Occupational Therapy and the PD Stigma

This is an open letter to colleagues far and wide, in the UK and across the pond. With an estimated 1 in 4 adults having a diagnosable mental health condition, chances are not only will a portion of your caseload have a mental illness, but there’s odds that so will some of your colleagues.

I am 1 in 4.

You would think that, given our profession, this would be fine to say, that I wouldn’t need the anonymity of the internet. That it wouldn’t feel like a “confession”. It’s 2018 after all! Unfortunately, not. I’ve had a mental health diagnosis for 12 years, and been a qualified OT for 4 of those. I’m saddened to say that I’ve never come across more stigma about mental illness, in particular BPD, than within mental health professionals.

The day my diagnosis was changed from BPD to something else, was probably the best day in my “mental health patient” life, because I wouldn’t have to listen to colleagues describing those with BPD, and hear them, in ignorance, make assumptions of me too. The power that that one diagnosis can hold over somebody is huge, because it comes along with all of these misconceptions. Now, I don’t think for a second that any of us would directly state any of these prejudices to a service user; it would be unthinkable to tell your client “you’re not really depressed, you’re just attention seeking”. But, I’ve heard this very sentence spoken in a staff office about someone with a BPD diagnosis. “He’s acting out, it’s just behavioural, not mental illness”… “She’s being deliberately manipulative”… “They self-harm? Probably a PD” … “He has PD, he’s difficult”

These are all examples of prejudices I’ve heard – in a variety of settings – repeatedly, throughout my time as both a professional and as an OT student. Think about it, and you can probably come up with examples from your own role where you’ve heard “the BPD stigmas”.

I know from experience that some of your reactions to this will be “but we need to discuss caseloads”, and I wouldn’t suggest otherwise. All I’m asking – pleading, really – is that you think first. Can I say this in a less stigmatised way? Because, sure your clients may not be aware you have this stigmatised view of them, but your colleagues do. Unless they disclose, you won’t know who of your colleagues has a label. Can you imagine coming into work and hearing that because of this diagnosis, you’re manipulative, attention seeking, even damaged? Would you ever say these things directly to someone you work with? Because they’re hearing it anyway.

I don’t even have the label anymore, yet it still feels risky to say I once did. In the words of Albus Dumbledore, “Fear of a name increases fear of the thing itself”. So, I’m Ozias. I had the diagnosis of BPD. I know colleagues who are in therapy, have a BPD diagnosis, and are still damned good practitioners. You can be a good practitioner and have a mental health difficulty.

Stigma isn’t helpful to anyone. It’s the exact opposite. So please, let’s be more reflective when it comes to our conversations, in the office as well as out.

If there is stigma in your health care team…
If there is stigma in your department …
If there is stigma amongst your health professional friends.

Don’t stand for it. Please email, print, save and share this testimony. You can be the change for a colleague struggling in silence.

#occupationaltherapy #personalitydisorder #borderlinepersonalitydisorder#stigma #endstigma #healthcareprofessionals #alliedhealth #nursing#socialwork #psychology #psychiatrists #OT #mentalhealth