This week, my focus will be on mental illness. Specifically, the stigma, policies and programs that directly affect those struggling with mental illness. According to the Mayo Clinic, stigma is when “someone views you in a negative way because you have a distinguishing characteristic or personal trait that's thought to be, or actually is, a disadvantage” (n.d.). Negative attitudes and beliefs are common towards those with mental illness. Stigma can lead to discrimination both directly and indirectly leading to poor health outcomes.
Stigma can have harmful effects in various aspects of a person’s life. The following are examples:
Reluctance to seek help or treatment
Lack of understanding by family, friends, co-workers or others
Fewer opportunities for work, school or social activities or trouble finding housing
Bullying
Poor self-esteem
In my practice, I have witnessed stigma firsthand. There is often a stigma associated with the diagnosis of Borderline Personality Disorder (BPD). Borderline Personality Disorder impacts the way you think and feel about yourself and others thus affecting your day-to-day life. The disorder is characterized by unstable mood, impulsive behaviours (self-harm included), as well as unstable interpersonal relationships (Paris, 2019). The National Alliance on Mental Illness discusses the stigma associated with BPD. Studies show that mental health professionals have more “stigmatizing views about BPD than any other mental health condition: As some choose to limit the amount of BPD patients they’re “willing” to see or refuse to treat people with BPD altogether (National Alliance on Mental Illness, n.d.). Often these individuals are labelled as treatment-resistant. They are then told to seek services elsewhere resulting in feelings of both helplessness and hopelessness. A concern is that BPD is associated with both self-harm and suicidal behaviour. As many as 10% of individuals with BPD die by means of suicide.
Accessing services for mental illness in Canada can be challenging. In 2017, the Government of Canada invested $5 billion dollars into mental health services. Even with the additional funding, barriers remained. These barriers include long wait times, shortage of mental health professionals, cultural and language barriers and stigma (Moroz et al., 2020). It is important to note that private insurance covers very little. Typically, an individual can receive 2-8 sessions through the employee assistance program. It is believed that Canadians spend “$950 million annually on private practice psychotherapists for mental illness, and 30% of Canadians pay out of pocket for these services” (Moroz et al., 2020, paras. 4-5)
There are many reasons that a person develops a mental illness. Risk factors include genetic predisposition, biological factors, trauma, cultural influences, poverty and other barriers to accessing services (Canadian Mental Health Association, n.d.). Mental illness is often a bi-product of social determinants of health. The World Health Organization (n.d.) defines the social determinants of health (SDoH) as the “non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life”. Regardless of the reason for someone developing mental illness, it is just another health problem. Much like a broken arm, diabetes and high blood pressure. So why is mental illness looked at differently? Why is there stigma associated with it and how do we address the stigma?
References
Centre for Addiction and Mental Health. (n.d.). Mental illness and addiction: Facts and statistics. CAMH. Retrieved February 22, 2022, from https://www.camh.ca/en/Driving-Change/The-Crisis-is-Real/Mental-Health-Statistics
Mayo Clinic. (n.d.). Mental health: Overcoming the stigma of mental illness. Mayo Clinic. Retrieved March 20, 2022, from https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health/art-20046477
Moroz, N., Moroz, I., & D’Angelo, M. (2020). Mental health services in canada: Barriers and cost-effective solutions to increase access. Healthcare Management Forum, 33(6), 282–287. Retrieved March 20, 2022, from https://doi.org/10.1177/0840470420933911
National Alliance on Mental Illness. (n.d.). The stigma associated with borderline personality disorder. Retrieved March 20, 2022, from https://www.nami.org/Blogs/NAMI-Blog/June-2017/The-Stigma-Associated-with-Borderline-Personality
Paris, J. (2019). Suicidality in borderline personality disorder. Medicina, 55(6), 223. Retrieved March 20, 2022, from https://doi.org/10.3390/medicina55060223
The Centre for Addiction and Mental Health. (n.d.). Addressing stigma. CAMH. Retrieved March 20, 2022, from https://www.camh.ca/en/driving-change/addressing-stigma
World Health Organization. (n.d.). Constitution. Retrieved February 5, 2022, from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
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