Stigma and shame over mental health illness and substance use disorder (SUD) keep people from asking for the help they need and can prevent them from ever entering into recovery.
Here are some experiences from three people in our community who felt shamed by providers who were supposed to be helping them:
“One time, my kidneys were failing… they didn’t even give me a room…they put me on a gurney out in the hall. I felt so dehumanized… I would rather die than just go there and deal with that.”
“I called the police for assault, and they didn’t believe me. The policewoman said, ‘When they’ve actually gotten into your apartment or beating you up, that’s when you should call me.’ She was making fun of me and mocking me and not taking my safety for real.”
“I rode the ambulance and overall, I think they were rude and unkind, kind of forceful, they strapped me down… I think I had gout in my foot.. but they saw my arms [with track marks] and they strapped me down.”
Marginalizing folks with mental health or substance use issues stops them from calling emergency services when in crisis, leading to possibly tragic outcomes. And this treatment doesn’t only come from first responders.
There are three types of stigma: societal, in which society “others” folks, seeing them as less than human; self-induced, where people carry so much shame about their illness that they are terrified to reach out; and also from recovery groups, where people are shamed for relapsing or not following the “rules.” No matter what type of stigma people experience, it creates problems in our society and can result in unnecessary pain and suffering, and even death.
So how do we change how we treat people with SUD or mental illness? Education is key. First, we need to acknowledge that addiction and mental illnesses are diseases as classified by the American Medical Association – they are not moral choices. Also, using person-first language is important. Defining someone as a human being and not their illness reduces stigma. Instead of calling someone a “junkie,” refer to them as a person with a substance use disorder. Don’t call someone a “schizophrenic,” but as a person who has schizophrenia. The difference can have profound effects on how people see themselves, and reduces shame.
Meeting folks where they are at, without judgment and without shame, greatly increases positive outcomes. If we respect the rights of people suffering from mental illness or SUD with a commitment to scientific evidence and recognize that trauma and oppression affect behavior, folks will be more willing to ask for help without fear.
Practicing harm reduction can also increase positive outcomes. Harm reduction calls for the non-judgmental, non-coercive provision of services and resources to people, and the communities in which they live, in order to assist them in safer life choices.
Harm reduction is not the opposite of recovery, but rather a stop-gap that safely prevents imminent and common harms that impact people with mental illness and SUD, and the public at large. By treating all people with dignity and autonomy, we can reduce stigma and shame, and help folks on their journeys where people in all walks of recovery are empowered to be their best selves.