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Complaints from People with Mental Illnesses.. The Role of Stigma Dorothy Cotton, Ph.D., C. Psych. CACOLE June, 2009 Why complaints from PMI? 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 That means 3.2 MILLION such calls a year What kinds of occurrences? Apprehensions under the MHA Offenses--Primarily minor At least as likely to be victims as perpetrators “other??” including social support contacts Often co-occurring substance problems and homelessness Often well known to police Why talk about stigma? Perceived as being as debilitating as mental illnesses themselves Priority of the Mental Health Commission of Canada 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 The dictionary definition… A mark of shame, a strain on person’s good reputation Syns: reproach, taint, tarnish, disgrace, infamy, disrepute 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 Stigma’s component parts Stereotypes Prejudice Discrimination 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 May be based of an iota of truth—or may be blatantly wrong Prejudice …unreasoning, unjustified, overgeneralized and negatively tinged attitudes related to their group membership …prejudgment Discrimination… 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 For example…women Stereotype: Prejudice Women are shorter than men Women are not as good as men at machinery and technical stuff Women are moody and unpredictable Women are bad drivers—watch out! Discrimination women should not have drivers licenses or be admitted into certain trades and professions The three core problems The problem of knowledge (ignorance) The problem of attitudes (prejudice) Things we do not know or think we know about the target group Conclusions we draw and things we think The problem of behaviour (discrimination) actions we take and rules we make based on the above ..what we don’t know…what we think we know… Schizophrenia=split personality Depression is not a MI <10% of people will experience a MI Mentally ill = dangerous Mentally ill = irresponsible, incapable MI is a moral/character flaw The problem of attitude.. Concern about social distance Visceral and emotional reactions to PMI Need for social control Attribution of responsibility Justification for discriminatory behaviour 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? 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 ..and what does this have to do with the complaints process??? 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”) When they get to you.. Likelihood of denial of mental illness or failure to disclose Reacting from previous experience Anticipation of rejection Failure to follow through because of lack of expectations The effects of self stigma What assumptions do we bring to the interaction? Mental Mental Mental Mental Mental illness=dangerous illness=unreliable reporting illness=limited intellect illness=always, everything Illness=misperceptions As an aside…. Most police have received training in regard to interactions with PMI.. Don’t assume lack of knowledge/skill on their part 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 How do these affect our interactions? 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?) Bias: are you sure there was nothing you did to…. To do.. Education for intake staff re mental illness User friendly processes Utilizing support persons Positive role models and leadership ?Dedicated staff “Mental illness is nothing to be ashamed of, but stigma and bias shame us all” Bill Clinton For more information… About the Mental Health Commission and its work on stigma… www.mentalhealthcommission.ca About interactions between police and people with mental illnesses… www.pmhl.ca