New resources aim to facilitate open dialogue about mental health and substance use

In an age of increasing polarization and fragmentation, people often find it difficult to address issues around which there are strong opinions and contested evidence. One area that requires people to come together to build understanding is mental health and substance use. Finding unity and empathy may be easier said than done sometimes, but now, thanks to the library of UNITE dialogue resources developed by BC Mental Health and Substance Use Services (BCMHSUS), in partnership with the Canadian Centre on Substance Use Research, people can feel supported in dialogue about this important topic.

“Dialogue is not about trying to persuade or change anyone’s mind. It is about seeking to understand through sharing and listening." - Miriah Hodgins

“The principles of dialogue can be used in so many ways to help bridge the gaps that exist between people with different beliefs and experiences," said Miriah Hodgins, knowledge exchange lead with BC Mental Health and Substance Use Services.

The UNITE dialogue resources are designed for anyone who wants to better understand the experience of stigma, whether that is people with lived experience who may want to share their own story, family members who want to support their loved ones, or people who work with mental health and substance use clients. These new resources are part of the UNITE anti-stigma initiative and go hand in hand with a three-part video series in which patient partners share their stories to challenge stigma.

“Each of the stories in the UNITE videos are so powerful,” said Victoria Maxwell, lived experience strategic advisor with BCMHSUS. “After making the videos, we wanted to take them a step further, creating a way for people to engage with them through dialogue. This means not talking to persuade someone, but bringing people together to understand and learn from one another. These resources are a framework for people to explore their own experience, inspired by the bravery of our UNITE storytellers who did the same.”

Putting resources into action with clients, family, care providers

The dialogue resources were first piloted in group sessions with clients, family members and staff at both the Victoria and Nanaimo Forensic Regional Clinics and have expanded across BC Mental Health and Substance Use Services. In Victoria, family members and staff came together to watch the videos and afterwards, participated in open dialogue guided by the resources. In Nanaimo, the session for clients and their families supported open dialogue to strengthen the understanding of each person’s experience.

"By getting staff, clients and family members to reflect on their own lives through a common theme like 'trust', we were able to show people that there are fewer differences between us than we think.” - Victoria Maxwell

“The first two sessions went really well,” said Maxwell. “We could see the empathy gap getting smaller as we got deeper into the questions. Instead of ‘otherness’, we saw people finding commonality. One topic we discussed was trust. Everyone has experiences with trust, or lack of trust, and what that feels like."

“I really liked that the concept in these sessions that ‘what needs to be said will be said’,” said Michelle, a family member who attended the Victoria group. “I constantly try to diminish the stigma attached to my son and others who have schizophrenia, and I left this gathering feeling surprisingly refreshed.”

"The dialogue session in Nanaimo showed me how stigma can perpetuate the ‘us versus them’ perspective and how dialogue can bring forward the ‘we’ perspective." - Shelley Birchard

Shelley Birchard, manager, Nanaimo and Vancouver Island Forensic Regional Clinics, felt the session supported a deeper understanding of lived experiences. “We are able to come together with our similarities versus being split by our differences, thereby finding common ground and achieve solutions as a collective.”

The team hopes these dialogue companions and resources will be widely adopted by health care providers, clients and families, community organizations and anyone who has contact with those living with mental health or substance use challenges.

“UNITE provided me a platform to put my beliefs and values aside and to be fully open and present to the perspectives and experiences of others,” said Samantha Knudson, a senior social worker with Forensic Psychiatric Services. “I am now able to better understand myself and further improve my understanding of the clients with whom I work through the diverse lenses through which they view the world.”

By helping people to move away from debating more towards active listening, BC Mental Health and Substance Use Services aims to facilitate specific and intentional listening exercises to eliminate stigma.

For more information about the UNITE project or using the dialogue companions, contact BC Mental Health and Substance Use Services.