Many people living with mental illness stand against two enemies. First they must find a way to control the often devastating symptoms of their condition, and then they also often endure the whispers, looks, and prejudices that follow.
"Stigma is alive and well and dug in deep with any mention of mental illness," says Brenda C., a woman who preferred not to give her real name. "Lots of lip service is given to talk about it, but the ramifications of 'outing' are enormous in so many aspects of a person's life."
As an example, she says that being diagnosed with depression makes it much harder for a person to acquire life insurance. She also suggested that no one wants to be associated professionally with someone with a mental illness, particularly in organizations or professions like police, military or first responders.
People can work closely with someone and not know they have a mental illness because they don't wear it on their sleeve, she continued. As soon as there is a diagnosis and/or symptoms appear and word gets out, that's where the stigma kicks in and it can't be undone.
"Bosses and co-workers can never 'unknow' that."
She says that her struggles affected her own family members. She requested anonymity partly out of an interest to spare them further public discrimination. She was neither specific about what that discrimination entailed nor what mental health issues she was dealing with.
Brenda did say that it presents challenges throughout every aspect of her life and close relationships are not immune. "It is next to impossible to live with someone who was as dysfunctional as I was and not become depressed."
It's not an uncommon story. When Aretha Greatrix told her friends about her mental illness in university, she says they made an effort to hide another friend's schizophrenia because they didn't know if she'd be strong enough to handle it.
"It's not a weakness," she says. "If anything, if people understood what you have to go through in a day they would probably see how strong you are."
Public awareness and education are key, Brenda insists.
"I'm not discounting the good that has been done and continues to be done in making people aware of mental illness: the signs, symptoms, what to watch for, how to help and so on. All good. The more people who recognize the real deal, the better."
Impact of stigma
There's no doubt that stigma has a major impact on the lives of people living with mental illness, and the effects can be extensive.
David Grauwiler, Alberta director of the Canadian Mental Health Association, says his organization hears from people who are affected by this stigma in relationships with friends and family, when they're seeking employment, and even when they're seeking housing.
"We still see on a weekly basis and hear from people who are impacted based on a diagnosis or their disclosure of and experience with mental illness," he says. "It does create barriers that people who do not disclose don't have any problems with."
The inevitable result is that some people will be reluctant to even acknowledge they're having problems, and may delay seeking treatment and avoid talking about it afterward. Unfortunately, their fears are often justified.
"Sadly, what happens with folks who are courageous enough to speak up about their diagnosis, about their experience of mental illness, are impacted time and time again by the fact they have chosen to talk about it," Grauwiler says. "That's a pretty clear indicator the stigma is still a huge issue."
While the true extent of the stigma is difficult to pin down, some telling statistics are available. A 2008 report by the Canadian Medical Association found Canadians' prevalent attitude about mental illness is somewhat negative.
One-quarter of Canadians say they would be fearful of being around someone who suffers from a serious mental illness, and nearly half think people use mental illness as an excuse for bad behaviour.
Only half of Canadians would tell friends or coworkers they had a family member with mental illness, compared to nearly three-quarters who would disclose a family member's cancer or diabetes.
Nearly half of Canadians say they are unsure if they would socialize with a friend who has mental illness, and more than half say they would be unlikely to enter into a spousal relationship with someone suffering from a mental illness.
Room for improvement
Clearly there is room for improvement, and Grauwiler points to the need for greater investment in early intervention services for those suffering from mental illness, suggesting, "a stitch in time saves nine."
A report commissioned by the previous provincial government, The Gap Analysis, identified that there is relatively little investment in prevention, information provision, and system navigation while there is a high level of investment in hospital beds, clinical care, and the like.
"It suggests really that if we were to do more in prevention, and more in the early years of life, etc., that would create then a reduction of emergency services and the use of the more costly clinical and hospital systems," he says.
If you look at the body of international evidence, Grauwiler says, it becomes evident that those who have access to mental-health services early on are less likely to need further intervention.
"There is growing international evidence that demonstrates promotion, prevention and early intervention will really support the health and wellness of kids," he says. "It provides positive returns on investment of mental health."
School psychologist Thomas Holmes echoes those sentiments. He says the single most important thing to help young people with mental illness is to reduce the stigma, and ensure funding for preventative services comes a close second.
"The stigma is declining, but it's still going to be an obstacle in – everyone, but certainly for children – in getting the help that they need," he says.
He emphasizes it's difficult to overstate the importance of providing services focused on early intervention and prevention of mental illness rather than on treatment when things come to a head.
In the current fiscal culture where governments are always trying to find savings and reduce spending, he says it's crucial those savings don't come from reducing a child's access to mental-health services in schools or elsewhere.
"The brain is where we learn," he says. "It's where everything happens, so if mental health is at risk we're not allowing our kids to be successful."
Start talking
"It's a good time to be talking about mental health," Grauwiler adds.
He points to the success of several recent high-profile campaigns to get people talking about mental illness, like Mental Health Awareness Week and World Suicide Prevention Day, as examples of steps in the right direction that are being taken in this country.
Governments appear to be taking the issue seriously as well. At the federal level, the Canadian Mental Health Commission was created in 2007 with a 10-year mandate, and the 2015 budget includes renewing that mandate for another decade.
At the provincial level, Grauwiler says his organization is currently involved with the bipartisan Mental Health Review, co-chaired by Liberal leader Dr. David Swann and NDP MLA Danielle Larivee, a registered nurse.
Right here in St. Albert, some high-profile speakers will be at the Arden Theatre this Friday, Sept. 25, to help kick-start the conversation in this community.
Kelly Hrudey and his daughter Kaitlin will speak about their experiences – Kaitlin was diagnosed with anxiety and obsessive-compulsive disorder as a teenager, and it continues to have a profound impact on their lives.
In 2013, they came forward publicly with their story, and Kelly said it's been an overwhelmingly positive experience for them.
"She's not ashamed and she speaks beautifully about what she's gone through and it's been really empowering for her," he says.
He says he hopes by talking about it, they can help people living with mental illness to realize there's no shame in that diagnosis. And in the two years they've been talking about it, the response has also been overwhelming from people who have gone through similar trials.
"It's heartwarming because they're sharing their stories with us, but it's also heartbreaking when a family tells us about what their young son or daughter is going through, right in the midst of it," Hrudey says.
Kent Davidson, of the St. Albert Community Foundation, explains this is one of the main reasons the philanthropic group organized Friday's presentation. The event will kick off fundraising for a new youth mental health fund, but more importantly, it is intended to bring these stories out into the open, to shine a light on local resources, and to spur discussion.
"They are often hidden in the shadows. That's what we need to get away from. We need people to get beyond that," he says. "We all need to be more astute and adroit at identifying the symptoms, recognizing them so that those people can get help."
