1. STIGMA CHANGE! What and Where is the Evidence?
Patrick Corrigan, Psy.D.
Illinois Institute of Technology
Chicago Consortium for Stigma Research

2. The Goals Today EVIDENCE Stigma Change is the Goal
Many examples
What works for whom and where?
EVIDENCE
For all stakeholders

3. STIGMA CHANGE PUBLIC STIGMA SELF-STIGMA Protest, Education, Contact
Group identification and support

4. What’s Out There? Current Programs
World Psychiatric Association
Programs by country (N>50)
US SAMHSA's Resource Center
Programs by state (N>100)
Canada Programs
“…the Commission is launching a major, national 10-year anti-stigma and discrimination reduction campaign. This campaign will be the largest systematic effort to reduce the stigma of mental illness in Canadian history”

5. RESOURCES

6. Media Watch
Fright Night Scream Park

7. Public Service Announcements
what a difference a friend makes

8. Personal Stories

9. Ahead of the Data! Intervene Now!
“There's a temptation for the Commission to sprint out of the gate with a mass marketing campaign, but that would be a mistake.”
Canadian Mental Health Commission
Ahead of the Data! Intervene Now!

10. The Evidence Where is the evidence? What is evidence?
Using evidence to make decisions

11. Lessons from mental health services research
What works regionally?
Governmental policy/support (SAMHSA)
Supported employment
Assertive community treatment
What works locally?
How does supported employment actually work in Chicago?

12. Evidence for Stigma Change
What kind of stigma change strategies should Governments/NGOs support?
Education, contact…
Do these strategies work locally?
Chicago, London, Paris
Beijing, Delhi, Riyadh

13. N=213 Stigmatizing Attitudes and Behavioral Intentions Contact:
Responsibility
Education:
Responsibility
Control
Contact:
Dangerousness
Education:
Dangerousness
Attitudes and post and 1 wk f-up

14. SELECTION CRITERIA STAKEHOLDER PERSPECTIVE State of the Evidence
Participatory Action Research
State of the Evidence
Ratio of Cost to Benefit

15. Participatory Action Research
PERSPECTIVE: Understanding the broad questions related to stigma change
POLITIC: interest and authority in subsequent stigma change
Who are the stakeholders?
diversity

16. SELECTION CRITERIA Stakeholder perspective STATE OF THE EVIDENCE
Participatory action research
STATE OF THE EVIDENCE
Ratio of cost to benefit

17. Evidence Based Considerations
Dependent measures
ATTITUDES
Physiological change
Information processing
Social behavior
Behavioral intention
BEHAVIOR

18. Evidence Based Considerations
Dependent measures
Psychometrics (reliability and validity)
Sensitivity
Social desirability

19. Evidence Based Considerations
Reducing discrimination versus affirming actions
Not just what does it stop (less prejudice)
but what is improved (more work)
Specificity
Not just whether it “changes” people, put does it change important groups
Employers, landlords, health care providers 19

20. Evidence Based Considerations
Effect Size
Is the effect noticeable?
Does it matter? (social validity)
Iatrogenic effects
Mental illness is a brain disorder
Manuals and Fidelity
Need to catalogue interventions
Feasibility
If you provide it, will they come
Fect 20

21. Example
Supported employment: Get more people with mental illness back to work. Get more employers to participate in supported employment. Challenge employer stigma: In Our Own Voice: Telling one’s stories

22. Example Dependent measures: Attitudes Behavior Affirming actions
Immediate: Participating in supported employment
Hiring people with mental illness
Affirming actions
Specificity
Effect size
Manuals and fidelity

23. SELECTION CRITERIA Stakeholder perspective State of the evidence
Participatory action research
State of the evidence
RATIO OF COST TO BENEFIT

24. Cost-Benefits The size of the sample The depth and breadth of effects
Local or broad
The depth and breadth of effects
Effect size
Specificity
Outcomes (no stigma versus more affirming actions)
The costs of the change strategy
The cost of evaluation

25. PUTTING IT ALL TOGETHER

26. Evidence Based Approach
WHO is to be targeted.
WHAT needs to be changed.
HOW will this be changed.
WHEN will change occur.
MEASURE IT

28. For Evaluating Programs Meant to Erase the Stigma of Mental Illness
TOOLKIT
For Evaluating Programs Meant to Erase the Stigma of Mental Illness
Patrick Corrigan
draft Oct 23, 2008

29. Patrick Corrigan