Moving beyond stigma

Nobody likes to be seen in a negative way. Nobody wants to be labelled “crazy”, “unpredictable”, or “criminal”. Nobody wants to be feared, misunderstood or ignored. Unfortunately, the experience of many people living with mental health issues is just that.

As a mental health social worker in a large Canadian city, I was a member of a multidisciplinary team that assisted people with major mental health issues to live successfully in the community. I witnessed first-hand how discrimination and stigmatization made community integration and recovery difficult for the individuals I was trying to help but, sadly, the stigma of being labelled prevents many people from asking for help. They want to be seen as a whole person, not reduced to a “diagnosis” or seen as a problem.

They blame themselves for the symptoms they are experiencing and do not see that mental illness is a medical condition that can be treated, like diabetes or heart disease. However, the longer it takes for a person to get connected to mental health support, the greater the impact on other areas of their life. Their symptoms may increase and their personal relationships may become strained. They may commit a crime and become involved in the criminal justice system. Furthermore, recovery for a young person who is labelled as a “delinquent” or for anyone who is called “criminal” can be delayed.

The stigma or negative attitudes surrounding mental health can make it very hard for someone to find and maintain a decent place to live or work. Landlords often do not want to rent an apartment to a person who is known to have a mental health issue and employers may be reluctant to hire and give the necessary support to such people. Although this violates the Human Rights Code in Canada, discrimination by landlords and employers is all too common and further complicates securing a safe place to live and finding a meaningful job.*

Often there is an outcry by neighbours when mental health and offender programmes locate or relocate into a community. This may be as a result of belief in the myth

by Joanne Wilson

that if there are people with mental health issues or past criminal convictions in the neighbourhood it will decrease property values or increase crime levels. Neighbourhood businesses can also make people feel unwelcome.

The families of those with mental health problems are also impacted by the negative attitudes, myths and stereotypes of mental illness in society. Stigma can lead those families to feel isolated and alone. They can feel guilty and ashamed of their loved ones, blame themselves for the illness and carry the burden in silence. The mental health system in any jurisdiction can be difficult to understand and navigate but when families are offered education and support they do not feel so alone and can help their loved ones to feel positive and hopeful that there is help available for them.

My work experience has shown me that educating the public and encouraging open discussion regarding mental health can reduce prejudices and discrimination. In Canada one out of five people will have a mental health problem at some time in their life. When people are reminded of this statistic they realize that it can affect anyone regardless of age, race, religion, education and income levels.

In Canada there are many programs funded by the government as well as by some private companies to provide this education. The goal is to eliminate the stigma of mental health and to allow people to talk about it without embarrassment or feelings of awkwardness.

By addressing difficult issues such as these and focusing on both positive experiences and effective treatments, individuals, families and communities can move beyond stigma.

Mental health, social stigma and lack of understanding

There were up to 1.7 million people In Hong Kong, with mental health issues in 2016 according to a study by the Economist Intelligence Unit, which looked at mental health integration in 15 Asian-Pacific territories. 70,000 to 200,000 of them suffered from suffer from more severe forms of the illness.

Research has found that 71% of people in Hong Kong are unwilling to live with mental health sufferers, with a third even willing to end friendships with those diagnosed with mental illness. More than half believe they will be penalized at work for talking about their mental health challenges. 55% have experienced stigma or know someone who experiences stigma.

The number of public sector psychiatrists in Hong Kong per 100,000 people is 4.8 compared to 8.59 for many highincome countries. Patients’ can wait over two years to see a mental health specialist and each appointment lasts on average only 6-8 minutes. 60% of Hong Kong adults do not know where to seek help regarding mental health outside of hospitals. Low-income families are often unable to afford private sector psychiatric consultations which, when unsubsidised, range from about HK$1,000 to over HK$3,000.

The situation got worse this year, with about 12.5% of individuals using the Samaritans’ hotline and email services reporting suicidal thoughts in January and the figure rose to 13.5% by April. The HKFYG 24-hour text platform, Open Up, aimed at 12-29 year-olds, reported an increase of 28% in young people contacting them due to emotional distress.

Read more

• scmp.com/news/hong-kong/health-environment/article/2026822/hong-kong-ranks-7th-mental-health-study-scoring • mind.org.hk/mental-health-in-hong-kong/ • scmp.com/news/hong-kong/health-environment/article/3105943/hong-kong-witnesses-alarming-rise-young-people

In Hong Kong, the Rehabilitation of Offenders Ordinance and the Personal Data (Privacy) Ordinance (among other legislation) seek to strike a balance between the needs of an employer for sufficient information about prospective employees and protecting an individual’s right to privacy. However, it is not always easy to know when an employer can require an employee or candidate to disclose prior convictions, and whether the employee can refuse.

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elegislation.gov.hk/hk/cap297 hsfnotes.com/employment/2018/01/29/hong-kong-disclosure-of-criminal-convictions/ Joanne Wilson (MSW) has worked as a social worker for over 30 years and now divides her time between Canada and Hong Kong.