In February, 2015, I attended the Jack.org Summit, Canada’s largest student-driven mental health conference to date. I am deeply grateful for the opportunity to attend the event and to reap its benefits; it was an inspiring weekend and I have seen many fellow delegates bring their mental health initiatives to fruition since then. As someone who researches the nature of learning and human development, I do have several critical comments on my experience as a delegate.
The theme that stood out the most was the idea that stigma is perpetuated by educational policy that does not fully recognize the importance of addressing mental health in curriculum. The ideas created at the summit were meant to implement mental health awareness, which is a crucial part of the puzzle, but it does not tackle the root of the problem. There are more systemic problems to address, such as political and cultural environments that perpetuate stigma. While I do sincerely appreciate mental health awareness efforts – and to know that without them we could not further build our efforts – I recognize that we now need to address stigma in different ways.
We do need to educate the public about mental health, but we need to do this in a more informed way than making metaphors between taking insulin for diabetes to taking lithium for bipolar disorder. We can accomplish this through the power of knowledge translation – i.e. taking research and scientific findings and making them accessible and digestible for everyone, regardless of scientific knowledge and educational attainment.
I believe knowledge translation for mental health is in its early stages, and this is why stigma continues to persist. It is a complicated answer because research is, in itself, still inconsistent. How we define concepts is critical in translating knowledge, and disagreement about these concepts and terms is an obstacle to getting this crucial information out to the public. For example, can we accurately define the spectrum of depression and depressive symptoms if research categorizes samples into major and mild depression? There is a disconnect between how researchers view depression, how scientifically literate people view depression, and how the average person views depression, for example. There is often unwillingness between these groups of people to listen and learn from each other.
Solutions are in place, though. Community-Based Participatory Research (CBPR) is a major step in the right direction. At CREST.BD this means taking people – someone who has bipolar disorder, a healthcare provider, a family supporter, etc. – and involving them in research at every step of the process. By involving the community in research, CBPR closes the gap between individuals who come from distinctly different backgrounds and expertise.
It is my hope that education flows both ways in these methods of research – that the community member learns as much from the researcher as the researcher learns from the community member. In my days participating in research through psychology classes, I was never asked, “What do you want to be asked?” As research subjects, we do not control the questions. We take it in faith that researchers are asking the right questions. In studying bipolar disorder, the traditional approach has been to create questions without being informed by someone who lives with bipolar. As someone who both lives with bipolar and someone who has research experience, I believe that research is enriched when you give your participants the power to tell you what they want to be asked.
At the interpersonal level, I believe this must begin with conversations; we need to have conversations person to person, no matter what letters or lack of letters fall behind our names – it is our unique experiences that matter most. We need to break down our personal walls and be comfortably uncomfortable in realizing that we all have mental health needs — this puts us all on the same page. The community has to be based on this; after all, a community is merely a group of individuals. When our communities support mental health and increase scientific information, political and cultural changes will follow.
To add a final sentiment, when we do talk about mental health we often stray from mental illness, despite knowing that people who have mental illnesses also have mental health. This was something I observed at the Jack.org Summit in 2015, and it frustrated me. Even within the mental health conversation, there can still be stigma toward less understood symptoms and conditions. As we take the next steps in our communities to decrease stigma, we must also ask ourselves – even if we live with a certain condition – if we are stigmatizing others because we do not entirely understand what their experiences are. Taking the next step means being uncomfortable with what we may not know; however, with education, knowledge translation, and CBPR we can approach stigma in a more compassionate and mindful way.