Grateful to @WillBynumMD and @AcadMedJournal for the opportunity to contribute to this important piece. We explore how perfectionism and power drive mental illness stigma in #meded. Dismantling stigma will require courage and action.
1) A culture of perfection - field by high stakes assessment paradigms, identity compartmentalization, and fear of help seeking.
2) An unequal distribution of power that leads to disproportionately negative impacts of stigma on certain groups compared to others.
3) Structural stigma - policy and regulation that inhibits help and treatment seeking and adversely affects those who disclose their mental health or substance use struggles.
Dismantling stigma requires honouring our shared vulnerability like Dr. Kirch did in his brilliant piece here. journals.lww.com/academicmedici…
We must replace intolerance with acceptance;
perfectionism with vulnerability;
judgment with grace;
and hiding with sharing
"If maintaining power and hierarchy leads us to suffer in the shadows, we must embrace the emancipatory power of disclosure."
"If we are going to break our culture of silence...we must dismantle structural forms of stigma and build systems where help seeking is celebrated and facilitated instead of punished."
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Anyone who wants to be an ally, please don’t call yourself one. Don’t put “ally” in your twitter bio. To be an ally is to accept that you don’t get to call yourself an ally. You don’t have that kind of power. Trying to maintain your power is the opposite of allyship.
Being an ally is more than tweeting hashtags and pronouns. It requires active dismantling of oppressive systems of power. It requires resisting censorship and silencing of dissent in the name of niceness and civility. /1
Being an ally is more than warm fuzzies or self congratulations. It requires persistent, enduring, constant struggle and endurance. /2
This is what structural stigma looks like: Hard hit #Peelregion explicitly excluding physicians working in psychiatry/addictions from vaccination despite the fact that many work in high risk congregate community settings with vulnerable populations. #onpoli@ROPpublichealth
There are many colleagues in #Peel who work in community settings like group homes, shelters, outreach, shared care, etc. Many who see complex and high risk patients in person. This kind of policy decision reflects biases baked into the system.
Provincial guidelines specify that ALL patient facing health workers should be prioritized. They also specify prioritizing non patient facing hospital workers. They don’t call for excluding all community docs working in addictions or psychiatry.
If you’re interested in hot topics like moral distress, advocacy, anti-racism, etc.,
Check out the work that your colleagues in #MedEd research have done for years. We study this stuff! Join us, let us help you take these ideas on, and help amplify our work.
If anyone has an idea for a research study or is looking for help to organize a project on an issue they are passionate about, feel free to contact me via DM or by emailing me. I’m more than happy to help! #meded#MedTwitter
Here are a few examples: My mentor @LingardLorelei has studied healthcare teams for years. Her work inspires me and countless others to consider how diverse groups manage conflict, tension, and collaborate effectively in healthcare and beyond. /1
We conducted this study before the #covid19 pandemic at a time when there was a significant amount of apprehension about adapting compassion education for health professionals in a digital realm. /1
We learned that while participants revealed concerns about the constraints of technology on human interaction, they also described technology as both inevitable and necessary for the delivery of future compassionate care curricula. /2
I am learning unconfirmed reports today that front line #mentalhealth workers in Ontario are being redeployed to work in other areas due to pandemic related staff shortages. I believe this is unacceptable. We need all the resources we can due to unprecedented demand.
Other services should be redeployed to mental health. Not the other way around. It makes no sense to send a trained therapist to become a screener or a trauma therapy trained nurse to work outside of where they are needed. It causes harm.
I often wonder if it were the other way around, if all of us working in #mentalhealth were in a crisis and short of resources, would the systems and organizations we work in have our backs?
Conversations about equity and racism can be challenging and emotionally charged for multiple reasons. When we hear about the experience of others, our impulse is often to react with how their experience relates to us... (a thread)
Did I do something wrong?
Are they judging me?
Do they think I'm racist?
These are normal reactions. There is nothing inherently wrong with them. Our challenge is to recognize the normal tendency to centre ourselves in these conversations, and actively resist the impulse to react.