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Speaking out on stigma

Persons with psychosocial disabilities often face stigma, discrimination and rights violations, including within and from the medical community, reflecting wider societal stigma. Here, a doctor talks about his personal experience and how he uses it today to challenge stigma.

When Dr Ahmed Hankir first experienced extreme mental health problems in 2006 as a medical student in the UK, he put off seeking help because of the shame and stigma of having a mental illness.

His grief was compounded by the stigma of being a man of color and a Muslim, which, with his mental health condition, formed what he called a “triple whammy” of stigmas that he “internalized”. It led to him feeling “dehumanized”.

The stress and strain of working low-paying jobs to support himself as a student, and the outbreak of war in Lebanon, the country of his origin and where his parents lived, made matters worse. Meanwhile, he lived in a dilapidated house in one of Manchester’s most dangerous areas.

The intersectionality of these stressors — which added a “layer upon layer” — is often overlooked at the individual level, he said. Racism can be passed over. “Maybe there’s some gaslighting…so you know, you’re not a victim of racism.”

Born in Belfast when his parents fled the war in Lebanon in 1982 but later returned to Lebanon as a teenager, Hankir also said he had an identity crisis. “We want to be accepted, but I was not treated as a Brit in the UK and I was not treated as a Lebanese in Lebanon.”

Stigma “rampant” in the medical profession

Yet it was in his own profession that he felt the stigma of mental health most deeply, leading to delays in seeking help. He was “ridiculed” by fellow medical students and ostracized by his closest companions. When he sought help from the person in charge of student support, a person who had the power to remove him from his education, he was “psychologically tortured”. He had to temporarily interrupt his studies.

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“Stigma reigns in the medical world. Unless we address it, it will continue to destroy and devastate the lives of many. We’re just scratching the surface now – I don’t know of an expert on stigma. There is a lot of ignorance about how to deal with mental health,” he said.

There is not only ignorance, but also arrogance from health care providers, some of whom look down on people with mental illness and psychosocial disabilities, he said.

“It takes strength to accept that you could be a source of stigma. What we need is humility. But I have met inspiring, humble doctors who have contributed to my recovery and continue to contribute to my resilience.”

“My lived experience is my superpower”

Today, Hankir is a psychiatrist and draws from his past: “My lived experience is my superpower. It’s a strength, not a weakness. It makes me more insightful, empathetic and driven.

“When I work in primary care psychiatry providing 2 a.m. care to a person in a mental health crisis, I often draw more from my personal expertise than my professional expertise, especially when trying to build a rapport and ‘therapeutic alliance’. develop with the one who is cared for by me.”

He believes that many of his peers have also experienced mental health issues but have chosen to remain silent about them. “I am honest and open about my experience of living with a mental illness. More people are talking about it. We are normalizing life with mental illness.”

Delivering the “Wounded Healer” presentation around the world

Hankir is now known for its “Wounded healerpresentation, which aims to debunk myths and humanize people with mental illnesses by combining performing arts and storytelling with psychiatry.

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The Wounded Healer also follows Hankir’s journey of recovery. “Speaking out about stigma helps reduce it,” he explained. More than 100,000 people in 20 countries have heard him speak. In recognition of his work, Hankir received the 2022 World Health Organization Director-General Award for Global Health, among others.

He welcomes the WHO’s Quality Rights Initiative, which takes an approach to mental health based on a human rights framework that empowers, dignifies and humanizes people with mental illness.

“Our human rights are violated regardless of time and place – high-income country, low-income country. Too many people feel they have been mistreated,” he said. “If care is available, there are also concerns about the quality of care.”

He continues to face negativity from some psychiatrists, some of whom have “suspected” his success. “They accuse me of making up that I have a serious mental illness. It’s as if people with severe mental illness can’t recover or excel, and can only think about surviving. I have felt unhappy for years. But now I’m not just surviving, I’m thriving,” he laughed.

A version of this story first appeared in the WHO Global Report on Health Equity for Persons with Disabilities.

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