In keeping with this column’s current stigma reduction and stigma awareness focus, I have the privilege of speaking on the subject tomorrow to an audience of clinicians from the Caribbean region.
On the invitation of the Pan American Health Organization/World Health Organization (PAHO/WHO) I will tell a bit of my story and speak on how stigma has impacted me on my journey. This event addresses participants of the online self-learning and tutor-guided virtual course: Understanding Stigma and Strengthening Cognitive Behavioral Interpersonal Skills.
The idea behind the training according to the course material is “to reduce mental health-related stigma and improve clinical and management skills among primary care providers when working with individuals that are experiencing mental health challenges.”
On the initiation of PAHO/WHO adviser, noncommunicable diseases and mental health for T&T and other Caribbean territories, there was a discussion with some of the leads on this training, including the Mental Health Commission of Canada, and I readily agreed to speak as a person with lived experience.
As an advocate, I take opportunity to speak of my journey. Only last Sunday, my partners in advocacy, Garth St Clair and Natasha Nunez, featured an interview with me telling of some of my experiences with stigma and prejudice, among other subjects, at different periods in my life (https://youtu.be/h0HrMhEMhb0).
The hope always is that someone will hear and be helped.
Stigma being one of the main reasons people, diagnosed and undiagnosed with mental disorders, do not access interventions from clinicians or help from family and friends, I believe that speaking out and making my experience as normal as possible could bring people—those ill and those observing and commenting on the issue—to a better understanding and a more compassionate perspective.
People who carry prejudices and who have learned stigmatising attitudes can cause other people deep hurt. I have become pretty resilient to the bigotry but even more aware of how stigma works to hinder people’s response to mental ill health in their life and in the life of others.
Despite my resilience, and in spite of overwhelming support for my story and for my life, I am still unsettled, sometimes waylaid, when someone spews stigmatising verbiage at me or my work. My first reaction is one of defensiveness. I see it and think that person may not be the safest space for me and my work. But I reason quickly that their partiality is not about me.
Realising that people often do not even understand their prejudices and how they stigmatise the mentally ill have taught me something else. I have learned patience and compassion. I practise kindness and remain assertive about my advocacy.
Commonly, I find that people who are willing to speak about everyone’s cancer journey or diabetic pathology always seem to think I talk too much (and too loud) about mental health and illnesses. I have to remind myself prejudice is learned and deep-seated because of people’s upbringing and understanding. We were taught that mental illness is a family shame and a family secret.
People stigmatise so matter-of-fact that you get to thinking they are certain they are right in their view(s). If I think challenging their ideas would help, I do. But sometimes you really just have to leave people to work out stuff for themselves.
Before, I would simply cut people out of my safe circle but I am maturing comfortably with the knowledge that not everyone would come along with my narrative or the appropriate discourse, and that those who come will learn and understand at their own pace.
So many people, and among them primary care providers: doctors, nurses, psychologists and so on, stigmatise the mentally ill. There is so much work to be done.
About the training course:
This course includes the following topics: raising awareness, the impact of stigma, challenging stigma & discrimination, cognitive behavioural interpersonal skills & self-management strategies, problem and strength-based assessment to action planning, common mental health challenges in primary care, depression and anxiety self-assessment questionnaire.
The PAHO Mental Health Unit in partnership with the Mental Health Commission of Canada, developed a modified version of the Understanding Stigma /Cognitive Behavioral skills in-person training for primary healthcare providers.
It targets primary care practitioners from Caribbean countries, including:
• MD general practitioners, specialised nurse practitioners, clinical psychologists and other mental health care providers directly involved in health services user care.
• Those with two or more years of clinical working experience in health care at the primary care level (preferably in mental health services).
• Those interested in enhancing their capacity to understand stigma and implicit biases when treating mental health services user within their Primary Health Care networks.
This course will be delivered via PAHO’s Virtual Campus for Public Health as a blended online self-learning and tutor-guided course. (paho.org)