Compassion or stigma? How adults bereaved by alcohol or drugs experience services

How to promote compassionate care within public services is a concern in several countries; specifically, some British healthcare scandals highlight poor care for service users who may readily be stigmatised as ‘other’. The article therefore aims to understand better the relationship between stigma and compassion. Since people bereaved by a drug- or alcohol-related death often experience stigma, the article draws on findings from a major British study, conducted 2012-15 by the authors, of people bereaved in this way, in order to see how service provision can be improved. 106 bereaved family members were interviewed in depth about their experiences of loss and support. Thematic analysis developed theoretical understandings of participants’ lived experiences. This article analyses our data on how bereaved people experienced stigma and kindness from practitioners of all kinds.
We found that stigma can be mitigated by small acts of kindness from those encountered after the death. Stigma entails stereotyping, othering, and disgust, each of which has emotional and cognitive aspects; kindness entails identification and fellow feeling; professionalism has classically entailed emotional detachment, but interviewees found cold professionalism as disturbing as explicit disgust. Drawing on theories concerning the end of life, bereavement, and emotional labour, the article analyses the relationship between stigma, kindness and professionalism, and identifies some strategies to counter stigmatisation and foster compassion.