Some slides from Patrick Corrigan PhD, IL Institute of Technology, international stigma researcher WISE Basics Increasing Inclusion, Hope and Support Beating the Stigma of Mental Illness
Mar 31, 2015
Some slides from Patrick Corrigan PhD, IL Institute of Technology, international stigma researcher
WISE BasicsIncreasing Inclusion, Hope and SupportBeating the Stigma of Mental Illness
Statewide collaboration oforganizations and individuals. Promote evidence based practices, current research and outcomes evaluation. Majority speak from experience of stigma and recovery.
Offer insights, resources, and support for stigma reduction
WISE Active Partners:
Care Connections (Waukesha County NAMI Support Group)Center for Suicide AwarenessCOPE ServicesDry HootchGrassroots Empowerment ProjectIllinois Institute of Technology LaCrosse Mental Health CoalitionLatino Health Coalition – Mental Health Action TeamMHA WisconsinMilwaukee Center for IndependenceMarian UniversityNAMI WI, Greater Milwaukee & RacinePrevent Suicide WIRogers InHealthUniversity of WI Milwaukee and MadisonWI Department of Health Services WI Family TiesWI United for Mental Health
ETC.
Explore stigma ◦Public stigma
◦Internalized shame Frame stigma change Connect to your work and that of WISE
GOALS
4
IIT – Patrick Corrigan PhD Yale U Penn Rutgers Temple
www.ncse1.org
National Consortium on Stigma and Empowerment
schizophrenia
depressiontrauma
anxiety
eating disordersDrug and alcohol abuse
EPIDEMIC?
1 in 4
47% in our lifetime
What is stigma?
Where does it come from?
8
Stigma Definition and Types
Stigma
Definition
Stereotype-ideas
Prejudice-beliefs
Discrimination-
actions
Types
Internalized Shame
Public
Structural
9
STEREOTYPE◦People with MI are: weak, dangerous….
PREJUDICE◦They are bad because: scary, shameful.
DISCRIMINATION◦So, don’t: hire, serve, rent to them
Example of Public Stigma
Avoidance and apathy
self esteem
So, why try?
I am not good
Internalized ShamePublic Stigma
sense of efficacy
I am not able
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Racial Discrimination
12
Religious Discrimination
Gender Discrimination
Co-Occurring Stigma (public and internalized) Heterosexism Racism Sexism Ableism Etc.
2011 YRBS data showed LGBT youth in WI had:
- 5X the rate of suicide attempts - 3X more likely to skip school due to feeling
unsafe- 50% felt like they did not belong at school
15
In the movies
People with mental illness are dangerous
16
People with mental illness are dangerous
In the newspapers
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In advertising
People with mental illness are dangerous
What’s the harm?
20
“Benevolent” Stigma
People with mental illness are lovable and incapable
21
OK, but isn’t it better lately?
Trenton State
Hospital has fire.
July 10th, 2002
The false idea that people with mental illness are more dangerous has increased
Phelan, Link et al24
…and remains high.
DANGER
Phelan, Link et al
25
Examples of Discrimination?
Public Stigma:It’s Impact on SOCIAL INCLUSION
Lost employment
Subpar housing
Worse health care
Diminished education opportunities
Alienated from faith community
Protest
Education
Contact
28
Stigma Change Processes
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Protest◦Review stigmatizing images
◦“Shame on you for thinking that
way”
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Unintended consequences of well intended actions
“The white bear”
Beware of the rebound effect
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Education
Review key myths and facts that counter these myths
Myth: People with serious mental illness can not care for themselves; need to be institutionalized.
Fact: Long term follow-up research suggests 2/3rds of people with schizophrenia learn to live with their disabilities.
RECOVERY is the rule
Myth: People with serious mental illness are dangerous.
Fact: People with untreated mental illness are slightly more dangerous especially when using drugs or alcoholBUT…
◦They are more likely to be victims of violence
Meta-Analysis: Knowledge and Stigma
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
DOES STIGMA DECREASEAS KNOWLEDGE INCREASES?
Knowledge: Causes of Mental Illness Stigma: Acceptance
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Brain Disease
META-ANALYSIS FINDINGS: CAUSE
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Neighbor
META-ANALYSIS FINDINGS: ACCEPTANCE
Impact?
◦Blame went down
◦Belief in recovery also went down
1990-2000 Decade of the Brain
38
Contact
“Meet Bob Lundin”
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Bob’s story◦ My name is ______ and I have a severe
mental illness called schizo-affective disorder
◦ My childhood was not unusual…
◦ Unfortunately, my mental illness was
traumatic. It did not go away quickly…
◦ Despite these problems, I have achieved several accomplishments.
Avoidance: from pre to 1-month follow-up
What a DIFFERENCE a friend makes!
44
frequency
27%27%
28%28%
29%29%30%
30%31%
31%32%
(March 2008) (May 09
frequency
Video Games
45
Website visits
46
Effect Size100 MILLION
thousands
47
Effect Size100 MILLION
thousands
Just going to the site is not enough
88% left after one minute!
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Framing Stigma Change
Protest Education Contact
Media-based
X XX XXXX
Live X XX XXXXXX
vehicle
-------processes--------
Many education efforts have helped us to understand the pain of mental health crises.
Yet, there exists a curtain of
ignorance about recovery.
Recovery: Mental Illness and AddictionA process of change through which people work to improve their own health and wellbeing, live a self-directed life, and strive to achieve their full potential.
SAMHSA’s four essential dimensions of recovery:
◦Health◦Home ◦Purpose ◦Community
Targeted Local Credible Continuous Change-focused Contact
TLC4
52
Who Should the TARGETS Be?
Health care professionalsEmployersLandlordsTeachersLegislatorsFaith communities
x
MILWAUKEE
Does it play in
Wausau?
What is LOCAL Contact?
City Office Church, synagogue, mosque Workplace School
55
Local
Contact with peer
Example- • Nurse to nurse• Pastor to pastor• Football player to football player
What is CREDIBLE Contact?
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Once is not enough
And variety is needed
CONTINUOUS Contact
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What do you want the target group to do differently as a result of the contact?
CHANGE-FOCUSED Contact
Targeted Local Credible Continuous Change-focused Contact
TLC4
59
the Grand Plan
Speak up everyoneSpeak up everywhere
Honest, Open & Proud“strategic disclosure”
Levels of Disclosure
Social Avoidance – avoid situations
Secrecy – work to keep it a secret
Selective Disclosure – share it with select
people
Open Disclosure – no longer hide it
Broadcast Your Experience – actively share it
6262
Your Recovery Story
Engage Organizations Seeking to Reduce
Discrimination
Train/Support Storytellers
General Public Programs/Contact
Components:1. WiSE Basics Discussion
2. Support for Strategic Disclosure HOP
3. Consultation as Organizations Apply TLC4
4. WiSE Guide to Design, Implement and
Evaluate Plans
5. Statewide Evaluation
SIX WAYS TO END STIGMA TOGETHER 1.Seek out people with lived experience - listen to
their story.
2.Reinforce & support their resilience & recovery.
3.Wear lime green to create curiosity - be prepared to speak up.
4.Consider the story you can tell about recovery
5.Share other’s stories – for short video stories go to Rogersinhealth.org
6.Bring the conversation to your community – work, civic, faith, schools
Story and Discussion