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No Shame, No Blame

John Harden – There is a saying in AA, “you are as sick as the secrets you keep.” We know from experience that the secret burden of addiction is taken silently to the grave by far too many people, due to the barrier to recovery imposed by stigma. Stigma (and the resulting feeling of shame) is not limited to the disease however. There is also stigma associated with receiving treatment for the disease.

When I asked Patrick Kennedy why he was such a vociferous proponent of insurance parity for mental health, he energetically recounted a story of being sent “down the hall” for his own treatment to a lesser part of the health care facility. “As if the disease was not stigmatizing enough, we also have to put up with inadequate facilities, undertrained staff and poor or no insurance coverage,” he stated.

Countering stigma and alleviating shame expands access and improves outcomes. To be effective, contemporary treatment models must conscientiously tailor all aspects of care (environment of care, treatment planning, staff training, credentialing, family component, employer component, marketing) to promote human ecology.