Dehumanization and stigmatization in healthcare: Experiences of individuals with severe mental illness and/or substance use disorder

Individuals with severe mental illness (SMI) and/or substance use disorders (SUD) face profound levels of stigmatizing behaviors from family members, the general population, employers, and healthcare providers. These stigmatizing behaviors have the potential to deeply affect their emotional, mental, physical, and social wellness. Individuals who experience stigmatization may have decreased self-esteem, self-efficacy, physical and mental wellness, quality of life, and service-seeking in the healthcare sector. We conducted a qualitative phenomenological inquiry with individuals with SMI and/or SUD, exploring their experiences receiving healthcare provisions. The intention of collecting these data was to highlight and amplify the voices of individuals with SMI and/or SUD, as they have historically been silenced. Moreover, we wanted people with lived experience (PWLE) of SMI and/or SUD to inform the development of a de-stigmatization training program for healthcare students. We interviewed focus groups comprising PWLE using open-ended questions from a semi-structured interview guide to better understand their perceptions of and engagement with healthcare providers. Thematic analysis of our data resulted in six themes: (1) Agency in treatment decisions, (2) Emotional and structural challenges to healthcare, (3) Power dynamics in healthcare, (4) Interpersonal relationships between patients and healthcare providers, (5) Healthcare advocacy, and (6) Dehumanization and disregard of patient insight. These findings demonstrate the many ongoing challenges and barriers that individuals with SMI and/or SUD face when seeking healthcare services. Moreover, these data provide important considerations for the development and implementation of future de-stigmatization training programs for individuals in the healthcare sector.