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HA

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The Stigma of Mental Illness - Written by the Office of Public Health, Canadian Medical Association

OTTAWA, Oct. 14 /CNW Telbec/ - People with a mental illness or addiction and their families and friends face two challenges: dealing with their illness and dealing with the stigma that surrounds it. Often this stigma can be as difficult to deal with as the illness itself.

Mental illness ranges from mood disorders, including depression (which about 8 per cent of Canadians will develop at some time in their lives) and anxiety, to eating disorders and schizophrenia. The Public Health Agency of Canada says mental illnesses are caused by "a complex interplay of genetic, biological, personality and environmental factors."

In many ways, mental illnesses resemble other health problems. They can be chronic or life-long, or episodic. They can be severe enough to be disabling, or something people live with while continuing to function day-to-day. Many patients respond well to treatment, and like heart disease or cancer, those who do not suffer from mental illness likely know someone who does.

Where mental illnesses differs from most other diseases, however, is in the negative attitudes that surround them. Whether because of fear arising from centuries of ignorance, or hostility because people don't believe the mentally ill are 'really sick' if they are not visibly ailing, there's a lack of understanding and support for people with mental-health problems.

As a result, many people either hide their mental illness or even deny it altogether. Studies show men are particularly likely to refuse to accept that they suffer from a mental illness, because it seems weak or self indulgent. In fact, mental illness is no more a result of personal weakness than any other type of sickness.

The stigma of mental illness can also discourage people from getting treatment. Many try to continue to function as usual; something they would not do if they had pneumonia or a broken leg. Even those who have accepted the need for help may cut off counseling or medication too soon because they feel pressured to "get over it."

"More education about the realities of mental illness would go a long way toward showing Canadians it is neither shameful nor threatening, but a health problem that can usually be effectively treated to the benefit of those affected, their families and the country as a whole," said Dr. Ruth Collins-Nakai, President of the Canadian Medical Association.

Unfortunately, people who delay getting help for mental illness tend to get worse and become harder to treat. And people suffering from mental illness who don't get adequate treatment are far more likely to kill themselves than the rest of the population. Studies show they also are likely to have more trouble getting work than others, even more than people with physical disabilities.

However, in the last decade or so, as we have learned more and developed better treatments, society has become less judgmental and hostile to the mentally ill and more people are willing to admit they have a mental illness and seek help. Many companies, offer access to different kinds of counseling through employee-assistance programs and more people are admitting they need those programs - an admission that once would have been seen as a career risk and personal failure.

For further information: Carole Lavigne, Media Relations, (613) 731-8610
or 1-800-663-7336 ext. 1266
 

Retired

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Heartart,

You have introduced a fascinating topic that could benefit from being explored and from learning about the specific prejudices people have in keeping their mental illness a deep dark secret.

Does it have to do with the images we grew up with seeing those colossol so called asylums where people with poorly understood psychiatric disorders were warehoused?

What about the adverse publicity of electric shock therapy? Are people afraid they may be given treatments without their consent?

Of coures there's one's reputation among family, friends and co workers...are people really supportive and understanding or are peole who seek treatment for mental illness just written off as "crazy"?

It sometimes seems that enen the medical community, including some physicians are somewhat prejudiced against Psychiatrists....is it because they worry their colleagues in Psychiatry can read their minds??
 

HA

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It sometimes seems that enen the medical community, including some physicians are somewhat prejudiced against Psychiatrists....is it because they worry their colleagues in Psychiatry can read their minds??

lol, Steve.

Where stigma shows it's ugly presence the most is when an emergency department physician says to the psychiatry department of the hospital- "We have another nutcase here for you." There may be a case for some physicians to have to vent through humour or not taking their jobs too seriously in order to prevent burnout but I doubt very much you would hear one calling the oncology department and saying, "We have another pile of rotten cells for you." This was pointed out to happen very often in an article written about stigma and mental illness by a psychiatrist who noted that change needed to come from within the medical profession itself.

I was impressed that the Medical Association took the time to address mental illness because it is at the bottom of the list of priorities in the medical arena and the political one too.

A good example of stigma is to list all of the names that are used in a degrading manner that are related to mental illness.

Nutcase
Psycho
Lunatic
Schizo
Nut
Crazy
Kook
Wacko
Fruitcake
Weirdo
Screwy
Demented and on and on...

While the above are just a few of the words used to describe those with a mental difference lets look at some of the names used to describe people with cancer.




Can you think of any? No, because there are no words that are disrespectful or offensive for serious illnesses such as cancer.

I do believe that the continual portrayal of psychiatric hospitals as the place where all bad things happen and that the only pictures or documentaries you see or read about are from the past, and a major reason for the continued fear and misunderstanding which feeds the stigma monster.

If mental illness was given the funding that phyisical illnesses are given then you would see more up to date hospitals being built instead of closing what little beds we have left and replacing hospital care with family care or the street. More community funding would help but we also need specialized psychiatric care facilities.

The hospital my family has used is brand new with the most modern architecture of primarily glass and lots of art work. It is a beautiful healing environment and built with that in mind. Much more comfortable than your regular hospital ward.

I think fear of being at risk or vulnerable to mental illness just by the very fact that we are human is another reason that people don't want to aknowledge and talk about mental illness.

Cheers
Judy
 

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Judy,

I worked in a profession that brought me in close contact with many physicians in Emergency, in General Practice and in Psychiatry.

Gladly I can report never having heard any disrespectful or derogatory characterization of a patient in crisis. Sorry you had to be exposed what may have been an isolated case of a health care worker having a bad moment.

Your original point about one' fear to confront mental illness might be related to the fact that mental illness changes who we are

No other physical illness or disorder I know of does that, and as a result, people unfamiliar with the manifestations of the illness and who come in contact with the mentally ill patient do not or cannot make the distinction between what the patient is saying and what the illness is making the patient say.

The result is often rejection or being ostracized from the community, in the worst case scenario.

Re integration after being treated must be very difficult, and society is not very understanding.

Perhaps creating awareness is the answer, getting into schools, giving in service presentations and allowing young people to actually meet and interact with someone with a psychiatric disorder under the guidance and supervision of that patient's physician..to de-mystify the illness
 

HA

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TSOW said:
Judy,

I worked in a profession that brought me in close contact with many physicians in Emergency, in General Practice and in Psychiatry.

Gladly I can report never having heard any disrespectful or derogatory characterization of a patient in crisis. Sorry you had to be exposed what may have been an isolated case of a health care worker having a bad moment.

I have never experienced this myself, Steve. Thank Goodness! This example was taken from an article written by a psychiatrist talking about how prevelent this kind of stigma behaviour is within the medical profession. He wrote an excellent article about stigma. I found it here
How Can We Reduce the Stigma Of Mental Illness? by Jim Bolton


Perhaps creating awareness is the answer, getting into schools, giving in service presentations and allowing young people to actually meet and interact with someone with a psychiatric disorder under the guidance and supervision of that patient's physician..to de-mystify the illness

Yes, these are good ideas that are in practice. Public Education is very important.

Cheers
Judy
 

David Baxter

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Excellent thread. Thanks to both of you for some thought-provoking comments.
 

comfortzone

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I agree...good thread!

It is interesting how people have to use these "categories" to distance themselves from people who experience mental illnesses. I think the words you mentioned above are those people's way of thinking they are not susceptible to these illnesses. Sticks and stones can break bones and word can be devastating too. Words can also be healing and helpful such as, Thank you Judy for starting this wonderful thread! I appreciate Steve and your input.

Good topic!
 

sweetanise

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TSOW said:
Your original point about one' fear to confront mental illness might be related to the fact that mental illness changes who we are

No other physical illness or disorder I know of does that, and as a result, people unfamiliar with the manifestations of the illness and who come in contact with the mentally ill patient do not or cannot make the distinction between what the patient is saying and what the illness is making the patient say.

Just a few comments. They may be a little disjointed as it is the middle of the night and my grasp of English is not all it could be right now.

Alzheimer's is a condition where the patient's personality is changed. Yet, the social stigma attached to this disease is nil compared to the ones attached to mental illness, IMO.

My grandmother has Alzheimer's right now. In my family, there is a strong sense that her illness is real, while my own (chronic depression, panic disorder) is not, although this is not always said in so many words. And this, even after my father commited suicide after a long battle with mental illness himself.

It occurs to me right now that many people suffering from mental illness feel guilty for being sick and often tend towards self-deprecation. Recently, a good friend of mine has been having problems with anxiety and has had to look into getting therapy and meds. When talking to me about it, he often refers to himself as being crazy, something he would never call me, even though we suffer from similar symptoms. I've called him on it, but I know that he feels guilty that he has an anxiety disorder and is sort of punishing himself for not being able to deal with it on his own. Also, my friend can talk to me about his mental health, as I've been there and done that, but feels he cannot let on to his collegues at work for fear that he will be seen and treated differently and that his career will be irreversably affected.

I'm sure we can all relate to this. I know I've felt the same way.

So yes, at the risk of repeating what everyone else has said, more public education, as well as advocacy, would be a great deal of help in reducing prejudices and helping the mentally ill obtain better treatment. It's a no-brainer, really, if you'll pardon the awful, awful pun...

G'night!
Mel
 

sister-ray

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It has always puzzled me as to why people with mental health problems are seperated from everyone else, we have to go to "pyschriatrict " hospitals, or mental health resource centres where all "our" people are based, these places are very often seperate from ordainary hospitals, clinics and social work departments, this just reinforces the stigma, no wonder people see mental illnesses as different, even dangerous sometimes, because we are isolated and seperate from other places where people get treated for their illnesses, we should be seen in ordainary hospitals and then people might understand that mental illness is a illness like any other.
 

comfortzone

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Hi Eyes,

It is unfortunate the way that mental health issues are dealt with in so many ways. During my training it was repeatedly pointed out that a person is not the disorder instead a person WITH a disorder. I am an advocate for better mental health treatment, services and such. The saddest part to having a mental illness is the shame/blame game. There should be no shame for experiencing an illness of any kind, medical or mental.

It is important to me to treat all of my clients with dignity, respect and unconditional positive regard.
 

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A family that supports one of its members through the terrifying deterioration of Alzheimer's must be commended. But even Alzheimer's can affect one's behaviour, where there may be mood changes.

The person with Alzheimer's may say things to the family which may seem hurtful or insulting, but if the family understands it is the illness which is speaking and not the person speaking, their relationship may not deteriorate.

People with cancer sometimes find themselves isolated from their friends, because people don't always know the words to say....and so they say nothing, and the person with cancer is alone.

Why do we sometimes have difficulty conversing with people who are gravely ill?
 

comfortzone

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I wonder if it has anything to do with the desire to fix the problem or see the person cured. Knowing a person can't do either leaves them feeling helpless over the problems of others...leading to the need to distance oneself from those individuals who are gravely ill.
 

David Baxter

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Perhaps. I think a lot of it is about fear. People don't want to be reminded of mortality or misfortune because it confronts them with the reality that it could also happen to them or someone they care about.
 

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I just wanted to say that, as some of you said you have never encountered this negative talk at a mental health setting, that it does occur and I have witnessed it many times- I have a job at an agency where people w/ mental ilness go to primarily find a job, reenter employment etc. and workers there are trained and have years of education and experience behind them, and yet, there are many instances when clients are made fun of. Again, I don't know if this is to put light on a situation and make things more bearable, or maybe just to justify a client's behaviour that seems unexplainable or out of the ordinary, or maybe to justify their own uneasiness w/ the situation. But it is not ok, and it hurts me personally, having family members and friends that have mental ilness, and I KNOW that they are regular people like you and I. And they deserve our respect and yet, even when they try to reach out at professional places, are they ridiucled behind their backs b/c of their mental ilness. There is enough stigma out there in society and even though strives have been made and people are becoming more accepting and aware, I find that those that are have some kind of personal connection to someone w/ a mental ilness so that they understand it's just like having a physical ilness. Labels are given, assumptions are made, and the person exists as their ilness, not as a person who happens to have an ilness. Even physicians that I know of look down on things like depression, giving the general attitude that the person is just being lazy, being whiny, and should get their lives together. Their best solution is to stuff patients full with medication. And this is North America.
 

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As one gets older, a fact I rarely admit to {smile} as our contemporaries deal with illness, and as we begin seeing contemporaries die, I find I have an easier time to have a straightforward conversation with a gravely ill friend.

It seems our attitude toward mortality changes, as we learn to deal with the new physical limitations our age places on us. You can see yourself doing it in your mind, but your body won't let you do it!!

workers there are trained and have years of education and experience behind them, and yet, there are many instances when clients are made fun of

Your anecdote reminds me of the days when people with a "wooden leg" were ridiculed and imitated in a demeaning manner and called "gimps". How about moving the furniture when a blind person enters a room...always good for a laugh. How about watching a person in a wheelchair negotiating a rotating door in a store??

Most of these situations have been corrected and people have become sensitive to the disabilities of others so thankfully less of this abuse is seen today.

Perhaps with time, the same will be true for people with mental illness.

Awareness, education, demystification and contact with mental illness will make the difference I would hope.
 

JJ

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Acceptance

We have lived with a mental illness in our family for many years.

All we knew was that our daughter was ill - the mental illness bit didn't come into it at the time. She needed us that was the priority.

However, it was to be some time before we could go 'public' on it for it was to be up to Suzy when that would happen. But happen it did. And latterly it was to be big time.

We are totally upfront about mental illness. - it is a case of just as we all have physical health so we have mental health and for 1 in 4 of us it will become unwell too.

I recall when Suzy told an old acquaintance about her disorder the friends respons was 'I don't know how to deal with you now'. Suzy responded that in fact she was still the same person as she was a few minutes ago - the only difference being that the friend now knew why there were times when Suzy wasn't about (because she would be ill) - so there was no need to change in attitude. IE - you accepted me when I didn't have a label - so accept me with one.

For us - and in particular our daughter - mental illness is only a part of our lives. The point is that it is the emphasis is on 'only a part of'. Suzy is Suzy first and foremeost.

We hope that through The Cairn we can raise awareness and understanding for the challenge that is mental illness.

The Naked Bird Wtcher by Suzy Johnston, ISBN 0954809203
To Walk on Eggshells by Jean Johnston, ISBN 0954809211

www.thecairn.com
 

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I have a friend that is absolutely one of the funniest people on the planet. She is extremely quick and witty, and is almost never at the loss for words. Talking to her is laughing. Sometimes her humor seems biting, or somehow belittling (as she can seem as if she's blowing things off), and at times it may appear that she's poking fun at the situation. But sometimes, laughing is not what is needed.

Once upon a time, during a very difficult time for me, I was sharing some of my thoughts and feelings with her. And everytime I said something, she'd have a come back or a question (that I found patronizing), or it seemed as if I was repeating myself which made me think she was just humoring me and not really listening. To make the long story short, I was annoyed and...well...short. Shortly after we said our goodnights and went on our way. The next day I received a letter from her that humbled me and just about broke my heart.

In that letter, she explained that hearing some things is very difficult for her. While she may seem like she's not a serious person and does not take things to heart, and that it may seem like everything is a joke, the opposite was true. Her humor was/is her way of coping with difficult subjects. Her "lack" of seriousness is intentional to protect self from the (empathetic) pain. She also added that sometimes she truly aches but because she's been fortunate in her life, she simply does not know how to cope with it all and the only way she knows how is to keep things light, and keep laughing. She understood the pain I was dealing with and, in her own way, felt she was helping me. She said that she loved and admired me for the ability and the determination to work through these things, because she didn't think she'd ever be able to do it herself. She also said that no matter what happens, what I choose to do or not do, who I am, she would always love me and wish the best for me, in her own wacky way. She said she hoped, that one day, I can do the same for her.

I read that letter a few times over, very ashamed that I allowed my troubles cloud my judgement this way. I realised that I was selfish in wanting her to feel bad for me, with me (what a horrible thought now). I wanted someone to tell me "poor you" and I missed the "wonderful you" message that she was sending. I cried, because I was angry that I allowed my issues dictate my behaviour and stand in the way of good things. And then I wrote her back: "Thank you for showing me my own behind....I didn't realize I can be so flexible."

Our friendship remained and my issues were addressed as issues, and were not used as crutches. A few weeks later she told me she read the book called "A child called "It"" It took her 2 months to read it (it's a very short book but difficult subject). I asked her what made her select that book. Her answer was: "Because I love you, and now I know better."

So, to end this ramble...it's all a matter of perspective. Sometimes, it is easy to get lost behind our own wishes and desires, but we must be careful not to loose sight that our wishes and desires are ours alone and don't necessarily work for others. A good start of change is usually within self.
 

JJ

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JJ

An open mind tends to be a good mind

I like the sound of your friend Lana.


Don't worry about how long it takes to read a book - we've heard of someone who is still on Chapter 2 of Suzy's after some 6 months - finding the subject matter hard to get to grips with and we know of others who have read the books in one sitting - and even one politician who will remain nameless who has read them at least twice (but then that's politicians for you - says it all really!)

JJ
 

poohbear

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mental health jokers...

Like I said in my very LOOOONG intro., I'm a nursing student. But at night, I work at a Medical University in the staffing pool, so I'm put anywhere there's a shortage. I frequently come in contact with nursing personnel and doctors. I have seen medical personnel joking about a particular patient's condition, many times. But, I can assure you, this is primarily a coping mechanism. Sometimes, these patients are exceptionally demanding, irrational, rude and are frequently violent and sexually inappropriate. Keep in mind, that a "mental patient" may also be a stroke victim, who has cranial swelling, or a patient with some other neurological injury, that is totally unaware of their behavior, or the consequences related. These patients crave attention. Our nurses (nationwide) are so frequently understaffed, they really don't have the extra 30 minutes to spend in a patient's room talking about walking soup cans or voices in the lamp. They are in and out, not necessarily rude, but to-the-point. The nurses I've heard joking do it to cope, but would not compromise care. In fact, I have run into many nurses who could be considered patients themselves. We kow where the patient is coming from-- literally!!--POOHBEAR
 

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