Preparing for and Supporting Disclosure of Mental Health Experiences

Transcription

1 Preparing for and Supporting Disclosure of Mental Health Experiences WISE Stigma Basics Honest, Open and Proud Sue McKenzie, Co-Director, Rogers InHealth Some slides from Patrick Corrigan PhD, IL Institute of Technology, international stigma researcher

2 Statewide collaboration of organizations 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

3 WISE Active Partners: Care Connections (Waukesha County NAMI Support Group) Center for Suicide Awareness COPE Services Dry Hootch Grassroots Empowerment Project Illinois Institute of Technology LaCrosse Mental Health Coalition Latino Health Coalition Mental Health Action Team MHA Wisconsin Milwaukee Center for Independence Marian University NAMI WI, Greater Milwaukee & Racine Prevent Suicide WI Rogers InHealth University of WI Milwaukee and Madison WI Department of Health Services WI Family Ties WI United for Mental Health ETC.

4 GOALS TODAY Explore stigma Frame stigma change Explore disclosure options Outline personal story or plan to support decision making 4

5 National Consortium on Stigma and Empowerment IIT Patrick Corrigan PhD Yale U Penn Rutgers Temple

6 Stigma Stigma Definition and Types Definition Stereotype-ideas Prejudice-beliefs Discriminationactions Types Self Public Structural 6

7 Self Stigma Public Stigma self esteem I am not good sense of efficacy I am not able So, why try? Avoidance and apathy

8 Co-Occurring Stigma (public and internalized) Heterosexism Racism Sexism Ableism Etc 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

9 Drivers of Public Stigma Movies Newspapers Advertising Unethical Research, Drug Side Effects & Poor Quality Care 9

10 Benevolent Stigma People with mental illness are lovable and incapable 10

11 OK, but isn t it better lately? 11

12 Despite what you might think, the percentage of Americans who viewed people with mental illness as dangerous doubled from 1956 to % % who viewed those with mental illness as dangerous 80% 60% 40% 40% 20% 20% 0% Source: BG Link, JC Phelan, M Bresnahan, A Stueve, BA Pescosolido American Journal of Public Health 89 (9),

13 That figure held steady from 1996 to % % who viewed those with mental illness as dangerous 80% 60% 40% 40% 40% 20% 20% 0% Source: BG Link, JC Phelan - The Lancet, 2006

14 Why Should You Care? Impact of Stigma on Social Inclusion Lost employment Subpar housing Worse health care Diminished education opportunities Alienated from faith community Coercive treatment

15 Our Relation To Stigma Stigmatizers Stigmatized De-stigmatizers

16 Personal Reflection When am I most likely to notice fear, condemnation, frustration, anger, etc. rising within me related to mental health challenges?

17 What Are The Drivers Of Stigma Within Schools and Workplaces? Confidentiality paradox Lack of understanding and experience of resilience and recovery Understanding of compliance and relapse Restraints on disclosure within the workforce and with students

18 What Works to Reduce Stigma? Protest Education Contact 18

19 Protest o Review stigmatizing images o Shame on you for thinking that way o Unintended consequences of well intended actions o The white bear -Beware of the rebound effect 19

20 Education Review key myths and facts that counter these myths 20

21 DOES STIGMA DECREASE AS KNOWLEDGE INCREASES? Knowledge: Causes of Mental Illness Stigma: Acceptance Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

22 META-ANALYSIS FINDINGS: CAUSE Brain Disease Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

23 META-ANALYSIS FINDINGS: ACCEPTANCE Neighbor Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

24 Decade of the Brain Impact? Blame went down Belief in recovery also went down

25 Contact Meet John, Mike, Charles, Jackson, Tim, and Mark 25

26 Their Recovery Story My name is and I have a mental illness and/or addiction My childhood was (normal/traumatic) My mental health challenges were difficult for me and others. They did not go away quickly Combining my internal resources with external resources, I found recovery I have achieved a satisfying life with several accomplishments. 26

27 The effects of contact with someone living in recovery with mental illness versus education about mental illness were greater when measuring attitudes of avoidance pre post -4 control group education: dangerousness education: responsibility contact: dangerousness contact: responsibility

28 The effects of contact on attitudes of avoidance were sustained at the one month follow-up. 3 pre follow-up control group education: dangerousness education: responsibility contact: dangerousness contact: responsibility

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31 A process of change through which people work to improve their own health and wellbeing, live a selfdirected life, and strive to achieve their full potential. SAMHSA s four essential dimensions of recovery: Health Home Purpose Community

32 The TLC4 Model Targeted Local Credible Continuous Change-focused Contact 32

33 What is CREDIBLE Contact? Contact with peer Example- Teacher to teacher Pastor to pastor Football player to football player 33

34 CHANGE-FOCUSED Contact What do you want the target group to do differently as a result of the contact?

35 Recovery Stories are the Gold of the Movement

36 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

37 Speak up everyone Speak up everywhere Honest, Open & Proud strategic disclosure

38 Reversing Self and Public Stigma Inclusion and Support Public Stigma self esteem I am good sense of efficacy I am able I care for myself & others Motivated engagement

39 If this is true for adults what impact would contact with youth who share their stories of mental health challenges and resiliency have on peer, school staff and parent stigma?

40 Statewide Study on Youth Disclosure Focus Groups-Youth with and without mental illness, parents, and teachers How mental illness is discussed in schools and families Benefits outweighed the costs across groups Benefits- deal with stigma, reduce isolation and differentness, and pursuit of mental health services Costs- harsh and unfriendly response to disclosure Strategies to minimize risk described where and to whom youth might share their stories

41 Ethics of Strategic Disclosure and Youth Do I encourage one to disclose Statewide online survey to further research WISE and our state collaborators revising tool to support careful decision making and disclosure Do I disclose? Professional organizations codes of ethics Seek supervisory and peer input

42 Honest, Open and Proud Outline Lesson 1. Considering the Pros and Cons of Disclosing 1. Do you identify yourself as a person with mental illness 2. Secrets are part of life 3. Considering the pros and cons of disclosure

43 Lesson 2. There are Different Ways to Disclose 1. Different ways to disclose 2. To whom might you disclose 3. How might others respond to your disclosure

44 Lesson 3. Telling Your Story 1. How to tell your story 2. Honest, Open and Proud through SOLIDARITY and peer support 3. How did it go? 4. Putting it all together

45 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

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47 Discussion: What can I begin to do today? What can my school or other organization in my community do to support stigma reduction?