Words and Actions Matter

As healthcare professionals I am not sure we understand fully the magnitude of our words and judgements. How often do patients just leave a provider and never return because they weren’t heard or felt judged? They certainly don’t always tell us that we have wounded them. Our words, our actions, our judgements, they matter and carry tremendous power. Our choices, whether intentional or otherwise, have the power to not only impact whether someone engages in treatment and healing but can create new wounds or deepen the wounds that are already there. Let that really sink in, because in your rush to judge, in the slight roll of your eyes, the tone of your voice and the questions that you ask, you are telling someone how worthy they are of help. How valuable you believe they are. Consider the magnitude of that, when the person you are interacting with is already vulnerable, is already in a state of crisis and likely, is already in the process of self-loathing, struggling with their value or feeling like a failure. Consider the magnitude of that to those that are fragile, misunderstood, and tired.

Professionals need to be the example to society. To demonstrate treating those with mental illness and substance use without stigma and judgement. To demonstrate recognition that we are all humans with flaws and wounds and pain. Aren’t we all one or two steps removed from finding ourselves in crisis? Consider what would need to happen for you to find yourself or a loved one in need of mental health care or substance use treatment. The reality is, probably not very much--the loss of one job, the death of a loved one, being victim to or witness to a crime, an unexpected illness, a stressful life event, the end of a relationship. In an instant, it can all change for each one of us. If you believe it would be impossible for you to end up there yourself, you are living in fantasy. You are perpetuating the belief that those with a substance use disorder or mental illness are somehow different than the rest of us.

We have the responsibility to do better, to be better, to get it right. Too often in healthcare we make judgements about people without asking, knowing, or caring about the full story. We decide who deserves our time, our care, and our resources. Those judgements can be made because of fatigue, lack of time, burn out, shortages of resources, or frustration. The challenge is to recognize that when we make those critical judgements, it may only be one moment in time for us, but for the patient or their family the impact could be lasting. The wound can cut deep and can mean the difference between seeking help or not, between starting to heal and continuing in pain, between life and death.

So, how do we get there? That is the real challenge. It isn’t going to happen through law or policy (that is another discussion). It is going happen in a million small moments that change the culture. It is going happen when we recognize we are all humans and none of us have it 100% together or are immune to hurt and harm. It is going to happen when we start asking what each individual needs and empowering them to help steer their own course. It is going to happen when we start challenging our peers to show up and get it right. When we stop standing by silently, allowing those with substance use disorder or mental illness to be perpetrated by the very people they rely on for medical and mental health care. It is going to happen slowly and painfully, because it will mean that we will have start talking honestly and openly about the ways that we have failed, the ways that we have hurt people and the ways that we have wronged people who needed humanity and care. I recently heard Brené Brown say in a podcast, “I am not here to be right. I am here to get it right.” Her words stuck with me, and I believe that this is the attitude that we will need to bring to our profession to bring about a change in stigmatization related to substance use and mental health. When we have done something wrong or hurt someone, we need to put aside the part of us that wants to explain why we did what we did. We need to not justify our actions but really hear how our words, or judgements, or actions, or body language made someone feel. It will mean approaching things differently, not as experts who have the answers but with open hearts and minds ready to explore how to get it right. It will mean eliminating the words I did it because from our vocabulary. It will mean apologizing when we fall into old habits. It will mean asking how we can do better. It will be a journey, but it will begin the process of healing and changing the overall mental health of our country.  It will mean that people can seek treatment for themselves or their families with hope rather than fear and that the process of seeking care won’t add to wounds that have not yet had the chance to heal.