For years, as a clinician, I've been frustrated by how society addresses mental illness and substance abuse, and the lack of progress made. Advances in psychotherapy and medication have had little impact.

Two reasons, of many, are the issues of stigma and the poor understanding of the dynamics involved. Stigma is so pervasive in society. We're blind to it, and it makes mental illness and substance abuse so reprehensible no one wants to be associated with either, let alone admit to being one. This goes for family, friends and many treatment professionals.

The stigma of substance abuse is so negative most would prefer a diagnosis of mental illness instead. Certain attitudes, theories and treatment regimens make it difficult — if not impossible — to effectively treat either disorder, especially since they most often co-occur. Some professionals give inconsistent and conflicting advice, which confuse and unknowingly enable substance use.

Unless we learn to destigmatize both, we'll struggle and fail in reducing their presence. Stigma motivates people to work hard on finding less offensive causes (usually wrong), for mental illness and substance abuse. What we resist will persist.

Before we can achieve a better understanding and create more effective strategies in treating mental illness and substance abuse, we must learn to feel more comfortable in how we view them. The above may offend some, but I ask: Why is it that 95% of addicts don't believe they have a problem, or only 1% to 3% of them ever get help? Do cancer patients typically behave this way?

BRENTON KAHLE

Astoria

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