Foundations in Mental

Health and Addictions

 
ADMH 5001
Unit One – Weeks One and Two
Sylvia Starosta
Sylvia.starosta@humber.ca

This Photo by Unknown author is licensed under CC BY-NC-ND.

Unit One – Introduction to Key
Concepts in Mental Health and
Addictions
What are we talking about?
 Mental Health
Mental Illness
Mental Disorders
Key Terms Substance Use

for Unit Addiction

One: Conurrent Disorder

Harm Reduction
Recovery
Stigma
 Mental Health Continuum

• https://www.youtube.com/watch?v=ihT2e903E5I

• Discussion

• What did you already know

• What did you learn
BREAK
Mental Health
A sense of Strong
purpose relationships

Feeling
Having a good
connected to
sense of self
others

Coping with
Enjoying life
stress

Canadian Mental Health Association https://cmha.ca/blogs/mental-health-what-is-it-really

Defining Mental Health
“A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and
emotional capabilities, function in society, and meet the ordinary demands of every day life.” (World Health
Organization (WHO), 2010a). 

Mental Health includes the ability to:

• Understand oneself and one’s life
• Relate to other people and respond to one’s environment
• Experience pleasure and enjoyment
• Handle stress and withstand discomfort
• Evaluate challenges and problems
• Pursue goals and interests
• Explore choices and make decisions
Mental Health exists
along a continuum

• Diminished capacities—cognitive,
emotional, attentional,
interpersonal, motivational or
behavioural—that interfere with a
person’s enjoyment of life or
adversely affect interactions with
society and the environment

• Eg. frequent frustration or

irritability, burnout, feelings of
stress, excessive worrying

This Photo by Unknown author is licensed under CC BY-SA.

Definition of Mental Illness
• Just like cancer or diabetes, mental illness is a medical condition that affects the lives of individuals experiencing related
symptoms. Mental illness can affect an individual’s thinking, mood, personality and daily functioning. Symptoms can range
from mild to severe, but early intervention and treatment can lead to recovery, well-being and a successful future for
individuals faced with mental illness.
• One in five people will be affected by mental illness in their lifetime. Mental illness can affect individuals of any age, race,
religion or income level, and there are many treatment options available to develop individualized recovery plans.
• In addition to medication, other forms of treatment include cognitive behavioural therapy, psychiatric and psychological
therapy, group therapy and peer support counselling. Diet, exercise, good sleeping habits, meaningful activities and a
positive environment are also very important in achieving and maintaining a successful recovery.
• Serious mental illness can include, but is not limited to, depression, bipolar disorder, schizophrenia, anxiety disorders,
eating disorders, personality disorders and post-traumatic stress disorder (PTSD).
Mental Illness and
Mental Disorder(s)
• The defining of mental illness and
mental disorders relies heavily on the
diagnostic criteria of the Diagnostic
and Statistical Manual (DSM).
• The DSM has undergone a
few iterations, with the DSM-
5 currently being the most recent
publication
• We will discuss the DSM-5 further in
Week 8 (unit 3)
Mental Illness cont'd
• Mental disorders or illnesses are clinically significant patterns of behavioural or
emotional function that are associated with some level of distress, suffering, or
impairment in one or more areas of functioning

• The National Institute of Health (NIH) defines mental illness as “a health condition that
changes a person’s thinking, feelings, or behavior (or all three) and that causes the
person distress and difficulty in functioning.”

• The Public Health Agency of Canada defines mental illness as “characterized by

alterations in thinking, mood, or behavior associated with significant distress and
impaired function.”
Substance Use
• There are many views about substance use
across individuals, families, and cultures
• Reflective question: What are the beliefs
your friends/family hold about substance
use?
• It is helpful to think about substance use along a
continuum, informed by personal values/beliefs,
frequency, quantity, purpose, benefits and harms
• Reflective question: If your own substance
use, or that of a friend, were to become
'problematic', how would you know? What
would the indicators be?
Substance-Related and Addictive  Disorders
Now a large classification (over 100 pages!) under the DSM-5:
• Alcohol-related disorders
• Caffeine-related disorders
• Cannabis-related disorders
• Hallucinogen-related disorders
• Inhalant-related disorders
• Opioid-related disorders
• Sedative-, Hypnotic-, or Anxiolytic-related disorders
• Stimulant-related disorders
• Tobacco-related disorders
• Other (or Unknown) substance-related disorders
• Non-substance-related disorders (DSM-5 only identifies Gambling)
 Johann Hari: 'Everything you think you know about
addiction is wrong'
https://www.youtube.com/watch?v=PY9DcIMGxMs

Views of
• What stands out to you about what is being said
Addiction here?
• What does this talk challenge about your own
beliefs?
• What do you agree/disagree with, and why?
Addiction
• We can understand addiction as a
particular concern along the
substance use continuum,
however
• Addiction is not only in reference
to substance use 
 Factors for Consideration in Addiction

1. Salience
• The behaviour/substance is one of the most important things in a person's life.
2. Mood Modification:
• The behaviour/substance produces a desired effect that the person struggles to obtain otherwise.  Can include a
'rush', an 'escape', a 'calming', etc.
3. Tolerance:
• The person must engage with the behaviour/substance more and more frequently to achieve the desired effect.
4. Withdrawal Symptoms:
• The person experiences withdrawal when the behaviour/substance is unavailable/unobtainable
5. Harm and/or Conflict:
• Ongoing use or engagement in the behaviour despite the experience of harm. This can include direct or indirect
harm, conflict or negative consequences from the susbtance/behaviour.
6. Relapse:
• The person struggles to abstain from the behaviour/substance, despite a desire and intention to do so.
Concurrent Disorders
• A combination of mental/emotional/psychiatric
problems with the abuse of alcohol and/or
another psychoactive drug and/or gambling.  
Mental Concurrent Substance
(Health Canada) Illness Disorder Use
• People with mental illness have much higher rates
of substance addiction than people in the general
population. 
• Individuals with substance addiction have much
higher rates of mental illness than people in the
general population.
(https://ontario.cmha.ca)
 • Careful not to confuse CD with the term "Dual
Diagnosis" (DD).  DD is a term used to describe
mental health issues experienced by people with a
developmental disability.
Concurrent • Developmental disability - when a person has
significant limitations in cognitive functioning
Disorders (intellectual capacity to reason, organize, plan,
make judgments and identify consequences) and

cont'd adaptive functioning (capacity to gain personal

independence, based on the person’s ability to
learn and apply conceptual, social and practical
skills to everyday life).
JANUARY 18 2022
 Understanding Stigma

https://www.youtube.com/watch?v=IpgKDKAhwBQ
 

Discussion
1. What percentage of Canadians will be affected by mental illness
directly or indirectly in their lifetime?
a) 10%
b) 50%
c) 65%
d) 100%
The correct answer is 100%
• 100% of us will be directly or indirectly impacted by mental illness (MI) in our lifetime
[Fast Facts: Mental Health/Illness – Mental Health Awareness Week May 2011 (Canadian Mental Health Association)
Here are the facts.
• One in five Canadians will suffer from mental illness in their lifetime.
• 15% of children and youth are affected by MI at any given time.
• 15-20% of women develop post-partum depression.
• One in 13 seniors over 65 will be affected by Alzheimer’s disease.
• In the world , the rate of suicide is one every 40 seconds.
• The strongest predictor of a physician visit or a hospitalization is depression or another psychological health
issue.
• The facts highlight the pervasiveness of mental illness and addiction and the reality that these issues touch us all.
2. The likelihood that people with mental illness will commit a violent
act.
 
a) Not likely
b) Likely
c) Very likely
d) No greater than the general public
The correct answer is No greater that the general public.
• In fact, people with mental illness are 2.5 times more likely to be victims of crime.
• Many of us still have concerns about our safety with individuals who have mental health issues. These fears are
fuelled by the media. The MHCC is targeting the media to try to ensure accurate portrayals of people with mental
illness and substance use. At a 2009 Anti-Stigma Symposium for journalism, nursing, social work and justice
students, the importance of raising awareness of the role of the media in perpetuating stigma was highlighted.
Otto Wahl, of the University of Hartford noted “the media portrays people with mental illness as violent and
dangerous and most are not”.
• Another presenter who has mental illness noted that growing up in a small town, the only time he heard about
mental illness was when something bad happened. When he started to experience symptoms, he didn’t seek help
because he thought having a mental illness was an “insult”. This example demonstrates the impact of stigma.
• Research demonstrates that more than one third of the stories presented by the media about MI focus on murder
and violent crimes. (MHCC website).
• We need to be informed and weigh what we read and hear with the facts to help us have a more balanced view.
3. Drinking alcohol increases one’s risk of developing a number of chronic health
problems. Which of the following health problems are related to drinking alcohol?
a)cancers of the breast, colon, rectum, liver, esophagus, head and neck (for
example, mouth, larynx and pharynx)
b) cardiovascular diseases such as heart disease and strokes
c) liver disease
c) inflammation of the pancreas
e) alcohol dependence
f) mental health problems.
g) All of the above
The correct answer is All of the above.
• The interconnectedness of alcohol use and physical health issues is important to understand when working
with people with substance use issues.
• How alcohol affects the individual depends on how much and how often they drink.
• For example, for middle aged and older adults, as little as one drink every day can help protect against heart
disease. On the other hand, three or more drinks per day increases the risk of high blood pressure, stroke
and heart problems.
• Alcohol also increases the risk of liver, throat, breast and other cancers.
• Alcohol dependence often results in clinical depression and the rate of suicide is six times higher amongst
those who are dependent on alcohol.
(Centre for Addiction and Mental Health)
4. What causes mental illness?
a) Poor parenting
b) Making poor choices
c) A complex interplay of genetic, biological, personality and environmental
factors causes mental illnesses.
d) Bad luck
The correct answer is a complex interplay of genetic, biological, personality and environmental
factors causes mental illnesses.
• Like physical health problems, mental health problems arise from the interaction of many factors
(Fast Facts: Mental Health/Illness May 2011).
• In the past, people often blamed parents unfairly for mental health issues in their children.
• We know now that strong and supportive parenting can be an incredible resource.
• Some parents have challenges that impact their parenting abilities.
• It is important to address these issues sensitively.
• Judging or blaming builds stigma and may prevent parents from seeking.
5. Stigma prevents many people from seeking treatment. What
percentage of those who feel they have suffered from depression or
anxiety have never gone to see a doctor about this problem?
a) 5%,
b) 10%
c) 25%
d) 49%
e) 75%
The correct answer is 49%
• Almost one half of those with depression or anxiety have never gone to see a
doctor about this problem.
• Stigma and discrimination is a serious barrier, not only to diagnosis and treatment
but also to acceptance in the community.
• Some studies have shown that two thirds of people struggling with mental health
and addiction issues have not sought help.
6. Mental illnesses can be treated effectively.
a) True
b) False
The correct answer is True
• Mental illness can be successfully treated .
• Medication, counseling, and other services significantly reduce symptoms and
help improve quality of life for up to 90% of those with MI.
• Mental illness if left untreated results in longer periods of dysfunction and
painful feelings.
• Early intervention can make a dramatic difference.
• Currently, only 1 in 6 children get treatment.
7. We have some control over our mental health.
a) True
b) False
The correct answer is True.
• We cannot control our genetics, upbringing and family history.
• However most of us can control how we react.
• We can promote our mental health.
• We can learn ways of coping, of thinking and ways of looking at things that will
make it less likely that we’ll experience a mental illness.
• Some people do become unwell and then it is up to health care providers to
support and assist them.
8. Only professionals with extensive experience treating people with
mental health and addiction issues can help individuals who are
seeking help.
a) True
b) False
The correct answer is False.
• Healthcare professionals can provide help without expertise in
mental health.
• Staff can make a very positive impact by providing care,
communicating with kindness and compassion, and facilitating next
steps.
9. Someone close to me (a friend, relative or colleague) has or has had
a mental health or substance abuse problem.
a) Yes
b) No
• When this question is asked in a group, 75-100% of attendees raise
their hands.
• Responses to this question clearly demonstrate the pervasiveness of
mental health and addiction issues.
• If you have indicated that someone close to you has or has had one of
these issues, then you know the impact and understand the
pervasiveness.
Now that you have tested your knowledge through our quiz,
please copy and paste the following link into your browser and watch this short video.
https://youtu.be/ezI2W32yNg8
While you are watching, think about what one thing you can do differently.
The key message of this learning module is,
“Stigma…you can make a difference. Look beyond the mental illness and addiction.”
We hope that you will be able to incorporate what you have learned today. We know that you will
make a difference!
 • 'Stigma' refers to negative stereotypes held about a
particular circumstance, experience or person
• What are some of the negative stigmas you have
heard surrounding:

Stigma • Mental illness?

• People who use substances?
• People living in poverty?
• Suicide?
Stigma relies on particular perceptions:
• The issue/concern is considered the sole responsibility of the person
•“They chose to use drugs.”
• The issue/concern is seen as permanently dammaging
•“If this happens to me I will never be the same.”
• The issue/concern is considered highly contagious and harmful
•“If I get this disease, I will die!”
• The issue/concern is believed to be harmful to others 
•“He’s schizophrenic, therefore he’ll hurt me.”
• The issue/concern is believed to disrupt social interactions
•“Don’t invite them, they’ll make people uncomfortable.”
• The issue/concern is perceived as repellent or disgusting
•“Those people are disgusting, they make me sick!”
Discussion:
• What are some of the
effects these stereotypes
might have?
• Where does stigma come
from?
 Stigma is a negative stereotype and discrimination is
the behaviour that results from this negative
Stigma and stereotype. 

Discriminatio There are two broad types of discrimination:

n Structural and Personal/Individual

Structural Discrimination
Formed by sociopolitical forces and represents policies of private and government institutions that
restrict the opportunities for stigmatized groups.  Examples can include

Resource Allocation  Legislation and Policies  Health Care &

•  decisions about how money • include human rights Treatment
is spent, and for what, are violations, and/or those which •  assumptions about who is
informed by who and what is restrict personal autonomy deserving of care, and poor
deemed to be 'important'.   based on negative perceptions quality of care 
of capacity 

Education & Criminal Justice Media 

Employment Exclusion
• barriers in accessing
education;  barriers to
employment
• bias in the development and
implementation of laws and
punitive practices
• ongoing discourse that
reinforces negative
stereotypes (belief in
violence,aggression, blame or
helplessness)
Personal Discrimination
Exist between individuals as well as groups of people.  Examples can include:

Limited opportunities  Social exclusion One-dimensional

•  decisions about who is
capable of attaining particular
achievements and who  is
deserving of opportunities for
success
• Not being welcomed to personalities
participate in social • Assuming that one quality or
activities/groups feature defines everything
about that person

Questioning credibility Removal of Autonomy

• Assuming someone is lying;
questioning a person's ability
due to the way the look
• Assumptions that some
people don't know how to
take care of themselves, or
make decisions for
themselves.
 • Avoiding stereotypes – every person is a unique
individual with their own
Avoid experiences/needs/values
• Recognizing strengths – don't define people by
stigmatizing their difficulties or problems
• Including people in discussions and decisions that
others by: affect them "nothing about us without us"
• Being mindful of language and how you talk about
people is always important
 Examples of Language

Instead of..... Try.....

Addict Person living with an addiction
Crack-head/meth-head/junkie Person who uses [substance]...
Schizo Person (diagnosed) with schizophrenia

Clean/sober Maintaining abstinence

Non-compliant Chooses differently
Prostituting Engaging in sex work
 • Refers to policies, programs and practices which
aim to reduce the negative health, social and
economic consequences that may result from the
use of drugs, without necessarily reducing drug
use.
• The cornerstones of Harm Reduction are public
Harm health, human rights and social justice.
• Seeks to ensure people who use substances are
Reduction treated with respect and dignity
• Recognizes the inherent worth of every person
• Seeks to maintain autonomy of self
• Recognizes and seeks to address the harms
perpetuated within health, education, and
criminal justice systems

(Street Health: https://www.streethealth.ca/services-old/harm-reduction-
program)
Harm • What are some examples of harm reduction you
are aware of?

Reduction • What are some examples of how the principles of

harm reduction can be applied to:
• Self-harming behaviour?
• Sex work?
Recovery
Recovery is the personal process that
people with mental illness go through in
gaining control, meaning and purpose in
their lives.
Recovery involves different things for
different people. For some, recovery
means the complete absence of the
symptoms of mental illness. For others,
recovery means living a full life in the
community while learning to live with
ongoing symptoms. (CMHA, 2020)

This Photo by Unknown author is licensed under CC BY.

Unit One Wrap
Up
We covered the following terms and concepts:
• Mental Health
• Mental Illness
• Mental Disorders
• Concurrent Disorder
• Substance Use
• Addiction
• Harm Reduction
• Stigma
• Recovery
 Unit One Wrap
Up
• Your Reflective Paper assignment
(10%) is due Mon Sept 20th
• Submit on Blackboard via Assignment
tab, you will receive email confirmation
when it has been submitted
• We will start next week with the Unit
1 Test (15%)
• You will have 60 min to complete the test
• The test is comprised of short-answer
questions, for a total of 15 marks.