Stigma is barrier to treatment for behavioral health


Five years ago in September, I had started a new job in a large Colorado health system, working to expand behavioral health services, chronic disease management, and public health programs. I was also calling hospitals and jails to see if my brother was still alive. He was living on the streets of St. Louis and, after 12 years of addiction to prescription painkillers, had started using heroin.

I would sit in my beautiful office with a view of downtown Denver and look in the mirror before my next meeting to see if they could tell I had been crying again. I could never let them know what I was going through: How could they trust me as a public health professional if I couldn’t even help my family?

One day, when we hadn’t heard from him in weeks, I broke down in an executive management meeting, in front of a team of doctors, Ph.D.s, and a senior vice president. I tried to apologize, and pull myself together — and what happened next surprised me. Every person in that meeting came to me after and told me a personal story about mental health or addiction. On this day, when I felt so alone, all of these people were right there in front of me all along. And all that fear and shame? That was MINE. As I learned that day and have continued to learn since, there is hardly a person I know who hasn’t felt that same isolation and loneliness.

When my brother was finally ready to get treatment, he lived with me for a year. During this time, I had to explain to other people my family situation and what it was like to be a caregiver for someone in recovery. It became one of the most important things I’ve done in my life. To be there for him. To make sure he felt accepted. To make sure I understood more about his illness. To make sure he could always come to me with a relapse.

When the Colorado Office of Behavioral Health started the Lift the Label anti-stigma campaign in 2017, we had heard clearly from our community partners that stigma was a very real barrier to people seeking treatment. The Colorado Health Access Survey from that year found that of the 67,000 Coloradans who needed but did not get services for drug or alcohol use, almost 60% said stigma kept them from getting the care they needed.

Writing this op-ed and being a part of this campaign is scary and I wonder how people will judge me, my brother and my family. Part of me wants to be protective of him. But I have to get over my fear to bring stories public. It’s only when we realize we all know and love somebody who has been touched by addiction that we can move forward.

During National Recovery Month, I want to share a message of hope and support for anyone seeking help. I want anyone who has been through — or is wanting to go to — treatment to know that getting help is nothing to be ashamed of; it is something to be proud of.

If you or a loved one wants to learn more about treatment for opioid use disorder, you can go to the Lift The Label site at to find a licensed substance use treatment provider, including those who accept people without insurance. You can also download the app OpiRescue to find a primary care provider or substance use treatment provider who specializes in opioid addiction. I also want to encourage you to get involved with the new Colorado Behavioral Health Task Force. Speak up for yourself and loved ones so we can make the behavioral health system work for all Coloradans. Make Colorado a place where everyone can get the treatment and services they need to live their best life.

Cristen Bates is the co-creator of the Lift The Label campaign and the sister of a brave big brother in recovery. She is currently the affordability lead at the Colorado Department of Health Care Policy and Financing.

Cristen Bates


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