Ripples of Despair -  Shining a light on the impact of lives lost to alcohol, drugs, and suicide (2024)

Part of what got me into the hole was this stigma attached with what happened to me, the stigma then attached with my mental health as a result of what happened.

Stigma, shame and discrimination deeply affect people harmed by alcohol, drugs and suicide. They shape how individuals experience these struggles during their lives and how families, friends and communities grieve after a death. Unlike other illnesses, like cancer, addiction and mental health conditions are often misunderstood, with society sometimes viewing them as issues of personal choice or control. This unfair perception creates barriers to seeking help and reinforces feelings of shame. 

A recent report (156) commissioned as part of the NHS Stigma Kills campaign identified stigma as:  

• Discrimination - the behaviour that resulted from the prejudice from others
• Experienced stigma - the experience of being stigmatised by other people 
• Social or public stigma - the negative attitudes and prejudice held by society 
• Anticipated stigma - the feelings people had when they expected to be on the receiving end of bias from other people 
• Self-stigma - the internalisation of stigma felt by individuals resulting from social stigma 
• Perceived stigma - the perception of how a particular stigmatised group is treated by others

Stigma is also embedded in the language, narratives and media that surround us. Labels and negative descriptors dehumanise people and shape how society views them and how they view themselves (157). For example, describing addiction as a "lifestyle choice" or mental illness as an "excuse" creates damaging stereotypes that blame individuals for the struggles they face and ignore the systemic disadvantages and traumas that contribute to these conditions. 

With 'commit suicide', we talk about people committing a crime, but something about committing suicide, to me, suggests that it is in the same ballpark. It sounds like a deliberate act.

Outdated language, like "commit suicide", reflects stigma rooted in the past where suicide was a crime in England and Wales until 1961. Although attitudes have shifted, stigma around suicide and mental health remains. Research shows that 1 in 5 people will have suicidal thoughts during their lifetime and 1 in 15 will attempt suicide (82), yet most won't disclose their feelings due to fear and worry about how others will respond (158).

My cousin took her own life as a result of heroin. Her family refused to use the words 'committed suicide'; instead, they would say she 'took her own life'.

Language matters. The words we use to describe addiction, mental health or suicide can either reduce stigma or deepen it. These judgements extend to healthcare settings, where stigmatising views can influence the care people receive (159). Stigma shaped by society may be internalised. People start seeing themselves through the lens of the prejudice they face, lowering their self-esteem (160) and pushing them further into addiction and/or despair (161).  

The impact of stigma and shame  

Stigma has real, harmful consequences. It stops people from seeking help, isolates them from support networks, and creates barriers to treatment. (162,163) For example, men are often discouraged from expressing emotions due to traditional ideals of masculinity, making them less likely to seek help for mental health or addiction (164,165) .

For women, stigma is often tied to societal expectations about their roles. A recent study found that women in recovery from alcohol dependence described shame as stemming from failing to meet stereotypes of being a "good mother" or "ideal woman". These expectations contributed to their use of alcohol as a way to cope (166).

Mental health is also stigmatised in many parts of the world, with different cultural concepts of mental health and internalised stigma reducing people's chances of seeking adequate healthcare even when available (167). In some communities, mental ill health is not spoken about. Refugees and asylum seekers in particular can face stigma, with many fearing seeking help due to cultural taboos, mistrust of healthcare systems, fear of authority, as well as a potential lack of familiarity with treatment for these conditions (165,168,169).

Reducing stigma  

Reducing stigma starts with changing how we talk about these issues. Using compassionate, non judgemental language in all aspects of our life can make it easier for people to seek help and encourage society to see addiction and mental health struggles as health conditions, not burdens to face alone. 

Case study: Recovery Connections Coffee Bike 

The Free Hot Coffee Bike, launched in Gateshead by Recovery Connections, is breaking down stigma around addiction. Lived experience volunteers and staff use the bike to offer free coffee in exchange for conversations about recovery.

It's a simple, powerful way to make recovery visible, share support options and challenge misconceptions and stigma around addiction.  

At an event held at the Quayside last summer, the coffee bike sparked 220 conversations. By chatting with people who have lived experience, many attendees changed their views about addiction and learned that recovery is possible. The bike's success demonstrates how small acts of connection can reduce stigma, spread awareness and inspire hope.