Health services providers talk about stigma

Health service providers from across the North Simcoe Muskoka area in northern Ontario came together on April 6 for for an inaugural "CAMH in the Community" event. By using the Ontario Telemedicine Network to "Embrace New Approaches for Reducing Stigma," participants were able to connect from across the area to shear what Dr. David Goldbloom and Tom Regehr had to say about this critically important topic.

CAMH psychiatrist Dr. Goldbloom described how stigma disqualifies a person from full social acceptance and how social inclusion is part of our entitlement. "It is the full entitlement for each of us as a citizen," he said. Stigma is the attitude that people have, and discrimination is the behaviour that is a result. "Evidence shows that attitudes develop in a person by Grade three," said Goldbloom. "Stigmatizing attitudes therefore are seen in children by the time they are 8 years old."

This is why implementing early anti-stigma programs with youth is so critical and why the Mental Health Commission's Opening Minds anti-stigma strategy is focusing on two target groups: children and youth, and health care professionals.

Goldbloom spoke about the adjectives that are used to describe someone with cancer - such as courageous or strong. These are also germane to someone battling a mental illness or a substance use problem, but those adjectives are rarely used in describing people living with these issues. Similarly, sometimes stigma is more about what we don't see than what we do see. For example, if we were to visit a hospital and count the number of get well cards and flowers on the surgical unit, and then compare it to the number found on the psychiatric unit - well, there they scarcely exist. The cards and flowers are signs of hope, connectedness and love. Their absence often reflects the stigma and lack of support experienced by people living with mental health or substance use problems.

Goldbloom shared with the group three ways we as health care providers can all fight stigma and discrimination: through education, through protest when we see discriminatory language or behaviours, and through contact - by getting know people who have substance use or mental health problems. "It's very hard to discriminate against someone when you really get to know them first!" said Goldbloom.

Tom Regehr, founder of CAST Canada, which provides workshops for health care providers, is a trauma survivor who has struggled with addiction, homelessness and mental health issues. He knows very well the stigma people can feel in trying to receive support from health care providers. Regehr spoke about the many unsuccessful times he would reach out for help.

But he also recounted how, during a time of murky recollection, he nonetheless recalls one specific thing very clearly. He made a phone call from a pay phone to a local health agency and told the woman on the other end of the line that he was an alcoholic and needed help. Unlike his past experiences, this time he got help that worked. And it started with compassion at this first point of contact. "The woman on the other end of the line had time for me," said Regehr. "There was no condescension; there was no 'I'm busy.' And I can still hear her words: 'Tom, here's our number. And you can call back anytime you want.'"

Regehr described the impacts of non-verbal communication and how little control we all have over our body language. If we are not aware of all the ways that we communicate with clients, we can say one thing and show another. He encouraged participants to be aware of their own body language in working with clients and said that what had saved him was not a "tool" or "strategy learned in a book," but rather the fact that the people helping him were "present." They were able to check in with their own feelings and were able to be honest and respectful.

Participants at the forum came from a variety of helping backgrounds, including police, corrections, education, health and social work. But one sentiment was shared by all of them, best expressed by one participant when asked what they had learned from the forum: "That compassion and deep listening are a foundation for anyone in the helping field."

CAMH in the Community events are organized by CAMH's Provincial Services staff, part of Policy Education and Health Promotion, as part of its responsibility to provide professional education across the province. Check here for upcoming events.