#antistigma

[fightstigmaposts-blog]

MentalHealth 01

Throughout the semester in CYCP 113 we learned the basics about mental health disorders, the signs and symptoms that follow, and different ways to fight stigma. As CYCP’s we can help our youth fight stigma by educating them and getting them involved. By educating those who are unsure about mental health in general, you clear away any uncertainties that they may have. By talking about mental health awareness in a public setting it normalizes the conversation. By normalizing the conversation it makes those who are affected feel as though they can come forward and talk about their struggles without being isolated.

[askatherapist-blog]

#sundaymadness #sundayfunday #happyeaster #anxiety #anxietyquotes #anxietydisorder #mentalhealth #mentalhealthawareness #mentalillness #mentalillnessawareness #recovery #mentalhealthadvocate #askatherapist #bullies #selfawareness #thoughts #endthestigma #stigmafree #antistigma #begreat #🙏

[freshnewsnow]

Cj Wallace

For many creative individuals who tend to think in non-linear patterns, cannabis is a catalyst. For some artists, writer’s block does not exist and cannabis elevates their efforts to heights unparallelled. Such is the case for Christopher Wallace, better known as The Notorious B.I.G. from Brooklyn, New York. Although his life was tragically cut short due to senseless violence, his hymns and…

[sofiaolga]

#selftimed #stretching @unicohijowow asked me why I had 6 @instagram accounts. Told him it is #OCD. *** #mobilephotography #photographersoninstagram #photoholic #photographerslife #mentalhealthawareness #antianxiety #antistigma (at Goa, Camarines Sur) https://www.instagram.com/p/CEvyqdjH5Qa/?igshid=lgu8hdy6lbec

[roofdancer]

“You are you” is the first Moscow anti-stigma festival to support youth with mental disorders. It was a free event with lectures on mental health, workshops, psychological consulting and human library. ID: a wall with multicolored pieces of paper with phrases “you are you”, “I’m not my diagnosis”, “be yourself”, “don’t be afraid”, “you’re not the only one like this here”.

[bluewatsons]

Patrick W. Corrigan, Where Is the Evidence Supporting Public Service Announcements to Eliminate Mental Illness Stigma?, 63 Psych Services 79 (2012)

Abstract

Advocates and social marketers have used substantial resources to develop public service announcements (PSAs) as a lead strategy in public education and awareness campaigns meant to eliminate stigma associated with mental illness. Evaluations of PSAs are needed to determine whether this is a good investment. The author notes that very few studies have been reported in the peer-reviewed medical and psychological research literature addressing this question. Reports of government contractors suggest that PSAs have some effect as measured by population penetration, but such data provide no meaningful evidence about the impact of PSAs, such as real-world change in prejudicial attitudes and discriminatory behaviors. The author considers reasons for the limited impact of PSAs and proposes that social marketing campaigns could enhance their impact by targeting local groups.

Most advocates agree: life opportunities of people with serious mental illnesses are egregiously impeded by stigmatizing attitudes toward and beliefs about mental illness. For example, stigma undermines vocational goals when employers share these beliefs and attitudes and hinders the search for independent housing when landlords do so.

Advocacy groups have embraced a variety of strategies to erase stigma. Prominent among them are public service announcements (PSAs), issue-focused advertisements featured in television, radio, print, outdoor, online, mobile, and other media. Typically, these are developed as part of a broader public service campaign, a multilevel program designed to tackle stigmatizing attitudes and discriminatory behavior. Some PSA campaigns require significant financial investments. They are comprehensive, multimedia campaigns sponsored by well-established nonprofit organizations or national governments; such campaigns have been undertaken in many industrialized English-speaking countries, including Canada, Australia, England, New Zealand, Scotland, and the United States. Funding these campaigns encumbers resources that might be used for other public health communication efforts. Thus these programs need to be evaluated to inform ongoing PSA development. In this Open Forum, I briefly describe PSAs and then summarize evidence on their influence. PSAs are then framed in terms of broader social marketing principles, which lead to recommendations for ongoing research and development.

Addressing the stigma of serious mental illness

Stigma has been described in terms of prejudice (agreement with stereotypic beliefs leading to hostile emotional responses, such as fear and anger) and discrimination (the behavioral consequence of prejudice, which leads to social distance and the loss of opportunity, such as a good job or nice place to live) (1). For more than a century in the United States, there has been opposition to prejudice and discrimination associated with serious mental illness, with consumer groups having the most organized and strident voice. In 1908 Clifford Beers, founder of the National Committee for Mental Hygiene (now Mental Health America), wrote A Mind That Found Itself, a summary of his experiences in psychiatric hospitals of the era, where he encountered the abuse that was characteristic of the system (2). In 1977, Judi Chamberlin wrote On Our Own, widely recognized as the consumer manifesto for personal empowerment and against stigma (3). Advocacy against stigma's pernicious effects has soared in the past decade with the energy and resources of professional groups (for example, the American Psychiatric Association and the World Psychiatric Association), advocacy groups (for example, the National Alliance on Mental Illness and Mental Health America), pharmaceutical companies (for example, Eli Lilly), and government bodies (for example, the Substance Abuse and Mental Health Services Administration [SAMHSA] and the National Institute of Mental Health [NIMH]).

In the social psychology literature, programs meant to eliminate the stigma of mental illness have been described as educational or contact based (4). Educational programs provide information as a way to challenge prejudice and discrimination. Some research has supported this hypothesis (5–7), although other studies suggest that effects of education are relatively short lived (8). Stigma is further diminished when members of the general public have direct contact with people with mental illness who are able to hold jobs or live as good neighbors in the community. Research shows that members of the community who meet and interact with people with mental illness as part of antistigma programs are less likely to show prejudicial attitudes and some proxies of discriminatory behavior (8–10). Although some PSAs fall neatly into these categories, many combine education and contact; for example, some PSAs feature a person who, in the process of telling his or her story, shares important facts about the illness.

Examples of PSAs

After the 1999 White House Conference on Mental Health, the U.S. government seems to have actively pursued antistigma campaigns in a systematic way. As a result, Tipper Gore and Alma Powell formed the National Mental Health Awareness Campaign in 2001. Among its materials were PSAs featuring adolescents forthrightly discussing their experience with major depression. The advertisements targeted teens with age-appropriate music and graphics and were distributed to teen-friendly media outlets such as MTV.

SAMHSA has been a major force in antistigma efforts. In 2004, SAMHSA started the Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated With Mental Health (www.promoteacceptance.samhsa.gov), a project designed to counter prejudice and discrimination associated with mental illness by sharing information and by providing technical assistance to help organizations design and implement antistigma initiatives. SAMHSA partnered with the Ad Council to develop a campaign—“What a Difference a Friend Makes”—designed to encourage young adults to step up and support friends living with mental health problems. The PSAs launched nationally in December 2006 and incorporated television, radio, outdoor, print, and Web elements, including a print brochure and new Web site. In an especially poignant television PSA in the campaign, two young men are sitting next to each other in a darkened room playing a computer game (www.whatadifference.samhsa.gov/site.asp?nav=nav00&content=6_0_media). They are seemingly frozen, not pushing the buttons on their controllers, and they appear uncomfortable, stealing sidelong looks at each other. Voice-over: “It can be a little awkward when your friend tells you he's been diagnosed with a mental illness. But what's even more awkward is if you're not there for him, he's less likely to recover.” One of the young men then says, “I'm here to help, man. Whatever it takes.” The PSA fades to the URL for the Web site (www.whatadifference.org).

This campaign is actually SAMHSA's second antistigma campaign with PSAs; the first was called the Elimination of Barriers Initiative (EBI) a three-year pilot project begun in eight states in 2003. One of its PSAs featured a scene with “regular people” (a storeowner, a mother of two, and an honor student) with a voice-over that stated that all the people shown have “recovered from a mental illness.” It ended with the phone number of the National Mental Health Information Clearinghouse and its Internet address.

Another PSA, the most recent when this Open Forum was written, received support from SAMHSA and NIMH. It was released on October 21, 2009, and features film star Glenn Close (bringchange2mind.com). Set in a large train station, pairs of actors wear light-colored T-shirts, half of them labeled in blue print with a mental illness. Each is partnered with another person labeled as a loved one. For example, one man's shirt says “schizophrenia,” and next to him in a similar shirt is “mom.” Another man wears a shirt with “bipolar,” and paired with him is “better half.” Glenn Close's shirt reads “sister,” and standing next to her is real-life sister Jessie with “bipolar” on her shirt. There are definite benefits to this kind of PSA. Close's star power, for example, has had notable effects, as evidenced by the news coverage and online activity created by the PSA.

Evaluating PSAs

Evidence is needed to determine the influence of PSAs, but a search for published studies is a bit disconcerting. There are few on the evaluation of U.S. PSA efforts in the traditional research literature—for example, in searches using via PsycINFO, Google Scholar, and PubMed. In fact, no studies on the effects of PSAs were found in such searches. SAMHSA contractors collect data, but their reports are typically not peer reviewed. General considerations about PSAs from authors in the public health field provide some interesting guidelines. For example, they assess PSAs on the basis of penetration and impact (11,12). Penetration is the extent to which a targeted population is made aware of and otherwise informed about mental illness stigma. Impact is the degree to which penetration leads to important change in prejudice and discrimination.

Penetration might be viewed as a function of recall and recognition memory: can individuals remember seeing or hearing a specific PSA? Consider this self-test of a PSA's effects. Ask how many people in a group of acquaintances recall seeing the Glenn Close PSA, “Change a Mind.” The Ad Council does not measure recall of its advertising per se, but it provided a report with recognition scores for the tracking survey on the campaign “What a Difference a Friend Makes.” An online tracking survey found that 31% of a sample of young adults age 18 to 25 recognized any PSA from the campaign in March 2008, and 28% recognized any PSA in May 2009.

Impact is more difficult to assess. One approach is to examine visits to Web sites listed at the end of many PSAs; this is based on the rationale that viewers are seeking further information to learn more about stigma and to work against it. The Ad Council reported Web site traffic for the “What a Difference” campaign from its launch in December 2006 through September 2008, with a monthly median of 64,098 visits. From the first month of the campaign to September 2007, Web site visits increased to a high of 102,416. Average time spent on the Web site was almost eight minutes.

Findings were a bit different for PSAs from EBI (13). During its eight-month campaign that began in November 2004, monthly visits to the site almost tripled, from 2,743 to 7,627—a highly significant increase. The effect size, however, is quite small. U.S. Census data as of July 2008 reported 124 million residents in the eight pilot states, which means that .000061% of people in these states visited the Web site. Of additional concern, however, was the finding that 88% of visitors exited the Web site in less than one minute; less than 30% of visitors returned to the site in the subsequent months.

Measuring Web site visits is a limited indicator of impact. It does not show whether learning from the Web site leads to any important change: whether employers are hiring more people with mental illness or landlords are more likely to rent property to them. In some ways, addressing the stigma of mental illness is more difficult than targeting the more discrete health goals of other PSAs. The goal of antismoking PSAs is to stop cigarette smoking, and the goal of breast cancer PSAs to persuade more women to get tested. What more or less is sought in the mental illness stigma PSAs? Some social critics have argued that PSAs targeting nebulous social justice goals might lead to “slacktivism” (14). This term refers to feel-good measures that require minimal effort in support of a social cause and that have little meaningful effect other than yielding self-satisfaction. Examples include signing Internet petitions, wearing awareness ribbons for a social justice cause, or joining a Facebook advocacy group. Concern about mental illness stigma may fall into this category. People use their “electronic voice” to express a concern that translates to little effort for real change.

Consistent with the health examples above are PSA efforts that are designed to guide people in need of psychiatric services to seek treatments. A Web site included in such a campaign might be a clearinghouse for this purpose. Unfortunately, data on this kind of impact are absent from the literature.

In sum, research on PSAs is mostly lacking, provides moderate support for penetration at best, and fails to show meaningful impact at this time.

Social marketing for targeted and local change

Who should be the target of antistigma campaigns? For many PSAs, targets are samples of the entire population (for example, all TV viewers in the United States). This can be contrasted with a strategy for narrower, targeted antistigma efforts. Targets are important when they play a power role vis-à-vis people with a psychiatric disability; such targets might include employers, landlords, legislators, educators, and health care providers (15–17). Some employers, for example, agree with the statement, “People with serious mental illness are not able to do real work,” and therefore they do not interview people with mental illness for job openings. Prejudice and discrimination specific to this targeted group provide a good base for a social marketing campaign. For example, a goal of an effort aimed at employers would be to replace myths with contact—“Most people with serious mental illness can work a regular job, especially with legal accommodations.”

Effective stigma change is not only targeted but also local. Antistigma programs are likely to be more effective when they target a power group living or working in a relevant and accessible community. For example, although targeting employers as a group to change prejudice and discrimination may be beneficial, challenging the prejudice of employers working in the Greater Lawn neighborhood of Chicago (a largely African-American area, with residents of low socioeconomic status) is even more potent. Describing a community in terms of diversity (for example, by race-ethnicity and socioeconomic status), economic opportunity (availability of jobs), and resources (availability of mental health or educational programs) will significantly advance corresponding antistigma programs.

A focus on targeted and local antistigma programs might diminish the influence of population-focused PSAs. One of the strengths of the Glenn Close PSA, for example, was that tens of millions of people viewed it during the final months of 2009. Breadth of PSA penetration is narrowed when targeted goals are addressed. Instead of distributing population-focused PSAs to all radio and television media in a market, approaches that target employers might use social marketing plans in venues that are rich in business owners and employers. Service groups such as Rotary International, for example, may be excellent venues for targeting employers. PSAs by themselves may seem cold and distant in such a relatively intimate setting as a Rotary meeting. In these situations, actual contact with a person with mental illness may have the best impact.

Future directions

Given these findings, I propose three directions for future consideration. First, funders of public service and PSA campaigns clearly need to include support of evaluation efforts not only to examine penetration but also to determine whether the PSA yields any tangible positive impact. Second, the PSA campaigns described here are in some ways an anachronism; fewer and fewer people are using television and radio as major sources of the media (18,19). Many Americans, especially younger people, rely on a variety of online resources, including social networking and relatively instant information via Twitter. At this point, however, no systematized or widespread strategies have emerged to address Internet phenomena. Third, population-based approaches to stigma change need to be balanced with more targeted and local efforts. Social marketing efforts should be developed for individual power groups, so that employers will interview and hire more people with mental illness and landlords will rent to them. Funds may need to be diverted from PSA development to advance these kinds of programs. Considerations such as these will help advocates partner with funders to develop programs that have the greatest impact on stigma and that create more opportunities for people with mental illness.

References

Corrigan P : On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington, DC, American Psychological Association, 2005

Beers C: A Mind That Found Itself. Oxford, England, Longmans, 1908

Chamberlin J: On Our Own. New York, McGraw-Hill, 1977

Corrigan P , Penn D : Lessons from social psychology on discrediting psychiatric stigma. America Psychologist 54:765–776, 1999

Corrigan P , River L , Lundin R , et al.: Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin 27:187–195, 2001

Keane M : Contemporary beliefs about mental illness among medical students: implications for education and practice. Academic Psychiatry 14:172–177, 1990

Penn DG , K , Daily T , Spaulding W : Dispelling the stigma of schizophrenia: what sort of information is best? Schizophrenia Bulletin 20:567–578, 1994

Corrigan P , Rowan D , Green A , et al.: Challenging two mental illness stigmas: personal responsibility and dangerousness. Schizophrenia Bulletin 28:293–309, 2002

Pinfold V , Toulmin H , Thornicroft G , et al.: Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools. British Journal of Psychiatry 182:342–346, 2003

Schulze B , Richter-Werling M , Matschinger H , et al.: Crazy? So what! Effects of a school project on students' attitudes towards people with schizophrenia. Acta Psychiatrica Scandinavica 107:142–150, 2003

DeJong W , Wolf R , Austin S : US federally funded television public service announcements (PSAs) to prevent HIV/AIDS: a content analysis. Journal of Health Communication 6:249–263, 2001

Goldman L , Glantz S : Evaluation of antismoking advertising campaigns. JAMA 279:772–777, 1998

Bell J , Colangelo A , Pillen M: Final Report of the Evaluation of the Elimination of Barriers Initiative. Arlington, Va, James Bell, 2005

Feder B : They weren't careful what they hoped for. New York Times, May 29, 2002

Link B , Phelan J : Conceptualizing stigma. Annual Review of Sociology 27:363–385, 2001

Farina A , Felner R : Employment interviewer reactions to former mental patients. Journal of Abnormal Psychology 82:268–272, 1973

Bordieri J , Drehmer D : Hiring decisions for disabled workers: looking at the cause. Journal of Applied Social Psychology 16:197–208, 1986

Brandtzaeg P , Lüders M , Skjetne J : Too many Facebook “friends”? Content sharing and sociability versus the need for privacy in social network sites. International Journal of Human-Computer Interaction 26:1006–1030, 2010

Vasalou A , Joinson A , Courvoisier D : Cultural differences, experience with social networks and the nature of “true commitment” in Facebook. International Journal of Human Computer Studies 68:719–728, 2010

[quashstigma]

#equity4eatingdisorders One of the reasons it took me so long to get help for my eating disorder was fear of stigma. I experienced self stigma, I was afraid of public stigma. For many people, access to eating disorder treatment or help is limited by stigma, whether it is the stigmatizing system that has been created to perpetuate the notion that only people in smaller bodies are “sick enough” to require help, or fear of a label and the impact this could have on them. I was terrified to have a label attached to myself- I was scared it would affect my employment, my friendships my relationships. None of which has been the case. In fact owning my voice, my story has provided me with opportunities and relationships I never imagined. I hope that if you’re reading this, afraid to seek help because of the fear of stigma, I hear you, but don’t let that stop you from accessing or reaching out for the help you needs One day my hope is that everyBODY will be treated with complete equality no matter the gender, shape, size, ethnicity. But until then we need to find power in our voices to make change happen. #equity4eatingdisorders #eatingdisorderrecovery #eatingdisorderawareness #eatingdisorderecovery #edwarrior #edwarriors #allbodiesaregoodbodies #allbodiesareworthybodies #haes #antistigma #quashstigmas #anorexiarecover #anorexiarecovery #anorexiawarrior #bulimiarecovery #bulimiafighter #atypicalanorexia #atypicalanorexianervosa #hypothalamicamenorrhea #hypothalamicamenorrhearecovery #bulimianervosarecovery #bingeeatingrecovery #bingeeatingdisorderrecovery #orthorexia #mentalhealth https://www.instagram.com/p/CPju75xJqN8/?utm_medium=tumblr

[anbnvzw-blog]

Gooi ook eens een vooroordeel omver! 🌸 Welkom op Stadsplein Genk #infocampagne #antistigma #rodeneuzenactie #dagtegeneetstoornissen2017 #vvgg #Te Gek!? #anbn #eetstoornis #eetstoornisherstel #anorexia #boulimia #eetbuistoornis #bingeating #zelfhulp #dagtegeneetstoornissen2017 (bij Het Stadsplein Genk)

[yello80s]

Looking for that holiday gift that won’t be forgotten? Give the gift of reading! The Book of Moon: an Loúr ihn G’éalach is available now! “Written as an allegory of childhood mental illness, characters and events in The Book of Moon: an Lour ihn G'ealach are based on on the author's experience as a child and teenager growing up with a mental illness with the intent to help create awareness of the isolation, discrimination and stigma experienced by the mentally ill in their everyday lives.” Thebookofmoon.com to purchase. #holidayreading #christmasgifts #yabooks #fantasybooks #allegory #mentalhealth #mentalillness #illustratednovel #teenbooks #thebookofmoon #antistigma #xmas2020 #linkinbio #supportwomenauthors #indieauthors #indiebooks #giftsforreaders https://www.instagram.com/p/CJD7qUmgLwR/?igshid=ch7bls0dec36

[knowuslikeus-blog]

Hello!

This humble project began in November of 2015, in a small back room of a Mental Illness Community Service Provider (CSP) office where the founders gathered to discuss their next community service project. What began as a simple idea to reach out to college students has evolved into what will hopefully become a more wide spread campaign to reduce the stigma of mental illness. Our mission is simple: bridge the gap between people with and without mental illness  through the facilitation of positive interactions that expose the simple truth: we are more alike than different. The Know Us Project seeks to put the power of combating stigma in the hands of people with mental illness. To let them show the world they are so much more than a diagnosis and a media image. The Know Us project empowers those without mental illness to reach out, to connect through the stigma screen. This page represents a place for those with and without mental illness to connect and interact in ways they may not otherwise have the opportunity. We hope that by posting recovery stories, sharing ideas of combating stigma, and generally posting positive experiences that highlight the multiple aspects of who we all are as individuals, we can get to know each other and begin the process of overcoming stigma, together. If a story or post inspires you, we encourage you to take a risk, reach out, and ask questions. Remember, to know us, is to like us. Please note this page is meant to be a positive and safe place. Ridicule, criticism, blaming, or trolling will not be tolerated. If your comment or post contains hateful, incendiary, or harmful content, you will be issued a private warning, followed by blocking if behavior does not resolve.

[askatherapist-blog]

#beyou #eccentric #different #embraceyourself #iam #who #me #selflove #selfawareness #reflection #mentalhealth #mentalillness #mentalhealthawareness #mentalhealthadvocate #endthestigma #stigmafree #antistigma #believeinyourself #focus #live #love #dream #itsanewlife #goodmorningamerica #askatherapist

[eriecountypeersupport]

Wellness On The Waterfront 2017

It’s 4:41 PM on Saturday, May 20th, 2017.  I’m sitting at my desk at the Mental Health Association of Erie County.  In front of me is a medium iced mocha and a broccoli cheddar soup from Tim Horton’s.  (Don’t judge.  I am VERY hungry.)  Kelli Pickler is singing in the background, and I am breathing for what feels like the first time in days.  

The Youth Peer Mentors working for the Erie County MHA joined forces to plan and host a youth-focused community wellness event intended to promote mind-body healthy living.  (Shout out to Caitlin and Erin for not only dreaming up the event, but also writing and receiving the grant from Youth M.O.V.E. National that made it possible for us to put it on!!)  It took a lot of time and effort, but today it finally happened.

The day was filled with heavy lifting and laughter and sweat and tears and excitement and pride and vulnerability and courage.  Candy was consumed. Stress balls were made using flour and balloons.  We fought with the wind to keep flyers and posters on the tables.  The Executive Director of the Mental Health Association of Erie County was creamed in “Corn Hole.”  We listened to powerful live music performed by Among The Wolves. A group of brave teens took the stage to share about their personal experiences with mental illness through poetry, rap, and other creative means.  

IT.  WAS.  AMAZING!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I think I speak for all of the Youth Peer Mentors at the Erie County MHA when I say THANK YOU!

Thank you to our supporters and cheerleaders.  Thank you to our mentors. Thank you to those who volunteered their time to make this event possible. Thank you to the Western New York community for taking a stand against the stigma associated with mental illness.  

And perhaps most importantly, thank you to the youth who allow us to be a small part of their own recovery.  We are so proud of you, and so privileged to know you.  Thank you for giving us the motivation to work hard at raising awareness and decreasing stigma.  

Thank you for giving us the courage to keep fighting every. single. day.  

--Carly-- 

[matdale]

The clock tower of High Royds Mental Asylum in Menston, which are now luxury apartments and houses, can be seen peering through or looming over buildings all around the grounds of the former Asylum which was open from 1888 until its closure in 2003. For many patients this was the first thing they saw as they were admitted to the Asylum. #mhaw17 #mentalhealthawareness #mentalhealthawarenessweek #mentalhealth #stigma #antistigma #history #leeds #menston #highroyds #asylum

[thewhitepariah-blog]

Go watch the live stream I guested on over at @tofutommy120180 YouTube channel - we talked anorexia, mental illness, Asperger's, autism and more :) #eatingdisorderrecovery #eating #vegan #veganism #mentalhealth #mentalillness #vegandrama #stigma #antistigma #youtube #youtubers

[alsana2]

Nearly 2 in 5 adults struggled with mental health issues in 2020, compared to about 1 in 5 adults before the pandemic. A...

Nearly 2 in 5 adults struggled with mental health issues in 2020, compared to about 1 in 5 adults before the pandemic. Among adults with mental illness, only 46% received treatment in 2020, a number that is far lower among Black Americans (37%), Hispanic/Latinx (35%), and Asian Americans (21%). Source: @namicommunicate As advocates, allies, caregivers, survivors, policymakers, and one compassionate community, we must come TOGETHER for Mental Health Awareness Month.💚 Recovery happens in community. #Together4MH #MHAM #mentalhealthawarenessmonth #mentalhealth #mentalillness #antistigma #healthequity #notalone #eatingdisorderrecovery #community

from https://www.instagram.com/p/CdEv2GSMX7t

[lupine-publishers-sjpbs]

Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Lupine Publishers | Give, and You Shall Receive: Mental Health Professionals and Stigma Towards Persons with Mental Illness 

Abstract

Stigma is one of the barriers that hinder people with mental illness from successfully engaging in treatment, which contributes to mental illness having a substantial global burden of disease. This review article examines the duality of the relationship between mental health professionals and stigma towards mental illness. Mental health professionals are subject to associative stigma by virtue of the people with mental illness whom they work with, which can bring about significant distress to the mental health professionals. Despite the need for a non-judgemental attitude for optimal engagement, Health care professionals are not immune from stigmatizing beliefs of their own. On top and above of anti-stigma initiatives with the general population in mind, healthcare workers have been prioritized as a target group for anti-stigma efforts. This is because they have the Potential to impact others, including both persons with mental illness and the general public, through the course of their daily work. Before their professional roles, the training stage might provide the ideal platform to introduce anti-stigma efforts. This benefits of this might not be immediately evident, but this has a long-lasting impact with the potential to turn the wheels of change at the societal level.

Keywords: Social stigma; Mental illness; Medical staff; Physician patient relations; Nursing staff; Nurse patient relations

Introduction

Persons with mental illness grapple with stigma and the discrimination that comes along with their mental health condition. At the public health level, this represents a major concern as it contributes to the treatment gap which discourages those in need of professional help from seeking assistance. Looking across the consultation table, mental health professionals themselves are also subject to associative stigma from peers who might be working in domains outside of mental health. This divide comes across as ironic, given the advocacy for an integrative approach towards mind and body. Mental health professionals work to help those with mental illness, but are individuals themselves shaped by influences and personal experience from their immediate surroundings and societal environment at large. They would also form their own opinions about people with mental illness, with some of these opinions dating back to even before undergoing training in their field. When surveyed in comparison to the general public, mental health professionals in Australia [1] and America [2] were found to have more positive attitudes about people with mental health problems. This was also the case for Croatian medical doctors [3]. However, these results were contrary to the author’s experience when surveying ward-based doctors and nurses in an acute hospital about patients with alcohol use disorder [4], which revealed stigma amongst healthcare workers to be worse than the general public. This article consolidates literature over the recent two years pertaining to stigma towards mental illness and healthcare professionals. It considers healthcare professionals from both perspectives, as the recipients of such stigma and the personnel concurrently exhibiting discriminatory attitudes.

Mental Health Professionals Being Stigmatized

Mental health professionals experience associative stigma, where they are negatively stereotyped because of the people with mental illness whom they work to help. This has an impact on them, similar to what their clients and patients would experience. While there might be a cultural component in associative stigma such that a greater degree of respect tends to be accorded to mental health professionals in China than the US [5], examining the manner in which Chinese psychiatrists address the topic of stigma with psychiatric patients and their relatives [6] might shed light on how this comes to be the case. As a consequence of stigma, doctors with mental health concerns might experience reluctance in opening up. Whether at the stage of a trainee [7] or beyond, disclosing mental illness might cause an individual to be perceived as “weak” and undermine their professional competence. They are hence less likely to disclose this in the work setting, to co-workers and employers alike, and to seek professional assistance for themselves. There is room for much more to be done to support professionals with mental illness. Ensuring the presence of medical care with sufficient confidentiality, occupational health support and back-towork interviews [8] are but some of the measures with potential to make a difference.

Healthcare Professionals as Stigmatizers

It is paradoxical to note that healthcare professionals concurrently exhibit stigmatizing attitudes. The “Inter Nos” (Latin for “Among Us”) study surveyed attitudes of healthcare professionals towards mental illness, across multiple centres in Spain, Portugal and Italy [9]. Hospital-based staff were found to have more stigmatizing responses on both the Attribution Questionnaire (AQ-27) and The Community Attitudes towards the Mentally Ill (CAMI), agreeing more readily with restrictive options, coercion and segregation. In particular, the more discriminatory attitudes and responses tended to come from nursing assistants as well as staff in non-clinical and “other clinical” roles. When mental health professionals stigmatize the persons with mental illness whom they work with, this has the potential to undermine diagnosis, treatment and successful health outcomes [10]. Right from the start, this might adversely affect the therapeutic alliance. This in turn hinders the mental health professionals’ understanding of the service user’s problem, leading service users to disengage from treatment more readily [11] which ultimately sets up a vicious cycle as a self-fulfilling prophecy. This only serves to reinforce the pre-existing negative stereotypes held by the mental health professional.

Education as a Possible Means of Addressing the Problem

Before health care professionals assume their vocational roles, they are, first and foremost, individuals in society just like every member of the public. Interventions targeted at the general public would have an impact on them, but yet more can be done during the course of their professional training. Experiences at the early stages of training can certainly go a long way in terms of professional development, and others have advocated for antistigma initiatives to begin at the educational stage. Data from United States demonstrated the presence of an educational gap [12], such that psychiatry coursework for pharmacy, nursing and social work students did not improve stigma towards mental illness. This might seem disheartening, but the identification of such educational gaps is the first step in allowing them to be addressed by means of appropriately incorporating anti-stigma training. Following exposure to the mental health curriculum, improved attitudes towards people with mental illness were found in medical students from UK [13] and South Africa [14], as well as nursing students from Turkey [15-17] There might truly be a role for the revision of curriculum pertaining to mental health, for anti-stigma programmes to be included as part of the courses. This might turn out to have a more profound educational impact than factual content found in textbooks and learnt by rote, about what constitutes mental illness and how these are treated.

Future Research

From direct contact intervention to Responding to Experienced and Anticipated Discrimination (READ), there have been no shortage of ideas on how to tackle stigma through education. However, the single most effective modality of delivering the anti-stigma message remains to be seen. Though focused on low- and middle-income countries, a recent systematic review had difficulty in pinpointing the most effective anti-stigma intervention [18]. Future head-tohead comparisons of these varying modalities would help to point the best way forward. Healthcare workers in particular have many opportunities to come into contact with persons with mental illness. For the person with mental illness, each interaction can either work out as a disappointment or a positive encounter. Their influence cannot be understated, and the impact of stigma in this group warrants anti-stigma interventions to prioritize this group. It is worthwhile to note the protocol for a randomized controlled trial in Chile [19] targeting primary healthcare workers, and to see how this would unfold.

Conclusion

Corrigan & Nieweglowski suggested a parabolic relationship between familiarity of mental illness and public stigma [20], where people tend to stigmatize those with mental illness when they were either unfamiliar or too familiar with them. This proposal does suggest that too much of exposure might not be a good thing after all, and there exists an optimal balance in terms of the experience to deliver during training. The need to address stigma towards mental illness has never been questioned, though the best methods to do so remain elusive. While the sentiment of the public is important, this author is a believer of the saying “charity begins at home”. Mental health professionals and healthcare workers working outside of mental health domains are two groups that need to be targeted. This is for the wellbeing of their service users, as well as themselves.

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