{"id":4556,"date":"2019-06-03T00:01:43","date_gmt":"2019-06-03T04:01:43","guid":{"rendered":"https:\/\/www.providecare.org\/?p=4556"},"modified":"2024-09-16T19:24:54","modified_gmt":"2024-09-16T19:24:54","slug":"how-identify-signs-symptoms-environmental-stigma","status":"publish","type":"post","link":"https:\/\/www.providecare.org\/blog\/how-identify-signs-symptoms-environmental-stigma\/","title":{"rendered":"How to Identify Signs and Symptoms of Environmental Stigma"},"content":{"rendered":"

\u201cAs professionals we get caught up in the daily motions. It’s easy just to come into your office and do what you do every day. We lose our genuine effectiveness in helping our patients, and we don’t necessarily stop and examine if we have biases or prejudgment, we don’t think about that when we are just going through the motions. So now when I am meeting with people I am really stepping aside and asking, \u2018Am I feeling a certain way, anything that is going to hinder me from helping this patient?\u2019\u201d<\/em><\/span><\/strong><\/h2>\n

Social Services Program Manager, Tennessee<\/em><\/strong><\/span><\/h2>\n

At Provide, our central driving value is the belief in the fundamental and inherent worth of all people\u2014including those who cause us discomfort. Often, this discomfort is a product of stigma: the negative view we hold of people because of a certain quality or circumstance. Stigma sits at the forefront of our work in providing abortion referrals trainings, as well as in the work of many of our partner sites, which includes domestic and sexual violence, family planning, HIV, and substance use disorder. Only by recognizing and working against stigma can we create systems that can truly provide patient-centered care for our clients. Our blog series on stigma discusses how it shows up in health care and social service delivery<\/a>; how to identify signs and symptoms of stigma at the individual<\/a>, environmental, and structural<\/a> levels; and how individuals can help to remove stigma from their workplace.<\/p>\n

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How to Identify Signs and Symptoms of Environmental Stigma<\/span><\/h2>\n

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In seeking to identify where stigma might be present in your professional setting, it can be helpful to think about stigma as occurring at three levels:<\/p>\n

Individual:<\/strong> from the individual provider who is interacting with the patient\/client<\/span><\/p>\n

Environmental:<\/strong> from the immediate environment where health care and social services are delivered (the community or clinic in which you practice is also part of the environment)<\/span><\/p>\n

Structural:<\/strong> from the immediate policies and procedures that guide how health care and social services are delivered (this can include individual organizations, as well as local, state, and federal laws and policies)<\/span><\/p>\n

These levels are interconnected. Individuals can influence their environment to be stigma-free, but structural change requires leadership buy-in. Environmental stigma is important to understand because institutional cultures that normalize stigmatization create social pressure for the health care staff to stigmatize particular patient populations<\/a>. This may cause a patient to receive sub-par or incomplete care that doesn\u2019t address their needs, and also can influence the provider\u2019s practice throughout their career.<\/p>\n

For example, environmental stigma is often attached to people who use drugs. The opening of a methadone clinic in a community is often met with protest, despite the fact that treating substance use disorder with methadone is an effective and evidence-based practice. Methadone treatment itself is also extremely stigmatized. Presumptions are made about substance users and what their presence might mean to a community, which in turn might contribute to a lack of treatment options for those who seek help.<\/p>\n

\u201cI think that in this area there is a stigma with substance abuse. Since that’s an area I work with, people are already so afraid to talk about their substance abuse and they minimize it anyways. And if a woman is pregnant and is also using substances, there is even more pressure on her. And, from what I have heard from women, they feel like they’re letting people down, letting their child down. Addiction is addiction. So for me it is just breaking down that wall and talking about it. And the more you talk about it, the more it goes away. It’s kind of like suicide. Just because you don’t talk about it, doesn’t mean it doesn’t exist. The opposite is true. The more you address it, the less it is likely to happen.\u201d<\/em><\/span><\/p>\n

Substance Use Case Manager, Kentucky<\/em><\/span><\/p>\n

Our Referrals Training and Technical Assistance Program attempts to address stigma by reviewing interactions with clients (Individual), staff policies and procedures (Environmental), and leadership initiatives (Structural) that can ensure that people receive the care they deserve without being stigmatized.<\/p>\n

\u201cWhat sticks in my mind, we had a client who was pregnant and she was going to raise the baby. But one day she had someone fax adoption papers, and she never talked to us about it. That always stood out to me. I felt we had failed her, and I wondered, where is the disconnect?\u201d<\/em><\/span><\/p>\n

Domestic Violence Therapist, South Carolina<\/em><\/span><\/p>\n

\u00a0<\/em><\/p>\n

Visual cues can signify to clients whether they might be stigmatized at a clinic and can also informally signify to staff what may be acceptable or unacceptable practices in the workplace. For example, placing a bowl of condoms out can signify to clients that they can talk about safe sex. Having pregnancy posters or brochures that discuss all three pregnancy options (parenting, adoption, and termination) in bathrooms and waiting areas signifies that patients can be comfortable talking about current or past reproductive health history. Some questions to ask to help you determine whether environmental stigma exists in your workplace include:<\/p>\n