Without sounding too basic, I want to make my first point: advocates harbor stigma too–even mental health advocates.
While some are overtly less discriminatory than others, many secretly follow and believe in the medical model despite saying differently.
These advocates will disparage and call other people names, and they are not as worthy of advocates. They are debasing other people’s skillsets, putting them into question, and even being openly critical of why you or I became an advocate.
At the root of it, they are pathologizing advocates. I have met them. These folks believe people with schizophrenia and the more severe diagnoses are less likely to heal and recover. To be more precise, they feel a certain way about people with my diagnosis. Like we are less than, sicker, and less trustworthy to be adherent to our treatment.
I’ve heard advocates say downright nasty things about people with schizophrenia. Oh, some of them might seem like they are even cheering you on, albeit in a condescending way. Others will be openly critical and negative towards people with more severe and complex clinical pictures.
This conversation about stigmatizing advocates comes after coming across the http://www.deardiagnosis.com/ project.
It is operated by a Licensed Clinical Social Worker (LCSW) with experience treating medical and mental health issues.
I was exceedingly curious when I came across this blog. After all, I am a licensed clinical social worker running a mental health blog. People with lived experience submit articles through a form-based submission process. The form collects the person’s name, age, and diagnosis and asks if they want to be anonymous or have their name published in their article’s byline.
Naturally, I submitted it to the blog. I received an automated response, then a personal message informing me when to hear about it and the turnaround time to review my submission. I am glad I submitted it because the email from the site manager after checking my blog was the impetus for this blog. The site manager complimented my writing and made insightful notations to improve my submission and move along through the publication process. So far, I was impressed with her insights and how professional the blog seemed.
That was when I read this notation from the editor saying:
Other advocates have stigmatized me. Stigmatizing other advocates given bias, discrimination, diagnosis, and everything wrong is nothing new in the public mental health system.
So, I was in a car accident earlier this year due to my unresolved sleep apnea and was overworked. A peer I was working with at the time had a hard time reaching me on the phone. The peer couldn’t contact me because I was out of town at a conference and was unreachable due to a car accident.
When I regained access to my phone, it was already ringing from this peer. I explained to the peer I was in a car accident. That was when the peer made inferences about my sobriety and mental health. I was appalled.
My car accident wasn’t an indicator that I was relapsing. But for this peer, it was enough indicator to turn on me. Suddenly, past completed projects weren’t up to par, and there were instances (according to this peer) that I was unprofessional. When I asked him if he could speak positively about any of our work to date, he said: “No.”
Being unreachable and having car issues were my peer’s meter sticks for health and how stable I was. Well, if this isn’t hypocrisy, then my following statement will make you cringe. Isn’t being a peer and providing real authentic peer support mean not being judgemental and creating a space to listen and support their peer with the issues they define as the ‘problem’?
Absolutely, but back to my original theory. Advocates, even peer advocates, can be stigmatizing. The impact is catastrophic for people expecting unassuming and nonjudgemental supports in the system. We need to do something about this and expose people who harbor these ideas and discharge them from their jobs as advocates.