Patient Care and Health Provider Attitudes in Alaska

As part of an overall evaluation of the Alaska Health System's response to the problem of alcoholism, the attitudes of all levels of health providers toward mental health problems were examined. The evaluation instrument was the Opinions About Mental Illness Scale developed by Cohen and Struening. Health workers from physicians to paraprofessional aides were tested and the results scored and compared. Results were examined in relation to geography, discipline and other factors. They were then considered in relation to such things as treatment outcome, selection of workers and possible training programmes. The rate of death due to alcoholism in the native population of Alaska has increased from 4.6 per 100,000 in 1960 to 41.4 per 100,000 in 1970.( 1 ) This can be contrasted to a U.S. rate of 6.30 per 100,000 for the same period.( 2 ) In 1972, the Alaska Native Health Board launched an in-depth evaluation of alcoholism treatment services in the state ( 3,4 ) as the first step toward the objective of evolving the current pattern of care services into a self-correcting integrated system designed to reduce the impact of alcoholism and mental illness on the native population. The definite linkage between health care workers' attitudes about mental illness and the impact of these attitudes in compliance to standards within the care process or the outcomes of the care process has not been established. However evidence has been presented that there is a relationship between professional judgment of health workers' performance and health workers' attitudes( 5 ) and patient judgment of health workers' performance and health workers' attitudes( 6 ). As a component of the baseline evaluation study, opinions about mental illness of the health workers were obtained for subsequent analysis and definition of the relationship between attitudes, process and outcomes.