1. An Introduction to HOP: Honest, Open, Proud
Presented by:
Nina Danielsen
Ally Linfoot

2. A little bit about us…...
Introduce ourselves. How did we come to this work. What of our lived experience might we share?
For the purposes of this workshop, remind participants this is not the full class but rather an introduction to the program.
If you are provider of services: HOP can be useful in reflecting on your own lived experience. It can also greatly inform the profound vulnerability and risk people take when they share their story.
If you are considering sharing your story and want to learn how: HOP is an amazing tool that helps guide you through the decision making process, thinking critically about what parts of your story you might share and also to whom you will share and where you might share.
Thank you for being here today and being brave with your story!

3. Why HOP? What’s in a name? Hurting myself with self stigma.
Why people disclose. Why people may choose not to disclose
Changing the landscape of stigma surrounding suicide.
Why HOP?
Put out questions to frame up the presentation.
As an introduction to the workshop today, we’ll be talking about:
What’s in a name? How do you identify with mental health, mental illness, mental health challenges, mental health struggles, mental health disorders?
Hurting myself with self stigma. What is it, how does it create stigma and prevent us from being and sharing ourselves.
Why do we disclose? What is the impact of disclosure.
How can this change the landscape of stigma and suicide.

4. HOP Around the world. Canada U.S.A Scotland Germany Belgium Italy
150 VA Medical Centers
Canada
U.S.A
Scotland
Germany
Belgium
Italy
Israel
Australia
400 US College Campuses
Touch briefly on Pat Corrigan’s work and the scale of HOP globally. The World Health Organization describes the impact of stigma in the following way.
“Stigma is a major cause of discrimination and exclusion: it affects people‘s self-esteem, helps disrupt their family relationships and limits their ability to socialize and obtain housing and jobs. It hampers the prevention of mental health disorders, the promotion of mental well-being and the provision of effective treatment and care. It also contributes to the abuse of human rights.

5. Stigma is Complex Self-Stigma
The closet is horrible on health and well-being.
Public Stigma
Contact with LIVED experience changes attitudes and behaviors.
Stigma is Complex
Define Self Stigma: “Self stigma is associated with a number of negative outcomes such as giving up life goals, social withdrawal, keeping one’s mental illness secret and perception of stigma as a threat and stressor that exceeds one’s coping resources.”
Define Public Stigma: Negative attitudes, perceptions and judgement from community towards those with mental illness. Common examples might be a landlord discriminating against a tenant with mental health challenges, a employeer who discriminate against an employee.

6. CONTACT is KEY Explain slide
When people come into CONTACT with someone they know who discloses their challenges this is found to have the greatest impact on decreasing stigmatizing attitudes. We need to give people the tools the need and supportive environments to share their story.

7. Core Values for Supporting People with Lived Experience
All activities designed to help attempt survivors, or anyone who has been suicidal, should be consistent with one or more of the following core values:1
Foster hope and help people find meaning and purpose in life
Preserve dignity and counter stigma, shame, and discrimination
Connect people to peer supports
Promote community connectedness
Engage and support family and friends
Respect and support cultural, ethnic, and/or spiritual beliefs and traditions
Promote choice and collaboration in care
Provide timely access to care and support
Core Values for Supporting People with Lived Experience 
Lived experience is a game changer in the landscape of stigma reduction but we need to be mindful, respectful and cautious as we engage with people who are choose to disclose.
Ally, here you can speak to Peers, training and values. And how Peer work has influenced mental health treatment because of the intentional inclusion of lived experience.
Suicide Attempt Survivors Task Force. (2014). The way forward: Pathways to hope, recovery, and wellness with insights from lived experience. Washington, DC: Author.

8. Lesson 1: Disclosure Options
“Our goal here is to consider what the costs and benefits are of disclosing one’s mental health experiences to some people. We also seek to discuss strategies for coming out most effectively should you decide to do so.”
Lesson 1: Disclosure Options
Introduce HOP

9. Marie and John Henry Marie 32 years old
Struggling with schizophrenia for more than 12 years
Things are good – has not been hospitalized in 5 years
Has a good job
Supportive Husband
Frequently attends mutual help groups and provides support
Outspoken advocate against stigma
Marie is a person who identifies herself as “mentally ill.”
John Henry
32 years old
Struggled with schizophrenia since age 19
Married
Works a great job in a law office
Has not been hospitalized in 5 years
No one at work knows about his diagnosis
No one in his social circles know either
John Henry is a person who does not identify himself as “mentally ill.”
Marie and John Henry
HANDOUT
Introduce Marie and John Henry
Depending on the size of the group have a group discussion or break into smaller group. Discuss pros and cons.

10. To Disclose or Not, that is the question…..
Discuss the pros and cons of:
Disclosure or NOT
What do you think of Marie’s approach?
John Henry’s Approach?
Is one right and one wrong?

11. Challenging Personally Hurtful Self-Stigma
It’s hard to decide to come out when internalizing self-stigma. This additional HOP lesson might help with the decision to self-disclose.
| | | | | | |
Very much Very much
disagree disagree
____ Sometimes I agree with stigma. People with mental illness are weak.
____ Sometimes I agree with stigma. I should feel ashamed of myself.
____ Sometimes I agree with stigma. I think I am less a person because of mental illness.
____ Sometimes I agree with stigma. I can’t reach my goals because of mental illness.
Challenging Personally Hurtful Self-Stigma
HANDOUT
Remind people of the definition of self stigma. Ally, can tell a little about her story of self stigma around physical challenges.
How does this intersect with suicide? Shame, Burdensomness, Guilt. Suicide is inherintley self-stigmatizing. If we can create more opportunities to hear from people with lived experience of suicide attempts, we can support those who are struggling see a way out. We can create hope.

12. Decision Time What did you decide? To whom? When? Where?
_____ Yes, I would
No, I would not
_____ Still unsure
There are both benefits and costs to coming out
Only you can weigh them to decide whether it is worth coming out
Cost and benefits differ depending on the setting, work vs. your neighbors.

13. Do a Test.
We can role play this for the class…..
“….The thing is, because we can’t see it, we don’t know who’s going through what and we don’t know when and we don’t always know why. Mental health is an invisible thing, but it touches all of us at some point or another. It’s part of life. Like DeMar said, “You never know what that person is going through.”

14. Craft your story. It’s hard to stop the clanging bell.
Quote from Thurgood Marshall. Once you put your story out there, you can’t take it back. Be ready.

15. This year we are joining efforts with the Clackamas Art Alliance on the Ask the Question Project to listen to the voices of those with lived experience of a suicide attempt. 
We will be selecting survivors along with someone they have identified as a support to share their story through an interview and photography session.
We are currently accepting applications for anyone 18 and older until March 30.   
In Clackamas County we recently launched the Ask the Question project. This project provides a safe place for people with lived experience of a suicide attempt to share their story of recovery.

16. Questions? Thoughts? Nina Danielsen Ally Linfoot
Health Promotion Coordinator
Peer Delivered Services Coordinator