Stigma
Negative stereotyping, prejudice, and discrimination against individuals with mental health or substance use conditions that creates barriers to care.
On the exam, stigma questions usually arrive as a communication item: a colleague, family member, or the client themselves says something dismissive (“addicts always relapse,” “I’m just crazy”). The tell is that you are asked for the nurse’s best response, and the credited answer intervenes on the stigmatizing statement rather than ignoring it or simply reassuring. The rule it hinges on: nurses advocate and reframe, often by noting that mental illness and substance use disorder are treatable medical conditions, not character flaws or willpower failures. Watch for self-stigma (the client internalizing shame), which lowers help-seeking and adherence.
A classic trap is confusing the target of each related concept. Empathy, rapport, and therapeutic technique describe how you connect with one client; stigma is the broader social prejudice and discrimination you actively challenge — interpersonal, internalized, and structural — including your own implicit bias. Don’t pick the “supportive silence” option when the item demands advocacy. Memory hook: stigma is a barrier you break, not a feeling you share.
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