The Double Stigma Against People with Mental Illness and Addictions
Reprinted from "Concurrent Disorders" issue of Visions Journal, 2004, 2 (1), p. 13
Prejudice can show its ugly head in many forms; racism, sexism, homophobia and other forms of social injustice are unfortunately still very much a part of our society. But while social movements have begun to address these forms of injustice and have made some gains in recent history, we are only gradually beginning to realize that discrimination against people with a mental illness and/or addiction are issues that need to be dealt with as well.
Mental illness and addiction are both conditions that can have an enormous impact on the lives of those affected by them, as well as on those around them. While these conditions can be very debilitating in and of themselves, their impact on peoples’ lives can be increased greatly by the ways in which these people are treated in society. People with a mental disorder or addiction are often blamed for their condition. Many people believe that a mental illness or addiction represents a weakness, a behavioural choice or an inherent character flaw that needs to be changed.
This is worse for people with an addiction than a mental illness. In one research study, a sample of interviewed people – including caregivers of people with alcohol addictions, mental health professionals, educators and judges – blamed people with alcohol addictions twice as much as people with mental illnesses for their respective stigmas.1 One thing is clear though: people with both these conditions are too often treated with anger, fear and resentment, instead of compassion and support. Consequently, people with a mental illness or addiction have so internalized their shame that they often feel unjustified in speaking out for their right.
The impacts of prejudice and discrimination on people with a mental illness or addiction are manifold. They are at a much higher risk of having their human rights violated. For instance, a person with a mental illness is more likely to be the victim of an act of violence than the perpetrator.2 This is in direct contradiction to the commonly-held myth in society that people with mental illness are more aggressive and violent. Moreover, people with a mental disorder or addiction are often dehumanized and seen in terms of a diagnosis, rather than as a person – not just by the public, but by mental health professionals as well. A 1990 British study found that psychiatrists were more likely to rate a patient (who had been arbitrarily diagnosed with an alcohol addiction for the purposes of the experiment) to be difficult and annoying than those who had not.3 This is part of the process of justifying the continued discriminatory treatment of people with a mental illness and/ or addiction.
Discrimination against people with a mental illness or addiction goes further than simple name-calling or public perceptions, however. It also means that they have more difficulty finding and sustaining employment, decent housing and a good education, and that they are more vulnerable to being treated badly by societal institutions like the legal system, the police and the health care system.
People who have a dual diagnosis of a mental illness and an addiction are faced with even more barriers to wellness. Mental health services may refuse treatment to a person with an active addiction, while at the same time, addiction services may not treat the addiction until the mental illness is dealt with. In this way, people with a dual diagnosis may end up being shuffled back and forth between the two systems, and may never get treated for either. While those who work in the mental health and addictions systems are now beginning to realize that both issues need to be dealt with concurrently, there are only a handful of available support services that are starting to do this.
Perhaps what is now necessary is for people with a mental illness or addiction (or both) to learn from other social movements and begin to stand up for their human rights by demanding essential services and a change of attitude towards the ways they are perceived and represented in society. In this way, we can move towards a society free from all forms of discrimination – and live up to our image as a society that protects the rights and freedoms of all its members, particularly those who are most vulnerable.
About the Author
Harkirat is a volunteer and farmer co-op student at the Canadian Mental Health Association's BC Division
Fulton, R. (2001). The stigma of substance use and attitudes of professionals: A review of the literature. Toronto, ON: Centre for Addiction and Mental Health
Hiday, VA, Swartz, MS, Swanson, JW, Borum R, & Wagner, HR. (1999). Criminal victimization of persons with severe mental illness. Psychiatric Services,50(I), 62-68
Farrell, M & Lewis, G. (1990). Discrimination on the grounds of diagnosis. British Journal of Addicition, 85, 883-890