In Our Own Voice

In the cycle of commentary that follows mass shootings in the United States, calls for increased mental health services nearly always surface. It’s hard to refute the need for supporting those with mental illness, and it’s certainly easier than navigating the politics of gun control. Still, as the New York Times editorialized, less than five percent of gun homicides can be linked to people with diagnosed mental illness.

That prominent voices in contemporary debates can associate mass violence with mental illness demonstrates how much stigma people with mental illness must endure. Unlike other conditions, there’s a sense of blame attached to mental illness. We don’t fault people with arthritis for their pain, yet somehow we believe that people with mental illness could have made different choices to avoid the suffering.

The theme of conscious bias has guided the Schwartz Center Educational Rounds at the MGH Institute this year. To provide compassionate care, health professionals must acknowledge and counteract the assumptions they bring to working with certain patients and clients. As student speakers on a panel about caring for people who are homeless commented, you have to see the individual story behind each person.

This year’s Ann W. Caldwell President’s Lecture: Interprofessional Rounds featured two people with mental illness narrating their personal stories. The “In Our Own Voice” presentation by the National Alliance on Mental Illness took place on Thursday, January 21, 2016 from 5:30 to 7:00 pm at the Simons IMAX Theatre at the New England Aquarium.

Health professionals, like anyone, can’t eliminate the conscious and unconscious biases they harbor toward groups of people. However, Eliza Williamson and Kristin Stiles-Hall showed that, through reflection and discussion, they can become aware of those biases and neutralize them to deliver person-centered care. Their stories generated more questions than the time could accommodate, so I include them here in hopes that Eliza and Kristin can continue the conversation.

Dark Days

  • What could your loved ones have done to help you early on?
  • Do you think there is a way to stop the downward spiral before hitting rock bottom?
  • Drug abuse and suicide have risen dramatically amongst young people. Do you feel that mental illness isn’t recognized enough or diagnosed properly?
  • When you were diagnosed, was it in the primary care setting? If so, did you feel supported or just passed off to another specialty?

Acceptance

  • In what situation have you felt like you needed to withhold or not share information about your mental illness? Do you feel like you can discuss mental health with your primary care provider or other health care providers, why or why not?
  • How have you approached explaining your bipolar/borderline personality disorder diagnosis to your children/niece?
  • Have your family members reached the same level of acceptance that you have?
  • How have your friends helped you? What has been the most significant or important thing friends have done for you?
  • What are some methods of introducing the topic of getting treatment to a loved one with a currently untreated mental illness?
  • How would you approach a friend who may be struggling with mental health but doesn’t want to talk about it?
  • How do you combat self-stigma?
  • How did you decide with who and how much you could be honest and vulnerable?
  • I’ve heard people try to reduce stigma by saying that we all have some amount of mental illness. I’m wondering if you find that view insensitive and not supporting the idea that mental illness is real and needs to be taken seriously.
  • In your expert opinion, do you think there are certain types of mental illnesses that are less stigmatized and more socially accepted (or understood) than others? If yes, why do think this might be?

Treatment

  • I am especially interested in the comment Kristin made about GI health and mental illness. Would it be possible for you to share these resources with us?
  • As future practitioners, what language do you encourage us and the general population retain when talking about mental illness?
  • How do you fight for insurance? How do you get qualified for insurance?
  • How did you find therapists that you trusted and felt comfortable speaking with?
  • What can we as PT’s, OT’s, that are not in the mental health field specifically do when working with patients with mental illness that would be helpful?
  • You both mentioned medicine as a large part of your treatment. Did you initially have resistance towards medication, especially with the stigma some people associate with medication?
  • How often is appropriate for a practitioner to address your mental illness when you are in for a visit that does not specifically have to do with that?
  • Has there been a time when medication has made you feel worse?
  • Has your mental illness ever posed barriers to seeking medical care?

Recovery

  • How long have you both been free from an in-client hospitalization?
  • Did you have a mantra or repeated saying that helped you through periods of severe depressive thoughts?
  • It seems like investing in yourself and treatment is vital. What can we as health care workers do to facilitate or strengthen that process in the patients we work with?
  • Have you participated in peer led recovery groups? If so, are there aspects of these spaces that you have found particularly helpful?
  • How do you feel when people ask you to tell your story? Are you always as comfortable as you were today?

Hope

  • Have any of these talks been given, or are any being planned for high schools to expose adolescents to this de-stigmatization?
  • Kristin: When you had kids did you worry at all about “passing on” your mental illness? Eliza: Have you considered adopting?
Peter Cahn

Role: Associate Provost for Academic Affairs, and Interim Director and Professor in the Center for Interprofessional Studies and Innovation.

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Posted in Interprofessional Education, Schwartz Center Educational Rounds

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