1. severe mental illness
Working together to help everyone affected by severe mental illness recover a better quality of life
I’m CP, ceo of Rethink
The charity for everyone affected by severe mental illness
We are a membership based information, advice and campaigning charity
And the UK’s largest social enterprise providing mental health services across Northern Ireland and England, helping over 7000 people each day
Here in Northern Ireland we provide services ranging from advocacy and employment to housing and residential care
And all our work is dedicated to helping people affected by mental illness to recover a life they find meaningful and fulfilling
We have a fantastic programme today, but just before we start, a few housekeeping points:
Fire exits - smoking - refreshments
q&a after each speaker - roving microphones

2. Northern Ireland context
Poor mental and physical health
Poverty, inequality, deprivation
Emergence from decades of conflict
High level of suicide
8.4% of health and social care spend is on mental health - compared to 12% in England
No service framework
No priority status
Northern Ireland has both more problems and more possibilities than the rest of the UK on this issue
Both mental and physical health of the population are poor compared to the rest of europe
Heart disease, cancer and accidents all cause more deaths here
And the prevalence of mental health problems at 24% for men and 175 for women is a fifth higher than in England or Scotland
Why? Poverty, inequality and deprivation are part of the answer,
We all know the proportion of people dependent on income support here is 60% higher than in England, and household incomes are 22% lower
But a special factor is the emergence from decades of conflict directly impacting on such a high proportion of the people of Northern Ireland
And experience from around the world tells us that mental health problems soar in the years after the violence
But less health and social care money is spent on mental health in Northern Ireland than in England, despite the greater need
And there has been no service framework, no priority status, none of the focused investment which is making a difference elsewhere

3. What is Stigma? Problems of knowledge = ignorance
Problems of emotions = prejudice
Problems of behaviour = discrimination

4. Discrimination in numbers
Over 80% unemployed
40% have no social contacts
Tripled mortality rate
Doubled incidence of heart and lung disease
High levels of homelessness
Highest level as victims of crime
Lets put some numbers to that
Over 80% of people with severe mental illness are out of work
40% have no social contacts other than with care staff
Physical health suffers too with tripled mortality and doubled incidence of heart and lung disease
People with mental illness make up 37% of all homeless people in Belfast
And they are the group in society who experience the highest level of being victims of crime
Stigma is wrecking lives
And as a result, in the words of the Prime Minister’s special adviser Professor Lord Layard, mental illness is now a bigger cause of misery and a bigger social problem than unemployment 12

5. What is Stigma? Problems of knowledge = ignorance
Problems of emotions = prejudice
Problems of behaviour = discrimination

6. European Views on Schizophrenia
Split personalities
Danger to others
Austria (n=1044)
29% -
Germany (n=7246)
80%
18%
Greece (n=1199
81%
75%
Italy (n=583)
27%
Poland (n=1000)
50%
39%
Slovakia (n=508)
61%
31%
Spain (n=518)
Turkey (n=707)
41%

7. What is Stigma? Problems of knowledge = ignorance
Problems of emotions = prejudice
Problems of behaviour = discrimination

8. 1. Discrimination at Home
Adverse reactions by family
lazy / weak / amusing / bereavement/ shunning
Negative reactions to family members
‘courtesy stigma’, stigma by association
Low status or segregated housing
Institutions, hospitals or social/care homes
High rates of homelessness
Neighbourhood reactions to residential care

9. 2. Discrimination in Friendships, Intimate Relationships and Childcare
Loss of husband/wife/partner
Disappearance of friends
Impaired long-term sexual relationships
Sexual performance affected by drugs
Lower fertility rate for women with schizophrenia
Higher rates of loss of children to care

10. 3. Discrimination at Work
Lower rates of short-listing and hiring
More often sacked for poor attendance/performance
Lower rates of pay
Poorer promotion prospects
Dilemma of whether to disclose
Difficulties in getting reasonable accommodations / adjustments

11. 4. Discrimination in Social Life
Limitations in leisure and social clubs
Travel: low rates of car ownership
Less access to affordable insurance Low income / welfare benefits
Low rates of registration to vote
Limitation on jury service, property ownership, legal ability to sign contracts
De facto cannot be a reliable witness in court
Human rights may be fundamentally limited

12. 5. Discrimination in Healthcare
Avoidance of seeking help for fear of stigma
Pessimism of mental health care staff
Less thorough investigations and treatment for physical health problems
Stigma against mental health care staff
Consumers often decide to discontinue care

13. 6. Discrimination in the Media
Newspaper 40-70% of items-violence
These do have negative effects on popular views
0-Mentally ill characters on TV more more violent than usual characters
85% of children's animations show MI as violent
Psychiatrists as ‘manipulator, as priest, as pervert, as lecher, as stricken, tortured soul’ (Clare, 2004)
Few direct accounts from consumers
Usually journalists ‘editorialise’

14. 7. Self-Discrimination Avoidance of close personal relationships
Reluctance to apply for jobs
Feelings of loss of agency eg cannot volunteer
= anticipated stigma
Can lead to self-fulfilling prophesies
ie vicious cycles/circles
Avoidance of healthcare to avoid the label
Core identity can change to a disabled person

15. Social relationships & social support

16. And can I take this opportunity to thank all of those – members, volunteers, service users and staff, and our funders and partners
Who have made it possible for Rethink to plan this programme and carry it through successfully
We could not do it without you
Thank you, and now its my great pleasure to introduce our first speaker for today
Monica McWilliams is the Chief Commissioner for Human Rights in Northern Ireland
Appointed in June this year, she was Professor of Womens studies and social policy at the University of Ulster
And a member of the legislative assemby from 1996 to 2003an expert in conflict resolution, peace negotiator, and signatory to the Belfast Agreement, her work has been recognised by accolades including the John F Kennedy Leadership and Courage award
Ladies and gentlemen, please welcome Monica McWilliams