Can changing clinic policies and training doctors reduce stigma around addiction?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: Individuals must meet all of the inclusion criteria in order to be eligible to participate in the study. 1. Site inclusion: * The sites will be selected using convenience sampling. * The inclusion criterion will be sites with at least 4 providers. 2. Provider inclusion: * Providers at participating sites will also be recruited using convenience sampling. * Any psychiatrists or psychiatric NPs are eligible to participate as long as they are employed at the participating LSH site. 3. Patient EHR inclusion: * All new patients entering mental health services during the 3-months prior and 3- months after the intervention will be included in the EHR data sample to assess whether substance use was addressed during their first visit and subsequent 3-month retention in care. * Existing and new patients with alcohol use disorder (AUD)/opioid use disorder (OUD) will be identified through the EHR to assess pharmacotherapy initiation. 4. Patient survey inclusion: * Half of the survey sample (n=20) will include patients without a substance use disorder (SUD) documented in their chart at the time of data collection * The other half of the survey sample (n=20) will include patients who do have an ICD-10 code for SUD in their chart. * Patient stratification rationale: the intention is to compare experiences and perceptions of stigma among patients who have SUD noted in their EHR and those who do not. This is also to assess stigma among patients who may not have their substance use addressed during a MH visit but who have substance use related health risks and substance use disorders (assessed through the ASSIST questionnaire). Exclusion Criteria: All individuals meeting any of the exclusion criteria will be excluded from study participation. 1. Provider exclusion: * Providers may be excluded if they were not employed by LSH and seeing patients for the past three months at the time of enrollment. 2. Patient exclusion: * Patients may be excluded from the SUD-stratified portion of the survey sample if their SUD diagnosis is only for a tobacco use disorder. * Patients may also be excluded if they are unable or unwilling to give written informed consent. * Patients who are currently in jail, prison or other overnight facility as required by court of law or have pending legal action that could prevent participation in study activities will also be excluded.