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 www.rethink.org

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 www.rethink.org

What is Stigma? Problems of knowledge = ignorance Problems of emotions = prejudice Problems of behaviour = discrimination www.rethink.org

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 www.rethink.org 12

What is Stigma? Problems of knowledge = ignorance Problems of emotions = prejudice Problems of behaviour = discrimination www.rethink.org

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% www.rethink.org

What is Stigma? Problems of knowledge = ignorance Problems of emotions = prejudice Problems of behaviour = discrimination www.rethink.org

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 www.rethink.org

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 www.rethink.org

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 www.rethink.org

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 www.rethink.org

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 www.rethink.org

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 10-20 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’ www.rethink.org

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 www.rethink.org

Social relationships & social support www.rethink.org

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 www.rethink.org