfield, R. M. A., Demyttenaere, K., & Baldwin, D. S. (2002). Optimizing outcomes in depression: Focus on antidepressant compliance. International Clinical Psychopharmacology, 17, 65–71.CrossRef
go back to reference Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–603.CrossRefPubMed Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–603.CrossRefPubMed
go back to reference Landers, R. N., & Behrend, T. S. (2015). An inconvenient truth: Arbitrary distinctions between organizational, mechanical Turk, and other convenience samples. Industrial and Organizational Psychology, 8, 142–164.CrossRef Landers, R. N., & Behrend, T. S. (2015). An inconvenient truth: Arbitrary distinctions between organizational, mechanical Turk, and other convenience samples. Industrial and Organizational Psychology, 8, 142–164.CrossRef
go back to reference Lindsey, A. (2016). Explaining for whom, how, when, and why diversity training works (Doctoral dissertation, George Mason University). Lindsey, A. (2016). Explaining for whom, how, when, and why diversity training works (Doctoral dissertation, George Mason University).
go back to reference Macrae, C. N., Milne, A. B., & Bodenhousen, G. V. (1994). Stereotypes as energy-saving devices: A peek inside the cognitive toolbox. Journal of Personality and Social Psychology, 66, 37–47.CrossRef Macrae, C. N., Milne, A. B., & Bodenhousen, G. V. (1994). Stereotypes as energy-saving devices: A peek inside the cognitive toolbox. Journal of Personality and Social Psychology, 66, 37–47.CrossRef
go back to reference Madera, J. M., Neal, J. A., & Dawson, M. (2011). A strategy for diversity training: Focusing on empathy in the workplace. Journal of Hospitality and Tourism Research, 35, 469–487.CrossRef Madera, J. M., Neal, J. A., & Dawson, M. (2011). A strategy for diversity training: Focusing on empathy in the workplace. Journal of Hospitality and Tourism Research, 35, 469–487.CrossRef
go back to reference Malpass, A., Shaw, A., Sharp, D., Walter, F., Feder, G., Ridd, M., & Kessler, D. (2009). Medication career or moral career? The two sides of managing antidepressants: A meta-ethnography of patients’ experience of antidepressants. Social Science and Medicine, 68, 154–168.CrossRefPubMed Malpass, A., Shaw, A., Sharp, D., Walter, F., Feder, G., Ridd, M., & Kessler, D. (2009). Medication career or moral career? The two sides of managing antidepressants: A meta-ethnography of patients’ experience of antidepressants. Social Science and Medicine, 68, 154–168.CrossRefPubMed
go back to reference Mann, C. E., & Himelein, M. J. (2008). Putting the person back into psychopathology: An intervention to reduce mental illness stigma in the classroom. Social Psychiatry and Psychiatric Epidemiology, 43, 545–551.CrossRefPubMed Mann, C. E., & Himelein, M. J. (2008). Putting the person back into psychopathology: An intervention to reduce mental illness stigma in the classroom. Social Psychiatry and Psychiatric Epidemiology, 43, 545–551.CrossRefPubMed
go back to reference Masuda, A., Hayes, S. C., Fletcher, L. B., Seignourel, P. J., Bunting, K., Herbst, S. A., et al. (2007). Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders. Behaviour Research and Therapy, 45, 2764–2772.CrossRefPubMed Masuda, A., Hayes, S. C., Fletcher, L. B., Seignourel, P. J., Bunting, K., Herbst, S. A., et al. (2007). Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders. Behaviour Research and Therapy, 45, 2764–2772.CrossRefPubMed
go back to reference Mathers, C. D., & Loncar, D. (2006). Updated projections of global and mortality and burden of disease, 2002–2030: Data sources, methods and results. World Health Organization. Mathers, C. D., & Loncar, D. (2006). Updated projections of global and mortality and burden of disease, 2002–2030: Data sources, methods and results. World Health Organization.
go back to reference McConahay, J. B. (1986). Modern racism, ambivalence, and the Modern Racism Scale. Burlington, MA: Academic Press. McConahay, J. B. (1986). Modern racism, ambivalence, and the Modern Racism Scale. Burlington, MA: Academic Press.
go back to reference Melfi, C. A., Chawla, A. J., Croghan, T. W., Hanna, M. P., Kennedy, S., & Sredl, K. (1998). The effects of adherence to antidepressant treatment: Guidelines on relapse and recurrence of depression. Archives of General Psychiatry, 55, 1128–1132.CrossRefPubMed Melfi, C. A., Chawla, A. J., Croghan, T. W., Hanna, M. P., Kennedy, S., & Sredl, K. (1998). The effects of adherence to antidepressant treatment: Guidelines on relapse and recurrence of depression. Archives of General Psychiatry, 55, 1128–1132.CrossRefPubMed
go back to reference Oberle, C. D., Nagurney, A. J., & Lee, C. N. (2011). Implicit prejudicial biases in student learning: The effects of sexual orientation. Journal of Homosexuality, 58, 447–461.CrossRefPubMed Oberle, C. D., Nagurney, A. J., & Lee, C. N. (2011). Implicit prejudicial biases in student learning: The effects of sexual orientation. Journal of Homosexuality, 58, 447–461.CrossRefPubMed
go back to reference Petty, R. E., & Cacioppo, J. T. (1984). The effects of involvement on responses to argument quantity and quality: Central and peripheral routes to persuasion. Journal of Personality and Social Psychology, 46, 69–81.CrossRef Petty, R. E., & Cacioppo, J. T. (1984). The effects of involvement on responses to argument quantity and quality: Central and peripheral routes to persuasion. Journal of Personality and Social Psychology, 46, 69–81.CrossRef
go back to reference Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. In R. E. Petty & J. T. Capioppo (Eds.), Communication and persuasion (pp. 1–24). New York, NY: Springer.CrossRef Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. In R. E. Petty & J. T. Capioppo (Eds.), Communication and persuasion (pp. 1–24). New York, NY: Springer.CrossRef
go back to reference Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S. (2011). Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric Services, 52, 1615–1620.CrossRef Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S. (2011). Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric Services, 52, 1615–1620.CrossRef
go back to reference Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, Pl. Friedman, S. J., & Meyers, B. S. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479–481.CrossRefPubMed Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, Pl. Friedman, S. J., & Meyers, B. S. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479–481.CrossRefPubMed
go back to reference Smith, N. A., Sabat, I. E., Martinez, L. R., Weaver, K., & Xu, S. (2015). A convenient solution: Using MTurk to sample from hard-to-reach populations. Industrial and Organizational Psychology: Perspectives on Science and Practice, 8, 220–228.CrossRef Smith, N. A., Sabat, I. E., Martinez, L. R., Weaver, K., & Xu, S. (2015). A convenient solution: Using MTurk to sample from hard-to-reach populations. Industrial and Organizational Psychology: Perspectives on Science and Practice, 8, 220–228.CrossRef
go back to reference Tajfel, H., Billig, M. G., Bundy, R. P., & Flament, C. (1971). Social categorization and intergroup behavior. European Journal of Social Psychology, 1, 149–178.CrossRef Tajfel, H., Billig, M. G., Bundy, R. P., & Flament, C. (1971). Social categorization and intergroup behavior. European Journal of Social Psychology, 1, 149–178.CrossRef
go back to reference Tajfel, H., & Turner, J. C. (1986). The social identity theory of intergroup behavior. In S. Worchel & W. G. Austin (Eds.), Psychology of intergroup relations (2nd edn., pp. 7–24). Chicago, IL: Nelson-Hall. Tajfel, H., & Turner, J. C. (1986). The social identity theory of intergroup behavior. In S. Worchel & W. G. Austin (Eds.), Psychology of intergroup relations (2nd edn., pp. 7–24). Chicago, IL: Nelson-Hall.
go back to reference Trivedi, M. H., Lin, E. H., & Katon, W. J. (2007). Consensus recommendations for improving adherence, self-management, and outcomes in patients with depression. CNS Spectrums, 12, 1–27.PubMed Trivedi, M. H., Lin, E. H., & Katon, W. J. (2007). Consensus recommendations for improving adherence, self-management, and outcomes in patients with depression. CNS Spectrums, 12, 1–27.PubMed
go back to reference Trobst, K. K., Collins, R. L., & Embree, J. M. (1994). The role of emotion in social support provision: Gender, empathy and expressions of distress. Journal of Social and Personal Relationships, 11, 45–62.CrossRef Trobst, K. K., Collins, R. L., & Embree, J. M. (1994). The role of emotion in social support provision: Gender, empathy and expressions of distress. Journal of Social and Personal Relationships, 11, 45–62.CrossRef
go back to reference Wang, J., Patten, S., Currie, S., Sareen, J., & Schmitz, N. (2011). Perceived needs for and use of workplace accommodations by individuals with a depressive and/or anxiety disorder. Journal of Occupational and Environmental Medicine, 53, 1268–1272.CrossRefPubMed Wang, J., Patten, S., Currie, S., Sareen, J., & Schmitz, N. (2011). Perceived needs for and use of workplace accommodations by individuals with a depressive and/or anxiety disorder. Journal of Occupational and Environmental Medicine, 53, 1268–1272.CrossRefPubMed
go back to reference Weaver, P., Wilborn, L., McCleary, K., & Lekagul, A. (2003). Diversity training management initiatives in the lodging industry: An exploratory analysis of underlying dimensions. Journal of Hospitality and Tourism Research, 27, 237–253.CrossRef Weaver, P., Wilborn, L., McCleary, K., & Lekagul, A. (2003). Diversity training management initiatives in the lodging industry: An exploratory analysis of underlying dimensions. Journal of Hospitality and Tourism Research, 27, 237–253.CrossRef
go back to reference Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65, 405–415.CrossRefPubMed Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65, 405–415.CrossRefPubMed
go back to reference Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58, 55–61.CrossRefPubMed Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58, 55–61.CrossRefPubMed
Metadata
Title
Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants
Authors
Larry R. Martinez
Shi Xu
Michelle Hebl
Publication date
01-05-2018
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 4/2018
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-017-0174-z

Other articles of this Issue 4/2018

Community Mental Health Journal 4/2018 Go to the issue