nursingforsocialjustice

I have been a nurse for 13 years. In the 13 years of my career I have seen notable shifts in public awareness of mental health issues, shifts in policy related to substance use. I have seen must less shifts in the way that health clinicians approach issues of mental illness and substance use. I have seen ongoing mismatch between the research and practice, exclusion or exceptions for people who have been identified and enter into the involuntary mental health system, lack of meaningful solutions of the major players in changing the highest intervention levels of care. However, I have seen all sorts of re-branding of old ideas as if new and discipline specific research that privileges certain types of knowledge and knowledge holders over others.

The way to reduce stigma of substance use is not to force people who use substances into treatment to usher them into a substance-free lifestyle. It’s an us and them. The moral right is the side of substance free and the wrong is the side of substance use. Substance use in itself isn’t a moral wrong. If we keep perpetuating these dichotomies, drugs are bad, no drugs are good, it does not matter how we brand Abstinence. It erases the contexts which people live. It erases the the distinction between using substances and the context and situation of the person using substances.

What if the treatment for concurrent disorder isn’t person specific? What if the solution lives in community-based social justice movements? What if the solution is fighting poverty? Health equity? Community building? After school programs? Harm reduction? Anti-racist action? De-colonization? These definition that we have created to classify…are they helpful knowing what we know in 2021? How helpful are they when the intervention does not acknowledge the larger social issues? When we locate the problem in an individual rather than society?

What is addiction?

What is substance addiction?

What images do you think of when you hear the term addiction?

Are there good addictions and bad addictions?

What is substance use?

What are substances?

What is innovation?

What is social justice?

It’s not a secret, the Diagnostic and Statistics Manual is based on normal and not normal and consensus about these definitions, these criteria, has shifted over time. This is influenced by all kinds of things that aren’t extensions wanting to make a more accepting and inclusive society that accepts and embraces difference. Here’s a tidbit of information: homosexuality was classified as a mental disorder until 1987. That’s within my lifetime. So, what things are disorders right now they may not be so 20 years from now? And so, that makes me think, what is this moving target we call concurrent disorder? And, is that how we group and treat people? Or should it be more of a clue about how we educate and train clinicians?

What is de-colonization? And should knowledge about this be mandatory curriculum in health disciplines?

What if we broke down bigger silos? Between healthcare and education? Between criminal justice and healthcare? Between not-for profits and governmental organizations?

Peace,

Michelle D.