Reprinted from "Stigma & Discrimination" issue of Visions Journal, 2005, 2 (6), p. 38
“A signiﬁcant challenge in developing welcoming, effective services is the stigma that exists concerning addictions. Strong moral stances are prevalent among service providers and in the community. This orientation training was fantastic in addressing my own values and beliefs and helped me to begin thinking about how I can change my own practice and perhaps inﬂuence the practice of my team.” – MHAS Professional Development Day participant
The subject of mental illness and/or substance abuse can generate considerable misunderstanding, prejudice, confusion and fear. Individuals known to have mental illness and/or addiction may ﬁnd it more difﬁcult to ﬁnd employment, be approved for a loan, or rent an apartment, even if they are well at the time.
To make matters worse, health care providers can sometimes poorly serve those with a mental illness and/ or substance addiction. Practitioners may be less willing to offer support and empathy if someone is suffering from a mental illness rather than a physical health problem. Due to their complex presentation, those experiencing mental illness and/or substance addiction tend to over-utilize scarce health care resources, and they rarely ﬁt into traditional medical treatment modalities. Individuals diagnosed with mental health or addiction concerns are often thought to have ‘done it to themselves’ and do not usually respond to ‘quick ﬁx’ remedies. Inevitably, this population produces difﬁcult to predict clinical outcomes and creates higher treatment costs for an already stretched health system.
Dr. Ken Minkoff, a psychiatrist and advocate, describes this population as “system misﬁts.”1 Why? Because he has identiﬁed the social prejudices within health care settings against this already marginalized group, and has a comprehensive understanding of how old mental health and addiction health care philosophies have failed to meet the needs of this clientele.
To help address these issues within the Vancouver Island Health Authority (VIHA), Mental Health and Addictions Services (MHAS) has announced its commitment to welcoming people who present with both mental health and/or substance use concerns. MHAS is committed to improving treatment outcomes by creating empathetic and welcoming relationships within programs, and providing appropriate services matched to the needs of the individual, their stage of change and phase of treatment. MHAS recognizes that meeting the needs of people with mental health and substance use issues requires an effective, integrated and coordinated continuum of services that, collectively, will address a wide variety of consumer concerns.
To further support this initiative, MHAS is providing its service providers with professional development education on current mental health and addiction topics.
As part of MHAS’s Comprehensive, Continuous, Integrated, System of Care (CCISC)2 initiative, a cadre of trainers is developing a series of educational workshops focused on core competencies for understanding mental health and addiction. One professional development workshop has already been developed in partnership with the South Island MHAS Practice Resource Team. This free training is offered one full day per month and is available for new MHAS employees, afﬁliated college and university students, and other health professionals wishing to build upon their skills and knowledge within the ﬁeld of mental health and addiction.
The morning session, facilitated by a CCISC trainer, focuses on theoretical models of addiction, beliefs about addictions and mental health, stages of addiction, life areas affected by concurrent disorders, harm reduction, stage model of change, and principles of motivational interviewing. The afternoon session, facilitated by the Practice Resource Team, focuses on comprehensive mental health and addiction assessment strategies, psychiatric emergencies, suicide and aggression. It includes abbreviated sessions on psychotic disorders, personality disorders, mood disorders, anxiety disorders, eating disorders, and the Mental Health Act. In addition, a plethora of teaching material is handed out to the participants. One of the most prominent resources distributed is the BC Partners for Mental Health and Addictions Information Primer.
Since January 2005, over 100 service providers have attended the Orientation to Mental Health and Addictions training. Evaluations from participants and program coordinators are extremely positive with outcomes including increased awareness of personal biases, of the importance of the stages of change when supporting people, and of harm reduction strategies.
This new educational initiative of VIHA’s Mental Health and Addictions Service intrinsically encourages improved treatment outcomes by creating empathetic and welcoming relationships, and by providing app- ropriate services matched to the needs of each individual, their stage of change and phase of treatment. We hope this article has led you to reﬂect on your own beliefs concerning social prejudice within our ﬁeld.
About the Author
Michael is Clinical Nurse Educator with the Vancouver Island Health Authority. He has worked in the mental health and addictions field for several years, with experience in emergency room psychiatric care and inpatient care
Sara is a Comprehensive, Continuous, Integrated System of Care (CCISC) trainer. A clinician and leader in the addictions field for 15 years, she works with VIHA and the community, providing addiction prevention services, consultation, education and resources
Minkoff, K. (2001). Dual Diagnosis: An integrated model. (Presentation).
Mindoff, K. (2004).The Comprehensive, Continuous, Integrated System of Care model. Visions: BC’s Mental Health and Addictions Journal, (2)1, 45-46.
BC Partners for Mental Health and Addiction Information. (2003). The Primer: Fact sheets on mental health and addictions issues. See www. heretohelp.bc.ca/ publications/factsheets