Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
In The Mark of Shame, Stephen P. Hinshaw addresses the psychological, social, historical, and evolutionary roots of the stigma of mental illness as well as the long history of such stigmatization.
Canada has long been recognized as a leader in the field of psychiatric epidemiology, the study of the factors affecting mental health in populations. However, there has never been a book dedicated to the study of mental disorder at a population level in Canada. This collection of essays by leading scholars in the discipline uses data from the country's first national survey of mental disorder, the Canadian Community Health Survey of 2005, to fill that gap. Mental Disorder in Canada explores the history of psychiatric epidemiology, evaluates methodological issues, and analyzes the prevalence of several significant mental disorders in the population. The collection also includes essays on stigma, mental disorder and the criminal justice system, and mental health among women, children, workers, and other demographic groups. Focusing specifically on Canadian scholarship, yet wide-reaching in scope, Mental Disorder in Canada is an important contribution to the dissemination and advancement of knowledge on psychiatric epidemiology.
This report is designed to raise the profile of mental illness in Canada among government & non-governmental organizations and the industry, education, workplace, & academic sectors. It describes major mental illnesses and outlines their incidence & prevalence, causation, impact, stigma, and prevention & treatment. Data presented are based on currently available provincial studies & data on mortality and hospitalizations. Five mental illnesses have been selected for inclusion in the report by virtue of their high prevalence rates or because of the magnitude of their health, social, & economic impact: mood disorders, schizophrenia, anxiety disorders, personality disorders, and eating disorders. While not in itself a mental illness, suicidal behaviour is also included since it is highly correlated with mental illness and raises many similar issues. The appendix includes information on data sources and a call for action on building consensus for a national action plan on mental illness & mental health.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
In December 2016, the CCA was asked by then Minister of Health Jane Philpott and Minister of Justice and Attorney General of Canada Jody Wilson-Raybould to undertake independent reviews related to medical assistance in dying (MAID). Specifically, the CCA was tasked with examining three particularly complex types of requests for MAID that were identified for further review and study in the legislation passed by Parliament in 2016: requests by mature minors, advance requests, and requests where a mental disorder is the sole underlying medical condition. On December 12, 2018 the CCA released the three final reports of the Expert Panel, one on each type of request: The State of Knowledge on Medical Assistance in Dying for Mature Minors; The State of Knowledge on Advance Requests for Medical Assistance in Dying; and The State of Knowledge on Medical Assistance in Dying Where a Mental Disorder is the Sole Underlying Medical Condition.