2Why do we label? Why do we label? In general terms: make sense of the world (child development) – our never-ending need to categorizeIn terms of negative labels: fear; generalizing a negative experience
3What is Beyond the Label? An educational kit for people working in the fields of mental health and/or addiction treatmentAn interactive framework to discuss, learn, understand and reflect on the impact of stigma on people living with concurrent mental health and substance use problems.
4Concurrent disordersAny combination of mental health and substance use disorders.Some examples are:an anxiety problem and a drinking problemschizophrenia and cannabis dependenceborderline personality disorder and heroin dependencedepression and dependence on sleeping pills
5Why was it developed?Forty to sixty per cent of people who have mental health problems will also have a substance use problem during their lifetime. These percentages are similar for people who seek help for their substance use.Concurrent disorders is not the exception.CD clients need the most help but often receive the least help or no help because the two systems are not always well integrated.Health Canada (2001). Best practices: Concurrent Mental Health and Substance Use Disorders. Ottawa: Author.
6Service Provider Stigma Negative attitudes toward clients with concurrent disorders can arise for several reasons. These may include:Attribution of responsibilityFeelings of inadequacy, frustration, disappointment when working with client with complex needsPerception of poor prognosis
7What are the objectives? To help service providers ensure that their services are accessible and that their attitudes and practices are supportive of people living with concurrent disorders.To provide mental health and addiction workers with a concrete tool that they can use in their agencies and in the community to raise awareness about the stigma associated with concurrent disorders.
8Who developed BTL?A CAMH team including two volunteers living with concurrent disorders, an education specialist, a product developer and program consultants from different areas in the province of Ontario15 reviewers17 pilot facilitators
9What’s inside the kit? 10 stigma-busting activities (menu) Master sheets to use as photocopy handoutsBackground information for facilitatorsPresentation tipsDiscussion pointsExamples of opportune times to use the kit
10The activities explore: The facts and myths about concurrent disordersThe power of language and how words can woundStigma, prejudice and discrimination as barriers to recovery for people living with concurrent mental health and substance use problemsWays we can incorporate anti-stigma practices into our workWays we can all be part of the solution.
11Approaching the elephant We acknowledged that everyone has blind spots, that many service providers do their best not to stigmatize and some are already part of the solution (stigma busters!) .Facilitated presentations both internally and externally
13How was BTL tested? 12 pilot workshops 13 different facilitators 10 different communities in Ontario, Canada159 participantsPre-test/post-test evaluation toolFrom 6 to 28 participants in each pilot workshopSome co-facilitation; lone facilitation2 facilitators helped develop the package, the remaining 11 were unfamiliar with the resource; 8 worked for CAMH; 5 were allied professionalsWorkshops varied in length and facilitators chose the activities that worked for them / their group13 questions pre-test/post-test
14Pilot test resultsAfter the workshop, participants indicated that they:Had a better understanding of concurrent disordersFelt more comfortable interacting with clients with CDHad an increased awareness of the the effect of stigma on people with CDWere more intent on addressing stigma whenever they could
15Promotion Promotion started before the kit was completed Regular project updates got people interested in what was to comeThe needs assessment, review and pilot processes were opportunities to promote Beyond the Label….so we did!.
16Feeding the elephant The Dissemination Plan Recruited and oriented CAMH program consultants across OntarioPCs were encouraged to co-facilitate BTL presentations with key stakeholders in their communityStigma-busters received copies of the manualPromotional materials widely distributedData collected every 3 months
17The statsOver a 3-year period, 3,983 individuals attended one of 198 BTL sessions.
18Today, BTL lives on… Incorporated into: Talking About Mental Illness presentations in secondary schoolsWorkplace health presentationsA Concurrent Disorders and Housing workshopMental Health and Addiction 101 online tutorialsConcurrent disorders curriculum for colleges and universities
19Keys to success Kept focus on Concurrent Disorders A project budget to produce the kitEasy to incorporate BTL activities into other learning modulesAccessibleCAMH’s provincial capacity in policy, education and health promotion
21Keys to success (con’t) Available in English and FrenchEasy to use; no train-the-trainer requiredTime to get stakeholders involved, incorporate their feedback and anticipate the productLeadership and passion
22Things you can do to stamp out stigma Acknowledge the prevalence of concurrent mental health and substance use problems.Try to “walk in the shoes” of a person who is stigmatized.Watch your language.Monitor media and openly critique stigmatizing material.Respond directly to stigmatizing material with a letter to the editor.Speak up about stigma to friends, family and colleagues.Be aware of your own attitudes and judgements.Provide support for organizations that fight stigma.There are a number of things that we can do to stamp out stigma, but the first and most important thing we can do is to assess our own attitudes, language and practices.
23“The limits of my language… mean the limits of my world “The limits of my language… mean the limits of my world.” - Ludwig Wittgenstein (1963)Everything begins with a change in language which allows us to see beyond the label.
24For further information This resource is available at:Marcia Gibson, Program Consultantext: 8209