The views represented herein solely represent the views of the Mental Health Commission of Canada.
Production of this document is made possible through a financial contribution from Health Canada.
We are a non-profit organization funded by the Government of Canada, yet we operate at arm’s length. Formed in 2007, the Commission grew out of a recommendation in the first-ever national report on mental health, Out of the Shadows at Last. This study was prepared by the Standing Senate Committee on Social Affairs, Science, and Technology; Michael Kirby chaired this committee and co-authored the report.
Our mission is two-fold: To change the attitudes of Canadians toward mental health issues and mental illness, and to work with stakeholders to improve mental health services and supports.
We are working with governments, mental health service providers, employers, and researchers, as well as Canadians living with mental illness, their families, and their caregivers, toward our ultimate goal of creating an integrated mental health system that places people living with mental illness at its centre.
We do not provide services – rather, we are a catalyst for action.
The Mental Health Commission of Canada
Mission & Goals
The Mental Health Commission of Canada works toward its goals by focusing on four initiatives and one program. They are:
• Mental Health Strategy for Canada
• At Home/Chez Soi: National Research Project on Mental Illness and Homelessness
• Opening Minds: Anti-stigma/
Anti-discrimination Initiative
• Knowledge Exchange Centre
• Partners for Mental Health
Eight Advisory Committees provide insight and direction to the Commission and its initiatives:
• Family/Caregivers
• Child and Youth
• Science
• First Nations, Inuit and Métis
• Service Systems
• Mental Health and the Law
• Seniors
• Workforce
The Mental Health Commission of Canada
Initiatives, Committees, & Partners
The Commission can only reach its goals by cooperating with partners across Canada;
we are already collaborating with some of Canada’s leading corporations, communities, and health and charitable organizations. We continue to seek new partnerships that bring expertise, innovation, and greater awareness to our initiatives and program.
OPENING MINDS
Changing How We See
Mental Illness
Seven million Canadians
will experience a mental
health problem this year
Mental Health in Canada
One in five Canadians will experience a mental health problem this year.
Chances of having a mental illness in your lifetime in Canada: One in four.
Mental illness touches all of us. If not you, it could be a family member, friend, colleague,
or neighbour.
Many people with
mental illness say it is
harder to live with the
associated stigma than
with the illness itself
The Impact of Stigma
Stigma can lead to:
Inequality in employment, housing, education, and other opportunities the rest of us take for granted.
Loss of friends and family members (the social and support network).
Discrimination which can become internalized, leading
to self-stigma and, in some cases, suicide.
40% of parents say
they would not admit to anyone, not even their doctor, that they had a
child with a mental illness
Youth and Stigma
70% of adults living with a mental illness say the onset occurred before age 18.
Early intervention can make a dramatic difference in the quality of life for a child or youth.
Only one in six children diagnosed with a
mental health problem will get treatment.
Some of the most deeply felt stigma and discrimination
comes from front line
healthcare professionals
Healthcare Professionals and Stigma
Stigma is one of the key barriers preventing people from getting help.
People who seek help for mental health
concerns feel disrespected and discriminated against by front line healthcare professionals.
Canada ranks first in the world in per capita
consumption of psychiatric medication.
Every day, half a
million Canadians are
absent from work for
psychiatric reasons
Workforce and Stigma
One out of every four to five employees is affected by mental health issues every year.
Mental illness costs the Canadian economy
$51 billion in absenteeism, disability claims, and medical services used.
Many workers choose to go untreated rather than risk being labeled as “unreliable,
unproductive, and untrustworthy.”
More than a third of the news stories about
mental health focus on
murder and violent crimes
Media and Stigma
The media has considerable influence on shaping public opinion.
Words have power. They have the power to soothe or hurt, honour or insult, inform or misinform.
Media depictions (movies, television, and
books) have been identified as playing a key
role in perpetuating negative and misinformed
perceptions of mental illness.
There is hope;
recovery is possible
Changing How We See Mental Illness
The Commission’s 10-year anti-stigma / anti-discrimination initiative is designed to change the attitudes and behaviours of Canadians towards those living with mental illness.
Opening Minds is the largest systematic effort ever undertaken in
Canadian history to reduce the stigma and discrimination associated
with mental illness.
Goals
To change the views of Canadians so they treat people with mental illness as full citizens.
To encourage organizations to eliminate discrimination.
To ensure individuals living with mental illness
have equal opportunities in society and life.
Target Groups
Youth: 70% of adults living with a mental illness say the onset occurred before age 18.
Healthcare Professionals:
Many people living with a mental illness feel disrespected and discriminated against by front line healthcare professionals.
Workforce: Countless employees choose to go untreated rather than risk being labelled as unreliable, unproductive, and untrustworthy.
Media: Stereotypes and misconceptions about mental
illness are prevalent in our media.
How
Work closely with the broad mental health community of consumers, stakeholders, and professionals.
Serve as a catalyst, mobilizing and focusing the actions of others to make a real difference in the area of anti-stigma.
Help build a research knowledge base that will
be shared.
Pilot Projects
Media Evaluation
Public Awareness
Pilot Projects
We don’t want to re-invent the wheel; we want to build on successful programs.
Very few anti-stigma programs in Canada have been scientifically evaluated for their effectiveness.
At present there is no best practice for reducing stigma and discrimination. The most promising practice is contact-based, where people with lived experience share their stories and engage program participants in discussion.
A Request For Interest was issued nationally and 250 proposals were received. A panel of national and international experts helped select 40 programs for further review.
Our goal is to identify successful programs and replicate them nationally.
Queen’s University • University of Calgary • University of Toronto • Memorial University • Dalhousie University • King’s College • University of Saskatchewan
• University of British Columbia • University of Alberta • Brandon University • McGill University • Children’s Hospital of Eastern Ontario • IWK Health Centre • B.C. Interior Health Authority • Alberta Health Services • Canadian Mental Health Association • Mood Disorders Society of Canada • Canadian Psychiatric Association
• Canadian Medical Association • College of Family Physicians • Royal College of Physicians and Surgeon • Schizophrenia Society • Central LHIN • Central East LHIN • Government of Ontario • TELUS • Canadian Pacific • North Bay General Hospital • Centre Hospitalier Universitaire • York University • Centre for Building a Culture of Recovery • University Health Network • The Self Help Alliance • The Childrens’s Hospital of Eastern Ontario • Stand Up for Mental Health • Ontario Shores Centre for Mental Health Sciences • Laing House • Mixed Company Theatre
• The Healthy Aboriginal Network • Iris the Dragon • Digby Clare Mental Health
Volunteer Association • Family Service Thames Valley • Workman Arts • Family
Outreach and Response Toronto • Centre for Addiction and Mental Health •
The Dream Team/Houselink • The Provincial Centre of Excellence for Child and
Youth Mental Health • Louis H.Lafontaine Hospital • McElhanney Land Surveys
Our experts began evaluating projects as the first phase of a nation-wide anti-stigma and anti-discrimination strategy.
Best practices are being determined. Tools and resources are being made available on a national scale to other communities and
stakeholders wishing to begin their own anti‐stigma efforts.
A national network is being built and continues to grow...
Pilot Projects
Media Evaluation
Public Awareness
Media Evaluation
A pilot symposium was held at Mount Royal University to educate journalism students about stigma, mental health, and the media.
Experts in media and mental health, as well as individuals who have experienced stigma first-hand, presented at the symposium.
This successful symposium is being replicated at journalism schools across Canada.
A media monitoring evaluation is underway which analyzes the language and tone used by the Canadian media (English and French) in reporting stories about mental health.
A Media Council is being developed to help create guidelines for fair and accurate news coverage about mental illness.
Pilot Projects
Media Evaluation
Public Awareness
Public Awareness Campaigns
A public awareness campaign was launched in the fall of 2009.
An integrated approach was taken, featuring newspaper series in the Globe and Mail and La Presse.
Customized CTV and MuchMusic ads ran accross the country.
Internet micro-sites were developed.
What’s Next?
Central LHIN
Mental Illness and Addictions: Understanding the Impact of Stigma
Information program including contact-based education
Took place February and March, 2010
Program delivered at seven hospital sites to a total of 272 healthcare providers working at Ontario’s Central LHIN health facilities north of Toronto
Pre-tests, post-tests, and three month follow-up tests were completed by workshop participants
Ontario’s Central LHIN Program
AFTER THE PROGRAM
34% increase in participants who believed their workplace was not free of stigma
22% increase in participants stating that their colleagues were not respectful to people with mental illness
These changes were not seen in the control group.
Evaluation Results: Attitudes Changed
AFTER THE PROGRAM
28% increase in participants who would become close friends with a person who has a mental illness
31% increase in participants who would admit to friends they had a mental illness
30% increase in participants who would go to a physician if the physician had been treated for a mental illness
These changes were not seen in the control group.
Evaluation Results: Attitudes Changed
AFTER THE PROGRAM
25% increase in participants who agreed employers should hire people with mental illness
21% increase in participants who agreed public health and early intervention programs are of value
35% increase in participants who agreed healthcare providers’
responsibility to encourage recovery in people with a mental illness These changes were not seen in the control group.
Evaluation Results: Attitudes Changed
AFTER THE PROGRAM
20% increase in participants who agreed healthcare providers should be advocates for people with mental illness
8% increase in participants who would still want to work with a colleague who had a mental illness
40% increase in participants who would admit to their colleagues if they had a mental illness
These changes were not seen in the control group.
Evaluation Results: Attitudes Changed
Four questions did not maintain positive attitude change when participants completed the survey three months after program
Decrease in respondents who agreed employers should hire people with mental illness if they are right person for job
Decrease in those who agreed it is healthcare providers’ responsibility to encourage recovery in people with mental illness
Decrease in those who would admit to colleagues they had a mental illness
Decrease in those agreeing healthcare providers should be advocates for people with mental illness
Three month follow-up to Central LHIN Program
Program showed positive changes when comparing attitudes and knowledge before and after the program
Some of the changes deteriorated at three month follow-up
Need for further training programs such as booster sessions or additional phases of anti-stigma training
Since a gold standard program aiming to reduce stigma in healthcare providers does not exist in Canada, Mental Illness and Addictions:
Understanding the Impact of Stigma is an ideal starting point for a
program which could be revised and refined for national roll-out in the future
Conclusions from program evaluation
Mount Royal Symposium
Education program delivered to approximately 400 journalism, criminal justice, nursing, and social work students during two 2-hour symposiums Statistically significant results showed a decrease in stigmatizing attitudes:
“People with mental illnesses tend to be dangerous and unpredictable.”
Before program: 56.2% disagreed
After program: 84.9% disagreed
“If I was an employer, I would not give someone with a mental illness a job.”
Before program: 70.8% disagreed
After program: 83.7% disagreed
Mount Royal University Symposium
“I would let someone with a mental illness baby‐sit my children.”
Before program: 37.2% disagreed
After program: 21.7% disagreed
“I would make close friends with someone who had a mental illness.”
Before program: 52.1% agreed
After program: 67.7% agreed
“I would not want someone with a mental illness to be a school teacher.”
Before program: 50.0% disagreed
After program: 67.7% disagreed
Mount Royal University Symposium
Alberta Criminal Justice Conference
Education program delivered to approximately 400 police officers, prison guards, court workers, lawyers, etc., at day-long programs in Edmonton and Calgary
Statistically significant results showed a decrease in stigmatizing attitudes:
“People with mental illnesses tend to be dangerous and unpredictable.”
Before program: 62% disagreed
After program: 84% disagreed
“I would not want someone with a mental illness to be a school teacher.”
Before program: 61% disagreed
After program: 72% disagreed
“Most Canadians need to adopt a more tolerant attitude towards people with mental illness.”
Before program: 84% agreed
After program: 95% agreed
Alberta Criminal Justice Conference
Our Research T eam
Bonnie Kirsh: Principal Investigator for the Workforce
An associate professor in the Department of Occupational Science and Occupational Therapy at the University of Toronto, Bonnie’s primary research focuses on community and work integration for persons with mental illnesses.
Another area of research is workplace mental health, including trajectories of persons who experience depression at work and related issues of disability management and return to work.
Terry Krupa: Principal Investigator for the Workforce
Terry is a professor in the School of Rehabilitation Therapy at Queen’s University in Kingston. Her research, teaching, and practice have focused on ensuring the full and meaningful community participation of people who experience mental illness.
Keith Dobson: Principal Investigator for the Workforce
A professor of Clinical Psychology at the University of Calgary, his research interests include psychological models of and treatments for various disorders, particularly depression. In addition, Keith has written about ethical and professional issues in mental health treatment.
Carolyn Dewa: Principal Investigator for Workplace Mental Health Economics
Carolyn is a professor at the University of Toronto in the Department of Psychiatry, as well as the Department of Health Policy, Management and Evaluation. She also heads the Centre for Addiction and Mental Health’s Centre for Research on Employment and Workplace Health, and currently holds a Canadian Institutes of Health Research/Public Health Agency of Canada Applied Public Health Chair.
Scott Patten: Principal Investigator for Healthcare Providers
Also at the University of Calgary, Scott teaches in the Department of Community Health Sciences. The focus of his work is on the longitudinal epidemiology of major depression, with the main goal of integrating epidemiologic estimates of incidence, recurrence, prevalence, episode duration, and mortality into a comprehensive epidemiologic picture. He also has expertise in methodological approaches to the analysis of longitudinal data.
Robert Whitley: Principal Investigator for Mental Illness and Media Project
An assistant professor in the Department of Psychiatry at McGill University and at the Douglas University Mental Health Institute, Rob has a particular interest in recovery from severe mental illness and the role of stigma and religiosity in enhancing or impeding recovery. He is conducting a systematic analysis of media coverage of mental illness in Canada in order to discern whether the media is taking a more positive approach to mental health.
Heather Stuart: Principal Investigator for Youth and Senior Consultant for Opening Minds
Heather’s main research interests are in the areas of psychiatric epidemiology and mental health services. Her main goals have been to undertake applied research that helps policy makers and planners solve day-to-day problems and make evidence-informed decisions. She has worked in both hospital- and community-based mental health treatment systems and on international projects with the World Health Organization, the Pan American Health Organization, and the World Psychiatric Association.
