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Discussion, Wednesday

On stigma, doctors and mental health

Researcher takes your questions

Globe and Mail Update

Just as lawyers can face a barrage of bottom-feeder jokes, psychiatrists, both in film and real life, have long been seen as doctors of a lesser science, Carolyn Abraham writes in her article on the stigma psychiatrists face within the medical profession.

Even their own physician colleagues can view their patients as difficult and time-consuming, Ms. Abraham writes. The negativity, experts say, is contributing to a national shortage of psychiatrists and shoddy care for mentally ill people.

Heather Stuart, professor of community health and epidemiology at Queen's University, consults for both the Mental Health Commission of Canada and the Canadian Medical Association. Both groups are working to erase the stigma mental illness carries in the health care profession and Prof. Stuart has conducted crucial research on effective strategies.

Over the past decade, the Geneva-based World Psychiatric Association, with 20 member countries, has evaluated about 250 interventions to combat stigma, Prof. Stuart said. They have looked at everything from mass media campaigns to local intervention efforts.

Canada was the site of three pilot projects, she said, in Calgary, Edmonton and Drumheller Alta. Prof. Stuart said they found that factual-based information, such as brochures and posters were much less effective in erasing negative attitudes than personal exposures to people with a mental illness.

Bringing in speakers with mental illness to address health care professionals and in medical schools had a high impact, she said. Also powerful was a play about what it's like to have schizophrenia, performed by people with schizophrenia.

We're please to have Prof. Stuart join us Wednesday at noon ET for a live discussion on psychiatry, stigma and mental health. What would you like to know about her research? What can be done to prevent stigma, in the profession and in general? Send your questions now and join us Wednesday to read Prof. Stuart's answers, which will be posted below.

Prof. Stuart received her PhD in Epidemiology from The University of Calgary. She is an Associate Professor in the Department of Community Health and Epidemiology, and cross appointed to the Department of Psychiatry and the School of Rehabilitation Therapy at Queens University in Kingston, Ont.

Prof. Stuart's main research interests are in the areas of psychiatric epidemiology and community mental health research. She has worked in both hospital and community based mental health treatment systems and with international agencies such as the World Health Organization, the Pan American Health Organization, and the World Psychiatric Association.

Prof. Stuart is co-founder and co-chair of the Scientific Section on Stigma and Mental Disorders for the World Psychiatric Association and the Founding Editor of the International Federation of Psychiatric Epidemiology Bulletin.

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Christine Diemert, globeandmail.com: Thank you Prof. Stuart for joining us today to talk about stigma against people with mental health issues and the doctors who care for them. In your interview with The Globe's Carolyn Abraham you spoke about the forces that shape prejudice being old and powerful. Can you explain that a bit further?

Heather Stuart: Christine: Thank you for the opportunity to share my views with your readers. When I spoke about the forces that shape stigma as being old and powerful I was thinking about the deep historical roots of mental health related stigma and discrimination, and the manner in which stigma and discrimination have pervaded so many aspects of our culture, ranging from the way in which people with mental disorders are portrayed in the mass media to the way in which we consistently fail to find ways to help people with mental disorders and their families obtain the basic things that the rest of us take for granted: safe housing, adequate health and social supports, and social inclusion.

Jung Frau from Switzerland: 'Even their own physician colleagues can view their patients as difficult and time-consuming, Ms. Abraham writes. The negativity, experts say, is contributing to a national shortage of psychiatrists and shoddy care for mentally ill people'.

If this quote is true (and I believe it is accurate), then the problem is not with the patients, it is with the doctors. Difficult?

Perhaps learning to respect the patients is a first step. For example, Dr Marius Romme of The Netherlands, the founder of Intervoice, was accused by a patient of not respecting the reality of her voices. He thought about that, and changed the direction of his work.

Recommend this article? 5 votes

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