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This chapter discusses the impact of relational stigma on mental health as an unfolding dimension of social harm amongst people who use drugs (PWUD). In traditional models of Social Determinants of Health (SDoH), ‘social relations’ are often ignored in favour of a positivist worldview yet they constitute a messy ‘invisible reality’ that shapes a person’s experiences. Drawing on Wellcome Trust qualitative research, we show how relational stigma contributes to a worsening of mental health amongst PWUD and a widening of health inequalities. This chapter builds on Tyler’s theory of the ‘machinery of inequality’ (2020) to show how social relations act in synergy with SDoH, damaging the mental health of already marginalised individuals.

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‘If I Wasn’t on Drugs or I Didn’t Take Anything, I Wouldn’t Be Here’: Mental Health ‘Problems’ as an Unfolding Dimension of Social Harm Generated by Stigma

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  • 出版模式：

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  • 发表日期：

    2025年

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  • Michelle Addison,
  • Monique Lhussier

摘要

This chapter discusses the impact of relational stigma on mental health as an unfolding dimension of social harm amongst people who use drugs (PWUD). In traditional models of Social Determinants of Health (SDoH), ‘social relations’ are often ignored in favour of a positivist worldview yet they constitute a messy ‘invisible reality’ that shapes a person’s experiences. Drawing on Wellcome Trust qualitative research, we show how relational stigma contributes to a worsening of mental health amongst PWUD and a widening of health inequalities. This chapter builds on Tyler’s theory of the ‘machinery of inequality’ (2020) to show how social relations act in synergy with SDoH, damaging the mental health of already marginalised individuals.