MENTAL HEALTH AND STIGMA

This is the first in a series of three modules to support the delivery of mental health content within strand D of the Grade 8 Health and Physical Education curriculum document. The module focuses on stigma related to mental health and mental illness, why it is an issue, and actions that can counteract it. Feeling respected as a complex individual with diverse needs is a critical part of positive mental health for everyone, including those experiencing mental health problems and/or mental illness.

NOTE:

If you determine that students need a refresher of the mental health literacy foundations set in grade 7, consider taking time to re-visit that learning by using module 7.1: MENTAL HEALTH, MENTAL ILLNESS, AND THE RELATIONSHIP BETWEEN THEM.
Remind students that the focus is on learning facts and reliable information rather than sharing personal stories. If there is a situation a student would like to speak about, invite them to see you after class. You can also share ideas about additional resources at the end of each module.
It is important to provide students with a supportive transition to both open and close the learning. Before starting a module, it can be helpful to create a transition into the learning with a mindful practice. Likewise, these practices can be used to draw mental health learning to a close before moving forward with other classwork or activities. A list of easy-to-use activities and suggested prompts to encourage students to seek help are included at the end of each module so students can transition to the rest of their day in a positive way.

CURRICULUM EXPECTATIONS

D3.4 - explain how word choices and societal views about mental health and mental illness can affect people and perpetuate stigma, and identify actions that can counteract that stigma

Refer to the Health and Physical Education curriculum document for a variety of considerations to support planning and delivery of this learning for every student (e.g., students with special education needs and English Language Learners).

LEARNING GOALS

We are learning:

That our words and actions affect us and others.
What stigma is and ways to reduce it related to mental health and mental illness.

SUCCESS CRITERIA

Co-develop success criteria with students using the following questions:
“How will we know we are achieving our learning goals? What will it look like/sound like?”

For example:

I can identify words that can cause stigma related to mental health and mental illness.
I know actions I can take to help reduce stigma.

MATERIALS

Explore Mental Health: A Notebook for Grade 8 Health and Physical Education (pages 3 - 6)
A computer and projector/digital display
Sticky notes/small squares of paper (or a digital equivalent)

The power of words

~ 10 min

PURPOSE: This brief activity introduces students to the power of language. It reframes the words we use as a tool that can be added to our toolbox of mental health strategies because the words we use not only influence how others feel, they influence how we feel, too. The activity invites students to consider using words that have a positive impact on their mental health.

NOTE: This activity was adapted from “Changing the Way We Speak” in the Thunderbird Partnership Foundation's Life Promotion Toolkit by Indigenous Youth.

TEACHER PROMPT

"Before we talk about stigma, we’re going to take a few minutes to think about the power of language. The words we use not only influence how we make other people feel, they influence how we feel, too."

INSTRUCTION 1

Ask students to consider:

The way we talk about ourselves to other people.
The way we talk about ourselves to ourselves. This is called self-talk.

Both can impact how we feel.

Invite students to consider the following word options. A slide deck has been provided for your use. Students may wish to record their ideas in the ‘Power of Words’ organizer found in their notebook.

“It’s too hard. I can’t do this.” versus “I have done hard things before. I’ll try my best.”
“I'm such a loser for crying.” versus “Something sad happened. Crying is a healthy reaction.”
“I should be able to handle the stress. Everyone else can.” versus “I will try my best and it’s okay to ask for help if I need it.”

For each set of words, ask students to consider the following:

Do the two ways of thinking feel different?
Which type of words do you use more often?
How might changing the words we use also change the way we feel?

TEACHER PROMPT

"Words can be powerful. Reframing our thoughts and the words we use can have a big impact on our mental health. It’s not about pretending there are never challenges. It’s about using thoughtful language that is balanced, realistic, and kind.

Often, we speak to ourselves in ways we would never speak to a friend, but we deserve the same kind of compassion and support. With practice, reframing our language can be a great strategy to support our mental health."

BRIGHT
IDEAS

Assisting students to replace unhelpful thoughts with more balanced and helpful thoughts can help support students’ mental health. However, a caring and sensitive approach is needed to ensure that when students identify thoughts that reflect difficult realities, we believe, acknowledge, and value them. It is critical to actively listen, believe and validate a student’s experience. Show you are listening through your body language, summarize and reflect back what has been said, and use neutral language like, “I hear you,” rather than vague reassurances like, “It’s going to be okay.”

Ongoing validation and compassion can support students to adopt affirming thoughts to replace those that stem from bullying, and/or marginalization.

Understanding stigma

~ 5 min

PURPOSE: A conversation to help students consider factors that may influence our experience/understanding of stigma, including how societal views about mental health and mental illness can contribute.

TEACHER PROMPT

"Next, we’re going to talk about our words and stigma. Stigma refers to negative attitudes, beliefs, or behaviours about or towards a group of people because of their situation in life. Sometimes stigma comes from other people, and sometimes we have heard negative messages so often we even say them to ourselves. This is called self-stigma.

There can be stigma related to many things, such as grades at school, abilities, gender, race, poverty, and body size or shape. Stigma related to mental illness can negatively impact how we talk about this concept and how we treat people experiencing mental illness, which can also affect how comfortable people are seeking support.”

Definition taken from stigma-why-words-matter-factsheet-en.pdf (canada.ca)

INSTRUCTION 1

Engage students in a discussion about stigma using the following questions:

Where does stigma come from? How does it spread?
What kinds of factors influence our experience/understanding of stigma?

As part of the discussion, introduce the following ideas:

Stigma can come from the way society and our local communities understand and talk about mental health and mental illness.
These perceptions exist because of misunderstandings and stereotypes that have been around for a long time and are often reinforced in media (e.g., descriptions of people with mental illness as dangerous/violent in movies or news media).
Stigma can also be linked to other factors, like cultural, racial, and religious views where mental illness is associated with a weakness, fault, or lack of willpower and can create shame and discourage help-seeking.
In some situations, social media has played a positive role in starting conversations about mental health that can reduce stigma. It can also play a role in spreading and reinforcing stigma.
All of these factors can make it hard for people to talk about mental health problems and to seek help, which can keep them from getting the support they need to feel better.

Reflect on and recognize the range of prior knowledge in the class. Anticipate that some students will come with misinformation or biased perspectives on mental health and mental illness.
Offer factual information, dispel myths, and model destigmatizing language for your class. If you need support with this information, refer to this fact sheet.

BRIGHT
IDEAS

The activities in this module can serve as a reminder that mental health is shaped by a wide array of factors. For example, in some cultures the concept of mental health and/or mental illness may not exist in the same way. This may require varied approaches to seeking help and discussing mental health, mental illness, and the connection to overall well-being.

Understanding this and collaborating to create a supportive space by promoting openness, understanding, and respecting and acknowledging student’s as complex individuals with diverse needs will help to support positive student mental health and well-being.

Stop stigma: what do you really mean?

~ 20 min

PURPOSE: This video addresses how language related to mental health and mental illness can contribute to stigma. It offers students ways to counteract stigma through thoughtful word use.

INSTRUCTION 1

A video and educator discussion guide have been provided to assist in this learning. Students may use the ‘Stigma and Language’ organizer found in their notebook to record ideas or make notes.

TEACHER PROMPT

"There is still stigma about mental health and mental illness in our society. Our word choices when we talk about them (including the messages we give and the slang and common expressions we use) can contribute to stigma and even cause harm. We can change the negative impact of stigma by changing the words that we choose. Words that are thoughtful, inclusive, respectful, and compassionate can make a huge difference in reducing stigma. They can also help change the way society views mental health and mental illness."

REFLECTION
QUESTIONS

(extension – space for responses is provided in the student notebook)

Where do you find reliable information about mental health and mental illness?
What helps you talk about your mental health?
What are the characteristics of the people you feel most comfortable talking with?

TEACHER PROMPT

"It might seem like a small thing, but words can have a big impact. I encourage you to use the language we’ve talked about today. It may make a big difference for someone around you. Remember, while using stigmatizing words can have a negative impact, choosing our words carefully can do the opposite. It can empower others, create openings to share experiences, and support seeking help."

STUDENT
VOICE

Leave space for students to ask further questions or offer additional ideas about the learning. This could be facilitated by the use of a ‘parking lot’ or question box. Provide students with a virtual or physical space to do this anonymously if they wish.

BRIGHT
IDEAS

It is important for students to know that they don’t have to manage all stigma on their own. They can speak to an adult they trust if they don’t know how to manage a situation or they know someone who needs help. There are supports available in their school and community if they need to talk things through or want help with their own mental health.

TRY IT!

Your mental health matters too! As you move through the video with students, consider your own language use. Are there any words, phrases, or expressions you would like to change? You can help reduce stigma alongside students, and your daily language in the classroom can be great modeling.

Also, consider ways you can reduce self-stigma (when we apply negative messages to ourselves). Self-stigma can make us feel we’re not entitled to the same support as other people, but this isn’t true. Improving the way we talk to ourselves can be a powerful strategy.

Taking action

Purpose: To provide an opportunity for students to take action by countering stigmatizing language, and to help bring about awareness and change. Students will create messaging, identify the audience who needs to hear it, and choose a way to share it.

NOTE: A brainstorming template is available in the student notebook (p.5) to help students organize their ideas.

CURRICULUM
CONNECTION

This activity has natural connections to several expectations within the Grade 8 Language curriculum. For example:

Media, Audience, and Production

A2.5 demonstrate understanding of the interrelationships between the form, message, and context of texts, the intended and unintended audience, and the purpose for production

Word Choice, Syntax, and Grammar in Oral Communication

B1.5 use precise and descriptive word choice, including domain-specific vocabulary from various subjects, and cohesive and coherent sentences during formal and informal communication, to support audience comprehension

TEACHER PROMPT

"In addition to the words we use, one way we can counteract stigma related to mental health and mental illness is by sharing some of what we learned today with others.

Let‘s think about what messages you want to share, who you think would benefit from hearing these messages, and how you might deliver them.

This activity not only helps educate others, it also raises awareness about mental health, helps others be aware of their behaviour and support those with mental health problems, and encourages kindness and compassion, which can all reduce stigma. Mental health problems are very common. This can make a big difference for many people."

INSTRUCTION A

Message – What do you want to say?
Start by reviewing the Key Learnings (found in the consolidation). Encourage students to share what they learned in their own words and add to the messaging provided. Students then identify the message they want to share.

BRIGHT
IDEAS

Students might choose to identify an action that can counteract stigma or choose specific language they have learned that is helpful when speaking about mental health and mental illness.

Audience – Who do you want to hear it?
Students identify the audience they are hoping to educate. Have them think about who needs this information specifically.

BRIGHT
IDEAS

The audience could be their peers, parents/guardians, younger students, a community group, a business or company, etc.

Medium – How do you want to share it?
Have students think about the best medium to deliver their message to their intended audience.

BRIGHT
IDEAS

Examples include school announcements, an image or poster placed in a bathroom stall, school or class newsletter, letter to a specific individual or business, a message for a class or school social media account.

Support students by allowing time to both complete and share this small project.

BRIGHT
IDEAS

Consider having students share with the class before they share with their determined audience.

Sharing strategies and learnings

~ 5 min

PURPOSE: to give students the opportunity to reflect on the learning and share their ideas.

NOTE: this student reflection is intended to be flexible. You may ask students to reflect individually or share their reflections (e.g., orally with a partner or the larger group, or through sticky notes or other digital tools). Students may also capture their reflections in their notebook.

What did you find interesting or helpful about what you learned?

Did anything surprise you? Is there anything you are still wondering about?

Has anything changed in terms of the way you think about mental health?

What is one action you could include in your everyday life that would help decrease stigma related to mental health and mental illness?

KEY LEARNING

There is still stigma related to mental health and mental illness in our society.
This stigma can negatively impact how we talk about mental health and mental illness, how we treat people experiencing mental illness, and how comfortable people are seeking support.
Our word choices can contribute to stigma and even cause harm, or they can empower others, create openings to share experiences, and support seeking help.
The words we use not only influence how we make others feel, they influence how we feel, too.
There are additional actions that can help reduce stigma too, such as showing kindness, compassion, and empathy for other people's feelings and experiences; respecting what is different and unique about each of us; and educating others.

Supportive transition

A supportive transition to and from mental health learning is recommended. A list of easy-to-use transition activities, as well as suggested prompts to support seeking help can be found on the Supportive Transitions Tip Sheet. It is an important part of the learning and should be repeated each time the module is paused or completed.

Parent/Guardian communication

You can use this brief parent/guardian communication to share and continue the learning following student participation in this module.

Stigmatizing	More Respectful	Why?
That’s insane/ crazy/ nuts!	That’s strange/ unbelievable/ funny/ interesting!	While not typically intended to be hurtful, this kind of language can reinforce stigma and have a negative impact on people experiencing mental illness. It may also discourage people from talking about their experiences with mental illness.
I’m so depressed.	I’m sad/ bored/ tired/ unmotivated/ disappointed.	We all feel sad at times, like when we face challenges, losses, and disappointments. Being sad and having depression are not the same thing. Both are important but they are different experiences and treating them as if they are the same can make it harder for people with depression to have mental illness taken seriously and/or to take their own mental health problems seriously. Mental illnesses should not be used as adjectives or in a casual way.
She’s such a psycho.	Her behaviour was unusual or unexpected. I don’t understand her feelings/point of view/behaviour.	This reinforces stigma, adds to misunderstanding, and trivializes mental illness. Using terms associated with mental illness as insults shows how negatively society has viewed mental health and mental illness, but the things we are learning today can help change this.
I’m so OCD.	This is important to me. I want to do well. I’m so careful/ organized/ neat/ precise.	This diminishes symptoms of mental illness and the experience of others. It is a casual use of words that can be very important to those experiencing mental illness.

Stigmatizing Unhelpful Language	More Respectful Language	Why?
You gave me a panic attack!	You surprised/upset me!	This reinforces stigma, spreads misinformation, diminishes the experience of others, and may discourage people from talking about mental health problems.
You’re so bipolar.	That was random. That was unexpected. You flip-flop in what you say and/or how you act.	This reinforces stigma, spreads misinformation, diminishes the experience of others, and may discourage people from talking about mental illness.
They suffer from depression.	They live with/are experiencing depression, or they have a diagnosis of depression.	This language suggests you can’t have good quality of life if you have a mental illness and paints the person as a victim. It does not acknowledge that everyone can thrive, including those with mental illness.
Depressed person	Person living with or experiencing depression	Does not put the person first/respect them as an individual, emphasizes the illness as the biggest or only part of who they are
Are you mental/crazy/nuts?	Are you serious? I disagree. I can’t make any sense of what you are saying/doing. I don’t think you understand.	This reinforces stigma, adds to misunderstanding, and trivialises mental illnesses.
That drives me crazy!	That bothers/annoys me.	This reinforces stigma and diminishes the experience of others.

MYTHS	FACTS
Mental illness is rare.	Mental illness is actually common. About 1 in 5 Canadians will experience a mental illness at some point in their lives. It affects many of us, or someone we care about.
Mental illness only affects adults.	Mental illness can affect people of all ages, including children and youth.
Mental illness is caused by personal weakness/lack of willpower or character flaw.	Mental illness is a medical condition that is caused by a combination of genetic, biological, environmental, and social factors.
People with mental illness are dangerous or violent.	Most people with mental illness are not dangerous or violent. And just because someone is violent or dangerous doesn't mean they have a mental illness.
Mental illness can’t be treated.	There are many effective treatments available to help mental illness, including lifestyle choices, support from a mental health professional, and medication.
Only people with severe mental illness see mental health professionals.	Mental health treatment can help many people, including those with milder concerns. Seeking help early can prevent things from getting worse and help us feel better sooner.
Seeking help for mental illness is a sign of weakness.	Seeking help for mental illness is a sign of strength. It takes courage to recognize when you need help and to take steps to get it.

MENTAL HEALTH AND STIGMA