The Scarlet Letter

Quite often we find that the largest barriers placed before us when seeking help in treating addiction is the barrier we find between our ears: fear.  Fear of stigma.  Fear of perception.  Fear of what others will think, do, and say.  Those fears are perpetuated by public stigma.

A recent article in Substance Abuse by Cockroft, et al. explored several ways that women seeking treatment for substance abuse disorders experience trust issues towards healthcare providers. In this study, several themes emerged as common barriers which impede patients’ ability to develop trust with their mental healthcare providers. 

The data shows that female study participants listed several areas of distrust with addiction treatment providers. Past experiences – such as previous negative experience with diagnoses and outcomes, and prior stigmatization – contributed to a general lack of trust. Healthcare administration issues also affected patient trust, including payment and reimbursement schedules and clinical resources such as time constraints or understaffed facilities. Additionally, concerns about breaches of confidentiality and patient rights raised further concerns. Finally, participants in this study blamed the medical system for causing and enabling addiction in themselves or loved ones through irresponsible prescribing practices. While much of this information is subjective – experiences and perceptions are just so – the reality is that these perceptions reinforce and exacerbate an already negative social stereotype of the mental healthcare system in the United States, and the public image of men and women struggling with addiction as being people with character challenges rather than health challenges.

Interestingly, these responses do not seem to be gender-related; distrust toward addiction treatment is common among both men and women. Yet the authors do note that there are statistical differences which affect trust between male- and female-identifying individuals with substance abuse disorders, and sadly those differences relate to the occurrence of sexual and physical abuse. 

This study, and others like it, have the potential to foster healthy debate about how mental health treatment programs can be more effective in treating female clientele by nurturing an atmosphere of trust and developing a more engaging clinical culture. Perhaps even more importantly, it behooves us all to identify the means to eliminate the ways that gender differences (and all experiences of otherness) are not focused on adequately in many treatment programs. 

At New Paradigm Recovery, we have developed a reputation as being a comprehensive treatment program which incorporates the treatment of trauma and family, so that our clients can heal from past trauma and build positive support systems to allow them to recover from addiction in a supportive, safe, and stigma-free environment.

Moreover, through including family and life partners we allow the clients’ world the opportunity to heal under the care of a kind and knowledgeable team whom we know by name. We endeavor to earn respect by being respectful, and to foster trust by trusting. 

Cockroft, J. D., Adams, S. M., Bonnet, K., Matlock, D., McMillan, J., & Schlundt, D. (2019). A scarlet letter: Stigma and other factors affecting trust in the health care system for women seeking substance abuse treatment in a community setting. Substance Abuse, 170-177. doi:10.1080/08897077.2018.1544184

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