Stigma in Mental Health

by: Natalie Guenette, M.A.

Stigma is a negative judgment and stereotype that brings people to feel ashamed, dismissed and dehumanized. People can be stigmatized by family, friends, colleagues, in social media, and sometimes even by health professionals. It changes how people see and feel about themselves, but also how other people see them. People living with mental health and substance use issues can be profoundly affected by stigma. They can isolate themselves for fear of being judged, which can bring them to have low peer support. It can prevent people from disclosing a mental health diagnosis and increase suicide risk.

Stigma is one of the greatest barriers to help-seeking and treatment, which can delay diagnoses and treatment options for people affected by stigma, however, there are ways to change this.

  1. Educate yourself and others around you by asking questions and doing research: you can visit for informative resources;
  2. Be mindful of the language you use to talk about mental health and substance use (i.e. non-judgmental, inclusive and respectful language);
  3. Be aware of your attitudes and opinions: upbringing and society can influence your views on mental health and substance use; and
  4. Speak up when you hear or see something that is stigmatizing: people do not always realize the impact they have on others and it is sometimes a question of not knowing all the facts about certain topics.

Clinicians at CFIR provide evidence-based treatments to individuals from an array of backgrounds based on their needs and personal differences. We continue to stay informed about leading-edge research related to the presenting issues of the clients who come to our offices.

Natalie Guenette, M.A., is a counsellor at the Centre for Interpersonal Relationships (CFIR) in Ottawa. She employs treatments that include aspects from Cognitive-Behaviour Therapy, Mindfulness-based Therapy, Motivational Interviewing, and Psychodynamic Theory, and she has an interest in working with adults experiencing a diversity of psychological and relationship issues. Natalie is currently completing a Master of Arts in Counselling Psychology at Yorkville University. At CFIR, she is under the supervision of Dr. Karine Côté, C.Psych.


Canadian Mental Health Association. (n.d.). Stigma and Discrimination. [online] Available at: [Accessed 29 Nov. 2019].

Centre for Addiction and Mental Health. (n.d.). Addressing Stigma. [online] Available at: [Accessed 29 Nov. 2019].

Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare management forum, 30(2), 111–116. doi:10.1177/0840470416679413

Mental Health Commission of Canada. (2019). Stigma and Discrimination. [online] Available at: [Accessed 29 Nov. 2019].

The Big Tent of Psychotherapy

Life can seem like a circus at times. We can feel like we are goofy clowns needing to always act silly or angry lions having to growl at everything. We could feel like brave acrobats, smiling in the face of danger, but needing to engage in death-defying stunts. We could feel like cyclists trying to balance on one wheel, contortionists trying to fit into impossible spaces, jugglers keeping all the balls in the air at once, or majestic elephants dancing to others’ tunes. Most of the time, we feel like ringmasters trying to keep all our different acts running smoothly, as part of a big show.  

Life presents its challenges in a similar vein. Sometimes our needs are about doing better in some areas, like managing our time and achieving the goals we have set for ourselves. At other times, we want to reduce our distress by managing our difficult emotions or problematic behaviours, like addictions. Deeper still, we need help with understanding our unhelpful patterns or in dealing with relationship issues. We could need help with managing our social situations or our physical pain. We might wish to work on our issues as individuals, or as parents, couples or families. We might need assistance in coming to terms with traumatic issues that happened decades ago, or yesterday. Perhaps we need to find ourselves, our identities, or our own answers to life’s challenging existential and spiritual questions. Often, we can feel that we are trying to manage more than one of these challenges, again as part of some big show. 

Psychotherapy is a framework that attempts to be an answer to these varied questions and challenges that present themselves to us. Psychotherapy can be the big tent, the space where all these different roles, problems, needs, wants and desires reach awareness, exploration, discussion, insight, and resolution. People often view psychotherapy as applicable only to others and not to their own problems. We often experience ambivalence about psychotherapy, with one part our self moving towards getting help, while another part wanting to avoid it at the same time. There are too many preconceived notions and stigmatizing ideas about psychotherapy in the media and culture around us to list here. Needless to say, such notions and ideas hurt rather than help. As discussed above, psychotherapy remains an important framework for a wide range of life’s problems. The various styles and techniques of psychotherapy, such as psychodynamic therapy, CBT, Rogerian client-centered therapy, ACT, DBT, EFT, IFS, mindfulness-based therapies, and so on, address one or more of these complex problems. Experienced practitioners can integrate many different styles of psychotherapy to tailor the treatment to each individual for addressing their scope of problems. If someone has even a dim awareness that their problems would be helped by talking to someone, they should seek professional help for their own unique issues. Psychotherapy is a big tent, and in a skillful and meaningful way, it addresses the challenges of life at many levels. It helps us to live and work freely, it helps the show to go on.

Dr. Ashwin Mehra, C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). He provides psychological assessment and treatment services to children, adolescents, adults, couples and families, and supports them to understand and overcome a wide range of difficulties related to anxiety and mood disorders, traumatic experiences, substance use and addictions, and interpersonal difficulties.

The Importance of Ecology in Mental Health Care

by Jonathan Samosh, B.A.

What is mental health care? Many people think that mental health care focuses on understanding our internal psychological world and relieving the distress that might exist within it. This perspective is indeed important for effective mental health care. However, a whole wide world also exists outside of our internal psychological experience. In fact, understanding how we all exist within many ecologies can have significant implications for our mental health.

‘Ecology’ refers to all of the complex social systems within which we live. For instance, our families, neighbourhoods, schools, cities, economies, laws, governments, and cultural expectations. In mental health care, ecology means that we want to understand our internal psychological world and all of the many important elements of our external worlds too.

Psychologists with an understanding of ecology can provide mental health care in many ways to promote the wellbeing of individuals, couples, groups, organizations, and communities. With awareness of the diverse ecologies that exist all around us, psychologists can see the bigger picture that enhances treatment to relieve individual psychological distress, alleviate couple relationship difficulties, empower marginalized groups, and address inequalities in social systems. This is the power of ecology in mental health care.

At CFIR, ecology informs psychological services relevant to a diversity of human experiences, such as culture, gender, relationships, and financial means. Read more about CFIR’s multicultural treatment service, gender and relationship diversity service, and accessible low fee psychological service options here.

Jonathan Samosh, B.A. is a counsellor at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Dino Zuccarini, C.Psych. and is currently in his third year of training in the clinical psychology doctorate program at the University of Ottawa. He provides psychological therapy and assessment services for adults and couples experiencing psychological, emotional, and relationship distress in a variety of areas, such as anxiety and stress, depression and mood, anger and emotion regulation, grief and loss, traumatic experiences, self-esteem issues, life transitions, personal growth, existential issues related to meaning and purpose, relationship difficulties, and issues related to sexual functioning.