Wrong message on mental illness

TheStar.com – Comment – Wrong message on mental illness
November 17, 2008. Anita Szigeti

Near the entrances to the Centre for Addiction and Mental Health (CAMH) at Queen Street West and Ossington Avenue in Toronto, two sets of bus shelter advertisements recently were on display

The first was part of CAMH’s “Transforming Lives” campaign intended to fight discrimination against people with serious mental health issues. The anti-stigma campaign financed by CAMH aimed to humanize the otherwise faceless person in crisis by identifying high-profile individuals as well as ordinary people who themselves or through family members’ experiences have lived with serious mental health issues.

The second set of ads were placed by the Ontario Public Service Employees Union (OPSEU), one of CAMH’s two nursing unions, and depicted an oversized photograph of a woman touching a hand to a giant black eye, the implication being that it had been sustained at the hands of a patient at CAMH. The slogan called upon CAMH to pro-tect its staff from violence. In case the not-so-subtle ad left any doubt, OPSEU went further to hold press conferences promoting how dangerous it was inside the hospital walls.

The contrast could not have been clearer. While Canada’s largest dedicated psychiatric facility struggled purposefully to lift the centuries-old stigma associated with mental disorder, its own unionized staff members were pulling in the opposite direction by orchestrating a thoughtless and misleading campaign to depict clients of mental health services as dangerous people who victimize the nurses who care for them.

Incidents of workplace violence should not be tolerated and the CAMH management must take responsibility for keeping its workers safe. OSPEU’s statistic of 23 incidents of workplace violence (the number cited in their press release) at CAMH in the month of September must be taken in context, however. CAMH is a 600-bed facility. According to its website, each year, CAMH treats more than 20,000 people and responds to more than 400,000 outpatient visits.

It is a very small percentage of interactions between staff and clients that result in any kind of assaultive behaviour. That’s because individuals with serious mental health issues are no more dangerous than members of the general public. It is only prejudice and stereotyping to insist otherwise.

Moreover, eight of the 23 incidents recorded were verbal threats involving no physical contact (according to CAMH) and some involved altercations between staff members rather than between patients and staff.

Despite this, OPSEU’s ad campaign left the public with the overwhelming impression that patients are the only perpetrators in workplace incidents at CAMH.

OPSEU’s efforts to demonize the very people that its members are trained to help restore to good health was not new. Often it has taken place in the context of the collective bargaining process. In October 1989, OPSEU members chained the doors of the Penetanguishene Mental Health Centre and locked patients in their rooms for three days in support of their bargaining demands. OPSEU’s actions on the picket lines and inside provincial psychiatric hospitals during a 54-day public service strike in 2002 dramatically worsened conditions for patients in Ontario’s then four remaining province-run psychiatric hospitals. While CAMH workers have recently reached an agreement with their employer, this month OPSEU kicked off its latest round of province-wide negotiations with the province.

The Mental Health Legal Committee (MHLC), a body of lawyers and community legal workers who represent recipients of mental health services, deplores OPSEU’s actions. Undoubtedly there are infrequent and unfortunate incidents of violence against staff by clients at the CAMH. This is indeed regrettable and every effort should be made to minimize the chances of such interaction.

What should be done? In our experience, while some nursing staff are knowledgeable and helpful to our clients, many are not. Temporary employees poorly trained and unfamiliar with the patients are used increasingly. It is all too rare that we see staff actually listening to or speaking with our clients, which is difficult to comprehend since talking is a large part of the therapy psychiatric patients ought to be receiving.

Psychiatric nursing is a specialty area that calls for well-honed skills in assisting clients in crisis with recovery and special abilities in the area of de-escalating the behaviour of individuals who may otherwise act out. This is all part of the job for which staff in Canada’s leading teaching institution ought to be well-trained and appropriately compensated. If OPSEU members are struggling and cannot cope, they need to ask for further training and assistance. These are all things OPSEU and CAMH can work together to improve, and we hope that they do. We only ask that no patient be harmed in the process.

OPSEU members who are nurses at CAMH are professionals who have chosen a career of service for the best interests of their clients. They of all people should be aware and concerned that the ad campaign was dehumanizing to the people they are serving. The MHLC calls upon OPSEU to engage in positive dialogue with CAMH management, patients and its own members to reduce stigma, improve workplace safety and truly transform lives for the better.

Anita Szigeti is former chair of the Mental Health Legal Committee.

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