Few anti-stigma campaigns based on evidence — Stuart

“Mental health is set aside as that other kind of health care we don’t want to talk about.” – Asante Haughton, one of three youth featured in the Ontario Shores produced film “Talk To Someone: You’re Not Alone.”

Queen’s University researcher Dr. Heather Stuart says the majority of anti-stigma campaigns are not evidence based and few are evaluated. In fact, her research suggests that we may even have to retrench and undo the damage some of these past campaigns have created.

That includes discussion of mental disorders as a brain disease. Her research shows that such descriptors actually increase social distance, not close it.

Speaking at the Ontario Hospital Association HealthAchieve on Monday, Stuart says protests over stigma can “backfire,” resulting in greater polarization of the issue. Stigma should be regarded as a “transgenerational problem.”

“You can’t sell social inclusion like you sell soap,” she told the packed conference room.

We’re all part of it, she says, including families and the mentally ill themselves who create a “self-stigma.” That includes self-blame.

Alyshia Jackson, one of three young people featured in the Ontario Shores film, described issues patients had with their own families. “My Mom told me I’d be locked into a padded cell,” she said. Jackson noted that often the patients’ own families don’t visit them in hospital.

Stuart’s research shows that 50 per cent of us would not socialize with a mentally ill colleague. 85-90 per cent would not hire a professional with a mental illness.

“Actions are more important than thoughts or knowledge,” she says.

Stuart says stigma is also very present among providers of mental health services.

Stella Ducklow, one of three young panelists from the Ontario Shores’ film, said that patients start acting differently depending on how they are treated. She said that if they are treated like prisoners, then they start acting like prisoners.

Ducklow and Haughton both said they wanted to be treated as a person, not an illness.

“You never hear a person say I am cancer. I am a person with bi-polar disease,” says Ducklow. “Basic compassion can mean so much.” That includes taking a couple of minutes to talk with a person and make sure they are okay.

Haughton says providers should “listen more, talk less.”

While the film is about creating a space in which we can talk about mental illness, it is clear that stigma leaves many reluctant to do just that.

Polarization of the issue may make some reluctant to talk about it for fear of saying the wrong thing and having the finger pointed at them.

“We know when you are tip toeing around a subject,” says Ducklow.

Stuart says every one of us is part of the problem.

“This is how we have been taught,” the Queen’s University researcher says.

Two of the three young people said they had difficulties accessing mental health supports. Given only one in five youth seek treatment, this is a problem when early intervention is such a key factor. Ontario Shores CEO Karim Mamdani told the audience that 70 per cent of adult mental illness begins before the person turns 18 years of age.

Ducklow says she was lucky to have a mother who advocated for her.

“It’s hard to receive treatment in Canada today,” she says.

Help often lies with peer support.

Ducklow brought the audience to laughter when she said “everybody in roller derby has issues.” She said that engaging in things you love with like-minded people is really helpful.

Stuart says that while traditional education is not effective in addressing stigma, having individuals talk about their own experiences is. The afternoon panel was a prime example of getting it right.

“Contact-based education is about recovery and hope,” she says.

All of us have a role to play, and Stuart suggests the place to start would be for each of us to think about one thing we could do differently.