Voices for inclusion: Described video



(The scene begins with a series of video participants in an interview setting. Like all other participants in the video, they have personal or professional expertise in stigma and health. They represent a diverse range of cultural, ethnic and socioeconomic backgrounds, genders, sexual orientations, ages, health conditions and abilities.)

Video participant 1:

I think that we're all affected by stigma in a range of ways.

(Cut to a new person.)

Video participant 2:

La stigmatisation brosse sur tout individuel.

Text on screen: Stigma touches every person. (Translation of original interview.)

(Cut to a new person.)

Video participant 3:

Who is affected by stigma is everyone.

(The scene changes. A person’s face appears in a circle on the right side of the frame. The image shrinks and moves to the top left side of the frame. One by one, 5 more faces appear on the right. As they finish speaking, their image shrinks and moves across the frame until all faces form a mosaic in the screen.)

Video participant 4:

People living with mental health problems or mental illness are among one of the most stigmatized groups.

Video participant 5:

Indigenous peoples, peoples of color, people with a variety of health conditions.

Video participant 6:

Stereotypical identification with terrorists.

Video participant 7:

He had an aggressive gene. This? No way.

Video participant 8:

We need to stop dehumanizing individuals living with obesity.

Video participant 9:

Just the word refugee is stigmatized.

(The scene changes)

Dr. Theresa Tam:

Stigma is a fundamental driver of health inequity in Canada. It blocks access to health services and opportunities in life.

(Cut to a person in an interview setting.)

Video participant 10/ text on screen:

I often have to use my term “doctor” in order to get treated differently in a healthcare system.

Dr. Theresa Tam:

It causes chronic stress. This can trigger a range of physical and mental health problems.

Text on screen: Stigma causes chronic stress.

(Cut to a person in an interview setting.)

Video participant 4:

The stigma they experience is often worse than the illness itself.

Dr. Theresa Tam/ text on screen:

And stigma can expose people to hate, trauma and violence.

(Cut to a person in an interview setting.)

Video participant 3/ text on screen:

To me, stigma kills people, it literally does.

(Various scene changes in succession. Dr. Theresa Tam listens and takes notes in a conference setting. A person speaks and holds a talking stick adorned with Indigenous carvings. A person speaks in a conference setting with animated gestures. A close up of a person speaking to another in the frame. A rapid series of people speaking or listening in a conference setting. A blurry shot of a room full of people holding hands. A rapid series of people speaking or listening in a conference setting. Dr. Theresa Tam speaking while holding a talking stick.)

Dr. Theresa Tam:

My name is Theresa Tam. As Canada’s chief public health officer, I’ve had the opportunity to meet many people across the country: Front-line health workers, researchers, parents, people with all kinds of identities, strengths, challenges and health conditions. While each person’s story is unique, I hear again and again is that stigma is a persistent barrier to good health. So this year, my report is a call for everyone to address, reduce, and ultimately end stigma in Canada’s health system.

(The scene changes.)

Stigma both drives and is driven by health and social inequity.

(Two circles drop into the scene. One is labelled stigma and the other inequity. A curved arrow is drawn from the circle labelled “Stigma” to the circle labelled “Inequity,” causing the latter to pulse. Another curved arrow is drawn from “Inequity” back to “Stigma,” and the stigma circle expands.)

(The scene changes. A crowd of people walk down a busy city street. The video slows. A pin graphic appears above 2 of the people and each follows them. Pins then appear above more people. A large question mark appears in the frame.)

And every day, many of the people in Canada who need health services the most cannot and do not access them. What can we do?

(The scene changes. A network of circles and lines appears in white. This graphic is titled “Forms of Stigma.” The circles are labelled with the terms “Mental Illness, Racism, HIV Status, Ageism, Homophobia, Infectious diseases, Obesity, Sexism, Ableism and Transphobia.”)

We can change the way we think about stigma. Many people in Canada experience multiple stigmas. These are not experienced one at a time.

(The circles labelled “Obesity, Mental Illness and Sexism” and the lines connecting them are highlighted. All other lines and circles fade. The circles labelled “HIV Status, Ageism and Homophobia” and the lines connecting them are highlighted. All other lines and circles fade.)

So, stigmas like these…

(The circles labelled “HIV Status, Mental Illness, Obesity and Infectious Disease” and the lines connecting them are highlighted. All other lines and circles fade.)

…cannot be addressed without also addressing stigmas like these.

(The circles labelled “Ageism, Homophobia, Transphobia, Sexism, Ableism” and the lines connecting them are highlighted. All other lines and circles fade.)

We can stop using dehumanizing language like this.

(The scene changes. Three outlines of speech bubbles appear. One has the word “addicts.” One has the word “mentally ill.” One has the word “poor people.”)

We can adopt new attitudes about those we serve, and everyone we meet.

(The speech bubbles are filled with colour. The phrase “people who use drugs” replaces “addicts.” The phrase “people living with mental illness” replaces “mentally ill.” The phrase “people experiencing poverty” replaces “poor people.”)

(The scene changes. A graphic that looks like a tablet device appears. The home button on the tablet is clicked. The first item of a checklist appears. It says “Cultural safety training” next to an icon of 3 human forms filled with a different colour or pattern. Another list item appears. It says “Inclusive retrofits” and is next to an icon that represents gender diversity. A third list item appears. It says “destigmatize communications” next to an icon of a document and megaphone. A fourth list item appears. It says “Engage community and report back” next to an icon of 6 human forms filled with different colours and patterns.)

In our institutions, we can review the systems that reinforce stigma. This means ensuring policies, practices (even physical spaces) protect and support people who face stigma. It also means measuring, monitoring and reporting on our progress, no matter what actions we take.

(The scene changes. People listen and take notes in a conference setting).

Video participant 4/ text on screen:

Getting people talking about mental health and normalizing it.

Video participant 11/ text on screen:

Hiring of staff that the affected community trusts.

(An Indigenous elder speaks to a group off camera while holding an eagle feather.)

Video participant 3/ text on screen:

People just love the elders being involved with them.

(People speak and listen in a conference setting.)

Video participant 12/ text on screen:

There was a change in the federal laws around criminalization of HIV non-disclosure.

Video participant 7:

We’ve already contributed greatly to today's society. This contribution must be acknowledged.

Text on screen: Translation of original interview.

(Various scene changes in succession. A person passes a talking stick to another in a talking circle. People speak with animated gestures to others in a conference setting. Two people shake hands while standing in a group. A person nods while listening. A wide shot of people holding hands and with their eyes closed.)

Dr. Theresa Tam:

Too often, those who experience stigma are also those taking action on stigma in the health system, but addressing stigma is everyone’s responsibility. Together, we can create the most inclusive health system in the world.

(The scene changes. The cover of a report appears.)

Text on screen: Addressing Stigma: Towards a More Inclusive Health System. The Chief Public Health Officer’s Report of the State of Public Health in Canada 2019.

(The report fades.)

Text on screen: Dr. Tam and the Public Health Agency of Canada thank those who generously shared their stories for this project. Canada.ca/CPHOreport. Public Health Agency of Canada.

(A Government of Canada logo with a small animated Canadian flag.)

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