[content warning for brief mention of drug use and self harm]

I want to talk about something that has come up for me when applying/asking for assistance from health care providers, doctors, therapists etc (but I think it also happens with friends, relatives and co-workers/teachers etc). 

I just applied for disability assistance and this involved a fair bit of paper work and assessment of my disabilities, limits and abilities to figure out what I need help with and what I can do on my own. People go through lists of issues and ask if I have them, and almost invariably in these situations they will come to more stigmatised things like delusions, hallucinations, psychosis, and instead of asking me like they did with every other item on the list they just say that obviously I don’t have them and go to the next point. This happened also with things like personal hygiene (I am able bodied; this is probably different with people with physical disabilities) and around intelligence and language abilities and sometimes with drug use and self harm.

This happened usually during the first appointment I ever had with these people, meaning they had known me for only ten or twenty minutes. This makes it extra blatant, but especially as a health care provider you should not make these assumptions no matter how long you’ve known a patient.

This puts me in a very awkward position because the other person has just made it clear that they think the issue in question is somehow too shameful to even ask if it may apply to me, so if I DO have any of those things it has now become extra difficult to admit to them. It is already difficult to admit to having stigmatised health issues, but this makes it ten times harder. 

So you should never skip these kinds of questions or answer them yourself because there is a high risk of people not speaking up and correcting you and ending up not recieving vital care. And these are people who may already have a hard time getting access to health care because stigmatisation and ableism make it extra hard for them to ask for help or even consider that they might be allowed to get care.