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Learning English with CBC Listening Lessons for Intermediate Students Based on CBC Manitoba Radio Broadcasts June 3, 2011 Lesson 69: Self Study Edition Level: CLB 6 and up Topic: Talking about Mental Health and Mental Illness Language Skills and Functions: Listening – listening to a short interview for detail Speaking – expressing concern Reading – reading and answering a questionnaire; scanning a poster for detail Writing – making notes Language Competencies: Language Tasks: Vocabulary, Pronunciation, Listening and Speaking Strategies, Socio-cultural/sociolinguistic Competence Answer questions about how different countries approach mental health and mental illness Listen for detail in a radio interview with a young woman who experiences anxiety and panic attacks Answer questions about mental health Calculate your personal stress level by completing a questionnaire about life events Scan a poster about Klinic’s drop-in counselling program and answer detail questions Speak to a friend who seems depressed using language to express concern Essential Skills: Reading text, numeracy, oral communication, writing Appendices: Transcript of the podcast Poster for Klinic Drop-in Counselling Program Answers to Worksheets Manitoba Memo Even though most cultures don’t talk about it easily, mental health is as important as physical health. Good mental health allows people to enjoy their life and cope with life’s ups and downs. Mental illness or mental disorders seriously affect a person’s thoughts, emotions and behaviour. They make functioning in everyday life more difficult or even impossible. Studies show that mental illness is more common than we think. In Canada, twenty percent of the population will experience a mental illness at some point in their lives. The good news is that mental illness is treatable. The vast majority of people with mental illness do get better and resume a normal life. Mental health and mental illness are culturally relative. That means that how we understand perceptions of both are deeply related to our culture. As one expert described it, mental illness is a “…window on a culture’s sources of distress and on the human consequences of such distress.” 1 Not surprising, immigrants and refugees often face multiple layers of cultural distress - in their home country, while migrating and in their new country. Different cultures use different expressions to talk about mental illness and about how it affects how they feel. Culture often dictates what symptoms people see as “normal” or “abnormal” and the kinds of treatment or services which are acceptable to them. Language also plays a role. For example, the word “blue” in English is not only a colour, it is used to describe feelings of sadness or depression. Other languages also have many different words for depression. There are many different cultural beliefs about mental illness. For example, some cultures believe: it is caused by the evil eye, by a curse or by supernatural forces; certain mental disorders, like schizophrenia, give people special powers or insight; it brings shame and disgrace to the family; those who suffer from mental illness should be isolated and left alone; some forms of treatment are more acceptable than others, for example, counselling may be acceptable but there may be stigma attached to seeing a psychiatrist; it is caused by certain foods, or by an imbalance of mind and body (yin and yang); it should never be discussed – the topic is strictly taboo; mental distress is expressed through physical symptoms and if you cure the body, you’ll cure the mind. Cultural differences in the perception and treatment of mental illness sometimes collide with the Western World’s medical model. As a result, symptoms may be missed and treatments may be less effective. The Canadian Mental Health Association, Immigrant and Refugee Organizations and mental health care providers have been working hard to adapt information and treatment in mental health so that cultural differences are taken into account. Talking about mental health and understanding why mental health is important is the first step. 1 Kleinman, A. & Coven, A. “Psychiatry’s Global Challenge.” Scientific American, 276(3), 86-89. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 2 of 20 Background 1. How would you answer the following questions? In your country, do people talk openly about mental health and mental illness? Or is the topic taboo, something that people avoid discussing or try to hide from others? How are people with mental illness treated in your country? Are they ever stigmatized or isolated? How is mental illness identified? What kind of help is available? Are there self-help groups or organizations? Counsellors? Psychiatrists? Are services easy to find? Is medication routinely prescribed? When immigrants first arrive in Canada, studies have shown that they have fewer mental health problems than the average Canadian. But over time, they experience a level of mental health problems similar to other Canadians. What do you think are some of the factors which affect the mental health of immigrants after they arrive? If you were to share one piece of advice on how best to talk with or treat someone from your own culture who is facing a mental health issue, what advice would you give? 2. Vocabulary definitions Here are some words you need to know to understand the CBC interview. physical health If your physical health is good, it means your body is healthy. You are not ill or unwell. mental health If your mental health is good, it means your mind is healthy. You are able to cope with life’s ups and downs. You do not suffer from mental illness. the Canadian Mental Health Association (CMHA) The CMHA is a charitable organization which promotes mental health and supports people who are experiencing mental illness. to break a taboo When something is described as “taboo”, people avoid talking about it or doing it because they are worried it could seem embarrassing or offensive. A taboo is broken when people decide to talk about the topic or take part in an activity they used to avoid. to submit something If you submit something you have written, you hand it in or to send it to someone. For example: Martin submitted the article he wrote on cross cultural issues to the editor of the school paper and to an online Journal. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 3 of 20 to be anxious/to have anxiety When someone is anxious or experiencing feelings of anxiety, they are worried or nervous about something. a panic attack A panic attack happens when someone is experiencing severe anxiety. They may have physical symptoms like shortness of breath and they may not be able to think or act sensibly during the attack. to feel tension Tension is a nervous, worried feeling which makes it difficult or impossible for your body to relax. For example, you may get a tension headache and your muscles may become very tight. symptoms Symptoms are things that are wrong with your body or mind. They are signs which may indicate an illness. to wrap your head around This is an idiom which means you are trying to understand something or figure out the reasons why something happened. For example: Sam tried to wrap her head around her new schedule so she could figure out where to find her first class. She had never seen a schedule as complicated as this one before. to be normal When something is normal, it’s usual or expected. In psychological terms, normal also means that you have a sound, healthy mind. to be super down This slang expression means that someone is feeling very depressed or really sad. to put on a different face This idiom is used when someone tries to mask or hide how they are really feeling. For example, you are putting on a different face if you are feeling very sad inside, but when people look at you, they see someone who is smiling and seems happy. to be open about something If you are open about a topic or a problem, you are willing to talk about it. You are not trying to hide your feelings or opinions. to be shy A shy person is someone who is nervous about speaking to others, especially to people they don’t know. to be nervous If you are nervous, you are worried or frightened about something. You are unable to relax. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 4 of 20 3. Predict what the podcast is about In this interview, Marcy Markusa interviews Eden Jamieson about her experience with mental illness. Eden is only nineteen, but she has suffered from anxiety and panic attacks for many years. Can you predict why Eden has decided to tell Marcy and radio listeners about her experience? Here are a few examples: I think she is talking about her experience… because talking about it makes her feel better. Maybe she thought that sharing her own experience…would help others who have anxiety disorders. Perhaps she’s sharing her experience...so others can learn from what she has been through. I wonder if she’s hoping to break the taboo…about talking about mental illness. I have no idea why she would want to share her experience. 4. Get ready to listen In this podcast, you will hear two speakers. You will hear: Marcy Markusa – host and interviewer Eden Jamieson – guest Play the podcast for the first time. After you Listen a) Review your pre-listening predictions Were you able to predict some of the reasons why Eden decided to talk about her experience with mental illness? Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 5 of 20 b) Listen for detail Sometimes when we listen, we are listening for main ideas and detail. One way to remember the details about what we hear is to take notes. Taking notes helps us pay closer attention as we listen. It also helps us remember to listen for stressed words and important information. Remember, we don’t need to hear or understand every word to get the gist of what is being said. Good notes may be one word, a phrase or a short sentence. They are usually written in point form. Practice writing notes as you listen to the interview between Marcy Markusa and Eden Jamieson. Use the outline and examples below to get started. 1. This interview is about… mental illness 2. The person being interviewed is… Eden 19 years old 3. Eden first had symptoms of mental illness when… 4. Her symptoms included… 5. She initially tried to hide her symptoms from others because… 6. Eden has decided to tell her story because… Bonus question: When might you need to take notes in everyday life? One example is during a training course at work. What other examples can you think of? Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 6 of 20 c) Answer questions about mental health What do you know about mental health, mental illness and some of the more common types of mental disorders? Read the following questions and choose the answer you feel best answers each question. 1. If your mental health is good, this means: a) you are always content and happy b) you have good coping skills and you are able to balance the different parts of your life c) you rarely get physically ill 2. Mental illness is: a) a type of illness that is very rare b) many different illnesses or disorders that affect the mind c) when you have a bad day 3. Mental illness affects: a) twenty percent of Canadians at some time in their lives b) less than five percent of Canadians 4. Who is most likely to experience mental illness/a mental disorder? a) the poor and uneducated b) people who work in stressful jobs c) anyone can be affected 5. Mental illness is caused by: a) personal weakness or frailty b) your genes – you always get it from your parents c) no one specific thing 6. Are people with mental illness likely to be violent? a) Yes, and they often put the general public at risk b) No, people with mental illness are more likely to be victims of violence than be violent themselves 7. If someone asks you if you are feeling blue, they are asking: a) if you are short of breath b) if you are feeling sad or depressed c) if you are frightened Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 7 of 20 8. Postpartum depression is: a) the lack of sleep a mother experiences after a baby is born b) a severe depression that affects some new mothers and can last for months after a baby is born 9. Match the following types of mental illnesses with their description. The first one is completed for you as an example. Look for clues in the descriptions. Type of Mental Illness or Disorder c Mood Disorder ___ Anxiety Disorder ___ Eating Disorder ___ Attention Deficit Disorder ___ Schizophrenia ___ Post-traumatic Stress Disorder ___ Seasonal Affective Disorder Descriptions a) an inability to focus your attention on something; affects both children and adults b) an inability to decide what is real and what isn’t real; difficulty thinking, speaking and interacting with others; likely to have psychotic episodes c) a sharp or significant change in mood and emotion; depression and bipolar disorder are examples d) a type of depression that often occurs in winter, or in seasons with less sunshine e) intense unhappiness with your weight or how your body looks which leads to eating and dieting habits that can be life-threatening; bulimia and anorexia are examples f) a high level of anxiety about situations others would consider normal; this is the most common mental disorder people experience g) a disorder resulting from the trauma of an unexpected or terrible event in your life; your mind keeps experiencing this trauma over and over Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 8 of 20 d) Calculate your personal stress level Stress comes from both the good things and bad things that happen to us. Stress becomes a problem if we aren’t sure how to handle an event or situation. We may become worried and increasingly anxious. Stress is cumulative. One stressful event on top of another or more than one event at the same time can greatly increase the level of stress we feel. We all need to find ways to deal with increased stress levels. If we don’t, we risk becoming physically or mentally ill. Thomas Holmes and Richard Rahe developed the stress scale2 on the next two pages by listing common stressful events in our lives and assigning each one a value or stress level. To use this scale, you add up the values for all of the listed life events that have happened to you within the 12 months. If a particular event has happened to you more than once in that time period, you multiply the value by the number of occurrences. Here is an example which uses three life events you will find on the scale. If you have had a personal injury or illness, two close family members have died, and you did not get married during in the past 12 months, your stress level for these items would look like this: Life Event Points Number of per times in 12 one months event Personal injury or illness 53 53 x 1 = 53 53 Death of close family member 63 63 x 2=126 126 Marriage 50 none Total score for these three items Total points 0 179 Your Task Now it’s your turn. Read through the list of life events. If you have experienced the event once or more than once in the past twelve months, write down/calculate your score for that event. If you haven’t experienced the event, write “0”. When you are finished, add up the totals for Part A and Part B to get your personal total. 2 The scale and rating system is from the following website: www.emotionalcompetency.com/srrs.htm Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 9 of 20 Part A Value Life Event Points Number of per times in 12 event months Death of Spouse 100 Divorce 73 Marital separation 65 Jail term 63 Death of close family member 63 Personal injury or illness 53 Marriage 50 Fired at work 47 Marital reconciliation 45 Retirement 45 Change in health of family member 44 Pregnancy 40 Sex difficulties 39 Gain of new family member 39 Business readjustment 39 Change in financial state 38 Death of close friend 37 Change to a different line of work 36 Change in number of arguments with spouse 35 Home Mortgage over $100,000 31 Foreclosure or mortgage or loan 30 Change in responsibilities at work 29 Son or daughter leaving home 29 Trouble with in-laws 29 Outstanding personal achievement 28 Spouse begins or stops work 26 Total points Total points, Part A Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 10 of 20 Part B Life Event Points Number of per times in 12 event months Begin or end school 26 Change in living conditions 25 Revision of personal habits 24 Trouble with boss 23 Change in work hours or conditions 20 Change in residence 20 Change in schools 20 Change in recreation 19 Change in church or faith activities 19 Change in social activities 18 Mortgage or loan of less than $100,000 17 Change in sleeping habits 16 Change in number of family get-togethers 15 Change in eating habits 15 Single person living alone ** Other- describe ** Total points Total points, Part B Write total points from Part A here Total points, A and B ** For the last two items, the scale asks you to estimate their importance. When you compare them to other events on the scale, how many points should they be worth? For example, if you live alone, is that more stressful than changing schools? Less stressful than divorce? How many points do you think this item is worth when compared to others on the list? Is there an event that has happened to you in the past year that is not on the list which you found very stressful? How would you rate the importance of this event? You can write in this item and decide how many points it should receive. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 11 of 20 What Does Your Total Score Mean? The authors say that it is very difficult to interpret people’s scores because we all cope with stressful situations differently and our situations vary greatly. In addition, some people have greater access to resources to help them deal with stress. However, the authors suggest using the following guidelines to interpret your score: A total of 150 points or less is good, suggesting a low level of stress in your life and a low probability of developing a stress-related disorder. If your score is 150 to 299, you have a fifty percent chance of getting sick in the near future. If your score is 300 or more, you have an almost 80% chance of getting sick in the near future. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 12 of 20 e) Scan a poster on a community counselling drop-in program for information Klinic is a community health centre located in Winnipeg. One of the services they offer is dropin counselling. The service typically provides one counselling session but it can provide up to six sessions. Problems are discussed and counsellors offer advice, as well as referrals, to other community resources. The poster in Appendix 2 provides some additional information on the program. Scan the poster. Can you find the information you need to answer the following detail questions? 1. Klinic drop-in counselling is available to anyone over 13 years of age. True False 2. Klinic drop-in counselling is available across the province. True False 3. No appointment is needed. People are seen on a first come, first seen basis. True False 4. Drop-in counselling is available five days a week at two locations in Winnipeg. True False 5. The program at 845 Regent is open Saturday afternoons. True False 6. Klinic drop-in counselling is free. True False 7. Any problem you may have can be discussed with the counsellor. True False 8. People are limited to one counselling session only. True False 9. Before going to the drop-in location, you should call or check the Klinic website to confirm dates and hours of operation. True False 10. If you work until 5 p.m., you could drop-in on Monday, Tuesday or Wednesday at the Broadway location. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC True False Page 13 of 20 f) Use language to express concern We all experience occasional blue moods or days when we don’t cope particularly well. But sometimes, people experience sadness that doesn’t go away. They stop enjoying things they once enjoyed, they may sleep poorly, lose weight, stop going out and/or have low energy levels. Depression can be treated and people do get better. Often, that process begins when friends or family members notice changes in someone, talk with them about how they are feeling, and offer their support. How do we start a conversation with someone we think may be depressed? What should we say? Are there things we should avoid saying? Here are some ideas. How to start… I have been feeling concerned about you lately. Are you okay? You might ask… When did you start feeling like this? You could offer help… Remember, if you need anything, I’m here. Recently, I’ve noticed that you’re not yourself. How are you doing? Did something happen that made you feel this way? Let me know what I can do to help. You’ve seemed a little down lately. I’m worried about you. Have you thought about seeing a counsellor? Depression is pretty common. Lots of people deal with it. Would you like me to help you find a counsellor? It’s important to try to get the person talking. But be sure you don’t say anything that gives the impression you think they can choose not to be depressed. Depression isn’t a choice. People generally can’t “snap out of it”, no matter how hard they try. Here are some things you should avoid. Don’t say… It’s all in your head. Snap out of it. Look on the bright side for once in your life. What’s wrong with you? Why can’t you be happy? You’ve got so much going for you, you have no excuse to be unhappy. Your Task Can role play a dialogue based on the scenario which follows? Use the information you have learned in this lesson to help you. Ask a friend to do the role play with you, or play both parts. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 14 of 20 Scenario Gina has noticed that Ilona is not coming to class regularly. She looks tired. Gina thinks she’s also losing weight. Their friend Aleksei is also concerned. He and Ilona used to volunteer together at the Food Bank, but she has stopped coming. Her friends think Ilona hasn’t been herself for several weeks and they are worried about her. Gina has volunteered to talk with her. Ilona is feeling depressed. She has been unable to find a job in her field. Her mother, who still lives in her home country, is very ill. Ilona can’t afford to travel to see her. She’s having difficulty focusing on her studies and doesn’t feel like going out much. Gina: ____________________________________________________________________ (Begins the conversation by expressing her concern to Ilona) Ilona: ____________________________________________________________________ (Explains how she is feeling and why) Gina: ____________________________________________________________________ (Asks a follow-up questions) Ilona: ____________________________________________________________________ (Answers the question) Gina: ____________________________________________________________________ (Asks Ilona if she has thought about getting help) Ilona: ____________________________________________________________________ (Says she has thought about it, but doesn’t know where to find help) Gina: ____________________________________________________________________ (Recommends Klinic drop-in counselling and offers to find out more information) Ilona: ____________________________________________________________________ (Thanks her friend for her help) Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 15 of 20 Want to know more… Much of the background for this lesson, including content for the questionnaire on mental health, came from the Canadian Mental Health Association website. You can find it at: www.cmha.ca/bins/index.asp Their Manitoba website is: www.manitoba.cmha.ca/bins/site2.asp?cid=284-683&lang=1 You can find brochures on some mental health topics in different languages at: www.cmha-edmonton.ab.ca/bins/content_page.asp?cid=4-42-211 The website of the Mood Disorders Association of Manitoba is: www.depression.mb.ca/ Klinic Community Health Centre’s website is: www.klinic.mb.ca/ This website helps you identify symptoms of common mood disorders so you can get help if you need it. You can also learn more about mood disorders and find resources to help yourself, your family members, or friends. Go to: checkupfromtheneckup.ca/resources.html Mind Your Mind is a website targeted at youth and young adults. It has information, resources and tools to help during tough and stressful times. Go to: mindyourmind.ca/ The information on cultural differences in the Manitoba Memo is from the CMHA Journal B.C. Visions, Number 9, Winter 2000: www.cmha.bc.ca/files/09.pdf The Manitoba government’s website lists mental health services by region: www.gov.mb.ca/health/mh/region.html Province-wide crisis lines which deal with mental health concerns: Klinic Crisis Line: (204)786-8686 (Winnipeg line); 1-888-322-3019 (toll free line) Manitoba Suicide Line: 1-877-435-7170 (toll free line) Kids Help Phone: 1-800-668-6868 (national toll free line available to Manitoba Youth) CBC does not endorse and is not responsible for the content of external websites Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 16 of 20 Appendix 1: Transcript3 April 21, 2011(broadcast date) Speaker Podcast Line Marcy Hi I'm Marcy Markusa and you're listening to Learning English with CBC. Why is it that people are so much more willing to talk about their physical health than their mental health? The Canadian Mental Health Association is trying to break the taboo about talking about mental health with a campaign called 5 Join the Conversation. In this interview, I speak with nineteen year old Eden Jamieson, who submitted her own personal story to the Association’s Facebook page. Marcy Good morning Eden. Eden Hi, good morning. Marcy So tell us ah about your own experience dealing with your own 10 mental health. Eden Alright, well ah, it started at a very young age, I um have been anxious and dealt with anxiety pretty much all my life. I’ve had panic attacks and um it was really hard to deal with. Marcy 15 What would it feel like? Like was it, do you remember the feeling physically or do you remember how often you’d feel anxious? Eden I would just feel so sick to my stomach like very single night. Like as soon as it got dark I would just feel so sick and I’d be 20 so worried that ah someone was gonna come and hurt my family and ah like a tension all in my stomach, y’know my breathing, it would get hard and now, as I got get older, I realize those are your symptoms for a panic attack and for really bad anxiety so… 25 3 You can hear the full interview as an Information Radio podcast: www.cbc.ca/podcasting/pastpodcasts.html?56#ref56, "Join The Conversation - Breaking the Taboo on Talking about Mental Health" Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 17 of 20 Marcy I read in part of your story that it was hard for people to wrap their heads around because you weren’t ah walking around sad all the time. Eden Ya, for sure, um at home, y’know I could be super sad one day and I didn’t want people to know because, y’know, it’s not 30 normal for people to come to school and just be not feeling good and being super down, so I learnt kinda to be different in public and y’know, put a different face on it, kind of and... Marcy Just ah why did you want to talk about this publicly on this website? Eden 35 I think it’s just so important to raise awareness and y’know, be open about mental health um I’m not shy about it at all, if anyone wants to talk to me about it, if anyone, y’know, has any questions like, I am so open talk about it I think it’s so important because I’ve seen it, y’know, people get really nervous about it, 40 people get super like nervous to talk about it and I just think it’s really important that we’re open to talk about it. Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 18 of 20 Appendix 2: Klinic Community Drop-in Counselling Program Poster 08 Klinic Community Drop-In Counselling Program Drop-In Counselling is currently offered at the following locations: Klinic on Broadway 545 Broadway Ave. (One block west of Osborne St.) Monday & Wednesday 12-7p.m. & Tuesday, Friday & Saturday 12-4p.m. Transcona 845 Regent Ave. West. ACCESS Transcona Tuesday 12-7p.m. This is a no charge; first come first seen counselling service for anyone (ages 13+) experiencing any problem. This includes a one-time and short term counselling service Contact the Drop-In information line @ 784-4067 for current times, locations and any change in hours, or visit our website at www.klinic.mb.ca Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 19 of 20 Answers to Worksheets Listen for Detail (answers will vary) 1. 2. 3. 4. 5. 6. mental illness Eden; 19 years old she was very young anxiety; panic attacks; difficulty breathing; sick stomach it wasn’t normal; she didn’t want people to know she wants to raise awareness; it’s important to talk about mental illness What’s Your Mental Health IQ? 1. b 2. b 3. a 4. c 5. c 6. b 7. b 8. b 9. c; f; e; a; b; g; d Scan a Poster for Information 1. T 2. F 3. T 4. F 5. F 6. T 7. T 8. F 9. T 10. F Self Study: Talking about Mental Health and Mental Illness Learning English with CBC Page 20 of 20