Stigmas and Silos: Social Workers' Accounts of Care for People With Serious Mental Illness and Cancer

Abstract

The purpose of this study was to better understand the processes of care for people living with serious mental illness who are diagnosed with cancer, from the perspectives of social workers. Interviews were conducted with 11 social workers at a multisite acute and tertiary care centre in Ontario, Canada. Analysis showed how patients diagnosed with serious mental illness were channeled to mental health services and their cancer-related concerns discredited, and how care was compromised by the compartmentalization of mental and physical health care. The study also revealed that relationships between patients and their families were often repaired or reactivated by a cancer diagnosis, and health care providers' empathy and resources mobilized. Theories of stigma are used to deepen study findings and to highlight the significance of social workers' actions in creating health care environments that are less disabling for people diagnosed with a mental illness. The vital roles social workers play in clinical coordination and in ensuring care equity—and the factors that impede these roles—are discussed.