Understanding and Reducing Social Stigma

Stigma

• Stigma involves negative attitudes, which can include prejudice, combined with discriminatory responses.
• Thinking poorly of a person because of who they are is considered stigma
• Stigma can cause individuals to feel unwanted and ashamed, potentially preventing them from seeking help.

How to Reduce Stigma

• Show everyone respect.
• Act caring and warm without being judgemental
• When encountered, challenge stigma
• Use language carefully
• Learn the facts about mental health and mental illness
• Increase mental health knowledge

Non-Stigmatizing Language

• Using neutral and medically accurate language is important when discussing substance use.
• "People first" terminology is advised
• Instead of "drug user," say "person who uses drugs" or "person with lived/living experience."
• Instead of "drug abuser / addict," say "higher risk substance/drug use" or "person with a substance use disorder."
• Instead of "drug habit," say "regular substance use."
• Instead of "addicted to...," say "has a... substance use disorder."
• Instead of "former / ex-addict," say "person in recovery."
• Instead of "suffering from an addiction," say "person living with an addiction."
• Instead of "stayed sober / clean," say "maintained recovery."
• Instead of "drug offender," say "person arrested for a drug violation."
• Instead of "non-compliant," say "chooses not to at this point."
• Adapted from Health Canada (2018)

Common vs. Person-First Language

• Avoid outdated and potentially offensive terms when discussing mental health.
• Instead of "mental health disorders," use "mental health issues, conditions, or illnesses."
• Instead of "individuals 'struggling' or 'suffering from'" or "having a mental illness," say "individuals living with mental illnesses" or "mental health condition or issue."
• Instead of "committed suicide" or "suicided," say "died by suicide."
• Instead of "successful / unsuccessful suicide," say "attempted suicide."
• Instead of "mental illnesses," use "a mental illness" and specify the disorder rather than generalizing.
• Instead of "mentally ill person," say "someone who has a mental illness."
• Instead of "someone who is bipolar," say "someone who is living with bipolar disorder."
• Instead of "patient / client," say "people with lived experience" or "individuals we serve."
• Instead of "addict / substance abuser," say "he/she has a substance use condition" or "he/she has lived experience of substance use."

Media Influence & Negative Attitudes

• News stories frequently sensationalize violent acts
• Strong correlation with misconceptions and fears.
• Stereotypes, denial of housing, health insurance, and jobs are consequences of negative public perceptions.
• Negative views about suicide lead to shame
• Can cause unwillingness to help

Key Facts on Mental Health

• Mental health statistics reveal higher negative trends for members of the 2SLGBTQI+ community, younger individuals, and health care professionals.
• 30% of Canadians identifying as 2SLGBTQI+ have considered suicide in the past year
• A significant proportion, one in four (24%) of working Canadians reports burnout 'most of the time' or 'always'
• Burnout is 38% for health care workers.
• Over half of people, 52%, who deal with Mental Health do not get proper assistance.

Social Determinants of Health

• Income and social status
• Employment and working conditions
• Education and literacy
• Childhood experiences
• Biology and genetic endowment
• Race / Racism
• Gender
• Access to health services
• Social support and coping skills
• Culture
• Healthy behaviours
• Physical environments

Stability for Mental Health

• Food, housing, and economic stability are pivotal for mental health outcomes.
• Canadians experiencing concerns about food and housing insecurity are likely to report severe symptoms of anxiety, depression, and psychological distress.
• Women, younger individuals, racialized Canadians, newcomers, and 2SLGBTQIA+ individuals are disproportionately affected by concerns regarding food and housing insecurity and economic strain.

Role of Nursing

• Nurses are maintaining awareness of health concerns.
• Poverty, shelters, violence are issues to act on.
• Nurses advocate for laws and policies that bring equity. Social justice involves the fair distribution of society's benefits and responsibilities, as well as their related consequences.

Psychiatric Assessment in Nursing

• Establishing rapport is a key goal.
• The problem and concerns should be discussed
• Assess risk factors of environment.
• There must be an MSE (mental status examinination)
• Psychosocial status should be assessed
• Identify mutual goals and care.

Nurse-Patient Relationship

• A base for treatment approaches.
• The nurse must remain safe, confidential, realiable and consistent
• Boundaries must be clear

Nurse-Client Relationship

• The nurse client relation is based on trust
• Focus on respect, professional intimacy, empathy, and power

Therapeutic Relationships

• Therapeutic relationships must hold the patients best interest.
• The nurse patient relationship is important.
• Use caring behaviors and skills to benefit outcomes.

Mental Health Laws in Ontario

• Three main acts fall under health laws
• The Health Care Consent Act deals with rules for those consenting
• Substitute Decisions Act relates to decsions that can be made for a person

Ontario Mental Health Act

• Deals with inpatient issues
• Regulates the involuntary admission into a mental health facility
• Protects the person in hospital as a patient

Canadian Mental Health Legislation

• Mental Health Act of (MHA) is used
• MHA provided frameowkr for rules and procedures.
• There are powers set that need to be adhered to.

Hospitalization reasons

Reasons may be due to:

• Unsafe patient
• Lost will to live
• Increased self-harm behaviors or made a suicidal attempt
• Failed trails of medication
• Symptoms of psychosis

Civil Committal

• Voluntary admission is when Patient comes through ER.
• General Physician, Psychiatrist, Out- patient
• Court order may be needed
• Involuntary admission.

Criminal Commitall

• Involves forensics
• Person not responsible due to mental disorder.
• Order by Criminal Code

Not Criminally Responsible

• If someone is not responsible criminally they are treated in forensics
• It would not occur in a prison

Voluntary Admssion

• Patients seek help in a condition
• Clients need to be free to leave facility.

Form 1 of MHA

• Assessed by physician over 7 days
• Completed by ER physician
• Valid for 72 hours
• Form needs to be an original copy for patient.

Rights

• Must be informed if place on Form 3 or Form 4
• Patient can decline treatment.
• Patient has right to the Consnt Capacity Board (CCB)

Form33

• A document given to patient notifying them that they have been deemed not mentally capable to consent to treatment
• Clients needs assessed for capacity to manage finances.

Treatment Method

• In-depth assessment on patient
• May require Medication, Electroconvulsive Therapy (ECT), OR
• May need social network of support
• Connections to new community resources

Community Treatment Orders

• Person has a plan in place that is best for supervision
• Used when client requested hospitalization.
• No forced treatment is allowed

Explore the concept of stigma, particularly related to mental health and substance use. Learn how negative attitudes and discrimination impact individuals and discover practical strategies to reduce stigma through respectful language, education, and challenging stereotypes. Understand the importance of using 'people first' terminology.