Separating Fact from Misconception: Street Medicine Detroit Talks about Stigma

By Anirudha Rathnam

Street Medicine Detroit comes across a wide variety of medical conditions during our clinic days. These range from the most common health conditions in the United States, such as cardiovascular disease and diabetes, to uncommon infections like trench foot, which is caused by extended exposure to dampness (first seen among WWI soldiers who fought in the trenches). One thing we’ve noticed is that people who experience homelessness usually don’t have just one medical condition. It’s often a combination of a few things that can complicate their health and well-being, such as chronic illness (asthma, diabetes, or epilepsy), domestic violence, sexual assault, being an unaccompanied youth, addiction, physical disability, unemployment, and/or mental illness. To clear up a common misconception, “wanting to be homeless” is nowhere in this list of factors; experiencing homelessness is not easy. Often, it results from people having to juggle a number of different needs. Health may not be their number-one priority at all times, but when illness hits, it makes focusing on their other needs difficult.

We see people at a vulnerable time in their lives and try our best to reduce any stigma they feel as they reach out to us. A major barrier preventing many from receiving care and assistance, societal stigma comes mainly from false impressions and blame stemming from misunderstanding. It can lead to shame, discrimination, and social exclusion and ultimately prevents individuals from changing their situation. In part, stigma towards those experiencing homelessness is also linked to stigmas toward mental illness and substance addiction. However, not everyone who experiences homelessness has a mental illness, and not everyone with mental illness experiences homelessness. In fact, the National Alliance of Mental Illness states that one out of four adults in the United States experience mental illness in a given year – that’s 61.5 million people.

While homelessness and mental illness are separate conditions with some overlap, the stigma associated with both causes very real barriers to seeking healthcare. Often, they both lead to poorer health outcomes: the homeless and mentally ill carry the risk of dying more 25 years younger than the general population. Mental illness has a tendency to be viewed differently from physical illness, but both can impact one’s health and well-being. Just as high blood pressure is a condition that affects your body’s blood system, mental illnesses are medical conditions that can disrupt how a person thinks, feels, socializes, or functions in everyday life. They can affect anyone regardless of age, race, or living situation, and they are caused neither by personal weakness, upbringing, nor lack of character. Common mental illnesses include depression, eating disorders, schizophrenia, and post-traumatic stress disorder.

You can play a part in reducing stigma. Instead of believing the common misconceptions, simply learning more about a condition and talking about it with others is a great leap forward. Avoid using hurtful labels like crazy, lazy, and, insane, and take a stand by asking those around you to stop when they do. Finally, you can become an ally. If you come across someone with a stigmatized condition, be open-minded and respectful. Reach out and make sure they get help when needed.

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