Sign up for alerts

Spring 2010 | Vol 13 No 3

Focus

The courage to “come out”

Social worker confronts stigma in the workplace

By Lesley Young

“I was depressed and went to see a psychiatrist. He told me with such arrogance that what I really needed was to find a job.”

“When I was admitted to an ER for self-cutting, I overheard one nurse comment to another: ‘I know her parents – they’re good people and well off, so she must just be trying to get attention.’”

These are just two of the many comments provided by consumers, whose feedback about stigma and discrimination by health care providers was solicited by CrossCurrents. They don’t come as a surprise to social worker Cheryl Peever, who has witnessed similar situations in health care settings. “People don’t always realize how their language can make others uncomfortable or even create a hostile work environment,” she says. Peever knows, because she herself has experienced mental health and addiction issues. “I would think, If only colleagues knew I was one of ‘those people’ and I turned out well – maybe they would see ‘those people’ in a different light.”

Peever says that working in an acute setting and seeing people at their worst makes it easy to forget that recovery is possible. “Sometimes you lose sight of the success stories,” she says. Peever had battled years of alcohol and cocaine addiction until she was treated for depression and began her recovery, which included going back to school to become a social worker. Peever has now been clean for 18 years and is manager of the Women’s Program at the Centre for Addiction and Mental Health (CAMH) in Toronto.

Working within the health care community, Peever had experienced the stigma of mental illness and addiction first-hand. But even so, she was unprepared for how deep it ran. “Taking clients to appointments in the community showed me that the stigma was not confined to health care. I witnessed it in government offices, banks and community services,” she says. Whenever she casually challenged a negative remark, she was chided for being naïve. “People acted like discrimination was justified,” says Peever. “I was told I was wasting my time, that people don’t want to get better, that they’ve done this to themselves.” But Peever has a different perspective: “To me, those are the people who are naïve, and I would think, ‘If only you knew …’”

After sharing her story with a trusted colleague who was struggling with a family member’s addiction, Peever was encouraged by the colleague to enter CAMH’s Courage to Come Back Awards (now the Transforming Lives Awards), which recognize Ontarians who have overcome mental illness or addiction and use their experience to help others. “I said, ‘Absolutely not,’” says Peever. “I had worked long and hard to get where I was professionally and personally, and the thought of exposing my history to colleagues and strangers was horrifying.” Looking back, Peever says that this is a prime example of how stigma causes people to self-silence.

But when the 2006 awards came around, Peever found the courage “to come out,” as she puts it. When she learned she would be a recipient of the award, her first reaction was fear and dread. “Exposing myself in that way made me the most vulnerable and scared I have ever been,” says Peever. Deep down, she hoped that sharing her personal experience would provoke honest discussion with colleagues. “I wanted to challenge people’s beliefs and present a different picture of who an addict is and what someone with mental illness can achieve.”

“We know how to talk about it in relation to clients, but we don’t know how to discuss it in relation to ourselves. That perpetuates a culture of ‘us’ versus ‘them’ and makes conversations difficult to navigate.”

Some people were clearly supportive. “For that, I will always be grateful,” says Peever. But there were other reactions too. Negative and derogatory remarks. Uncomfortable silence. Furtive support. “Some people would sneak into my office and say they were really proud of me,” says Peever. “But they said they didn’t want to say it in front of anyone else.”

The award announcement struck a chord. Peever received dozens of phone calls from people working in health care who shared their personal stories, who had encountered stigma in the workplace, and who worried about their job security if they disclosed. It was validating and deflating at the same time. “Hearing from colleagues confirmed that I wasn’t just being paranoid or thin-skinned,” says Peever. “But it also revealed that stigma and discrimination are real phenomena felt at all levels of health care organizations.”

Peever theorizes about why colleagues find it so hard to discuss mental health and addiction issues on a personal level. “Historically, it hasn’t been talked about,” she says. “We know how to talk about it in relation to clients, but we don’t know how to discuss it in relation to ourselves. That perpetuates a culture of ‘us’ versus ‘them’ and makes conversations difficult to navigate.”

When Peever hosts workshops about mental health and addiction in the workplace, she tells employers and managers, “Having someone in your workplace with a mental health issue does not reflect on you as a boss. How you respond to it does.” And since one in four people will experience mental health or addiction issues, chances are we all know someone. “Only about three per cent of people are chronically disabled by their illness,” says Peever, “so where are the rest? They are your friends, neighbours and colleagues.”

Thinking in those terms helps us shake the idea that people don’t recover, says Peever. “If you know somebody, it’s harder to discriminate. We should be able to talk about a mental health issue as though it were any other health issue. Talking about it is a rich way to share experiences and deepen understanding.”

Over the years, Peever has received support from colleagues who formed the Unusual Suspects, a group of CAMH employees who have experienced mental health or addiction challenges. “Some people have disclosed, some haven’t, but we are there to support each other,” says Peever. “It helps that there are others dealing with some of the same experiences.”

Peever has seen a noticeable shift in her workplace, where more employees have disclosed and had positive experiences. “If a colleague confides in you, you should feel honoured that they trust you,” says Peever. “It’s incredibly hard to talk about, so having a colleague disclose to you says they respect you.” Ultimately, Peever says that keeping mental health and addiction issues a secret only hinders discussion and dialogue, especially about stigma and discrimination.

At an organizational level, CAMH has made steps towards combating stigma by recruiting employees with mental health or addiction issues through the Employment Works! initiative. In its five year history, it has hired more than 160 people, not including 12 peer support workers. “These recruits often become the most committed employees, who are thankful for the opportunity to demonstrate their skills and abilities,” says Diana Capponi, the initiative’s co-ordinator.

While Peever copes with occasional scrutiny, she generally doesn’t mind her presence being a challenge to the status quo. “My goal is attitude change, but I will settle for behaviour change, even if people are a little less likely to make certain comments around me,” she says. Today, Peever is at peace with her decision to have opened up. “Now, I bring all of myself to work, rather than keeping a large part of who I am hidden. Someday, I hope everyone can do that.”