#BellLet’sTalk: Lakehead prof studies mental health stigma

Lakehead University, Mental Health Research Lab, Mental Health research, mental health, Amanda Maranzan, psychology, Bell Lets Talk, stigma“The stigmatized individual is asked to act so as to imply neither that his burden is heavy nor that bearing it has made him different from us; at the same time he must keep himself at that remove from us which assures our painlessly being able to confirm this belief about him.” — Erving Goffman, Stigma: Notes on the Management of Spoiled Identity

Information about mental health is more widely available now than ever before. Many of us have heard the statistic “1 in 5”—as many as one in five Canadians will experience a mental illness at some point in their lifetime. Nevertheless, stigma (negative attitudes, emotions, and behaviours directed at persons with a mental illness) continues to impact people with mental health difficulties and their families. The most common stereotype is that people with a mental illness are dangerous and violent. Other misconceptions include beliefs that people are incompetent, irresponsible, unproductive, and unattractive. Discrimination often takes the form of avoidance and withholding of help or opportunities. Stigma even keeps someone with a mental health difficulty from asking for help.

Reducing stigma through contact

In my lab, we are focused on better understanding and reducing mental illness stigma. Direct contact with a person with lived experience is a powerful way to change attitudes and behaviours, and we recently tested a contact-based anti-stigma initiative developed by the Canadian Mental Health Association Thunder Bay branch in the university classroom. Sixty-nine students attended a presentation about recovery and mental illness, watched a PhotoVoice presentation depicting experiences of recovery, and interacted with one of the PhotoVoice artists. Following the intervention students reported a reduced desire for social distance (a common measure of stigma), less fear/anxiety about people with mental illnesses, and fewer negative beliefs about mental illness.

We then wanted to use a randomized design (a sample of 303 students) to determine if the PhotoVoice presentation, on its own, could reduce mental illness stigma, as it has the potential to easily reach larger audiences. Compared to a control condition, students who watched the online PhotoVoice presentation reported decreased stigma in terms of less desire for social distance, lower fear/anxiety, and fewer beliefs about mental illness being dangerous. Why might contact reduce stigma? One potential mechanism is empathy—a (prosocial) reaction to the observed experience of another person. In our study we found this to be true—students in the PhotoVoice condition experienced greater empathy following the presentation and this empathy explained the decrease in stigma.

Being part of the solution

Amanda Maranzan, Lakehead University, mental health, stigmaCompared to their non-attending peers, university students are twice as likely to report a mental health symptom. Unfortunately many do not access the help they need. Stigma, as well as other factors such as awareness of and availability of services, impact support-seeking. Who do students reach out to when experiencing distress or a mental health difficulty? Research from my lab has shown it is primarily friends and family. In a sample of 335 students, 69% had reached out to a friend and 64% to a family member, compared to 31% who connected with a counsellor and 27% with a family physician.

Many of us will therefore have the opportunity to support someone experiencing a mental health difficulty. What can we do to help? I often hear this question from students in my undergraduate Abnormal Psychology course. My answer, distilled to a few words, is to continue being a good friend: Listen. Empathize. Ask how you can help. Listening without judgement is a great way to show support. Empathizing can convey compassion and understanding. Finally, asking what s/he needs and how you can help can demonstrate that your friend is not alone in this difficult time. Although this distillation provides a very general approach to support, its basic tenant underlies everything else one might do: continue being a good friend. (For readers who want a bit more on this topic, there are great resources online—one excellent example is the Bell Let’s Talk campaign every January).

The cost of stigma

The same advice applies for the general population, outside the school campus. Treatment avoidance and poor adherence to treatment protocols are direct effects of stigma. Despite the availability of evidence-based treatments, a significant number of Canadians do not seek treatment due to the direct effect of stigma. This only prolongs unnecessary suffering and increases the personal burden of mental illness, leaving individuals to not only cope with their illness, but the stigmatization of it, as well. Stigma is linked to low self-esteem, impaired social relationships, a host of discriminatory behaviour, and can keep a person with mental illness from obtaining employment, housing, and other independent living opportunities.

Economically, untreated mental illness and stigma is also linked to rising health care costs, through repeated hospital admissions and lost workplace productivity. Reports estimate this cost to be upwards of $20.7 billion in 2012, projected to grow to $29.1 billion by 2030 in Canada alone.

Anxiety and fear can keep us from asking for help when we need it, and from providing support when someone else needs it. Yet each of us can be better prepared to support others, and to seek support when we need it. Listen. Empathize. Ask how you can help. This is something we can all do to lessen stigma’s burden.

Amanda Maranzan is an Associate Professor in the Department of Psychology at Lakehead University and Research Director for the Northern Ontario Psychology Internship Consortium in Thunder Bay, ON. Her research is focused primarily on mental illness stigma. You can find out more about her research and the Mental Health Research Lab at http://flash.lakeheadu.ca~amaranzan/ or follow her on Twitter: @AmandaMaranzan.    

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