Andrew Torrens: building understanding to improve mental health care

Andrew Torrens wants nothing to get in the way of someone having care for a mental health issue.

Andrew struggled with depression and suicidal thoughts from a young age. With treatment and support, he is managing his illness.

These days, he is a peer navigator at GRH’s specialized mental health program. He’s trying to support others making their way recovering from a mental illness.

Andrew is also a key organizer for GRH’s “Stomping Out Stigma” effort to help end stigma and encourage support for mental health care. He notes reducing stigma is an ongoing and evolving process.  It begins and ends with an open mind, and the acceptance that none of us is without flaws.
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What's been your experience encountering stigma, either professionally, personally or both?

Living with a mental illness does not prevent me from having my own stigma.

When struggling with depression and thoughts of suicide when I was eight years old, I felt like I was a bad person for thinking about it, that if I didn't have such a flawed character, I'd be able to suddenly “get over it”.

When I was in high school, I turned some of those same wrong, hurtful, judgmental statements toward a good friend who attempted suicide, even while I was still quietly struggling to find a reason to live myself.

I almost missed out on an amazing life, and meeting amazing people, because I didn't want to take part in a mental health peer support group.  After all, I wasn't one of “those” people. That attitude lasted until about 30 seconds after joining the group, when I realized that I am one of those people because there is no “us” and “them”.  I am eternally grateful for being able to overcome that ignorant preconception, because it led to meeting some of the most wonderful people I've ever known.

When you've spoken to someone with lived experience, how has stigma affected them?

We often feel like we are not a person; not worthy of the same respect and rights afforded others. We are told so many falsehoods over the years from people who truly believe what they are saying, and as a result we often feel like we are less than we are.

When people regularly dismiss our concerns and our wishes as simply being a symptom of our illness, we grow to feel that our opinions and our needs aren't important. We are often left feeling alone. Friends and often even family keep us at a distance upon learning of our diagnosis, either because of ignorant beliefs about our diagnosis or because they don't know how to support us and are so afraid of saying or doing the wrong thing that instead they distance themselves and do nothing.

We often feel invalidated; that our perspective is “wrong”. As if we could effortlessly decide to see the world differently; to throw away our experiences as untrue. When people are dismissive of our perspective and emotions, we are often left feeling like those people are dismissing us.

We also lose out on many opportunities, and thus can experience a lower quality of life. 

How has that changed your approach as a care provider?

First and foremost, my goal in any interaction is to listen to and understand the person I'm supporting.  Many of the challenges and conflicts are the product of a breakdown in communication due to the differences in perspective experienced by all involved, so my approach is focused on efforts to ensure that I understand the person's point of view well enough to paint the best picture I can with the clinical team.

I do my best to ensure that team goals are in support of patient goals, that team decisions, terminology, and the clinical language is explained to the person in a way that they understand.

In all my work, I do my best to walk with the person where they are, rather than try and pull them forward.

What have been your roles in Stomping Out Stigma?

Last year I was part of the promotions subcommittee.  Effectively promoting it required us to raise awareness of the issue and show people why it was an event that was both relevant and important to their work. 

This year I share the role of chair with Patrick Henderson.  It was my first time chairing a committee, and it was an exciting opportunity to help develop the broader vision and mission for the event (which is challenging with the immediate demands in planning).  I have also worked with our leadership and our quality improvement specialist to develop an evaluation to ensure that our efforts are effective in reducing stigma.  This experience has been as wonderful as it has been terrifying, and I am incredibly fortunate in the team working with me to support the event. 

How do you think the hospital community has responded to SOS?

I have to say that when I first heard that the hospital was creating an event to reduce stigma, I was skeptical.  Would we only preach to the converted?  Would people be receptive to change?

I've been amazed by the responses I've had to the event.  In our evaluation survey, we had a great number of passionate and insightful comments that will help guide our future efforts, all while their comments encourage and support us in our work. 

Staff are enthusiastic, fierce advocates for patients and colleagues with mental health issues.

Perhaps most encouraging is the support from our leadership.  It's encouraging to know I work for a hospital that isn't just interested in looking good to the public; they are constantly looking for ways to do better.

What are some things individuals can do in their daily lives to prevent stigma?

Prevention is not always possible.  We all grew up in a world that held (and largely still holds) misguided, outdated or even downright harmful beliefs about mental illness.  Add onto that the fact that working in health care means we spend the most time with the people experiencing the most complex and difficult situations, and there is great room for us to develop a bias.

The best things we can do to reduce stigma are:

• Pay close attention to your language.  The right word can build someone up, while the wrong word can cause irreparable harm.
• Listen.  Understand the person's perspective.
• Withhold judgment, towards ourselves, our colleagues, and our patients.  When it comes to someone with a mental illness, realize that no matter how difficult and frustrating the situation seems from outside, it is far more difficult and frustrating from inside. I live with my illnesses 24/7. You only have to put up with me for a small portion of that time.
• Accept that we all carry stigma. Look for it in ourselves, and welcome people to draw our attention to ways we can change.
• Balance. We need to hear stories from people in all ranges of wellness. Most people with a diagnosed mental illness are leading full successful lives. Hearing those stories helps prevent us from thinking that what we see in a crisis is what mental illness means.
• Eliminate assumptions. When we assume we know a person's experience, we reduce the chance we see who the person truly is. If I'm having a bad day, it's not always a relapse.  Just like anybody else, I have bad days sometimes.
• Share (when safe). The more people are able to share their own stories about their mental illness and recovery, the more it will become safe to share. That being said, we need to be mindful of what we share and how we do so. While sharing is the best way to break down stigma, it carries significant risks because of that same stigma.