1. David Oddie, B.Sc., M.A., M.S.W., R.S.W.
Employment Support and Development Team
Community Support and Research Unit
Centre for Addiction and Mental Health
Mental Illness:
What it is
Myths and Facts
Accommodation
Recovery

2. Agenda
• Mental Illness
• Types of Mental Illness
• Accessing Support
• Myths
• Points to Remember
• Accommodations
• Recovery
~~~~~~~~~
• The Social Determinants of Health
• Information about CAMH and the CSRU
• Assessments and Crisis Support

3. Mental Illness
• Mental illness encompasses a wide range of
illnesses which can affect an individual’s
• mood
• thoughts
• perceptions
• behaviour

4. Diagnosis
• Based on observation of behaviors
• No x-ray, blood test, cat-scan, swab, etc.
• Uses the Diagnostic Statistical Manual (DSM)
+• can help identify common
patterns and support research
that provides relief
-• Does not predict a person’s ability to
function at work or school
• Can often imply a greater
understanding of the condition than
actually exists

5. Categories
1. Mood disorders
2. Schizophrenic disorders
3. Anxiety disorders
4. Personality disorders

6. 1. Mood Disorders
Depression
• Prolonged feelings of sadness
and despair
• Hopelessness and
helplessness
• Fatigue, lack of energy
• Slowed thinking
• Forgetfulness
• Loss of interest in activities
• Change in eating and sleeping
patterns
• Agitation
• Affects about 10-25% of
women and 10–15% of men.
Bipolar
• Mania
• Depression
• Mixed State
• Hypomania
• Affects about 1-2% of population
Dysthymia
• Chronic, mild depression
• Affects about 1.5% of population
(National Institute of Mental
Health, U.S.)

7. 2. Schizophrenic Disorders
• Problem with brain chemistry/brain development
• Affect men and women equally
• Have a genetic predisposition
• Appear in cycles of remission and relapse
• Treated by medication, therapy, psycho/social
rehabilitation
• Affects about 1% of population

8. 3. Anxiety Disorders
• Anxiety that is disproportionate to reality
• Undermines a person’s ability to do everyday activities
• Anxiety also accompanies other psychiatric disorders
• Often appears in adolescence or early adulthood
• Affects more than 12% of population
• Examples:
• Panic Disorder
• Generalized Anxiety Disorder
• Obsessive Compulsive Disorder
• Phobias
• Post-Traumatic Stress Disorder

9. 4. Personality Disorders
• Many forms; often secondary diagnosis
• Patterns of behaviour, thoughts, feelings, relationships that differ
significantly from those of the culture
• Inflexibility
• Difficulty with interpersonal relationships
• Onset during adolescence or in early childhood
• A recent survey (U.S./U.K./Norway) showed a range of 4-14% of the
population having one. Up to 50% of prison populations have PD.
• Examples:
• Paranoid Personality Disorder
• Schizotypical Personality Disorder
• Antisocial Personality Disorder
• Borderline Personality Disorder
• Narcissistic Personality disorder
• Avoidant Personality Disorder
• Dependent Personality Disorder

10. Common Associated Issues
• Pharmacological side effects
– Cognitive delay, lethargy/drowsiness, weight gain, fatigue
– Client frustration with drugs and effects
• Secondary disability
– loss of vocational trajectory
– loss of family/friend networks
– feeling trapped by the system
• Poverty

11. Summary
• Mental illness is about mood, thoughts,
perceptions and behaviour
• Mental illnesses can have few or many
symptoms
• Symptoms can have varying degrees of
intensity, from negligible to extreme
• Impact on people’s lives is variable

12. Myths and Facts

13. Myths and Facts
• 1 in 5 people in Ontario will experience
some form of mental illness
• Only about 30% of us seek assistance

14. Facts
Reasons People Don’t Access Support
• No insight themselves into mental illness
• Not knowing who to tell or how to access support
• Trying to handle symptoms on their own
• Feeling ashamed or embarrassed that they need
assistance

15. Real
Difficulties With Disclosure
• stigma
• feeling different/not belonging
• don’t want to be labeled
• fear of being rejected, discriminated against
• fear around confidentiality
• fear they will not be treated with compassion
• fear this will become their identity

16. Myth
Recovery from mental
illness is not possible.
Fact
The majority of
people with mental
illnesses show
genuine
improvement over
time and lead stable,
productive lives.

17. Myth
All mentally ill
individuals are
unpredictable, violent
and dangerous.
Fact
The vast majority of
people with mental
illness are not
dangerous or violent.
This myth is reinforced
by sensationalized
portrayals in the media.
– The rate of instances of
dangerous or violent
behaviour by a person with
schizophrenia parallel the
rate for the normal
population
– The rate of being on the
receiving end of violence is
3x higher for a person with
a schizophrenia diagnosis

18. Myth
Employees with
mental illness are
second-rate
employees.
Fact
Employers report
higher than average
attendance and
punctuality from
employees with mental
illness.
Motivation, quality of
work and job tenure
are reported to be as
good as, or better than,
other employees.

19. Points to Remember
• Mental illness is treatable, and the majority of people
make a good recovery
• Not everyone with a mental illness takes, or should take,
medication
• Within each illness there is tremendous variation of
symptoms and degrees of symptoms
• Also variation in how a person copes with an illness and
how it impacts their lives
• Each person is the expert on what is problematic for
them.

20. Actions To Remember
• Important not to assume that you know what a person
can or cannot handle
• Don’t attribute every behaviour to an illness
• Demonstrate understanding and support, but set
reasonable expectations
• Do not assume that all individuals with mental illness
require accommodation
• Respect confidentiality – build a trusting relationship

21. Accommodating people’s needs

22. Accommodations
• Modifications to the school/workplace or its
procedures
• Can allow a qualified employee/student with a
mental or physical disability to perform the
essential tasks
• Can minimize or remove barriers to success for a
person with mental or physical issues

23. Accommodations
• A request for accommodation requires some degree of
disclosure
– This is one of the most difficult aspects of accommodation
• The act of disclosure is always assisted by an explicit
discussion of confidentiality
• The accommodation and the process of instituting it must
ensure individual dignity and respect
• Costs, if any, are usually quite low (averaging $500 for
non-physical barriers)
• People who need them don’t necessarily need them all
the time

24. Examples of Accommodations
• Flexible working/classroom hours
• Part-time attendance in workplace/classroom
• Instructions given verbally and in writing
• Longer learning period
• A buddy or mentor
• Assistive devices

25. Examples of Accommodations cont.
• Job modification or restructuring
• Providing training to staff/teaching staff or
supervisors (in the workplace)
• Modifying exam time and/or environment
• Modifying physical environment (e.g. using
environments with less distraction/stimulation)
• All types of accommodation last only as long as
they are needed

26. Recovery

27. The Recovery Framework
“It is important to understand that persons do not
‘get’ rehabilitated the way that a car ‘gets’ tuned
up.”
- Pat Deegan (psychiatrist-consumer-survivor)
– Developing a sense of belonging, meaning, and
identity apart from one’s diagnosis or disability
– Building or rebuilding a life in the community
– Successfully coping with a disability
– Redefining treatment as aiming for recovery, not a
“cure”.

28. What are clients recovering from?
• Loss of self, connection, hope
• Loss of roles, opportunities
• Multiple recurring traumas
• Loss of educational/employment trajectory
• Devaluing programs, practices and environments
• Social discrimination
• Internalized oppression and shame

29. Recovery Outcomes
• Gaining/regaining valued role
• Success and satisfaction with roles
• Reducing/managing symptoms
• Increased self esteem, feelings of well being
• Enriched interpersonal connections
• Improved physical health

30. • Hope
• Self- Determination
• Personal Empowerment
• Responsibility
• Focus on Strengths Rather than Deficits
• Personal Choice
• Respect
Principles of Recovery

31. The Social Determinants of Health
(The Canadian Facts, Mikkonen and Raphael, 2010)
• Income and Income Distribution
• Education
• Unemployment and Job Security
• Employment and Working Conditions
• Early Childhood Development
• Food Insecurity
• Housing
• Social Exclusion
• Social Safety Network
• Health Services
• Aboriginal Status
• Gender
• Race
• Disability

32. The Community Support and
Research Unit (CSRU), CAMH
• Income and Income Distribution
• Education
• Unemployment and Job Security
• Employment and Working Conditions
• Early Childhood Development
• Food Insecurity
• Housing
• Social Exclusion
• Social Safety Network
• Health Services
• Aboriginal Status
• Gender
• Race
• Disability
• Positive change at the service delivery, CAMH
and systems level
• Involved in a wide variety of projects, including
international projects

33. The Centre for Addiction and Mental Health
About CAMH
• One of the first organizations to bring mental health and addiction services together
• Formed in 1998, merging two mental health and two addiction facilities
• Brings together specialized care, research, province-wide education, health
promotion and public policy development
• Research and clinical practice are intertwined
By the numbers, 2010-11
• 2,859 staff
• 25,572 unique clients
– 30% of whom access addictions services only
• 467,663 outpatient visits
• 3,948 inpatient admissions
• 5,541 visits to Emergency
• 61.6 Average length of stay (days)
• Top two substances reported by clients- alcohol and crack/cocaine
• Postsecondary Education
– 40% of addictions clients
– 27% of mental health clients
• Employed
– 44% of addictions clients
– 28% of mental health clients

34. Assessments at CAMH
• No referral required for Addictions Assessment
Service.
• Client should contact the general intake
telephone line – (416) 535-8501 Ext 6616
• Referral required from physician for mental
health assessment – referral form on CAMH
website www.camh.net
• Emergency Services – 250 College St (no referral
required) – short-term follow-up from Crisis
Clinic

35. More Information
• Mental Health and Addictions 101 series
on CAMH website
http://www.camh.ca/en/education