Sadly even if I had unlimited $$ for a year, we could not end the stigma of mental health. For example in a recent case I staffed, the client/patient did not care for the psychiatrist so choose not to talk to them. They liked their social worker so they choose to engage with them. Subsequently the psychiatrist wrote in their chart that the client/patient was uncooperative and manipulative. And this “label” had a impact on the social workers ability to find placement for the client. In the end, those that should be on the front line of fighting the stigma of mental illness were the ones contributing to the stigma.
Thanks for playing, Grey! I'm sad to hear about your client. Let's keep pushing on the exercise though. If the root cause of the problem is stigma, how might you spend that Fort Knox money to overcome it?
So given the Dr's response which contributes to stigma, is stigma the problem, (it is a problem) but applying what you taught me, what norms are maintaining the problem? So the Dr's lens or view of the client can be a problem, and what might cause that lens or view of the client? Maybe the Dr. has had their own issues with mental illness which contributes to transference. Or maybe that was how the Dr. was taught by their mentor? or that is the culture of that clinic and that it is ok to see clients in that way.
Could $$ at Fort Knox be used to address any of these potential norms, and who are all of the potential actors? Maybe.
You are definitely going down the right path by saying, "Okay, if we had no limit on our resources, I would do something to address stigma." You could keep using your imagination to make a list of ways you might spend that money against stigma as quickly as possible -- given that you've got all the gold, push beyond PSAs or training. What would change not just the psychiatrist in question, but ALL the psychiatrists?
At the same time, one thing I notice in your response is that social work and mental health already have some vocabulary to talk about what might be happening. So you might go down that path too. "If we had unlimited resources to solve the problem of transference, what would we do?" The point is to find your own sense of what's most important -- then you can come back to reality and use those preferences to guide the way you spend your more limited resources.
You also ask about norms. We'll have plenty of discussion about norms in this space, but I would say this question addresses them more indirectly by playing with the limits dynamic. Since you've studied some of this, I'll explain... what this question really does is challenge some of the norms that have been created by working within some very narrow limits. The "Fort Knox" question blows up one of those limits in a gigantic way, helping you think about what norms really matter and what you might do to disrupt them, though you'll still have to do the work of adapting the stuff you dream up to reality.
Begin a fellowship/scholarship for ALL psychiatrists who are in residency. They take a course that addresses the stigma of mental illness, diversity, inclusion, and the impact of trauma. Upon completion of the course, they in turn have to teach what they know to their local community (give back X hours) then a % of their student loans are forgiven.
Well to me what that would suggest is that there is some deficit in training -- that's one area you could pay attention to. I'm also curious about student loan forgiveness and giving back to the community as means of accomplishing it all.
Let me dig in on something though -- isn't it strange that psychiatrists would have this stigma, since they chose to work with this population? Wouldn't you imagine them to be the MOST sympathetic group already? What happens in their education or training to make them otherwise?
Sadly even if I had unlimited $$ for a year, we could not end the stigma of mental health. For example in a recent case I staffed, the client/patient did not care for the psychiatrist so choose not to talk to them. They liked their social worker so they choose to engage with them. Subsequently the psychiatrist wrote in their chart that the client/patient was uncooperative and manipulative. And this “label” had a impact on the social workers ability to find placement for the client. In the end, those that should be on the front line of fighting the stigma of mental illness were the ones contributing to the stigma.
Thanks for playing, Grey! I'm sad to hear about your client. Let's keep pushing on the exercise though. If the root cause of the problem is stigma, how might you spend that Fort Knox money to overcome it?
So given the Dr's response which contributes to stigma, is stigma the problem, (it is a problem) but applying what you taught me, what norms are maintaining the problem? So the Dr's lens or view of the client can be a problem, and what might cause that lens or view of the client? Maybe the Dr. has had their own issues with mental illness which contributes to transference. Or maybe that was how the Dr. was taught by their mentor? or that is the culture of that clinic and that it is ok to see clients in that way.
Could $$ at Fort Knox be used to address any of these potential norms, and who are all of the potential actors? Maybe.
You are definitely going down the right path by saying, "Okay, if we had no limit on our resources, I would do something to address stigma." You could keep using your imagination to make a list of ways you might spend that money against stigma as quickly as possible -- given that you've got all the gold, push beyond PSAs or training. What would change not just the psychiatrist in question, but ALL the psychiatrists?
At the same time, one thing I notice in your response is that social work and mental health already have some vocabulary to talk about what might be happening. So you might go down that path too. "If we had unlimited resources to solve the problem of transference, what would we do?" The point is to find your own sense of what's most important -- then you can come back to reality and use those preferences to guide the way you spend your more limited resources.
You also ask about norms. We'll have plenty of discussion about norms in this space, but I would say this question addresses them more indirectly by playing with the limits dynamic. Since you've studied some of this, I'll explain... what this question really does is challenge some of the norms that have been created by working within some very narrow limits. The "Fort Knox" question blows up one of those limits in a gigantic way, helping you think about what norms really matter and what you might do to disrupt them, though you'll still have to do the work of adapting the stuff you dream up to reality.
Okay so I have a plan for Fort Knox money;
Begin a fellowship/scholarship for ALL psychiatrists who are in residency. They take a course that addresses the stigma of mental illness, diversity, inclusion, and the impact of trauma. Upon completion of the course, they in turn have to teach what they know to their local community (give back X hours) then a % of their student loans are forgiven.
Well to me what that would suggest is that there is some deficit in training -- that's one area you could pay attention to. I'm also curious about student loan forgiveness and giving back to the community as means of accomplishing it all.
Let me dig in on something though -- isn't it strange that psychiatrists would have this stigma, since they chose to work with this population? Wouldn't you imagine them to be the MOST sympathetic group already? What happens in their education or training to make them otherwise?
: ) it's not just psychiatrists, its counselors, social workers, mental health techs.
Paternalism contributes, I'm the doctor, therapist, etc thus I know best.
Maybe throw in some zero-sum gain; if someone is winning then someone must be losing.