In a perspective published in Neuropsychopharmacology, leaders from the National Institutes of Health address how using appropriate language to describe mental illness and addiction can help to reduce stigma and improve how people with these conditions are treated in health care settings and throughout society. The authors define stigma as negative attitudes toward people that are based on certain distinguishing characteristics. More than a decade of research has shown that stigma contributes significantly to negative health outcomes and can pose a barrier to seeking treatment for mental illness or substance use disorders.
Thirty five percent of people with serious mental illness in the U.S., and nearly 90% of people with substance use disorders, do not receive treatment. The perspective authors point to evidence that stigma-related bias among clinicians can contribute to a treatment-averse mindset and to flawed clinical care, including failure to implement proven methods of treatment. Further, when a person with a mental illness or substance use disorder continues to experience stigma, they may begin to internalize it. This “self-stigma” can lead to lower self-esteem and feelings of self-worth and can become an ongoing source of distress that may exacerbate symptoms and create barriers to successful treatment.
Conversely, efforts to reduce stigma may reduce the psychological burden it places on individuals and can be an important component of removing barriers to care. The authors highlight numerous studies showing that using scientifically accurate language and terms that centralize the experience of patients with mental illness and substance use disorders is one key component to reducing stigma. They argue that a shift in language is crucial for mobilizing resources toward mental health and addiction services and eroding the prejudices that keep people who need those services from seeking or receiving them. Though stigma is difficult to eliminate, they contend that changing the language we use to describe these conditions can make a significant and immediate difference for the people experiencing them.
ND Volkow, JA Gordon, and GF Koob. Choosing Appropriate Language to Reduce the Stigma Around Mental Illness and Substance Use Disorders. Neuropsychopharmacology. DOI: 10.1038/s41386-021-01069-4 (2021).
- Nora D. Volkow, M.D., director of the National Institute on Drug Abuse (NIDA)
- George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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