Stigma and Discrimination

Module Artefacts

  • Two re-enacted plays from the 1940s CBC radio series, In Search of Ourselves. Sociologist Kathleen Kendall provides valuable contextualization for Canada’s first mental health educational campaign
  • Frontline stories of marginalization, discrimination and nascent activism in Toronto’s deinstitutionalization era
  • A short satirical piece contrasting attitudes toward cancer patients and mental health patients
  • A reflection on the distance between the patient and the practitioner

Module Takeaways

  • Understand the complex societal, professional and personal ways in which stigma regarding mental health (media, expert knowledge, individual identity) is perpetuated
  • Understand systematic discrimination and marginalization as they relate to mental health
  • Appreciate the changes to identity that arise from engagement with the mental health system

Module Assessment

As a Canadian citizen, have your students write a 250-word letter to describe a stigma or discrimination-free society, using the artefacts which they have examined to develop their ideas.

Their letter should be addressed to one of the following people featured in these modules:

  • Kathleen Kendall
  • Pat Capponi
  • Lanny Beckman

Module Learning Lens

In the 18th century, Londoners used to travel to “Bedlam” – a vast institution for the mad on the outskirts of the city – for the holiday entertainment of watching the patients. Today, the Downtown East Side of Vancouver is regarded by some as a tourist destination, where visitors to the city can view the “street animals”, as one recounted on a recent web-posting that blamed the closure of large psychiatric hospitals for Canada’s poorest postal code. Such public showcasing of people who challenge societal notions of “normal” demonstrates the profound attitudinal barriers to social inclusion faced by people with mental health difficulties. They describe stigma as another whole aspect of their suffering, saying that deeply internalized shame can deter them from seeking help. 

1940s Mental Health Radio Plays: De-Stigmatizing Mental Health?

Takeaways: 

  • Relate social norms and notions of normal to the construction of good mental health, as viewed by mental health experts, the media and the wider society
  • Appreciate the power of authoritative knowledge brokers, i.e. mental health practitioners, the media, and public mental health educators in constructing notions of “good” mental health

Learning Lens: 

Head and shoulder's photo of Kathleen Kendall

Historical sociologist, Kathleen Kendall.

We had two 25-minute CBC radio plays from the 1940s reenacted for History in Practice by Ryerson University students. The radio plays can be listened to in class or on-line. Analysis and context audio segments by historical sociologist Kathy Kendall, the researcher who discovered the plays, follow these period performances.

Artefacts in Context: 

Two 1940s radio plays re-enacted for the Stigma and Discrimination Module take us into the heart of Canada’s first public mental health educational campaign. A joint venture between the fledgling CBC radio and the organization that we know today as the Canadian Mental Health Association, The Daydreamer and The Woman Who Turns Back were aired on the national radio network. These dramas were part of the award-winning In Search of Ourselves series, designed to teach Canadians about good mental health, healthy child development, and appropriate family relations. 

How were these broadcasts created? Taking direction from the case files of psychiatrists, psychologists and social workers, CBC scriptwriter Len Peterson crafted dramatic sketches with provocative titles like, “An Adolescent Gang,” “What’s Wrong With the Child,” and “The Unmarried Girl Becomes a Mother.” After each play, a mental health professional would deliver a commentary, encouraging listeners to interpret the intended messages “correctly.” The commentator featured in our two plays was Dr. Jack Griffin, who was both a psychiatrist and psychologist and an important figure in the Canadian mental health world from the 1930s to the 1970s.

Evaluating the Artefacts:

1940s Mental Health Radio Plays: Self-Guided Learning

Timing: 
55 minutes

Instructors can assign either Radio Play 1 and its accompanying commentary or Radio Play 2 and its accompanying commentary for students to listen to online or in class. Students should listen to their assigned play and take note of words and ideas that they find judgmental, value-laden, or even discriminatory. These notes can be used as a basis for in-class small discussion groups about how human behavior might be considered ordinary from one perspective, and a medical or social problem from another.

Radio Play 1: The Daydreamer: Donald’s father is unfair and distant, and his mother undermines his sense of accomplishment and ability. No wonder the troubled teenager escapes into daydreaming, with tragic results.

"The Day Dreamer" a re-enacted CBC radio/CMHA co-production broadcast in English Canada during the 1940s.

23 minutes

Hear Professor and sociologist Kathy Kendall put The Day Dreamer in context.

Historical sociologist Kathleen Kendall puts the CBC/CMHA 1940s radio play "The Day Dreamer" in context.

8 minutes

Radio Play 2: The Woman Who Turns Back: Frances is a reliable young woman with a good job and a nice boyfriend. When her roommate Ruby recklessly quits her job and foolishly loses her boyfriend, she turns to Frances for support. Affection and disaster ensue.

"The Woman Who Turns Back" a re-enacted CBC radio/CMHA co-production broadcast in English Canada during the 1940s.

25 minutes

Hear Professor Kathy Kendall discuss The Woman Who Turns Back, demonstrating how psychotherapist Sigmund Freud’s notions of “normal” social and sexual development and behaviour shaped understandings of mental well-being in the Post-World War Two era.

Historical sociologist, Kathleen Kendall, puts the CBC/CMHA 1940s radio play "The Woman Who Turns Back" in context.

6 minutes

Creating a Radio Play

Timing: 
35 minutes

These radio plays help us to understand the socio-political-historical context in which madness is defined and managed. The act of writing a script for a current radio play prescribing “appropriate” behavior allows students to explore how socio-political influences impact what we see as pathological in society around us. 

This exercise builds on the radio plays by introducing the important concept of discrimination and thus complicating the notion of stigma. Topics to take into account when writing scripts might include: poverty, sexuality, gender roles and expectations, race and indigenous experiences. Consideration of these subjects requires the students to have a working understanding of how race, class, sexuality, gender and other aspects of people’s lived realities impact their experiences of being labeled and/or treated within the mental health system.

Working individually or in groups of 3 or 4, students write and record/perform their own 2 to 3-minute radio play set in present time. Student plays should incorporate  language of today which imparts expectations of normalcy, i.e. words that are judgmental, value-laden, or even discriminatory. 

Learning Activity Type: 

Think Piece on Governmentality

Timing: 
50 minutes

Professor Kathy Kendall, the sociologist who discovered the 1940s radio plays, describes them as an example of governmentality, the creation of the ideal Canadian citizen through the guidance of mental health experts and the use of public education. Hear Kendall make these connections.

Kathleen Kendall analyzes the bigger aims of the post-war CBC/CMHA radio plays.

8 minutes

Have your students write a short essay or create a classroom presentation on the use of media in early Canadian mental health education as an illustration of the concepts which Kendall outlines in her explanation of the concept of governmentality.

This exercise can also be used as a graded assessment.

Learning Activity Type: 

Moving From Stigma to Action: Pat Capponi in Parkdale

Takeaways: 

  • Understand the importance of adequate personal and systemic support in ameliorating discrimination and marginalization in mental health
  • Appreciate the role of empathic knowledge informed by lived experience in fostering successful advocacy and activism

Learning Lens: 

Woman wearing cowboy hat sitting at banquet table

Pat Capponi in the 1990s wearing her trademark cowboy hat.

In the late 1970s Pat Capponi was released from a Toronto hospital psychiatric ward into the community of Parkdale. She went to live in a local boarding house, one of many former grand homes in the area that had been converted by private landlords into housing for psychiatric patients. Capponi’s initial reaction to her fellow boarding house residents was fear and repulsion, but she became an empathetic observer of impoverished people struggling to adjust to community living without adequate supports.

The trajectory of Capponi’s life was different her fellow boarding house residents, many of whom died in the decade following her boarding house stay. Capponi did not just survive; she emerged as a community activist and political force in Toronto’s social justice scene. She also wrote about her experiences and the people who were part of her boarding house life in the 1992 book Upstairs in the Crazy House: The Life of a Psychiatric Survivor. Set alongside audio segments from an interview with Capponi and selections from Toronto’s 1980s psychiatric survivor newspaper Phoenix Rising, evocative vignettes from Upstairs form the basis of this teaching unit.

Artefacts in Context: 

Pat Capponi’s activist memoir Upstairs in the Crazy House is not a local Toronto story. During the latter half of the twentieth century, in Canada and in other western nations, mental health care was transformed as patients were released from long-stay mental health facilities and relocated in the broader community. The motivations behind this policy shift were a complex blend of fiscal imperatives to fit costly mental health services into emerging welfare state funding structures, the availability of new pharmacological therapies, and emerging humanistic notions of social integration and patient rights.

Evaluating the Artefacts:

Moving From Stigma to Action: Self-Guided Learning

Living on the frontlines of community mental health during her stay at the Parkdale boarding house, Pat Capponi found an identity and a purpose in her Parkdale boarding house, creating coherence out of chaos of early deinstitutionalization. What makes her story such an excellent teaching tool is that it makes real the discriminatory and deeply stigmatizing aspects of the deinstitutionalization project. Students can work with Capponi’s thought-provoking artefacts either online or in class. These self-guided resources are well suited for flipped classroom use with an in-class or online discussion or learning activity. 

Capponi’s portraits of poverty with their details of deprivation and depression make even less sense when the reader tries to match them up with the phrases “independent living” and “community living’, buzzwords of the new era of mental health ushered in when the old guard institutions closed their doors. Read her description of winter in the Parkdale boarding house.

Listen to Capponi share her memories of mice infestations in the larder, uncaring bureaucracies, and the bedroom fires where she was left wondering, “Did everyone get out alright?”.

Pat Capponi recalling Parkdale boarding house life in the late 1970s.

6 minutes

A young woman with a college education, Capponi found boarding house society with its faces of madness, eccentric behaviors, and bodies clad in mismatched clothing hard to handle. But over time stereotypes became people, some of them firm friends, others to be handled with additional caution or kindness. She wrote about this in her book too.

Another thing happened to Capponi during this period. Tutored by experience as a student activist at college, she came to understand the systematic contours of discrimination in the post-asylum world. Read this Capponi quote on housing as a human rights issue which splashed across page 9 of the November 1982 issue of Phoenix Rising, Toronto’s psychiatric survivor tabloid.

Capponi’s emerging understandings of the situation of people with mental health histories as systemic discrimination fueled the emergence of an activist willing to take on the system. Listen to her describing early tactics that she and others employed to pull media cameras into the boarding houses and push government into action.

 Pat Capponi sharing stories of early mad activism in Toronto.

3 minutes

Read about Capponi’s career as an activist after she left the boarding house. Appreciate the role of empathic knowledge informed by lived experience in fostering successful advocacy and activism.

 

From Dislocation to Empathy to Activism

Timing: 
30 minutes

Pat Capponi’s story depicts her boarding house journey as one from dislocation to empathy to activism. Students can explore a similar journey and develop empathic critical thinking skills and a set of ideas for a successful job interview at the same time.

Directing students to all or a selection of the unit artefacts before class (online), ask them to begin by reflecting on what specific aspects of Capponi’s narratives they recognize in today’s mental health world and how they honestly responded to Caponi’s descriptions of her fellow boarding house residents.

Then tell students that they have a job interview for work in a supportive housing project. Capponi is on the hiring committee and wants them to answer 3 challenging questions that require they demonstrate empathy, critical thinking, and an appreciation for successful advocacy and activism.

  • There are a number of lessons that can be learned from my stories. Which one is most relevant today?
  • How would you work with me, and what could we do together that we couldn’t do alone?
  • Instructors can create a scoring guide or rubric for assessing interview answers or have students do this so they can consider elements of a high quality response.
Learning Activity Type: 

Getting to Activism

Pat Capponi and veteran Vancouver activist and writer Lanny Beckman have never met each other, but wouldn’t they have an interesting conversation if they did? Imagine the two talking about the life moments and influences that helped push them from personal dislocation to empathy and then to activism? Dividing students into 2 groups, have one person in the first group take the role of Capponi and another from the second group take the role of Beckman in a conversation role play. Other group members can act as coaches, suggesting topics of conversation and possible responses.

Learning Activity Type: 

What If? Using Satire to look At Stigma

Takeaways: 

  • Recognize stigmatizing attitudes toward mental health and mental health patients, as compared to other medicalized conditions and patients categories

Learning Lens: 

Humour is a useful teaching device, especially in exploring ideas of normalcy. What if we treated cancer patients as we treat mental patients? This short satirical piece by humorist and project community expert Lanny Beckman explores this question.

Evaluating the Artefacts:

Cancer Prisons: Intersectional Analysis

Timing: 
40 minutes
Graphic of small child holding a teddy bear and wearing striped "jail garb"

Would you put someone in jail for having cancer?

Use Beckman’s piece titled “Cancer Prisons” as a prompt for your students in a creative writing or cartooning exercise. Ask your students to respond to Beckman’s satirical treatment of the criminalization of mental difference and substance use. Encourage them to use humour (carefully!) to delve deeper into the ways in which people’s experiences of the mental health system are shaped by one of the following: race, class, gender or sexuality. Then bring student cartoons and creative writing pieces together to demonstrate and discuss how an intersectional analysis of oppression helps us understand the different ways power operates within the mental health system. This can be done in class or uploaded to a course website or discussion board.

Learning Activity Type: 

Us and Them: Stigma and Professional Separation

Takeaways: 

Lanny Beckman devant l'entrée du centre d'accueil de jour de la MPA

Community Expert Lanny Beckman, 2013

  • Recognize the profound dislocation of self and identity in mental health crises 
  • Appreciate the importance (and challenges) of empathic and critically-informed practice in bridging the distance between mental health practitioner and service user

Learning Lens: 

Why does professional training teach us so little about the lives of people who struggle with mental health difficulties? Why is empathy problematic in the professional encounter? Is effective empathy possible without critical thinking? In a memoir recounting his own history with the study and practice of mental health, project community expert Lanny Beckman considers the “otherness” of mental illness, reminding readers that there can be very little separating Us and Them.

Evaluating the Artefacts:

US and Them: Self-Guided Learning

Timing: 
10 minutes

In class or online, students can read Lanny Beckman’s memoir, a compelling consideration of the distance between mental health practitioners and people who live with mental health diagnoses. Ask students to use the following themes to guide their consideration of this artefact:

  • Professional knowledge vs. life and world knowledge (experiential knowledge)
  • Objectification of suffering
  • Compassion and wisdom
  • Otherness
Learning Activity Type: 

Us and Them: 2 Minutes / 5 Minutes and Report Back

Timing: 
20 minutes

Lanny Beckman explores the differences between what he learned about mental health in the university classroom versus his lived experience in the mental health system.

Dividing the class into small groups, give your students 2 minutes to talk about what parts of their program curriculum might contribute to the “us and them” views of people with mental health diagnoses. Next, have your students spend five minutes talking about ways in which their curriculum could link critical thought and empathy. If time permits, have each small group report back to the class with their top three ideas. This exercise can be done online with groups reporting their top three ideas to the course learning management site.

Learning Activity Type: