Wednesday, April 27, 2011

Frontline healthcare providers and the stigma of mental health: A true story

Feature Story By: Jen Jensen

OTTAWA, April 26, 2011 /Canada NewsWire/ - "Life is great today," Constantin says. That's a remarkable statement from someone who has lived with severe depression and anxiety for many years.

Hospitals were something Constantin tried to avoid, because he often experienced stigma from frontline workers who were too clinical and rigid. "It's not an environment that made me want to open up with a complete stranger who didn't seem to care or would look down on me." His tendency to shut down would then get him labelled as non-compliant or uncooperative, worsening an already difficult situation. "I never felt any compassion when I visited emergency rooms," he says.

Constantin recalls one visit to a psychiatric ward. "I couldn't escape the pain and the darkness inside of me. The medication wasn't working, and it had nothing to do with drinking or drugging; the partying had stopped a long time ago. This had everything to do with my mental illness."

With a bungee cord hidden in his shorts, he planned to strangle himself because "the system hadn't helped much in the last decade anyway," he says. But before he got the chance, a nurse entered his room, put her hand on his arm, and said, "Constantin, I can't imagine what pain you're going through, but we're going to work together, and we're going to find a way to help you. You're not alone."

This pivotal moment, a simple but profound act of kindness by a nurse, changed his life.

He says his journey toward recovery was like a puzzle, with pieces falling into place over time. And when he met that one kind nurse in the hospital, he decided to start helping himself get better.

Now well into recovery, Constantin is on a mission to make a difference himself by sharing his story at Ontario's Central Local Health Integration Network's (LHIN) workshops entitled "Mental Health and Addictions: Understanding the Impact of Stigma."

"The Central LHIN's Education Work Group was given a huge task to provide mental health education," says Arla Hamer, who chaired the workshop's Work Group at the time. On a tight deadline and an even tighter budget, her team developed a strategy to focus their efforts. "Intuitively, with all of us being mental health professionals, we recognized that the way to have the greatest impact was to address stigma," Hamer says.

The workshops have since been presented to about 900 health care professionals working in different hospitals and health care sites across the region.

The Mental Health Commission of Canada's Opening Minds initiative is partnering with and conducting evaluations of over 40 similar programs across the country, including the Central LHIN program. Each program is designed to reduce the stigma commonly experienced by many people living with a mental illness. The goal of Opening Minds is to share and promote successful programs across Canada.

Joanna Meeke attended the Central LHIN workshop when it was in Newmarket. A case manager at LOFT/Crosslinks Housing and Support Services, Joanna works with many people who live with a mental illness. Wondering why some are reluctant to seek help from a psychiatrist, she asks "if you fall off the deck, break your leg and experience a lot of pain, you go to the hospital and get a cast, right?"

Workshop participants received information about myths related to mental illness and the role stigma plays as a major barrier to people seeking help. According to the evaluations, the highlight was stories from people like Constantin: personal testimonials from individuals living with a mental illness about the challenges they've faced, the stigma they've experienced, and what has helped them recover. Recovery is often defined as reaching a point when a person with a mental health problem is able to get on with life, just like someone who learns to live with arthritis or diabetes. Similar to a physical illness, recovery is possible.

Many health care workers rarely get insight into recovery once their patients move beyond their mental health crisis. Constantin has a positive impact speaking to the workshop's audience, not only because he shares his personal story, but also because he is mentally healthy enough to stand in front of them and speak.

Because the Central LHIN program has proven to be effective at reducing stigma, Opening Minds is now helping to replicate it in other health regions across the country. In British Columbia, the Interior Health Authority adapted the Central LHIN program to deliver it to health care providers in seven communities last fall. The IWK Health Centre, a major children's hospital in Halifax, Nova Scotia, plans to use the program in the coming months. Another Ontario LHIN is running programs this spring, and plans are underway to take it to healthcare providers in the Northwest Territories as well.

The Mental Health Commission of Canada sees its role as being a catalyst for change. Ontario's Central LHIN is helping make that goal a reality.

About the Mental Health Commission of Canada (MHCC)

The Mental Health Commission of Canada is a catalyst for transformative change. Our mission is to work with stakeholders to change the attitudes of Canadians toward mental health problems and to improve services and support. Our goal is to promote mental health and help people who live with mental health problems lead meaningful and productive lives. The Mental Health Commission of Canada is funded by Health Canada. For more, visit

About Opening Minds, the MHCC's anti-stigma initiative

This year, seven million Canadians will experience a mental health problem. Stigma is a major barrier preventing many people from seeking help. Opening Minds is the MHCC's Anti-Stigma Initiative designed to change the attitudes and behaviours of Canadians towards those living with mental illness. Opening Minds is initially targeting four groups: Health Care Providers, Youth, the Workforce and Media and other Professional Associations. The initiative is currently evaluating anti-stigma programs across Canada to identify which are successful at changing attitudes and behaviours related to mental illnesses. The successful programs will be replicated and promoted elsewhere in the country.