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Mentally ill and ‘out' but not yet embraced
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Mentally ill and ‘out' but not yet embraced
erin anderssen
From Saturday's Globe and Mail
Published Friday, Jan. 13, 2012 5:15PM EST
Last updated Tuesday, Jan. 17, 2012 11:19AM EST
Michael Kimber's blog began about two years ago, as a love letter to the
girl who stuck with him through his lowest days. In Colony of Losers, he writes
how one morning in November, 2009, at the age of 25, he woke up in his Halifax
apartment stricken by anxiety so severe he could hardly get out of bed, how his
parents paid for a therapist when he was put on a six-month waiting list, how
in his wide-ranging search for a cure he tried mood-boosting almonds,
happy-themed YouTube videos, mindful mediation and finally antidepressants.
More related to this story
How the taboo against reporting on
suicide met its end
One-quarter of hospitalized psychiatric patients restrained
Breakdown: an in-depth report on
Canada's mental health crisis
And at the end of all this, he
started writing a blog. On March 28, 2010, he lost his not-dream job as a
“search engine optimizer,” and nearly the girl as well, but the medication had
started to work, and he was sleeping again. This was the day, as he puts it,
when he realized, “No one could save me. I had to save myself.”
By June, he was writing openly about
his experience with anxiety and depression. Today, his irreverent,
expletive-splattered blog is verging on one million hits and, now living in
Toronto and working for a documentary film company, he has signed with a
literary agent.
He also receives 3 a.m. e-mails from
people hoping he will talk them out of committing suicide. Strangers, learning
of his blog, spill their darkest secrets as carelessly as wine at a party – or
throw unsolicited advice in his face. He has even heard from a former teacher
who kept her own bout with mental illness secret for fear of losing her job. He
knows others who haven't told even their own families.
By “coming out,” as Mr. Kimber calls
it, he is daring people to judge, hoping to force understanding through
confession – he is the modern incarnation of the early mental-health advocates
who began coming out themselves in the 1980s, when the closet was crowded. Like
those early voices, storytellers such as Mr. Kimber may be the best hope of
reducing the enduring stigma that people with mental illness are afflicted
with.
Not much else appears to be working.
Stigma is a term bandied around so often that it has taken on the quality of an
incurable disease in its own right.
In 1963, Canadian psychiatrist
Erving Goffman wrote a classic definition of stigma, calling it the “spoiled
identity” that disqualifies an individual from full social acceptance. There
are undeniable issues that develop from a diagnosis of mental illness,
especially when symptoms are acute and untreated: People suffering from
depression and anxiety have, unsurprisingly, higher rates of absenteeism from
work, are more likely to self-medicate with drugs and alcohol. In the manic
stage, people with bipolar disorder often behave erratically, experience
delusions, or make reckless financial decisions. When Vincent Li beheaded a
stranger on a Greyhound bus in Manitoba in 2008, his diagnosis of schizophrenia
– and the media frenzy his gruesome act generated – only heightened a public
fear of people suffering with psychosis.
But part of the tragedy is that the
stigma itself prevents people from seeking out the treatment they need. Yet the
longer treatment is delayed – and the more isolated people feel – the harder
recovery becomes, a problem made worse by growing waiting lists and bed
shortages for psychiatric patients. In Vincent Li's case, for instance, his
ex-wife reportedly refused to get help for him, in part, out of concern about
how he would be treated, and a lack of understanding about his illness.
Studies in Canada and
internationally have shown that attitudes and behaviour toward people suffering
from depression and bipolar disorder, and, especially, schizophrenia, have
barely budged in the past decade.
In some cases, public awareness
efforts may have even entrenched certain misconceptions – stressing the genetic
and biological causes of mental illness has also shored up the false belief
that that it cannot be successfully treated, and that even patients in recovery
cannot be competent employees or reliable tenants. The term “mental illness”
has become a misleading catch-all for a range of complex and very different
illnesses and disorders. And the most pernicious misconception of all shows
little sign of retreat: that the majority of people with mental illness are
prone to violence.
In fact, they are far more likely to
be victims of violence, or a danger to themselves. And while people with
untreated schizophrenia have a higher risk of violence than the population as a
whole, these cases are extremely rare, and crimes against strangers are even
more so.
Facts aside, and even though one in
five Canadians will experience a mental illness, our phobias are firmly
entrenched: In a 2008 national survey commissioned by the Canadian Medical
Association, one in four Canadians said they would be fearful about being
around someone with a serious mental illness. More than half said they would be
unlikely to marry someone (or hire a lawyer, child-care provider or financial
planner, family doctor, or even a landscaper) with a mental illness.
“There is really very little
evidence that there has been a change in the attitudes toward people with
mental illness,” says Ross Norman, a University of Western Ontario psychology
professor who studies the nature of stigma. Research on stigma, in general, has
suggested that it originates from a sense that the individual is personally
responsible for his or her situation – so in the past decade, for instance,
anti-stigma campaigns have stressed the biological and hereditary factors
behind mental illness. Subsequent research shows that while people believed the
science, it didn't do much to change their attitudes, and if anything it shored
up the belief that mental illness was an intractable and unpredictable
condition, that, as Dr. Ross puts it, “there was something wrong with their
brains.”
That's where people like Mr. Kimber,
and other well-spoken, professional people come in, Dr. Ross suggests, by
countering stereotypes and creating positive role models. “It's probably one of
the best ways of making a difference,” he says.
People within Canada's mental-health
community, including patients themselves and family members who had watched
loved ones become lost in the system, began speaking out in the 1980s. Many
went on to play key roles in the organizations that now advocate for better
treatment and funding. Among those early spokespeople was June Conway Beeby, in
Kingston, Ont., who began telling the tragic story of her son who committed
suicide in 1981 after a long history with schizophrenia.
“I wasn't going to hide what
happened to Matthew,” she says. “I wanted people to know that he had a terrible
illness, and how we received very poor treatment, very little treatment at all,
in fact.” Friends and family assumed that her son had been on drugs, that he
was the victim of a deal gone wrong. People stopped talking when she passed by
at work, or they avoided her completely. “I can make sure the world knows what
happened to my precious boy,” she thought, and she began giving speeches and
speaking out in the media. She didn't spare the details: She found her son in
his apartment, lying in a pool of blood with dinner knives plunged through his
eyes where he had pounded them into his brain. “Now you know where my efforts
come from,” she says.
For her, the stigma is slow in
changing – the education campaigns often miss the point.
“Prevention is a mug's game,” she
says. By her reasoning, the surest way to fight stigma is to improve access to
treatment and hospital beds, especially for more severe cases of mental
illness. Every act of violence highlighted in the media, she points out, sets
back any effort to educate the public. “Why wouldn't they feel stigma and
fear?”
Political correctness can teach the
right language, but how deeply does it change attitudes?
For a decades, Andrea Schluter, now
a 47-year-old natural history painter in Vancouver, tried to keep her
depression quiet. A graduate student in wildlife biology, she knew all too well
what her peers in the field thought: “They equated depression with cowardice,
particularly if you were suicidal.”
In the 1990s, she was admitted to
hospital in a manic state, and felt she had to write about it publicly: “I recall
the realization that I had been thrown, violently, into another world,” she
explains. “And I knew, with every cell in my body carrying the genetic set-up
for this sickness of the mind, that I would need to find a way to live in that
world.”
She wrote a then-rare article for
The Globe and Mail's Facts and Arguments page, boldly describing the reactions,
both insulting and carelessly hurtful, of the people around her. “I just
thought, ‘Hang the consequences,' ” she says. “I couldn't believe how unenlightened
people were.”
Her outspoken approach led to a job
speaking about workplace accommodation from a first-person perspective.
She feels any stigma about her
disease less today. Her fierce openness forces people either to accept her or
slip out of her life, she says. But once in a while, she realizes her friends
may not be as enlightened as she hopes. She recalls a conversation at a dinner
party, in which a friend was critical about a new transition house for
psychiatric patients being built nearby: What kind of “mentals” would this
bring to the neighbourhood? Ms. Schluter pointed out that she herself had
stayed in this kind of housing in the past, and, when the woman refused to back
down, she left the party.
“I guess she was so irate, she
wasn't picking up on what I was saying,” she recalls “There were at least eight
other friends in this group sitting around that table. And nobody spoke up.”
Meanwhile, as Mr. Kimber's blog
continues to draw attention, he is using it as a vehicle to urge other people
to share their stories. As he writes, “You have to make the effort to make the
world understand. We don't need any more inspiring stories about instant cures
and celebrities defeating all the obstacles. We need to redefine what a happy
ending is.”
Erin Anderssen is a Globe and Mail
feature writer.
Related Links:
Michael Kimber's blog, Colony of
Losers
A video telling Michael Kimber's
story: The Cure Visual Poem
Another Michael Kimber video: Come
Out, Come Out, Wherever You Are
From ‘evil' to ‘mentally ill' in the
media
Newspaper stories don't toss around
the word “evil” any more to describe people who commit crimes. Instead, as a
McGill researcher has found in analyzing five years of Canadian media coverage,
readers are more likely to see the phrase “mentally ill” linked to a crime
story, especially the most sensational ones.
“In the old days, we would have said
an evil person was on the loose, and now people just say a mentally ill person
is on the loose,” says Robert Whitley, a psychiatrist at the Douglas Mental
Health University Institute. “The moral language has been replaced with this
medical language. Now [people with a mental illness] seem to be a shorthand way
to describe any person or event that is shocking or depraved.”
Dr. Whitley led a team of researchers
who analyzed nearly 9,000 articles from Canadian newspapers, as well as
television news. He says the research, which is yet to be published, found that
only 12 per cent of the stories took an optimistic or positive tone about
mental health. Another 29 per cent used derogatory language to refer to people
with a mental illness; Dr. Whitley cites an editorial on courthouse security,
for instance, that referred to “the mentally ill” as “nasty characters.” Nearly
40 per cent of the print stories related to violence and criminality, and
treatment or recovery was discussed in less than 20 per cent.
But Dr. Whitley says the most
surprising finding was the lack of voices in the stories – both in print and
TV. Three-quarters of the articles did not quote a mental-health expert, and 84
per cent didn't include a comment from a person with a mental illness. “You
wouldn't write an article about hockey without interviewing a player or manager
or Don Cherry,” he observed.
If the media are the main source of
information about mental illness, Dr. Whitley suggests, then current coverage
feeds into many persistent misconceptions.
“There is still a skepticism that
people with mental illness can be rational and good at their jobs and be a good
parent.”
