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Complaints from People with Mental Illnesses.. The Role of Stigma Dorothy Cotton, Ph.D., C. Psych. CACOLE June, 2009.

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Presentation on theme: "Complaints from People with Mental Illnesses.. The Role of Stigma Dorothy Cotton, Ph.D., C. Psych. CACOLE June, 2009."— Presentation transcript:

1 Complaints from People with Mental Illnesses.. The Role of Stigma Dorothy Cotton, Ph.D., C. Psych. CACOLE June, 2009

2 Why complaints from PMI? 20% of the population will experience a mental illness at some point in their lives 20% of the population will experience a mental illness at some point in their lives Estimates suggest that 5-10% of police calls will involved a PMI Estimates suggest that 5-10% of police calls will involved a PMI That means 3.2 MILLION such calls a year That means 3.2 MILLION such calls a year

3 What kinds of occurrences? Apprehensions under the MHA Apprehensions under the MHA Offenses--Primarily minor Offenses--Primarily minor At least as likely to be victims as perpetrators At least as likely to be victims as perpetrators “other??” including social support contacts “other??” including social support contacts Often co-occurring substance problems and homelessness Often co-occurring substance problems and homelessness Often well known to police Often well known to police

4 Why talk about stigma? Perceived as being as debilitating as mental illnesses themselves Perceived as being as debilitating as mental illnesses themselves Priority of the Mental Health Commission of Canada Priority of the Mental Health Commission of Canada

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6 What is stigma ? (the MHCC definition) A social process, experienced or anticipated, characterized by exclusion, rejection, blame or devaluation that results from experience or reasonable anticipation of an adverse social judgment about a person or a group

7 The dictionary definition… A mark of shame, a strain on person’s good reputation A mark of shame, a strain on person’s good reputation Syns: reproach, taint, tarnish, disgrace, infamy, disrepute Syns: reproach, taint, tarnish, disgrace, infamy, disrepute Global devaluation of a person on the basis of some characteristic they possess Global devaluation of a person on the basis of some characteristic they possess Origin: stigmata (brand) designed to expose something unusual and bad about the moral status of the signifier Origin: stigmata (brand) designed to expose something unusual and bad about the moral status of the signifier

8 Stigma’s component parts StereotypesPrejudiceDiscrimination

9 Stereotypes… …beliefs about a social group made in an all or none fashion, characterizing the group as a whole while dismissing individual differences or unique characteristics …beliefs about a social group made in an all or none fashion, characterizing the group as a whole while dismissing individual differences or unique characteristics May be based of an iota of truth—or may be blatantly wrong May be based of an iota of truth—or may be blatantly wrong

10 Prejudice …unreasoning, unjustified, over- generalized and negatively tinged attitudes related to their group membership …unreasoning, unjustified, over- generalized and negatively tinged attitudes related to their group membership …prejudgment …prejudgment

11 Discrimination… Unfair treatment of others or harmful actions toward them based on membership in a certain group Unfair treatment of others or harmful actions toward them based on membership in a certain group Discriminatory practices may be unofficial or officially sanctioned by law or policy Discriminatory practices may be unofficial or officially sanctioned by law or policy

12 For example…women Stereotype: Stereotype: Women are shorter than men Women are shorter than men Women are not as good as men at machinery and technical stuff Women are not as good as men at machinery and technical stuff Women are moody and unpredictable Women are moody and unpredictable Prejudice Prejudice Women are bad drivers—watch out! Women are bad drivers—watch out! Discrimination Discrimination women should not have drivers licenses or be admitted into certain trades and professions women should not have drivers licenses or be admitted into certain trades and professions

13 The three core problems The problem of knowledge (ignorance) The problem of knowledge (ignorance) Things we do not know or think we know about the target group Things we do not know or think we know about the target group The problem of attitudes (prejudice) The problem of attitudes (prejudice) Conclusions we draw and things we think Conclusions we draw and things we think The problem of behaviour (discrimination) The problem of behaviour (discrimination) actions we take and rules we make based on the above actions we take and rules we make based on the above

14 ..what we don’t know…what we think we know… Schizophrenia=split personality Schizophrenia=split personality Depression is not a MI Depression is not a MI <10% of people will experience a MI <10% of people will experience a MI Mentally ill = dangerous Mentally ill = dangerous Mentally ill = irresponsible, incapable Mentally ill = irresponsible, incapable MI is a moral/character flaw MI is a moral/character flaw

15 The problem of attitude.. Concern about social distance Concern about social distance Visceral and emotional reactions to PMI Visceral and emotional reactions to PMI Need for social control Need for social control Attribution of responsibility Attribution of responsibility Justification for discriminatory behaviour Justification for discriminatory behaviour

16 The problem of behaviour/discrimination Conceptualizing stigma as discrimination moved concern from attitudes to behaviour What do we actually DO to people with mental illnesses?

17 The Effects of Stigma.. Generally speaking.. Social isolation and withdrawal Lack of access to services Housing problems Employment problems Self-stigma Decreased optimism and morale Increased levels of depression Decreased participation in therapy Family conflict

18 ..and what does this have to do with the complaints process???

19 Before they ever get to you.. On the one hand… Stigma may be the reason they were involved with the police to start with On the other hand.. PMI may avoid making a complaint for fear of discrimination (“they won’t believe me anyhow”)

20 When they get to you.. Likelihood of denial of mental illness or failure to disclose Likelihood of denial of mental illness or failure to disclose Reacting from previous experience Reacting from previous experience Anticipation of rejection Anticipation of rejection Failure to follow through because of lack of expectations Failure to follow through because of lack of expectations The effects of self stigma The effects of self stigma

21 What assumptions do we bring to the interaction? Mental illness=dangerous Mental illness=dangerous Mental illness=unreliable reporting Mental illness=unreliable reporting Mental illness=limited intellect Mental illness=limited intellect Mental illness=always, everything Mental illness=always, everything Mental Illness=misperceptions Mental Illness=misperceptions

22 As an aside…. Most police have received training in regard to interactions with PMI.. Don’t assume lack of knowledge/skill on their part

23 But… Aside from MHA apprehensions, few police services have specific guidelines or policies around how to deal with situations involving PMI, which makes adjudication of complaints difficult

24 How do these affect our interactions? Social distance (how do I get this guy out of here as quickly as possible???) Social distance (how do I get this guy out of here as quickly as possible???) Second guessing (did you really mean that? Are you sure?) Second guessing (did you really mean that? Are you sure?) Bias: are you sure there was nothing you did to…. Bias: are you sure there was nothing you did to….

25 To do.. Education for intake staff re mental illness Education for intake staff re mental illness User friendly processes User friendly processes Utilizing support persons Utilizing support persons Positive role models and leadership Positive role models and leadership ?Dedicated staff ?Dedicated staff

26 “Mental illness is nothing to be ashamed of, but stigma and bias shame us all” Bill Clinton

27 For more information… About the Mental Health Commission and its work on stigma… About the Mental Health Commission and its work on stigma… www.mentalhealthcommission.ca About interactions between police and people with mental illnesses… About interactions between police and people with mental illnesses…www.pmhl.ca


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