According to a recent publication by the Canadian Association for Mental Health (CAMH) found here: http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx, 355,00 thousand disability cases in Canada are due to mental health diagnoses and 155,000 full time workers are absent from work due to identified mental health. According to the statistics cited at this link in any given week 500,000 Canadians are unable to work due to mental health. As well, did you know in any given year one in five Canadians will be affected by a major mental health disorder? Mental health is in fact the leading cause of disability in Canada. In spite of these daunting facts, in this same article, in spite of the high prevalence of mental health, only 50% of respondents to another survey would tell friends or coworkers if they were affected by a mental illness, 42% would be uncertain about socializing with someone with a mental health issue, and 64% would be concerned about working with someone with a mental illness. Yet 68% of the same respondents would tell a family member about diagnoses of diabetes and 72% or would discuss a diagnosis of cancer. Additionally, 46% of respondents thought people who say they have a mental health issue are just using it as an excuse for bad behavior. These statistics reflect that there is still a lot of stigma and shame associated with mental illness and this may be preventing some from getting the important support they need.
Mental health stigma is even more amplified in certain cultural groups where independence and competence are associated with maintaining values of rugged individuality and stalwart commitment to independence. In such community’s self-reliance is may even be viewed as a badge of superiority of family, community or group strength. So what is it about mental health that scares so many people from acknowledging mental health as a valid health concern?
Much of the stigma of Mental health has to do with how society-you and I view and understand mental and emotional health as being something inherently different from other physical disease or illness. However, mental health diagnosis advances in understanding brain biology and symptomatology have become highly accurate identifying evidence supporting the biological and genetic foundation or predisposition of mental illness. Environmental stressors, biological states for mental illness in our study of the brain and new brain imaging technology now shows how the brain is functioning when there are symptoms.
One reason the general public does not understand the biological basis of mental health because they do not have access to the equipment that demonstrates mental illness. Single Photon Emission Commuter Tomography (SPECT) can demonstrate the differences in brain function and biology, between the working parts and the parts of the brain that are firing properly, between someone who is experiencing depression and someone who is not. But if we were all to learn that the brains functions and tissue can look different in people suffering mental illness we can begin to then understand that the treatment of mental illness is a physical science and that these diagnoses are rooted in biology, genetics and the complex workings of the human body.
Just like a broken leg or a bad cut we can begin to understand that there is condition or injury present that is causing pain and suffering. This evidence is now becoming increasingly clear to those who investigate. There is no question that a person requires treatment in a situation where they break their arm due to a fall at work. We do not debate if the client has an injury or shudder at the medical descriptions, we treat it. If someone impales themselves on a sharp object and they are bleeding, we do not debate the description of the injury, we stop the bleeding. When there is an immediate need for treatment, we don’t debate this, and we treat it. If someone is in a car accident or is bit by a dog, health practitioners assess and act on the physical damage that is present and we treat the symptoms. These symptoms look different in mental health and they have different terms that may appear like labels to someone new to hearing them. However, there are also clinical terms used to describe an arrangement of complex symptoms and biological processes of mental illness.
It is obvious to most of us that these physical injuries are present and SHOULD be treated because their symptoms are much more recognizable as potentially life. If someone is bleeding out from a massive hemorrhage what do you do? First Aid approaches recommend applying immediate and direct pressure to the wound site to stop the person from bleeding out. In a similar manner mental health practitioners treat mental health conditions on a spectrum of severity and with different treatment approaches with a broad range of prescribed treatments varying in degree and intensity of intervention to deal with symptoms such as anxiety or depression. We somehow downplay and delegitimize the experience of those experiencing emotional and mental disease because we are distanced in a unique way. We often cannot look at those with mental illness in the same way we witness someone who has sustained a physical injury. This is because the physical symptoms and injury are “hidden”. It only becomes apparent when we experience behaviors or thinking that is outside of what you and I consider normal.
As well, we know now that mental health isn’t just rooted in genetics. It’s much more complex than this. According to geneticists environmental impacts can happen at different stages of the lifeline and genetic switches which have an impact on our biology can be affected by environmental switches. There is also mental health that arises from traumatic injury such as war or exposure to violence or physical injury itself. For the past half century social scientists and the medical profession have discovered how environmental traumas and inter-generational traumas are very real and have a measured social effect that is different to quantify. These result in learned and deeply entrenched cognitive, behavioral and emotional impacts that required treatment to achieve or maintain a level of mental health. People who are deeply impact also have different brain scans. We also know that addictions and the chronic use of addictive drugs can damage or affect who sections of the brain and create massive neurological dead spots that don’t function correctly. Advances in neuropsychology and neurochemistry, as well as renewed understanding in how environmental treatment, and even what were considered fringe or alternate therapies are gaining recognition. We are coming full circle and it is now even being shown that cultural therapies can positively change the way unhealthy brains function.
This balanced perspective provides us with an understanding of mental health which contrasts heavily to archaic, outmoded and antiquated explanations of mental health based on myths, superstitions and other harmful abstractions. For example, thinking that someone with schizophrenia is demon-possessed, or that depression and or anxiety were due to personal attributes such as lack of character, moral constitution or conviction. It is also due to these older misguided misconceptions of mental illness that keep stigma alive and may prevent people from getting immediate treatment. These less favorable interpretations have kept individuals under the control of religious institutions for centuries. In a similar manner, pandering to fears of being labelled is tantamount to buying into these older notions of mental illness. It is not the just descriptive language and clinical interpretations that create stigma. It is the underlying intentions and attitudes of superiority that accompany them.
Considering that one in five people in Canada have will experience a serious mental health issue this year we would be remiss not to address the huge problem of stigma which accompanies mental health diagnoses for Canadians. Another societal value which contributes to stigma is our shared meritocratic values which seem to diminish the value of those with mental illness or handicap as being somehow defective and less valuable to society-based on utility.
If we are to reduce stigma associated with mental illness we must also begin to understand that mental health sufferers may at times suffer from the same level of pain and suffering as those we see as having physical injuries. Those with mental illness are suffering painful emotional and cognitive stress and traumatic injuries which are hidden and EQUAL to other diagnosed physical traumas dealt with in other areas of the medical field.
Close to 4000 Canadians commit suicide every year with over 230,000 Ontarians who have seriously contemplated suicide in the last year. This demonstrates that people are somehow “falling through the cracks” in spite of our system’s efforts to remain open and engaging vulnerable clients suffering from mental health. Many are choosing to end their life in order to end their suffering. Sigma presents itself as a significant hurdle in our society. Yet I am encouraged every day. As I walk the streets of London or the London Transit System, I am seeing the beauty of human nature in how everyday people are accommodating and compassionate exhibiting grace and kindness when encountering someone who is exhibiting visible signs of mental illness. It is during these moments that I am most encouraged that we have within ourselves and our communities the capacity to move forward together, to help each other achieve understanding of mental health issues and how they impact our community. Together we can crush the stigma of mental health.