Opening up about mental illness

October 2010   Comments

It happened 19 years ago, yet the suicide of my best friend still haunts me every October 22. I was the last person to talk to her, and I prided myself upon being a good mental health nurse. Her family and I talked about the tragedy; understandably, they expected me to have all the answers. Her obituary and the chatter at her funeral focused on her heart attack at the young age of 33. There was no mention of the pills she had consumed or of the mental illness that was at the root of it all. 

Recently, two colleagues disclosed to me that they’ve lived with mental health problems for over 20 years. A few days later, one of them checked in with me because she needed reassurance that my feelings toward her had not changed. It’s strange that friends and co-workers will often openly discuss physical ailments, but not mental illness. The fear of being ostracized is alive and well.

I have worked in the area of mental health for most of my 33-year career. In my role with the Mental Health Commission of Canada (MHCC), I now have the opportunity to help change the face of mental illness, to shape the practice of mental health care, and to alter the attitudes toward those who live with mental health issues. How is it, then, that in 2010 I would have this colleague question whether I still see her as a friend?

Recently, I read a Canadian Nurse article in which Jennifer Pyke describes the advances in mental health over the past 45 years. I thought, yes, things have indeed improved in some ways, but in other ways, not so much. The sad reality is that stigma and discrimination toward those living with mental illness still exist, and continue to limit the effectiveness of some of the great medical advances in the field.

The stigma associated with mental illness is often worse than the illness itself. It’s why a parent will not talk about a child who has problems. It’s why so many people do not seek help. It’s one reason that people die.

Nurses and other health-care professionals are not immune to the effects of stigma or to a certain amount of criticism. Unfortunately, discrimination is found on the front lines of health care — in emergency rooms, ICUs and other areas of the system. In fact, people with mental health problems who do go for help say they experience some of the most deeply felt prejudice in these settings.

For this reason, the MHCC’s anti-stigma initiative Opening Minds targets health-care professionals. We are currently evaluating 20 projects across the country. Our goal is to learn which ones deliver the best results in changing attitudes and behaviours. By then sharing this knowledge, we hope to create some real transformation on the ground. One project in Markham, Ont., has had promising results: people living with mental health issues are sharing their stories with front-line hospital workers, discussing the impact of stigma on their recovery, and talking about what helps make a difference. This project is being piloted in six hospitals in British Columbia and Nova Scotia.

I believe part of what causes stigma is the general lack of education among Canadians about mental illness and the people who live with it. Mental Health First Aid Canada is a new MHCC program designed to teach everyday people how to react to someone who might be dealing with a mental health problem or emergency. Over 19,000 have already been trained — not to become therapists, but to be ready to help, just like the thousands who are trained in CPR or physical first aid.

Whenever I talk to someone I’m sitting next to on a plane and I explain where I work, the response is always the same. I hear a story about a sister, a brother, an aunt, a close friend — or something more personal. We all have a story about mental illness, and our stories should be shared. That act will open a door and perhaps encourage some people to get the help they need.

I believe that as nurses, we can start the dialogue and lead the way. I invite you to tell your story to your friends and colleagues.

Louise Bradley, MS, RN, CHE

Louise Bradley, MS, RN, CHE, has an extensive background in Psychiatric Nursing and is the President and CEO of the Mental Health Commission of Canada. The not-for-profit organization has a mandate to help improve the lives of people living with a mental illness in Canada.

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