I am still surprised and angered by the disrespect of people with mental illness and substance use disorders by health care professionals. Considering mental illness and substance use disorders are medical conditions with consistent symptoms, standard treatment protocols, approved medications, and documented prognosis, I fail to understand why professionals treat these individuals differently. I am not talking about the disease model of treatment for addictions but rather the fact that mental illness and substance use disorders are recognized diagnoses within the medical community. A health care professional would never treat a patient suffering an injury with the callousness that some treat patients with suicidal thoughts or the way they treat those going through substance withdrawals. Often the medical problems many people present to the emergency room with are the direct results of poor choices, unhealthy lifestyles, and stupid decisions. A person suffering from a heart attack associated with unhealthy nutrition are treated respectfully. Patients with injuries from not wearing helmets, refusing to use seat-belts, or failing to follow safety warnings on products are treated respectfully. Someone seeking treatment for smoking related illness are treated respectfully. Yet a person with mental illness or substance use disorder are left for last, not taken seriously, and often even mocked to their faces by people who have sworn to cause no harm. Suicidal ideation is a symptom of several mental disorders which are treatable and can sometimes can be associated with medical conditions as well (diabetes, urinary tract infection, heart conditions, dementia, head injury, medication side-effects just to name a few examples). Substance use disorders are sometimes the result of coping with a horrific trauma or some other untreated medical condition. Suicide and overdose are among the top causes of death in the United States (and other countries) yet are treated as less than urgent problems while the patients are treated like they don’t deserve the same standard of care as other patients. One would never ignore a bleeding patient, a patient having a heart attack, or a patient suffering a stroke. Treatment providers would never consider giving a lecture or shaming a patient in the middle of one of these types of emergencies even when the lifestyle choices associated with these medical conditions are well documented. Yet a suicidal patient or a patient withdrawing from substances are considered medical emergencies–they could die. I had a nurse talk so negatively about patients who are suicidal and my only response was, “this is from someone who has never experienced depression”. This same nurse, however, would demonstrate compassion for a patient with lung cancer from smoking even though she herself has never smoked. It’s no wonder people do not seek treatment, wait until they are in crisis, or worse–they die–before asking for help.