Types of Stigma

  1. “Public stigma” encompasses the attitudes and feelings expressed by many in the general public toward persons living with mental health or SUD challenges or their family members.
  2. “Institutional stigma” occurs when negative attitudes and behaviors about mental illness or SUD, including social, emotional, and behavioral problems, are incorporated into the policies, practices, and cultures of organizations and social systems, such as education, health care, and employment.
  3. “Self-stigma” occurs when individuals internalize the disrespectful images that society, a community, or a peer group perpetuate, which may lead many individuals to refrain from seeking treatment for their mental health or SUD conditions.”
  • Medical, Behavioral Health staff, Substance Use Counselors can be inclined to use street language to be more approachable to persons with SUD. Important to use dignifying language.
  • However, there is a time and place for everything, so people who are working with PWUD, for instance, may engage them using this language. It is important to realize what language works with the participant we are serving. There is certainly more wiggle room in peer based services. For clarification, language such as this Is never ok in a treatment or clinical service delivery setting. I will admit that as a young clinician, I sought to build therapeutic rapport with this language, which begs the question of, did I really build rapport, or did I engender some trauma bonding?
  • A 2019 study of over 400 patients indicated that people seeking inpatient detoxification continue to struggle with experiences of self and perceived stigma.
  • Stigma may be a barrier to accessing a first episode of substance use treatment (which was not the subject of this analysis).
  • Higher stigma is associated with previous detoxification program admissions.