The stigma of mental illness is alive and well, and kicking....hard. Recently, an able-functioning client told me that when she tried to seek care for her mental health needs, the resource staff seemed almost afraid of her. It wasn't the first time she had experienced this. And sadly, it wasn't the first time I had heard it. In fact, many years ago, I personally saw the reticence (disdain?) in some of the professionals I met, as I attempted to get my father psychiatric help. That only served to validate the familiar sense of shame, experienced by his family.  Unfortunately, growing up, children living in such circumstances, are very often isolated. Some of this is their need or the parents' demand to hide what goes on behind closed doors. More often it is the pulling away of friends and family members loathe to be connected to mental illness and it's tentacles. Social distancing is a common response to fear. (Corrigan, 2001) but in so doing it becomes it's own self-fulfilling prophesy. 
     In 2013, it was reported by Statistics Canada, that 1 in 6 Canadians had voiced their need for mental health care. Those are the consumers able and willing to participate in the gathering of information. What of those so shamed by the stereo type of the mentally ill, that they have proclaimed the stigma to be worse than mental illness? http://www.mentalhealthcommission.ca/English/initiatives-and-projects/opening-minds?terminitial=39

      As a clinical social worker specializing in the issues particular to adult children raised by a parent with a (un)diagnosed mental illness, I find this particularly painful.  Stigmatizing this community has added multiple layers to the plethora of experienced problems. As it is for any bigotry, stigma is based in ignorance: And while mental illness is not contagious, it appears that ignorance may very well be.
     My Parents Keeper: Adult Children of The Emotionally Ill (a book I highly recommend), written by Eva Marian Brown (1989) offers this honest experience.  In the preface of the book Brown states that she had, originally and consciously, chosen to use the term mentally ill in her title. Her purpose was to help neutralize the stigma. She was advised by the book distributors to change it, so as to make it more presentable to the bookstores. Only professionals, they explained, would be able to accept the term. And the purpose of preaching to the already converted is....?

    I am ashamed to admit that years ago, I, myself, voiced concerns to a family member who openly disclosed his own diagnosis. I suggested he maintain boundaries so as not to scare away social connections. I was well aware of the stigma and it's consequences and clearly recall struggling between saying nothing and possibly having him hurt or adding to the stigma with my own spoken words. That I even thought this, despite years of professional and personal experience, says much.

    How then do we decrease the negative label of mental illness? I am no youngster and it has implicated itself throughout my lifetime. I have knowingly contributed to it, even though I am educated and aware. What needs to happen in order for this stigma to lessen, to not have so much power? Has changed occurred in the years since Brown's book was published? How do we know? What can be observed?

     Familiarity with those who are stereotyped is a beginning. As a proud Canadian, I invite you to review the website of the largest ever, Canadian project undertaken for the purpose of dispelling the stigma of mental illness, entitled Opening Minds. This Ontario initiative, which began in 2009, is multifunctional, aimed at youth, healthcare, the workplace and the media. It encourages and supports projects geared towards greater and more empathic education, connection and discussion on all of these fronts in relation to mental illness and those affected. http://www.mentalhealthcommission.ca/English/initiatives-and-projects/opening-minds?terminitial=39
     Other provinces have joined in and are also assuming strong positions in the anti-stigma campaigns. In fact, in 2012, delegates from 29 countries attended the Canadian Mental Health Commission's conference, Together Against Stigma: Changing How We See Mental Illness. More than 700 delegates came together to help create a new landscape of the image of mental illness.

     Knowledge is key to decreasing the stigma, but it still does not create overnight change. Has there, in fact, been a decrease in the stigma of mental illness? When I opened my practice in 1997, few admitted that there was mental illness in their family. If I hadn't done addiction work as well, I would have had to close up shop. I now have a full practice of survivors who courageously deal with the legacy of growing up with a parent suffering from mental illness. The provincial and federal initiatives would never have come about 25 years ago. In fact, the lack of them enabled the stigma of mental illness to continue.  Resources have become more abundant and information is readily available through advanced technology. Ongoing educational opportunities are available for professionals who are, in general, better prepared and more educated than they were two decades ago. Funding for research into mental illness has also been made available. While not overly generous with their research dollars, the government is allowing for allotment.

     Time has begun to ease some of the nastiness of the label. The mentally ill deserve to be treated with respect and fairness. They deserve to have the same access to healthcare as anyone else and be allowed to live a life where they are welcome and contributing members of society. As that continues to develop we know that the stigma is lessening, tiny bit by tiny bit. 

Linda Kalman, M.A., M.S.W., P.S.W.

July 24, 2015
Montreal, Quebec