Today is Bell Let's Talk Day (#BellLetsTalk). By now, most Canadians are aware of this mental health campaign either through direct or indirect participation and understand the goal is to raise funds, eradicate stigma and increase public education. The key message concerns the importance of openly discussing our mental health in homes, schools and workplaces. The motivation behind this is an effort to work towards decreasing negative stereotypes and discrimination towards those living with a mental illness.
Given the widespread engagement through this campaign, we might think that we are positively changing our attitudes towards mental illness. Bell Let’s Talk advocates, Clara Hughes and Michael Landsberg, have played a pivotal role in helping Canadians make headway with respect to mental health education and awareness by openly sharing their own struggles with mental illness.
However, a 2020 research study conducted by Occupational Therapist, Taylor Riffel and University of Alberta Assistant Professor of Occupational Therapy, Dr. Shu-Ping Chen found that stigma is still widespread among Canadian University healthcare students. More needs to be done to equip healthcare students with a thorough understanding of mental health issues and to prepare healthcare students to provide compassionate care for those living with mental illness in their future professional endeavours. While there have been many different mental health initiatives, there appears to be a fundamental lack of education from elementary school through to post-secondary school. This study highlights how this even applies to healthcare studies, where students who will be working directly with people living with mental illness at some point in their healthcare careers not only lack fundamental education in mental health, but more importantly reveal deep-seated beliefs and attitudes that are stigmatizing and discriminatory.
WHAT IS MENTAL HEALTH STIGMA?
The Mental Health Commission of Canada defines stigma as “... a social process, experienced or anticipated, characterized by exclusion, rejection, blame or devaluation that results from experience or reasonable anticipation of an adverse social judgment about a person or group.”
Stigma of mental illness occurs at three different levels: intrapersonally (self-stigma), interpersonally and structurally.
THOUGHT EXPERIMENT RELATED TO MENTAL HEALTH STIGMAS
Imagine that you have been silently struggling with symptoms of psychosis for the past six months, leading to a hospital admission. You didn’t tell anyone you were struggling with symptoms of psychosis because you felt ashamed. This is an example of intrapersonal stigma (self-stigma).
Imagine that you are a fourth-year university student, applying to law school. You require a supportive letter from your doctor because you were sick as a result of your bipolar disorder and took time off from your studies. Your doctor refuses to write you a letter because he believes it will give you an unfair advantage. This is an example of interpersonal stigma because your doctor is speaking and acting in discriminatory ways.
Imagine that your depression has been becoming increasingly more severe, leading you to attempt suicide. You are treated differently when you are in the hospital ER because your presenting concern is mental health-related rather than physical health-related. This is an example of structural stigma.WHY IS THIS RELEVANT NOW MORE THAN EVER?
In their interactions with healthcare professionals, many people with mental illness report feeling “devalued, dismissed and dehumanized”. Patients diagnosed with mental illness have reported that the negative attitudes of healthcare professionals has adversely impacted the quality of care they have received, their recovery journey and their willingness to remain in treatment programs.
WHAT DID THE RESEARCHERS DO?
The researchers conducted semi-structured interviews with 18 Canadian University healthcare students. Disciplines included were: Dental Hygiene/Surgery, Dietetics/Nutrition, Medicine, Nursing, Occupational Therapy, Pharmacy, Physical Therapy, Psychology and Speech-Language Pathology. Half (9/18) of participants reported themselves having either diagnosed or undiagnosed mental health concerns. The researchers asked the participants about their knowledge, attitudes and behavioural responses toward those with mental illness.
WHAT DID THE RESEARCHERS LEARN FROM INTERVIEWING POST-SECONDARY STUDENTS IN HEALTHCARE?
Through their research, the researchers learned that:
Although all of the participants reported that they would feel comfortable disclosing a mental health issue to family members, friends or a professional, the majority stated that they would not disclose a hypothetical mental health issue in a work or school setting.
Several participants shared that they would be comfortable around those with less severe and more familiar mental illnesses like depression and anxiety, but not more serious ones.
Participants expressed the view that mental illness is more permanent, long-lasting and stigmatizing than physical illnesses, and that they are rooted in curses and religion.
Most participants reported changes in worldview and perception and development of empathy through their experiences.
WHAT IS THE MAIN TAKE-AWAY?
WHAT IS THE MAIN TAKE-AWAY?
The stigma of mental illness is present in many aspects of our lives. This study honed in on a specific population: healthcare students. Healthcare students are our future healthcare professionals. They will be entrusted to care for our most vulnerable, which includes those with mental illness. This is precisely why more formal education is needed. We have come a long way, but we still have a long way to go.
RESOURCES
If you are experiencing a mental health crisis and/or need support, I encourage you to reach out to the following resources:
Kids Help Phone
Phone Number:
1 800-668-6868
Website: https://kidshelpphone.ca/
Canada Suicide Prevention Service
Phone Number:
1 833-456-4566
As someone with lived experience of mental illness, I encourage you to look into the following resources to learn more about mental illness from the perspectives of people living with them.
The Mighty - https://themighty.com/
SickNotWeak - https://www.sicknotweak.com/
REFERENCES
Mental Health Commission of Canada. (n.d.). Structural stigma. Stigma and Discrimination. https://www.mentalhealthcommission.ca/English/structural-stigma
Riffel, T., & Chen, S. (2020). Exploring the knowledge, attitudes, and behavioural responses of healthcare students towards mental illnesses: A qualitative study. International Journal of Environmental Research & Public Health, 17(25), 1-11.
