Hi, guys, and welcome to today’s presentation. My name is Gilles Brideau. I’m a psychotherapist, hypnotist and coach that works and lives in Sudbury Ontario, Canada.
I thought I’d do a little presentation today on stigma, specifically what is it, how does it impact people, and that kind of stuff. One of the reasons I thought about doing that, and I’m going to cover that a little bit in the presentation today, was really about the language that I had heard from patients about their encounters with the medical community, and even people in general. One of the reasons that I have created this channel is to lower stigma overall in this country and globally. A lot of the videos that I put out is hopefully to help people reach out for help. I understand that could be difficult, especially because they face this topic today.
What is stigma, specifically? Well, it’s really kind of a complex idea that involves feelings, attitudes and behaviors. But it really refers to that negative mark that we attach to people that we feel are different than us, or “normal people,” whatever normal is. It’s when we view them as different. Often this different is viewed as undesirable or shameful, and that can result in a lot of negative attitudes from the people around them. Of course, stigma in terms of mental health concerns are actually quite common. It is more the norm that I see, especially within certain populations than not.
Just some quick stats here. One in four Canadians … I put Canadians stats, because I come from Canada and work in Canada. One in four Canadians will experience addition or mental illness in their lifetime. Usually, it’s one out of every ten people per year. I think that those stats are quite low. Most of the stats were gathered when I had my old job for the Center for Addition and Mental Health. The reasons I think that they’re skewed is because this is what has been reported to either physicians, mental health agencies or hospitals. Now, I know a lot of people, especially things like depression, suffer alone and they don’t really report it to anybody. So I think the stats are actually quite low. It’s probably closer to two out of every four people suffer with that, and usually two-thirds of people who need care and desire care don’t receive any care.
Even within our healthcare, which is mostly funded, sometimes access to groups and to therapists is quite limited. I know for my service I know some people contact their employer’s assistance programs, and you do get counseling, but it’s quite limited. It about only three sessions on average in the province of Ontario. So I know a lot of people go without receiving help.
It affects more people than heart disease, cancer, arthritis and diabetes combined. It’s really a prevalent, prevalent problem. It typically costs 32 billion dollars a year, in terms of presenteeism, which is showing up at work but not really being there, not really being present, or absenteeism, which is not showing up to work at all. Lastly, the last stat on my static page, is 20% of Ontario children require help, and only 4% receive help. Now, it is my belief that our children are our future, and if only 4% of our kids are getting help, it’s a really sad statistic about how they’re going to shape our world. We really need to make some changes in terms of how we help people overall.
How does it affect people? Well, I could lead to a lack of access to care, housing, employment. I made a reference here to the use of GOMER language. I was at a pain management workshop locally here, and there was a lot of physicians in the room, and as I’ve mentioned before, I’m not a physician, I’m a therapist. But I’m also a drug and alcohol counselor. The workshop was around new approaches in pain management. So I was quite excited about where the field was going. I found that a lot of doctors are really just kind of upset that they were being put restrictions on for prescribing, especially opiates. But there were a couple doctors that were pretty open-minded in terms of new, innovative strategies in terms of mindfulness, meditation and different ways to look at a pain, not just masking symptomatology and presentation.
There was one doctor who was very forward-thinking in that way, and he really talked about the need to change GOMER language, especially in the ER. He said that word a couple times, GOMER, GOMER, GOMER, and so I lifted my hands. I just kind of went “I’m sorry. I’m not a physician. What does GOMER mean?” This is what he said. “Get out of my ER.” He said it with sadness and shame as a physician. I said “Wow, that’s really offensive language, because that’s every single patient I see, patients with mental health, patients with additions, and patients in pain.” So I knew it was from that point, that was about five or six years ago, that I had to do everything that I could within my power to just kind of raise the profile of stigma. I’ve presented provincially and internationally on best practices in working with people with addictions and mental health issues. But I start every presentation, and I have done that last years with over 100 presentations per year, on talking about stigma and the importance of lowering the stigma rates in our country.
The other thing that happens is that people start believing the negative stereotypes generated by society and the media. People watch shows like Intervention saying … Family members will say, “Man, those addicted people just hurt their families and they never get well.” And they can start to believe that self-stigma that comes with that, so it might lead them to hesitating to get help, because of the high relapse rate that they would see in a program like that one, which can sometimes lead to a tendency to avoid getting help, and a lot more isolation.
The last one is a little bit more around hope. What can we do to end stigma? First, acknowledge the prevalence, especially concurring problems with substance abuse and mental health. Because a lot of people that I work with that have, let’s say, anxiety issues will also self-medicate with either cannabis or alcohol in the hopes of managing their problem so that they don’t have to go see a doctor and take medication. One of the tools that I use is actually just an interactive activity that helps people understand what it’s like to live with additions or mental health issues. We call it the NOT game, which is the Navigational Ontario Treatment. It’s just kind of help people get how frustrating this process is. Almost always when I’ve done that activity, I’ve received great feedback from people about how to do the game and how to promote that in their community. So it’s been really wonderful in that way.
The next point is really just being aware of the labels that we personally use, words like schizophrenic or “he’s bi-polar”. We always forget that there’s a person with. I was told that, actually, by a parent, because I kept on saying the word schizophrenic and she corrected me within a meeting and said “I’m really offended by the language that you used.” I was like of like “Ma’am, I’m not quite sure what I’m saying to offend you. Can you please enlighten me.” She said, “You keep saying the word schizophrenic.” I said “Okay, I’m not exactly sure what’s wrong.” She said, “There’s a person with. Even a psychiatrist doesn’t even acknowledge he’s in the room. He just talks to me about his medication.” He son was 21 years old. She said “He’s a person first. Why do you professionals forget that.” I’ve never forgotten that lesson. So just being aware of the labels that we use.
Speak up to friends, family, colleagues about stigma and the importance of just creating a real open-door kind of concept. Also, being aware of our own attitudes and judgment as it pertains. You know, when somebody doesn’t like you, how long does it take you to know? Hours? Days? It’s usually seconds. Two populations that are really sensitive to this is youth and people with concurrent disorders of mental health and addictions. They know that they struggle with people, so they already start from a guarded position. Just be aware of your own filters going into the game.
Lastly, really adopting a no-wrong-door approach. It’s not saying, “Okay, you have an addiction issue. You need to go here. You have a mental issue. You need go here.” It’s just kind of having an open mind, having open ears and just being present for a person who’s in pain. That’s kind of the key.
I hope that this has been helpful today. Thanks so much for joining me. As usual, I’d love to welcome your comments, thoughts, just about how we can go about changing stigma more on a global scale. I thank you for your time and for your attention today, and with that I wish you a phenomenal day.