A nuanced crusader
Head of CAMH aims to reduce discrimination against mental illness by educating the public
Even though she has her hands full as the president and chief executive officer of the Centre for Addiction and Mental Health, Dr. Catherine Zahn is still a practising neurologist.
Recently, one of her patients was discussing his treatment options for depression. Though he had a variety of options presented to him, Zahn says he wasn’t sure if he could go through with any of them.
“He was worried about accessing therapy because of discrimination,” she says. “He didn’t want anyone to find out that he was seeking help.”
Much has been made of recent efforts to remove the stigma that allows society to stereotype people with addiction or mental illness. But Zahn is leading a more nuanced crusade, which is to educate the public so that when presented with the stigma of a mentally ill person, the reaction is not discrimination.
According to Zahn, the stigma is just the sign that makes society aware of a difference. Discrimination is a different beast.
“Walk into the atrium of a children’s hospital, and you know it’s a hospital for children,” she says. That’s the stigma – the signs that make recognition of the disease possible. But discrimination is different, she says. Removing the stigma doesn’t remove the prejudice.
The labels given to every aspect of CAMH are carefully selected to further this mandate. In the 1970s, the hospital changed addresses from 999 Queen St. West to 1001, to shed the stigma that was reinforced, in colloquial terms, by Torontonians saying someone had “gone nine ninetynine.” Patients are called clients at CAMH. The Queen West site was once called the Provincial Lunatic Asylum; two out of the three words carry strong derogatory connotations. “CAMH has an ambitious mandate: to help transform the lives of people with mental illness and addictions through a new model of care and by breaking down stigma,” chair of Cham’s board Dan Burns said when Zahn was appointed. “Catherine brings the talent, inclusive values, solid experience and momentum required to lead CAMH in accomplishing its transformational mandate.”
Indeed, Zahn’s work goes beyond language and labels. Before joining CAMH in 2009, she was the executive vice-president of clinical programs and practice at the University Health Network. She studied neurology at the University of Toronto and completed her masters in health administration at the same school.
Zahn’s expertise in both adminis- tration and neurology can help reinforce CAMH’s mandate. By broadening research initiatives in the field and by reminding the public of the neurological aspects of mental illness, there will be a greater understanding of the field itself.
There’s a simple distinction between a neurological disorder and a mental illness, Zahn says. With diseases such as Alzheimer’s, neurologists are able to see shrinkage and abnormalities on the brain. With mental illness, different behaviours can be experienced, but the brain doesn’t necessarily reflect any structural abnormalities.
But there have been advances in how doctors can see brain function, Zahn says. New imaging techniques can see the electrical movement of the brain, neurotransmitter activity and blood flow. And, significantly, doctors now know that the brain can change, even in adult life: new cells can grow, and connections are mutable. Environmental factors, such as malnutrition, alcohol or emotionally traumatic events can alter brain function and produce mentally ill behaviours.
“The important message I want to give is that neither should be construed as more or less important,” Zahn says. “Whether it’s a functional or structural problem, there’s no hierarchy. They’re both important and should be functioning well so that an individual is able to do what one has to [in order] to have a good life.”
Zahn hopes that by continuing to educate the public about addiction and mental illness, more people will feel comfortable seeking the treatments they need.
Zahn proudly shares that Toronto Life magazine recently named the revitalized CAMH site “Queen West’s hottest address” as an example of how differently people are starting to perceive mental health. But she wants to take it even further.
“Wouldn’t it be fabulous if we reclaimed the old 999 [Queen St. West] address? We should celebrate this address.”