Stigma

People with alcohol problems and people who have mental health problems  often experience negative stereotypes and stigmatization. For example, a 1999 United Kingdom survey of 1,700 people's attitudes towards the six most common mental disorders found that:

• 74% of those surveyed rated drug addicts as dangerous while 71% thought people with  schizophrenia are a threat and 65% believed people with alcohol problems ("alcoholics") are a danger;

• 49% of people surveyed thought those with severe depression should 'pull themselves together'; 47% though drug addicts are to blame for their illness; 33% thought the same of people with alcohol problems  and 39% of people with eating disorders;

• 81% of people thought people with alcohol problems are unpredictable, compared with 78% for drug addicts and 77% for schizophrenics. Some 56% of people with severe depression and 50% of those suffering panic attacks were described as unpredictable;

• a majority believed the condition of people with dementia will not improve with treatment; 16% believed depression cannot be treated, compared with 15% for schizophrenia, 14% for panic attacks, 12% for drug addiction, 11% for alcohol problems and 10% for disorders.

These types of stereotypes need to be addressed.  The following is adapted with permission, from stigma and mental health work done by Dr. Otto F. Wahl, in his book Telling is a Risky Business: Mental Health Consumers Confront Stigma.

10 + Ways to Fight the Stigma of Alcohol Problems

by Charmaine Spencer

Having an alcohol problem and being a senior who is trying to deal with an alcohol problem is stigmatizing. In  particular, the label “alcoholic” plagues the lives of many seniors. The stigma and stereotypes that go with it can negatively affect many things, such as

- the treatment  that seniors receive from health care providers and community services,

- whether the person will be considered for a seniors' apartment,

- the way the person is treated by coworkers, current and potential friends, and members of the family.

The stigma can feel so oppressive that seniors can often feel overwhelmed by its extent and persistence.

As a community and as individuals, we must "start to eliminate the confusion, open up the lines of communication, and breakdown the secrecy barrier that exists before it can expect society to treat it with a more positive, less condescending attitude." (Kubinski, 1985)

1. Identify the myths and mis-information.

Recognize and challenge the myths, such as the belief that older adults do not have alcohol problems  ( in reality, anywhere from 6-20% of seniors may have an alcohol problem, depending on the setting), or the belief "Well it's his last little pleasure, why bother?".

There is a lot of debate at present about the nature of alcohol problems, and whether an alcohol problem can be considered a "disease." We do know the alcohol problems have psychological components and physical components. We know that some people may be predisposed to developing alcohol problems. We know that gender, age  and social environment makes a difference. We are learning more and more about the chemistry of alcohol problems.

2. Go beyond the stereotypes of alcohol problems.

Recognize that a label like "alcoholic" tells us little about what to expect from the person. These labels do not tell us that the senior is aggressive or incompetent or an unreliable volunteer. They do not tell us about the senior’s capacity for friendship or creativity or accomplishment. They do not tell us clearly about his or her specific symptoms or potential for recovery.

3. Learn more about alcohol problems in later life.

The better informed we are, the better we are able to evaluate and resist the inaccurate negative stereotypes of alcohol problems that are so common.

We also know that waiting  for older people to "hit bottom" is disastrous, because  many will simply die first

A common assumption is that all people with alcohol problems should use a particular resource, such as A.A. Or people may erroneously believe that the best way to handle a problem is for a group of people to confront the person about the alcohol problem ("hold an intervention").

4. Learn more about stigma and discrimination.

It is very common for older adults who are experiencing alcohol problems to face discrimination in  housing and health services. They are often treated as  burdens on services, or simply are refused admission to key services. Alternatively,  all their health or other problems are attributed to the  alcohol problem without looking to determine the real cause.

5. Listen to seniors who have experienced alcohol problems.

They are in the best position to tell us how alcohol problems and stigma affect their lives.

6. Monitor media and respond to stigmatizing material.

Changing the typically negative ways in which those with alcohol problems are portrayed in films and television shows that reach millions of people on a daily basis is necessary if stigma is to be reduced. Write a letter or e-mail the editor, TV sponsor or movie producer.

7. Speak up about stigma.

When someone you know misuses a term, tactfully let them know about the inaccuracy. Educate them about the correct meaning. 

When someone disparages a senior with an alcohol problem, tells a joke that ridicules an alcohol problem, or makes disrespectful comments about a person who has an alcohol problem, we can let them know that this is hurtful and that as people with alcohol problems or advocates we find such comments offensive and harmful.

8. Watch our language.

Most of us, including health professionals, health advocates and consumers use terms and expressions related to alcohol problems that may perpetuate stigma. We depersonalize the people by referring to them generically as "alcoholics".

9. Talk openly about alcohol problems.

The more alcohol problems remain hidden, the more people believe it is shameful and needs to be concealed.

Letting others see real people with alcohol problems - people who are resourceful, articulate and creative, who are familiar already as valued friends or coworkers, people who do not fit the stereotype is a powerful way to fight stigma.

10. Provide support for organizations which fight stigma.

The influence and effectiveness of organizations advocating for better treatment and greater acceptance of alcohol problems depend, to some extent, on membership size and adequacy of finances.

11. Demand changes from your elected representative.

Policies that perpetuate stigma can be changed if enough people let the appropriate politicians know that they want this change. Keep informed on key alcohol related issues and policies. Know the names of government officials to contact.

Adapted from Telling is a Risky Business: Mental Health Consumers Confront Stigma  by Otto F. Wahl, © 1999.

Other References and Resources

Cash, T.F., Briddell, D.W., Gillen, B., & MacKinnon, C. (1984). When alcoholics are not anonymous: Socio-perceptual effects of labeling and drinking pattern. Journal of Studies on Alcohol, 45(3): 272-275, 1984.

Combatting the Stigma of Mental Illness, BBC  News (Wednesday, October 13, 1999). Retrieved July 17, 2003 from: http://news.bbc.co.uk/1/hi/health/187364.stm

Kubinski, W.P. Stigma. Ethics. Condescending attitudes. Proceedings of the 31st International Institute on the Prevention and Treatment of Alcoholism: Volume II, Rome, Italy: 2 Jun - 7 Jun 1985.  (pp. 15-22).

Page last updated Saturday July 24, 2004

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