Opening Minds. Changing How We See Mental Illness

Size: px

Start display at page:

Download "Opening Minds. Changing How We See Mental Illness"

Isaac Black
5 years ago
Views:

1 Opening Minds Changing How We See Mental Illness Mike Pietrus, Director - MHFA & Opening Minds Romie Christie, Stephanie Knaak, Sue Mercer Sept 21, 2017 Copenhagen Together Against Stigma

2 OVERVIEW Opening Minds: Background HEADSTRONG / HEADSTRONG First Nations Healthcare Providers R2MR / TWM / TIM Media

3 Background: Mental Health Commission of Canada 2006: Senate Committee publishes Out of the Shadows at Last first and largest national study on mental health, mental illness and addictions Key Areas: Housing and Homelessness, Stigma, Workplace, Mental Health Strategy for Canada, Recovery, Peer Support, Suicide Prevention 2007: The MHCC is created by the Government of Canada 2009: Launch of Opening Minds: anti-stigma initiative 2013: Launch of Canada's first National Standard of Canada for Psychological Health and Safety in the Workplace

4 Opening Minds

5 Opening Minds Approach Bottom Up Use an evidence-based approach, identify successful interventions Determine active ingredients Identify gaps and potential solutions Create toolkits and training materials Replicate successful interventions Advocate for structural change

6 The Problem

7 Stigma

8 HEADSTRONG: A NATIONAL YOUTH ANTI-STIGMA Mental Health and Resiliency through the HEADSTRONG Movement SMYA INITIATIVE CONFERENCE October 21, 2016 Regina, SK

Roots of HEADSTRONG: Opening Minds Evaluation of 25+ Youth Programs Identified existing program partners using promising practices Created new outcome survey to

9 Roots of HEADSTRONG: Opening Minds Evaluation of 25+ Youth Programs Identified existing program partners using promising practices Created new outcome survey to measure stigma Evaluated programs using new scale (10,000 students surveyed) Identified promising practices and successful programs Chose one to roll out across Canada

10 HEADSTRONG The roots of HEADSTRONG come from the 15 years of delivering different anti-stigma programs by Durham TAMI. We modeled HEADSTRONG on their summit program

11 What made HEADSTRONG the right choice? Out of many programs evaluated, we looked for something that: Had positive evaluation results in reducing stigma Complimentary to existing mental health education programs Potential to reach and inspire a large number of youth across Canada Could work with diverse youth populations and in different geographic locations Would engage and empower youth

12 What is HEADSTRONG? HEADSTRONG is a day-long summit program where many schools send representative students (with a teacher) to: Hear stories about living with a mental illness Challenge own beliefs Plan anti-stigma activities to take back to their own student populations Timing is key

13 Recovery is Real Speaker Training: Contact-based Education

HEADSTRONG TOOLKITS Summit Coordinator Toolkit: Planning A Youth Anti-Stigma Summit MHCC HEADSTRONG School-Based Activities Toolkit Training your Speakers Toolkit Speaker Toolkit: Sharing Your

14 HEADSTRONG TOOLKITS Summit Coordinator Toolkit: Planning A Youth Anti-Stigma Summit MHCC HEADSTRONG School-Based Activities Toolkit Training your Speakers Toolkit Speaker Toolkit: Sharing Your Personal Story Toolkits are free and accessible online: Also accessible online: two videos that demonstrate what a HEADSTRONG summit looks like and how students are impacted. HEADSTRONG MHCC National Summit First Nations, Métis and Rural HEADSTRONG Summit video

15 HEADSTRONG First Nations

16 HEADSTRONG Summits SCHOOL YEAR #SUMMITS #SCHOOLS #STUDENTS Cascading Reach 2014/ , / , / , / * ,000 *(10 awaiting confirmation)

17 HEADSTRONG Grows with Strong Partnerships Youth Mental Health Education Government Stakeholder Agencies

18 How We Measured 22 self report items 11 items measured stereotype attributions (attitudes and beliefs) i.e. people with MI often become violent if not treated 11 items measured social distance, or acceptance and social responsibility i.e. I would try and avoid someone with a mental illness

19 FIDELITY MATTERS 30% Stereotype Attributions 25% 24,9% 20% 15% 16,6% 10% 5% 0% Strong fidelity to program agenda and speaker training amount of change Weaker fidelity to program agenda and speaker training k=24

20 Feedback from Teachers [The students] are excited to take what they have learned and share it with the whole school. The speakers really resonated with [the students] - they felt positive about the message of hope. They felt less alone in their own struggle and felt inspired to talk about things more openly.

21 Healthcare Providers

22 Do persons with MI experience stigma from health professionals? Research with people with lived experience: Treated in demeaning manner Feel punished, patronized, humiliated Threats of coercive treatment Excessive paternalism Research with health professionals: Often hold hostile and blaming attitudes towards consumers Prognostic negativity Problem of awareness: don t realize they carry stigmatizing attitudes or manifest stigmatizing behaviours

24 Tackling the roots of stigma Our research found healthcare providers have specific learning needs that relate to stigma: 1. Pessimism about recovery / feel like what they do doesn t matter 2. Lack of skills / confidence 3. Lack of awareness of own prejudices 4. See the illness before the person

25 Process Model

26 Opening Minds, through its research, has identified a number of evidence-based programs available for sharing and implementation 4 Different Program Models: Workshop model Skills-based model Intensive social contact model Workplace model

27 Successful programs Understanding Stigma (online version in development) Online training for physicians Practice Support Program (PSP) Online training for Nurses R2MR for HCPs University programs for HCPs

Understanding Stigma program 2 and 1 hour versions available; booster modules also available Program includes personal testimony, video clips, educational components, action plan items Tested in

28 Understanding Stigma program 2 and 1 hour versions available; booster modules also available Program includes personal testimony, video clips, educational components, action plan items Tested in numerous settings with various healthcare audiences with consistently positive results Program + booster best option 60% 40% 20% 'Understanding Stigma' Program Threshold of Success Measure (IWK, n=478) 38% 61% % of participants who crossed the threshold of success (answered 80% of OMS-HC questions in a non-stigmatizing way) [The program] made such an impact Hearing someone's personal experiences with mental health and what helped, what didn't, and be reminded how successful someone can be when provided with supports. It certainly made me think of how we treat people differently. the myths and facts stats were real eye openers. Pre program Post program

29 Adult Mental Health PSP-Learning Sessions & Action Periods

30 PSP Principal Components Three ½ day workshops with 6-8 weeks action period Main Tools Taught (3 EB Self Management tools, 1 Assessment tool): 1. Diagnostic Assessment Interview 2. The Cognitive Behavioral Interpersonal Skills Manual 3. The Antidepressant Skills Workbook 4. Bounceback (CMHA) Use of Practice Support Coordinator provides guidance and support to incorporate tools, skills, and processes in practice workflow Additional fee codes

31 Physician Confidence % of respondents reporting they felt 'very confident' in the overall quality of mental health care they provide to patients (n= ) 50% 45% 44,0% 40% 35% 30% 25% 20% 20,0% 15% 10% 5% 4,0% 11,0% 3,7% 11,0% 0% Intervention group Control group Pre-test Post-test Follow-up

32 Primary Outcome: Patients PHQ-9 scores at each follow-up time point: Intervention and control groups , ,4 9, ,5 8,4 7,6 8,4 7 6 Intervention Control 6, Time in Months adult-mental-health/tools-resources

33 Exploratory Outcome: Patients AD use at 6 months: Intervention and control groups 100% 80% 60% 40% 20% 0% 41,7% Intervention AD use at 6 months 68,4% Control adult-mental-health/tools-resources

34 R2MR &The Working Mind Workplace Mental Health & Wellness Presented by: Name, Title September 2013 R2MR

35 Workplace Objectives: R2MR/TWM Reduce the stigma of mental illness Promote mental health in the workplace and post secondary institutions Reconceptualize how people think and talk about mental health and mental illness Help people identify poor mental health in themselves and others Teach coping skills to manage stress and poor mental health, and increase resiliency Create a more supportive environment for all

36 R2MR/TWM: Main Components Education-based program Anti-stigma module and evidence-based content Video-based contact, myth-busting, facts, etc. Big 4 skills (SMART goal setting, mental rehearsal, positive self-talk, diaphragmatic breathing) Mental Health Continuum Model

37 Perceptions of Mental Health and Mental Illness HEALTHY Mental Health Normal Functioning Recovery from mental illness ILL Diagnosable mental illness Severe and persistent functional impairment

38 Mental Health Continuum Model 1) Moves from good to poor mental health along a gradient 3) Eliminates the need for stigmatizing labels and nonprofessionals diagnosing 2) Emphasizes the possibility to back and forth along the continuum 4) Each phase outlines signs and indicators for selfassessment

39 Video Personal Experiences with Stigma Stigma and Discrimination on Campus 39

40 Training Options 5 day Train-the-Trainer workshop which permits organizations to provide their own training on an ongoing basis Half day primary/basic workshop for members Full day leadership workshop for supervisors and managers (includes primary course) o Leaders learn to address employee mental health at each stage along the MHCM and manage accommodation (Optimum class size 24 participants)

41 Stigma Reduction 2,1 2 TWM 1,97 R2MR 1,9 1,86 1,92 1,8 1,78 1,81 1,81 1,7 1,72 1,6 1,61 1,54 1,62 Pre Post 1,5 Follow-up 1,4 Pre-post completers (n=1155)* All three surveys (n=415)* Pre-post completers (n=4649)* All three surveys (n=824)^ *p<.001; ^pre-post p<.001, post-follow-up p=.998; Mean scores can range from 1 to 5; lower scores indicate less stigma

42 Resiliency Skills 4,2 4 TWM R2MR 3,8 3,6 3,5 3,81 3,84 3,84 3,83 3,76 3,7 3,64 3,61 3,52 3,4 3,2 Pre Post Follow-up 3 Pre-post completers (n=1134)* All three surveys (n=398)* Pre-post completers (n=4624)* *p <.001; Mean scores can range from 1 to 5; higher scores indicate greater perceived resiliency skills All three surveys (n=793)*

43 Qualitative feedback Reduced stigma; more awareness & understanding I will try to pay more attention to how I talk & act, to become part of the solution & not the problem (TWM participant). I learned not be judgemental when dealing with MH patients, to be more supportive of coworkers and peers who may be struggling with mental health issues. (R2MR participant) This was very insightful and helped dispel many misconceptions I had! (TWM participant) Practical skills; better equipped to address MH: Not only did I learn how to respond to others around me in an open, positive, helpful way, but to also recognize the vulnerability in myself and how important early recognition is. (R2MR participant) More focused on setting SMART goals for myself and my family. I am will be more aware of how I am feeling and how others respond to me. (TWM participant) Learning the 'Big 4' is relevant to learn how to deal with things (R2MR participant) Workshops well received: Excellent videos of people with lived experience (TWM participant) I liked the varied forms of learning, participant, group discussion, short video clips, and brainstorming small groups (R2MR participant) The content was enlightening, fact and research based and involved multi-media which appealed to various learning styles. (TWM participant) I liked that it brings awareness to the issues and talks about the elephant in the room (R2MR participant)

44 Personalized Learning & Practicing Supplements In-Class Courses with Convenient & Engaging elearning; Empowers Individual to Practice The Big Four and Monitor Personal Progress; All Systems Compatible to Reach All First- Responders Equally.

45 R2MR Partners More than 80 Police services Adaptations developed for Fire, EMS, Corrections & others Over 60 thousand people trained

46 TWM Partners

47 News Media

48 Media Projects Media Action Research Study Media Resource Guidelines Journalism School Symposia & Online Curriculum

Media Monitoring Study 2005 - present After reviewing 25,000 newspaper articles: 46.

6 % did not quote a PWLE 19.7 % of articles were positive in tone 15.

49 Media Monitoring Study present After reviewing 25,000 newspaper articles: 46.7 % tie violence and danger to mental illness 73.5 % did not quote a mental health expert 80.6 % did not quote a PWLE 19.7 % of articles were positive in tone 15.5% had recovery as a theme 27.4 % discussed shortage of resources 77.3% did NOT discuss treatment 28.5 % stigmatizing in tone

50 Media Monitoring: Positive signs - Systematic review of articles by Research team at McGill University - Media coverage of mental illness has improved significantly since Findings in one published article suggests this could be due at least in part to the activities of the MHCC Results are promising: PI is hopeful we may have turned a corner Presented by: Name, Title September 2013 Many articles published Good model for any country to follow, to evaluate news coverage

51 Opening Minds: Lessons Learned Presented by: Name, Title September 2013

52 Questions? Comments?

Understanding Stigma: Results of a Mixed Methods Evaluation of An Anti-Stigma Program for Healthcare Providers in Canada

Understanding Stigma: Results of a Mixed Methods Evaluation of An Anti-Stigma Program for Healthcare Providers in Canada #OpeningMinds Stephanie Knaak, PhD Opening Minds, MHCC Together Against Stigma,