Psychologist and licensed alcohol and drug counselor Dr. Julio Rojas is an advocate for his patients, and even more so when social stigma surrounds getting help for mental health.
“I think stigma is the way we view a person as less than or unworthy simply because of who they are, a condition they have or a circumstance in life,” he said.
Stigma exists everywhere
Reducing the stigma surrounding mental health treatment is necessary to encourage people to seek treatment for themselves, Rojas said. Patients who seek help for their problems may immediately face judgment or bias, even from the medical community.
“They might say, ‘I’ve struggled with addiction,’ and then the provider might pivot with that one word and warn them that they better never try to get pain medicines from them,” he said.
If patients experience this type of reaction when they identify as being in recovery, or as someone who struggles with alcoholism or addiction, the patient’s trust can begin to erode.
Patients who do not trust their provider are less likely to seek treatment for their problems, he said. This can also lead to patients losing hope that there is a solution to the problem. Rojas recalled a patient who came in to get treatment, and continually apologized:
“I bet he told me ‘I’m sorry’ about 25 times. I said, ‘What are you sorry for?’ He said, ‘I’m sorry that I’m taking up your time. I’m sorry that my life is a mess.’ If he saw a physician, he probably never says, ‘I’m sorry, I have diabetes. I’m sorry, I have cardiovascular disease,’ but he’s been told by society that when you’re someone who struggles with drug addiction, you’re weak. You’re selfish. And unfortunately, before he developed the problem, he probably believed a lot of the things that society had taught him to believe.” Rojas said.
Fortunately, the patient took the first step by coming in for treatment. Rojas said he received the help he needed, but it was an example of how stigma hurts a person’s self-esteem and their ability to say, “I need help.” When patients don’t feel comfortable reaching out, they may become more isolated, which is very harmful for people with addiction or other mental health diagnoses.
Rojas said the problem is worse within communities that are already marginalized due to their race, socioeconomic status or disability. For example, if someone is a racial or ethnic minority and a member of the LGBTQ+ community, they can face compounded stigma, he said.
Compounded stigma can be defined as the additive and cumulative impact of being a member of one, or several, marginalized groups (e.g., racial/ethnic minority, LGBTQ+) and suffering from addiction, mental illness, and/or trauma, Rojas said. Each of these identifications carries its own stigma, therefore, it is a heavier burden to the person’s health and wellness. More importantly, it negatively impacts their ability to seek help, trust others, and care for their physical and mental health and well-being, he said.
Helping loved ones
If people have a family member or loved one who needs mental health assistance, they should first set aside any bias they may have before starting a conversation, Rojas said.
“What do you think about someone with alcoholism? Why do you think what you think, and is that a helpful way to treat sick people? Is that a helpful way to talk to someone who’s hurting?” he asked.
Rojas also urges people to talk to someone who found success in recovery.
“There are a bunch of people who are successful in recovery, and they’re happy to tell you about their journey,” he said. “If you or family members who are in recovery can be more open about that, and talk about getting counseling and getting help, then that’s a sign of strength.”
Rojas also recommends reading books that emphasize the importance of kindness when talking to a loved one who suffers from addiction. One of his favorites is Beyond Addiction: How Science and Kindness Help People Change.
“How can we love people who are hurting and at the same time, help them get better?” he asked. “Sometimes we get angry about the behaviors of someone who’s using, or we get angry about feeling helpless to convince them or change them. In that frustration, we draw from our uglier side, a hurtful side.”
Rojas also urges people to focus on something other than addiction. A single conversation about something positive could be the catalyst that helps the person seek treatment.
“I’ve talked to many parents who have lost their children to addiction, and the common regret they have is that’s all they talked about,” Rojas said. “They didn’t talk about the goals that person had. Who knows how a conversation about a goal or a dream might turn into the first step towards sobriety?”
While Rojas does not currently treat children or teens, he still encourages parents to create open and honest communication about any family history of addiction or substance abuse.
“Family history itself doesn’t mean it’s going to happen. But if you have family history and then these problems come up later, you can talk about it,” Rojas said.
He said parents can look for opportunities to talk with children about mental health, such as when a high-profile person like a celebrity or athlete mentions it. He is hopeful people will begin to think about behavioral health the same way they think about a visit to the dentist or their primary care doctor.
Stakes are high but help is there
Rojas hopes people will push through any doubts they might have about seeking help.
“When I’m sitting with a person, I know all the obstacles they had to overcome just to sit there in that moment. For some of them, it’s taken five or 10 years just to sit in that chair,” he said. “When I think about it from that perspective, I don’t want to miss the opportunity to talk about hope, to talk about healing, to talk about possibility.”
Rojas said since the stakes are often high, affecting every aspect of a person’s life, this can be another barrier to seeking help.
“If you have mental illness, you may lose custody of your children. You may lose your civil liberty. There is a reason for that trepidation because we as a society do things to folks with mental illness, and it’s usually not helpful,” he said.
Rojas said some of his patients have been denied life insurance because of mental illness, have lost jobs or have been denied the opportunity to serve in the military.
Fortunately, many treatment options have shifted away from blaming the person seeking help, Rojas said. In the 1990s, patients were told they were reckless, dangerous or selfish for their addiction. This harsh approach is counter-productive, he said, and can push the patient away rather than draw them toward help.
He is also encouraged by the approach of treating all of a patient’s needs at once, rather than one at a time. Patients were told to maintain sobriety for one year before being treated for other issues. This method failed to acknowledge that the patient may have first started abusing substances to self-medicate depression, anxiety or other disorders. This resulted in fewer patients maintaining sobriety for a year.
Rojas said an integrated approach is the best way to treat the person by addressing issues that contribute to the patient’s risk of going back to using.
Above all, Rojas wants to encourage people to push through barriers and reach out for help.
“If you have struggled with picking up the phone or talking to someone about what’s going on in your mind and heart, what I would encourage is to resist the messages that our society has communicated: You’re not defective. You’re worthy. You can get better. There is help. There are people who want to help you,” he said.
For more information about CPN Behavioral Health Services, visit cpn.news/bh or call 405-214-5101.