Recognizing trauma and stigma in housing instability and substance use

“ A human needs to be out of survival mode before they can truly focus on recovery, because the prolonged toxic stress of homelessness is an ongoing trauma.”

Cynthia Petion is currently the Deputy Director of Systems Management at the Behavioral Health Administration (BHA). She has been a member of the Anti-Stigma Project (ASP) workgroup since 1994, and a pioneer, change agent, and tireless advocate for creating a more respectful, responsive, and effective behavioral health system.

With so many more people experiencing what many of us have lived with for so long, I and many others began to wonder if the stigma related to mental health and substance use issues is diminishing, or if the pandemic is at least changing conversations about behavioral health needs.

We can take a holistic approach to the relationship people have with substances: shifting away from the idea of debating if the relationship should exist, and instead focusing on improving it on an individual level.

“The loss of resources associated with criminal charges, poor health outcomes from disrupted care due to repeated short incarcerations, and other impacts on the targeted group only further fuel stigma. By trapping people in a cycle of poverty, they are more likely to be vulnerable to disease and more likely to be pushed into other survival crimes, thus linking illness and crime without the nuanced understanding of how stigma and criminalization created those circumstances initially.”

“Shame is something that I struggled with for many years and was the motivation behind reading her work initially, but as I read these books I was able to make connections between shame and stigma and how understanding that connection is also vital to my work as an Anti-Stigma Project workgroup member and facilitator.”

“Art isn’t reduced to just pen on paper, nor paint on canvas. Art can mean just about anything creative. Writing a poem or essay, playing an instrument, dancing, acting, and so much more are healthy forms of self-expression. People around the world are using art as a way to fight stigma.”

“Practicing harm reduction made me kinder and more forgiving. By focusing on keeping people safe instead of changing their behavior I learned to value the people they were instead of the people I thought they could be.”

“This past May, the Anti-Stigma Project once again traveled across the country to help folks involved in the behavioral health system address the issue of stigma and its impact on recovery. This time, the specific focus was tackling the stigma faced by peer support specialists in the workplace.”

If you are or know someone with lived experience, that informs your knowledge and view of mental health consumers. People without direct contact with someone with a mental illness are reliant on other avenues to learn the facts about behavioral health. According to one source, “research has shown that many people get their information about mental illness from the mass media” greatly impacting how people think about this topic. Depending on the source, the accuracy of that information can vary greatly. Some news and entertainment make an effort to discuss and depict mental illness in a well-informed way that gives full context to these experiences, while others perpetuate stigma by negatively portraying characters or individuals, or by leaving out relevant information that fully humanizes those that experience mental illness.

Celebrity endorsements help bring the stigma conversation to the table, but do they really impact the “nearly one in five U.S. adults” who live with mental illness and addiction every day? An article in Psychology Today found that, “Stigma research has shown that the telling of positive stories about living with mental illness significantly reduces the myths of mental illness” and that when the general public learns about “a person who lives with a clinical disorder, manages it well, and experiences a rewarding life, stigma is reduced.” The research shows that celebrities can be influential and the general public can be deeply impacted by their stories.

Famous people like actor Ryan Reynolds, football player Brandon Marshall, TV personality Howie Mandel, and Olympic swimmer Michael Phelps are speaking out about their experiences and have demonstrated that all layers of social strata, even Hollywood actors and football stars, can struggle with mental illness and addiction. Ranging from OCD and anxiety to substance abuse and depression, the experiences of these celebrities can be eye-opening. Actress Kristen Bell believes that, “anyone can be affected, despite their level of success or their place on the food chain.”

In response to National Parents Day on July 22nd, the Distorted Perceptions Campaign decided to focus July’s Topic of the Month on behavioral health experiences through the lens of parents and families. We set out to explore the following questions: How does an individual’s behavioral health experience affect their family? How does stigma impact family members specifically? Can the stigma that family members receive cause them to stigmatize others? And what can families do to minimize the effects of internal and external stigma?

In acknowledgement of National Child Abuse Prevention Month and National Love Our Children Day, April’s Topic of the Month looks at behavioral health through the lens of childhood experiences. How prevalent are mental health issues in school-aged children? What do children’s behavioral health experiences look like? And how does stigma interact with these experiences? To pique your interest, we’ll lay out some of the information we found. But please know that the videos, articles, and websites are much more powerful when you experience them yourself, so be sure to check out our online post!

“Does knowing someone has a mental health or substance use issue change the way you see them?” Maybe it does, maybe it doesn’t. Maybe it does on Monday and doesn’t on Tuesday. Maybe it does with Mary but not with Steve. But the answer to that question may influence what I say, how I say it, what I do, and how I do it.

The Distorted Perceptions campaign encourages individuals to fact-check their assumptions, and offers tools to help them do that. We designed an array of educational materials, online resources, and in-person presentations to help people uncover their biases, challenge their assumptions, and connect in meaningful ways. Our series of postcards, fact sheets, eyeglass cleaning cloths, magnifiers, lapel pins, stickers, and t-shirts all prompt the same self-reflective process, and provide resource information for those who would like to find out more. The message is striking a chord, and we continue to hear that our mission is important, relatable, relevant, and that the campaign is unique, interesting, and helpful.

Tamara VanNewkirk is a clinical social worker in Baltimore and has been a member of the Anti-Stigma Project workgroup since 2015.

Suicide is a serious and preventable public health issue. It affects people of all ages, socioeconomic groups, ethnicities, cultures and religions. Suicide is the 10th leading cause of death in the United States and the 2nd leading cause of death for youth ages 15-24. It is estimated that 5 million people in this country have been directly affected by a suicide. In 2015, 9.8 million American adults had serious thoughts of suicide. It is widely accepted that most people who are suicidal do not want to die; they want to end the pain they are experiencing.

“It’s been a year and half since the Anti-Stigma Project’s Distorted Perceptions campaign was launched, and since its creation, the campaign has really taken flight.”

Written in Summer 2016 by Michelle Livshin, who is still with On Our Own of Maryland, inc. as our current Director of Network and Peer Services!!