Anecdotes of change are not enough
I recently lost a friend over a suggestion I made that they should seek counselling for their anxious behaviour. I was shocked by their reaction to my suggestion- they expressed that they thought I was out of line to suggest that they should seek help because our conversations often required more support than I was able to give (as a non-professional). Unfortunately, this person, whose friendship I had valued greatly, decided to stop speaking to me as a result.
Upon reflection, I realized that this person often carried a great deal of stigma to conversations about their own mental health. They constantly shunned both subtle and not-so-subtle suggestions in the past that they could benefit from help-seeking. They also expressed a great deal of fear towards the perception that others might have of them when they engaged in help-seeking in other domains. As well, they often expressed that they truly saw no need for help-seeking, inferring or at times outright stating that it was unacceptable behaviour to engage in.
I have always been very open about my own experiences with anxiety and depression, both in times of good and poor mental health, in part in order to combat this sense of shame and stigma that others might feel when they find themselves dealing with states of poor mental health. It is only very recently that anti-stigma campaigns have gained prominence in our society and helped shift the conversation from one of hushed whispers behind closed doors, invoking a sense of shame or embarrassment, to a much more open approach where one can be comfortable and accepting of their and others’ experiences. The efficacy of this anti-stigma movement is profoundly apparent, albeit on an anecdotal level- this friend was the first person I’ve encountered here at McGill who perceived the suggestion of seeking help as shameful. Everyone else I know, truly every single person, has shared their own experiences or asked me for support in their own help-seeking, and have been open to suggestions that they might not be in an optimal state of mental health if I or others have noticed behaviours indicative of anxiety or depression. The level of interpersonal support I’ve encountered has been astounding.
This experience and my subsequent ponderings on the experience of stigma brought back a flood of memories related to an assignment given in SOCI310 (Sociology of Mental Disorder). We were required to evaluate the efficacy of an anti-stigma campaign, and while at that time I was able to find a plethora of anti-stigma campaigns at both a local and national level, none of the campaigns that purported a positive impact had actually measured levels of stigma to support their claim. Neither qualitative nor quantitative approaches were utilized- the claims of success were, for the most part, devoid of any evidence or analysis!
In the field of psychology, stigma is well-established as a valid construct to be measured. For example, the Community attitudes toward the mentally ill (CAMI) scales appeared in 1981, and have been used or cited in over 460 publications (as per a Google Scholar search) since their advent. It appears, however, that the use of these tests is limited to the psychological/clinical domain, as a search of SocIndex, the most comprehensive sociological database (according to McGill’s library website), yields only 4 publications. This lack of cross-discipline use is extremely unfortunate, for the application of these tools would be of great value. These campaigns often receive government funding, grants from non-governmental organizations, and donations from individuals and corporations. Therefore, anything that could be used to strengthen the claim of efficacy could provide powerful motivation for further support.
I hope, in the future, to see such cross-discipline application in order to bolster support for efforts to promote help-seeking. Combatting stigma from all sides will help to further break down societal, institutional, and personal barriers to achieving balanced mental health for everyone. There is nothing to ever be ashamed of in asking for help and actively working on your mental health!!
