Friday, October 14, 2011

Psychiatrists Outline Plan to Tackle Stigma and Discrimination in Medicine: New Paper Released at Annual Conference of Canadian Psychiatric Association in Vancouver

An October 13th media release from the Canadian Psychiatric Association:

VANCOUVER, Oct. 13, 2011 /CNW/ - Today the Canadian Psychiatric Association (CPA) made public a paper that outlines how psychiatrists can tackle stigma and discrimination in medicine.

"Stigma and discrimination are one of the primary reasons that the one in five Canadians who will experience a mental illness in their lifetime either don't get help or delay getting help until their situation worsens," says Dr. Susan Abbey, author of the paper and member of the CPA Stigma and Discrimination Working Group. "People can recover from mental illness but until we address these issues, efforts to provide better mental health care will continue to be hampered," she adds.

Like their fellow Canadians, physicians, including psychiatrists, have been socialized with the same stigmatizing views towards people with mental illness. "Physicians are a reflection of their society when it comes to stigmatizing attitudes but it's devastating when patients who need help encounter such attitudes," explains Dr. Manon Charbonneau, Chair of the CPA Stigma and Discrimination Working Group. "That's why CPA chose to focus its efforts on tackling this issue in the house of medicine. As physicians and psychiatrists it is our responsibility."

Children and youth and health professionals are the two initial priority areas for the Mental Health Commission of Canada's anti-stigma, anti-discrimination initiative.

The three-prong approach on how physicians can reduce stigma presented by the paper can be summed up in three words, Protest, Educate and Contact. The CPA paper invites all psychiatrists to lead by example and protest stigma and discrimination when they encounter it, use education to counteract it and promote direct contact with people with lived experiences with mental illness.

"We need to protest discrimination at every level from the small injustices we witness in daily practice, in our clinics and hospitals, in our medical schools up to the federal and provincial level," says Dr. Abbey. The lack of funding for mental health is striking. While mental illnesses constitute more than 15 per cent of the disease burden in Canada, in the 2003-2004 fiscal year mental health care received only six per cent of total health funding—below the level in most European and developed countries.

Education is the second key to preventing stigma and making stigma it visible. "It's relatively easy to spot discrimination but it's harder to identify stigmatizing attitudes. Often people don't even realize they have these attitudes," notes Dr. Charbonneau.

The paper proposes education initiatives at many levels including making stigma and discrimination part of the formal medical school curricula, continuing physician education on the issue, talking about stigma with patients and engaging fellow physician organizations to effectively address discriminatory behaviour against psychiatric patients where they seek care—the emergency department, on inpatient medical and surgical wards, in walk-in clinics and when they see their family doctor.

Contact, the third pillar of the strategy, is crucial. "Research tells us that direct contact with people with mental illness who have recovered is a powerful tool that effects lasting change in attitudes," notes Dr. Charbonneau. The paper encourages medical schools to promote and teach direct personal contact with patients, both inside and outside the clinical context. It also advocates patients, as experts in their own care, be actively involved in their diagnosis and treatment and that patient advice be sought when new treatment and clinical structures are being planned.

"Tackling stigma and discrimination towards people with mental illness is the key to better mental healthcare. Canadian society and Canada's physician community efforts are in their infancy and much work remains to be done, but it can be done," says Dr. Charbonneau.

Read the position paper online:

The Canadian Psychiatric Association is the national voice for Canada's 4,100 psychiatrists and more than 600 psychiatric residents. Founded in 1951, the CPA is dedicated to promoting an environment that fosters excellence in the provision of clinical care, education and research.

For further information:

Helene Cote
Bold emphasis is mine.

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