1. Some slides from Patrick Corrigan PhD, IL Institute of Technology WISE Basics Increasing Inclusion, Hope and Support Beating the Stigma of Mental Illness

2. Statewide collaboration of organizations and individuals. Promote evidence based practices, current research and outcomes evaluation. Majority speak from experience of stigma and recovery. Offer insights, resources, and support for stigma reduction

3. WISE Active Partners: Care Connections (Waukesha County NAMI Support Group) Center for Suicide Awareness COPE Services Dry Hootch Grassroots Empowerment Project Illinois Institute of Technology LaCrosse Mental Health Coalition Latino Health Coalition – Mental Health Action Team MHA Sheboygan MHA Wisconsin Marian University NAMI WI, Fox Valley, Greater Milwaukee, Racine Prevent Suicide WI and local coalitions Rogers InHealth University of WI Eau Claire, Milwaukee, Madison WI Department of Health Services WI Family Ties WI United for Mental Health ETC.

4.  Explore stigma ◦ Public stigma ◦ Internalized shame  Frame stigma change  Connect to your work and that of WISE GOALS 4

5.  IIT – Patrick Corrigan PhD  Yale  U Penn  Rutgers  Temple www.ncse1.org National Consortium on Stigma and Empowerment

6. schizophrenia depression trauma anxiety eating disorders Drug and alcohol abuse They are us! 1 in 4 47% in our lifetime

7. What is stigma? Where does it come from?

8. 8 Stigma Definition and Types Stigma Definition: Stereotype (ideas) > Prejudice (beliefs) > Discrimination (actions) In a relationship of power - Oppression Types:  Internalized Shame  Public  Structural Language barriers

9. Examples of Stereotypes- Ideas People with mental health challenges are incapable, fragile, dangerous, cannot recover Mark Mike Linda and Nneka Val Dori

10. Examples of Prejudice- Beliefs They are scary, shameful, less than. Charles Simone Sumi

11. 11  Social ◦ I don’t want them to live next door, be a co-worker, marry into my family  Structural ◦ Employers do not hire/support recovery ◦ Health insurance does not provide equal coverage - parity is not enforced ◦ Education lacks effective supports for success Examples of Discrimination- Actions Paul Pastor Tim Denise

12. Avoidance and apathy  self esteem So, why try? I am not good Internalized Shame/Self Stigma Public Stigma  sense of efficacy I am not able

13. Characteristics of People Facing Mental Health and Addiction Challenges Stubborn Strength Resilient Flexibility Compass ion Organization Intelligent Empathic Creative Funny Short Tall Old Young Agnostic Religious

14. 14 Racial Oppression

15. 15 Religious Oppression

16. Gender Oppression

17. Co-Occurring Stigma (public and internalized)  Heterosexism  Racism  Sexism  Ableism  Etc. 2011 YRBS data showed LGBT youth in WI had: - 5X the rate of suicide attempts - 3X more likely to skip school due to feeling unsafe - 50% felt like they did not belong at school

18. 18 Movies Drivers of Public Stigma Newspapers Advertising Unethical Research, Drug Side Effects & Poor Quality Care

19. 19 Benevolent Stigma People with mental illness are “lovable and incapable”

20. Stigma’s Impact on SOCIAL INCLUSION  Lost employment  Subpar housing  Worse health care  Diminished education opportunities  Alienated from faith community

21. 21 OK, but isn’t it better lately?

22. Trenton State Hospital has fire. July 10 th, 2002

23. 23

24. Despite what you might think, the percentage of Americans who viewed people with mental illness as dangerous doubled from 1956 to 1996. Source: BG Link, JC Phelan, M Bresnahan, A Stueve, BA Pescosolido American Journal of Public Health 89 (9), 1328-1333

25. …That figure held steady from 1996 to 2006. Source: BG Link, JC Phelan - The Lancet, 2006

26. In any given situation we can be:  Stigmatizers  Stigmatized  De-stigmatizers (Healthcare Workers and Stigma, Ross C. A. & Goldner E. M. 2009)

27.  Protest  Education  Contact 27 Stigma Change Processes

28. 28  Protest o Review stigmatizing images o “Shame on you for thinking that way” o Be aware of unintended consequences of well intended actions o The rebound effect

29. 29  Education Counters myths with facts

30.  Myth : People with serious mental illness can not care for themselves; need to be institutionalized.  Fact : Long term follow-up research suggests 2/3rds of people with schizophrenia learn to live with their disabilities.  RECOVERY is the rule

31.  Myth : People with serious mental illness are dangerous.  Fact : People with untreated mental illness are slightly more dangerous especially when using drugs or alcohol BUT… ◦ They are more likely to be victims of violence

32. Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011 DOES STIGMA DECREASE AS KNOWLEDGE INCREASES? Results from a meta-analysis study:  Knowledge: Causes of Mental Illness  Stigma: Acceptance

33. Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011 Brain Disease META-ANALYSIS FINDINGS: CAUSE

34. Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011 Neighbor META-ANALYSIS FINDINGS: ACCEPTANCE

35.  Impact? ◦ Blame went down ◦ Belief in recovery also went down 1990-2000 Decade of the Brain

36. 36  Contact “I’d like you to meet Simone, Mike, Linda, Nneka, Paul, Charles, Val, Sumi, Denise, Tim, Mark and Dori”

37. 37  Their Recovery Story (part1) My name is ______ and I have faced mental health and/or addiction challenges… My childhood was… My mental health challenges were difficult for me and others. They did not go away quickly…

38. Their Recovery Story (part2) Combining my internal resources with external resources, I found my unique path to recovery… I have achieved a satisfying life with several accomplishments.

40. Yet, there exists a curtain of ignorance about resilience and recovery.

41. Resilience- the capacity of children and adults to succeed and thrive, despite experiencing trauma, mental illness and/or addiction. Resilient people have internal and external "protective factors.” Recovery- A process of change through which people work to improve their health and wellbeing, live a self-directed life, and strive to achieve their full potential. Four dimensions of recovery:  My Health  A safe and supportive Home  A sense of Purpose in my life  Belonging to Community ( from SAMHSA )

42. Contact with someone with lived experience was more effective than education in reducing the perception of people with mental illness as dangerous. A randomized control trial: Corrigan, P.W., et al. (2002). Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophrenia Bulletin, 28, 293-310

43. The effects of contact versus education were also greater when measuring attitudes of avoidance.

44. The effects of contact on attitudes of avoidance were sustained at the one month follow-up.

45. 45 Framing Stigma Change Protest Education Contact Media- based XXX XXXX LiveXXX XXXXXX vehiclevehicle -------processes--------

46. What a DIFFERENCE a friend makes!

47. 47

48. 48 Website visits

49. 49 Effect Size 100 MILLION thousands

50. 50 Effect Size 100 MILLION thousands Just going to the site is not enough 88% left after one minute!

51.  Targeted  Local  Credible  Continuous  Change-focused  Contact TLC4 51

52. Who Should the TARGETS Be? Health care professionals Employers Landlords Teachers Legislators Faith communities

53. x MILWAUKEE Does it play in Wausau? What is LOCAL Contact?

54.  Contact with peer  Example- Nurse to nurse Pastor to pastor Football player to football player What is CREDIBLE Contact? 54

55.  Once is not enough  And variety is needed CONTINUOUS Contact 55

56.  What do you want the target group to do differently as a result of the contact? CHANGE-FOCUSED Contact

57.  Targeted  Local  Credible  Continuous  Change-focused  Contact TLC4 57

58. the Grand Plan Speak up everyone Speak up everywhere Carefully Honest, Open & Proud “strategic disclosure”

59. Levels of Disclosure  Social Avoidance – avoid situations  Secrecy – work to keep it a secret  Selective Disclosure – share it with select people  Open Disclosure – no longer hide it  Broadcast Your Experience – actively share it

60. 60

61. Your Recovery Story

62. Motivated engagement  self esteem I care for myself & others I am good Reversing Self and Public Stigma Public Stigma  sense of efficacy I am able Inclusion and Self- Directed Support

63. Engage Organizations Seeking to Reduce Stigma Train/Support Storytellers General Public Programs/Contact Components: 1.WISE Basics Discussion 2.Support for Strategic Disclosure HOP 3.Consultation with organizations as they Design, Implement and Evaluate TLC4 4.Share learnings statewide

64. What YOU Can Do Today 1.Seek out people with lived experience - listen to their story. 2.Reinforce & support their resilience & recovery. 3.Wear lime green to create curiosity - be prepared to speak up. 4.Consider the story you can tell about recovery 5.Share other’s stories – one resource for short video stories is Rogersinhealth.org 6.Bring the conversation to your community – work, civic, faith, schools

65. Discussion