Presentation by Ellen O’Neal, Continuing Care Coordinator of Bushypark Treatment Centre, at public meeting on September 14th, 2010 at the Temple Gate Hotel in Ennis, County Clare addressing the Stigma of Mental Health. Addiction has profound negative effects on mental health.
What exactly do we mean by the “Stigma of Addiction?”
We can define stigma as a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid and discriminate against people suffering with addictions. Stigma also leads others to avoid living, socializing with or working with, renting to or employing people with addiction. Stigma leads to low self-esteem, Isolation and Hopelessness. If a situation or disease is not understood, it is easier for society to ignore it than to challenge its foundation.
Alcoholism and other drug addictions suffer from stigma, lack of public understanding and education, and professional disinterest. Family members often recognize signs of pathological drinking in their loved ones very early, but because of social stigma and other psychological reasons, prefer to ignore what they see.
Accountability is part of the treatment for addiction and for dealing with the stigma of addiction. Accountability must be tempered with compassion.
People still see addiction as a personal weakness. When stigmatizing addicts, people often perceive that the addict should have risen above weakness, that he or she could have chosen otherwise at the time addiction told hold.
Think of the people you know. Think of the people who are close to you…the people who are close to your family and part of your life. Now think of this…there is a good chance that someone in your family or someone you know has an addiction to alcohol or another drug or both. There is a good chance you know someone who is affected. Unfortunately, many people do not seek or receive treatment because of cost, fear, not knowing where to go for services, concern about confidentiality and the opinions of neighbours and the community. Fear of what people may think – the stigma that surrounds substance misuse and addiction is a serious barrier to treatment and recovery. Fortunately, everyone can do something to reduce stigma.
What can you and I do about stigma? Stigma is about disrespect. It is the use of negative labels to identify a person living with addiction. Labels contribute to stigma. Labels lead to stigma – a word that means branding and shame. Words like “she’s a drunk,” or “he’s a junkie” demean and devalue individuals. Labeling people by their illness is also damaging. For instance, instead of saying “he’s a drug addict,” say “he has an addiction to drugs.”
Some things we all can do are:
- Share the facts about addiction and substance misuse problems and about people who have these problems. Speak up if you hear or read something that isn’t true.
- Treat people with addictions with respect and dignity, as you would anybody else.
- Don’t label people with addictions as a “drunk”, “chronic alcoholic,” drug addict, or “junkie.”
- Support people with addictions by helping to develop community resources.
- Teach children about substance misuse and addiction. Help them see that these problems are like other illnesses that can be treated.
Stigma prohibits too many people from seeking the diagnosis and treatment necessary for improved life and improved mental health. Millions of people recovering from addictions lead full, productive and active lives. Stigma has many faces. Social isolation, labels, and outright discrimination all work to inhibit people with addictions from getting the help that they need.
Other Things we can do to fight stigma:
- Demand equal medical insurance coverage for alcohol and drug treatment.
- Write to lawmakers to remove the legal barriers that prevent people recovering from addictions from getting jobs. People with alcohol and drug convictions often find it nearly impossible to find jobs. Some employers have access to criminal records that are supposed to be confidential, making it easy for them to avoid hiring anyone with a past problem. This continuous punishment condemns many to wasted lives. Research has shown that recovering individuals who don’t have jobs are significantly more likely to relapse and commit new crimes than similar individuals who get jobs.
- Give more than lip service to the reality that addiction is a disease, not a character weakness. Large-scale social change often starts with small, sometimes uncomfortable, individual steps.
- Become aware of, explore, examine and question your own attitude toward addiction. Last Christmas someone close to me was arrested for stealing his girlfriend’s car, stealing his grandmother’s credit cards and cash from her wallet, stealing his aunt’s Blackberry, and stealing his cousin’s ADHD medication while under the influence of crack cocaine. Because of these behaviours I was forced to see his very serious cocaine addiction. When I said out loud “this person is a drug addict,” I nearly choked on my words. In that moment, I also became aware of my own prejudice and negative attitude. And I didn’t like it. Another family member is refusing to forgive him and refuses to speak TO him or ABOUT him, never asking how he is or how his mother is doing or feeling about her son. These attitudes and actions are not unique to this family, and they perpetuate stigma and contribute to the isolation and hopelessness felt by many addicts who want to get well.
- Be an advocate for an individual or family with an addiction problem. Recovering people need an advocate to ask the right questions, insist on appropriate medical insurance, and make sure there is a treatment plan that makes sense. They need someone who will say no to a suggestion that the patient come back in three weeks for an assessment. You can be that person.
Stigma leads to discrimination. Words can be poison. Stigma discourages. It does not ENCOURAGE people to get help. Stigma leads to fear, mistrust, and violence. Stigma results in prejudice and discrimination. Many individuals try to prevent people who are recovering from addictions from living in their neighbourhoods. People often do not want a Halfway House in “their” neighbourhood, a place where recovering people can experience safety and structure and assistance in getting well.
Words can heal.
- Learn more.
- Insist on accountable media.
- Recognize and appreciate the contributions to society made by people who have addictions. People with addictions are major contributors to Irish life – from the arts to the sciences, from medicine to entertainment to professional sports.
- Treat people with the dignity and respect we all deserve. People with addictions may include your friends, your neighbours, your co-workers, your boss, your doctor, your teacher, your family.
- Think about the person – the contents behind the label.
Even the Fear of stigma, and the resulting discrimination, discourages individuals and their families from getting the help that they need.
Stigma can cause families and friends to turn their backs on people with addiction.
- Do use respectful language.
- Do emphasize abilities, not limitations.
- Do tell someone if they express a stigmatizing attitude.
Ask yourself how YOU see the problem of addiction. Is it a symptom of an underlying deeper problem? Underneath addiction is always emotional pain, low self esteem, unmet needs, hopelessness, no reason for living, or any combination of these or other issues.
Challenge yourself to distinguish between the behaviour (which is seen and visible) and the individual (and what’s not seen and invisible). Seek to understand and to gain the trust of the individual. People are more than their addictions. Try to convince the person to get help. Show respect for where the person is, rather than judging.
When we judge, condemn, isolate, disrespect, label, discriminate against, ostracize….WE are part of the problem of stigma….WE perpetuate the life of stigma.
It’s up to us, to each of us in this room, to help to create beneficial conditions, for example, access to adequate treatment and other services, under which addictive behaviour can reasonably be expected to change. Once change gets underway, we can begin compassionate accountability.
By questioning the assumption that a person could have chosen differently given the exact circumstances in which the choice to use drugs arose, by continuing to unravel the etiology of addiction, we help combat stigma and discrimination
What we don’t do in questioning is let addicts entirely off the hook. Holding people accountable and responsible for their choices is part of what helps change behaviour. Seeing what caused addiction may help ensure that accountability is non-punitive and compassionate. Holding people accountable and responsible is respectful….for everyone.
I challenge each of us to explore our own role in the stigma of addiction. Let us each do our own part, one person at a time, one day at time, in eliminating the harmful and painful stigma of addiction. Help break the Silence of Addiction.
