The Emotional Impact of Stigma (Feel free to replace with own details – credit See Me and Lanarkshire Links with format for workshop) Benjamin McElwee, Policy and Practice Officer – See Me Scotland

What we’ll talk about today… The Facts Stigma & Discrimination Discussion Issues Lived Experience What Can You Do?

1 in 4? 2 in 3? The official Scottish Government statistic is that one in four people in Scotland experience a mental health issue at some stage in their life. However Mental Health Foundation commissioned research this year, carried out by NatCen (2017) found that of the +2000 people surveyed, either online or by the phone, 2/3 reported they had experienced a mental health problem and only 13% were able to report that they were living with high levels of positive mental health. Therefore, whilst the prevalence of mental health issues is up for debate, particularly as often people experiencing mental distress will not have an official diagnosis, what we do know is that mental health is everyone’s business. SG:http://www.parliament.scot/ResearchBriefingsAndFactsheets/S4/SB_14-36.pdf MHF:https://www.mentalhealth.org.uk/publications/surviving-or-thriving-state-uks-mental-health

The Facts People with mental health problems face unacceptably high levels of stigma and discrimination – 9 out of 10 Can face inequality in all aspects of life Are often excluded from decision-making processes that affect their lives Are at risk of suicide (mental health and stigma- related) In a survey carried out by Time to Change (Stigma Shout, 2008), they found that 9 out of 10 people who use supports and services had experienced the impact of stigma and discrimination directly. Experience inequality of opportunity and outcome at all stages of life – for example, they may receive inadequate support at school to enable them to fulfil their potential and go onto university, thus impacting their job prospects, their chances of promotion, and the income level they can achieve, their likelihood of being in unemployment, and so on, Can die 20 years younger, are poorer on average and have fewer opportunities in life than the general population Can have their rights legally limited as a consequence of mental health issues and laws designed to protect their rights are often ignored– e.g. in the treatment available, there is less effective choice for people struggling with their mental health, than people with physical ailments, or peopl can have their choices removed e.g. under Mental Health Act Are at greater risk of suicide, not only due to their mental health issues, but also because help-seeking is hindered as people may not seek help early enough nor feel able to talk about their problems and difficulties www.elament.org.uk

Group Discussion What is your understanding of stigma Group Discussion What is your understanding of stigma? Have you witnessed or experienced discrimination? When people experience either of these, how does it make them feel? 15-20 minute discussion session in groups of no more than 8 – This can cover stigma and discrimination in the broadest sense, e.g. people with red hair; people accessing social security; people of working class backgrounds, etc. Important to give prompts and examples if people are reticent to share Important to try and tease out the impact that this has on people emotionally, and how this is compounded by the impact it has on their experiences in life and life chances.

Common Issues People Face Employment and Social Security Isolation Relationships Difficulties being open Health anxiety Avoiding help-seeking Low self esteem and self-stigma Mental and physical health impacting on each other Many of the issues from the previous discussion will be highlighted in this slide, but can be recapped in further detail using suggestions below and any themes you can draw out from groups. Can also ask groups for any specific issues that were prominent, common or resonated with them Difficulty in finding and keeping a job, or obtaining entitlements Isolation from friends, family and daily activities Making excuses for not going out places due to the fear of telling people about how they feel Harder to stay in stable long-term relationships Fear of opening up to professionals, family and friends about mental ill health Anxiety about health due to overwhelming belief of not being listened to Avoiding speaking to doctors about mental health concerns which means treatment and care is not given. This can also have a knock on effect on recovery Negative experiences make it harder to ask for help  Low self esteem from internalised stigma and associating themselves with the stereotypes portrayed about mental ill health Physical health is often affected too, including through diagnostic overshadowing

Lived Experience Perspective 5-10 minute input from someone with lived experience of mental health issues This input should highlight: specific examples of where they have experienced stigma and discrimination, how that made them feel, and any impact it had on their recovery. Any positive experiences which demonstrate a better way to act It could also cover: Suggestions for how this negative experience could’ve been averted, What is important to them in dealing with health and social care services and professionals.

NO-ONE should ever be made to feel like this. Thank the person for sharing their lived experience and perhaps offer own reflections on what they have said

What Could You Do? Care in conversations (consider the whole-person) Show compassion and empower Support or signpost Self-awareness and time for reflection What Matters to You? Truly consider the context of someone’s lives, listen to their story, and tease out the best way to help them from what they are telling you In mental health, it’s important to look for the treatment option that empowers the individual, supports them to self-manage and matches their preference If you unable to provide appropriate support, assertively signpost to the people, professionals, or community assets that can (this may involve supporting them to self-refer, taking them to an appointment, etc.) Try to create time to look after your own health and reflect on your values and what you’re trying to achieve (and how you’re going about it) Instead of focusing on the deficit, focus on the assets they have that can be built upon, and the outcomes that are important to them – always consider their tastes, preferences, and what is most likely to work for them

Contacts: (Feel free to replace with own contact details) Benjamin McElwee, Policy and Practice Officer – See Me Scotland End Mental Health Discrimination Benjamin.McElwee@seemescotland.org