5. Ableism, negative attitudes, stereotypes and stigma

An “ableist” belief system often underlies negative attitudes, stereotypes and stigma toward people with psychosocial disabilities. “Ableism” refers to attitudes in society that devalue and limit the potential of persons with disabilities. Ableism is

…analogous to racism, sexism or ageism, [and] sees persons with disabilities as being less worthy of respect and consideration, less able to contribute and participate, or of less inherent value than others. Ableism may be conscious or unconscious, and may be embedded in institutions, systems or the broader culture of a society. It can limit the opportunities of persons with disabilities and reduce their inclusion in the life of their communities.[46]

Discrimination against people with mental health or addiction issues is often linked to prejudicial attitudes,[47] negative stereotyping,[48] and the overall stigma[49] surrounding mental health and addictions. All of these concepts are interrelated. For example, stereotyping, prejudice and stigma can lead to discrimination. The stigma surrounding mental health and addictions can also be an effect of discrimination, ignorance, stereotyping and prejudice. 

Where stigma, negative attitudes and stereotyping result in discrimination, they will contravene the Code. Organizations and individuals have a legal obligation under the Code to not discriminate against people with mental health or addiction issues, and to eliminate discrimination when it happens. These obligations apply in situations where discrimination is direct and the result of a person’s internal stereotypes or prejudices. They also apply when discrimination is indirect and may exist within and across institutions because of laws, policies and unconscious practices.

Stigma, negative attitudes and stereotypes can lead to inaccurate assessments of people’s personal characteristics. They may also lead institutions to develop policies, procedures and decision-making practices that exclude or marginalize people with mental health disabilities and addictions.

Example: In one case, a human rights tribunal recognized that a decision not to investigate an alleged crime could be discriminatory if based on a belief that the allegation was “unfounded because it resulted from an assessment of the person’s psychiatric condition rather than a genuine incident.”[50]

Example: In one case, a female bartender developed an anxiety disorder and began to experience panic attacks after she was seriously assaulted by two customers. Her employer accommodated her by allowing her to be absent when she was too ill to work. Then the complainant got a new manager who became impatient with her absences. A tribunal found that the manager discriminated against her when he reduced her shifts and made comments about her medical condition in front of others, including saying that she was “messed up” in her head, “needed drugs” and looked “pretty unstable.”[51]

There are a number of prevalent stereotypes about people with mental health disabilities and addictions. For example, people with mental health disabilities are often characterized as being violent.

Example: A man with a mental disability lived in a trailer park with his mother. The disability resulted in some “peculiar” but “harmless” behaviour. The owner began to be frightened of the man because of his perceived mental disability, and eventually warned other tenants to protect themselves and not provoke him. Otherwise harmless actions began to be interpreted as threatening. For example, the owner received a letter from the tenant asking her to repair a potential gas leak, and instead of investigating, she viewed him as “crazy” and dangerous, believing he might blow up his trailer. Eventually, he and his mother were evicted. A human rights tribunal concluded that there was “no reliable evidence” that the claimant posed a threat. The respondent sought the tenant’s eviction because of her perceptions and misconceptions about his mental disability, and based on unfounded and stereotypical views, she concluded the tenant was a threat to the safety of herself and other residents. This was found to be discriminatory.[52]

Stereotypes related to violence persist even though studies show that most people with mental health disabilities are no more likely to engage in violent behaviour than the general population.[53] In fact, research shows that people with serious mental illnesses are more likely to be victims of violence themselves, than other members of the general population.[54]

People with mental health issues may also be perceived to lack the capacity to make decisions in their own best interests, even where this may not be the case. They are often seen as “childlike” and in need of help.[55] These perceptions may result in paternalistic attitudes and practices that can create barriers.

Certain types of disabilities are more stigmatized than others due to the stereotypes associated with them. People with schizophrenia or drug addictions may experience particularly negative attitudes from others based on beliefs about dangerousness, anti-social behaviour or risk. People with addictions may also experience particularly negative behaviour because of assumptions about how much they are personally responsible for their disability, and assumptions about their involvement with crime.[56]

Because of the extreme stigma around certain types of mental health disabilities and addictions, many people may be afraid to disclose their disability to others. They may worry about being labelled, experiencing negative attitudes from others, losing their jobs or housing, or experiencing unequal treatment in services after disclosing a mental health issue or addiction. Fear of discrimination can also result in people not seeking support for a mental health issue or addiction.[57]

Negative attitudes, stereotyping and stigma can also lead to harassment towards people with psychosocial disabilities in the form of negative comments, social isolation and unwanted conduct (including mental health profiling) from employers, landlords, co-workers or service providers. The Law Commission of Ontario’s consultation on disability showed how negative attitudes and stereotypes can lead to actions that further marginalize people with mental health disabilities:

[M]any persons with mental health disabilities, particularly those who have been homeless, shared experiences which demonstrated that they had been subject to heavy judgment and negative assumptions when dealing with legal systems. Lack of supportive services for persons with mental health disabilities, together with stigma and fear about these disabilities may lead to increased contact with police and may contribute to the criminalization of persons with mental health disabilities, an issue of great concern to many participants.[58]

Organizations must take steps to address negative attitudes, stereotypes and stigma and to make sure they do not lead to discriminatory behaviour toward or treatment of people with psychosocial disabilities.