Mental Health Care and Stigma in Canada

Question 1

disparities in mental health care

Answer 1

• gender/sex
• race/ethnicity
• income/SES

Question 2

public expenditure on mental health in Canada

Answer 2

• about 7% of health care budget in Canada is spent on m.h.
• lowest proportion of funds among G7 nations
• what does this indicate ?
• majority of the 7% is spent on meds and in-patient treatment

Question 3

is mental health usually covered on insurance?

Answer 3

no, if yes, not at a lot

Question 4

mental health care providers

Answer 4

1. clinical psychologist
2. counseling psychologist
3. school psychologist
4. psychiatrists
5. social worker
6. marriage/family therapist
7. psychiatric nurse
8. guidance counsellor
9. occupational therapist
10. community health worker
11. family doctors

Question 5

where is mental health care provided

Answer 5

• health care
• specialist
• social services
• education

Question 6

who is receiving care ?

Answer 6

• ## lowest income bracket are more likely to report unmet/partially met needs

Question 7

barriers to seeking mental health care

Answer 7

1. fear of being labelled
2. public perception (stereotypes, prejudice, discrimination)

Question 8

forms of stigma

Answer 8

1. self-stigma
   - individuals internalize beliefs about their group
2. social stigma
   - societal negative belief about group
   - community endorses these beliefs
3. structural stigma
   - rules, police, procedures, practices restricting rights to opportunity of people living with mental health conditions

Question 9

harmful effects of stigma: self and social stigma

Answer 9

1. lower self-esteem
2. lower treatment seeking
3. lower opportunities for work, school, etc.
4. more psychiatric problems
5. reduced hope
6. social isolation

Question 10

harmful effects of stigma: structural stigma

Answer 10

1. inequitable distributions of resources
   - underfunding care + research
2. undertreatment and denial of services
   - diagnostic overshadowing
   - triage/prioritize physical health over mental health
3. fragmented, non-coordinated care
4. lower quality of care
   - negative attitudes among providers
   - adverse healthcare interactions
   - overuse of coercive practices

Question 11

decreasing social and self-stigma

Answer 11

1. advocate for parity
2. be aware + examine own attitudes + behaviours
3. change attitudes + practices of care providers
4. choose words carefully
5. counter myths about conditions + treatments
6. expand access to treatment
7. foster inclusion
8. holistic approach
9. increase m.h. literacy
10. offer support
11. strengthen integration + coordination of care
12. talk openly about m.h.

Question 12

research: practice gap

Answer 12

• gap in transferring or translating research into practice
• on average, takes 17 years to move evidence into practice
• basic research - efficacy research - effectiveness research - routine clinical practice

Question 13

addressing the research gap

Answer 13

• increase research dissemination
• engage stakeholders in research-practice partnerships
• implementation science (how to get science into the world)
• rethink research designs and study implementations