Melissa Bartsch, Ph.D. Presented as part of Innovations 2.0

ACPA- Indianapolis, 2014

COMBATING THE STIGMA OF MENTAL ILLNESS FROM

THE INSIDE OUT

Providing clinical supervision

Teaching practicum

Conversations with clients

Reflections on my own training

ORIGIN STORY

Negative effects (Couture & Penn, 2003) Low self-esteem Discrimination (employability, leasing) Reluctance to seek treatment Perceived as being responsible for mental illness Exclusion

Identified as the number one barrier to mental health treatment by the U.S. Surgeon General (1999)

MENTAL HEALTH STIGMA

Stigmatizing attitudes (Corrigan & Penn, 1999) Fear and exclusion Authoritarianism Benevolence

Trained professionals within mental health have stereotypes about mental illness (Lyons & Ziviani, 1995)

MORE ON STIGMA…

Education (Corrigan & Penn, 1999) Personal info about the individual with mental illness Directly attack myths Involve discussion Increase empathy through simulations

Contact (Corrigan, 2001)

Perspective-taking (Mann, 2010)

Protest (Corrigan & Penn, 1999)

LEVELS OF INTERVENTION

Modeled after UT’s Safe Zone training curriculum

Incorporated effective destigmatization education

Second-year Counseling Psychology doctoral students

Experiential Activities Stereotypes and Messages Continuum Storyboards

Reaction/reflection paper written after the training

OUR TRAINING

Goals Become a mental health ally (inside and out)

Among peers and colleagues On campus In session In the community

Become inclusive, affirming, and broadening prospective

Facilitate dialogue regarding interaction between personal beliefs and professional behavior

Discuss ways in which beliefs impact therapy

GOALS

Two groups of 3

3-hour training

Experiential activities and dialogue

Rules and debriefing

Exploration vs. shame Agree to disagree

TRAINING STRUCTURE

Diagnoses on large notepad around the room Bipolar Disorder, BPD, Alcohol Dependency,

Amphetamine Abuse, GAD, Anorexia, Adjustment Disorder

Instructions: List messages received or things believed/heard about each

Time: 2 minutes per sheet

Discussion Questions: What stands out? What was surprising?

STEREOTYPES AND MESSAGES

Strongly Agree to Strongly Disagree

Instructions: Stand on the continuum after each of the following questions: I would be comfortable referring my clients for

medication I would tell my friends I’m in therapy I would be in a relationship with someone who has

Bipolar Disorder

Discussion Questions: Do you notice any discrepancies regarding what’s o.k.

for clients and not o.k. for you? How did I get to this place on the continuum?

CONTINUUM

“I think what really stuck with me was writing down our stereotypes for certain diagnoses. I became really aware how we, as mental health professionals, talk about our clients in sometimes negative ways, and how labels can be damaging because of stigma. After that class, I remember making conscious efforts to talk about my clients as if they were healthy individuals experiencing life difficulties, rather than disordered or diseased people. It was just fun to do, too. Way better than just getting a lecture on stigma =).”

A TRAINEE’S PERSPECTIVE

“One thing that sticks to my mind is that through this activity I was able to acknowledge how my expectations of others as clients is different from my own expectations as a client. It helped me realize that I have my own bias towards others, especially those with psychological disorders, even if these biases are somewhat unconscious. It also provided a more experiential understanding of the fears and stigma tied to psychotherapy and psychotropic medication that many clients probably feel when making the decision to seek help.”

ANOTHER TRAINEE’S PERSPECTIVE

Be flexible Time devoted to discussion versus activities

Tailor training to audience Mindfulness of basic knowledge level Language

Room for debriefing

COMMUNITY INTERVENTION

• What efforts are being made on your campus to combat mental health stigma?

• How might you adapt this destigmatization training to fit your needs?

• What sorts of things are you doing on your campus to combat mental health stigma?

• What might be some of the challenges of implementing this sort of training with other professions?

QUESTIONS FOR THE AUDIENCE

Byrne, P. (2000). Stigma of mental illness and ways of diminishing it. Advances In Psychiatric Treatment, 6, 65-72.

Corrigan, P. & Penn, D (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765-776.

Corrigan, P. (2004). How stigma interferes with mental healthcare. American Psychologist, 59(7), 617-625.

Couture, S.M. & Penn, D.L. (2003). Interpersonal contact andthe stigma of mental illness: A review of the literature. Journal of Mental Health, 12(3), 291-305.

Lyons, M. & Ziviani, J. (1995). Stereotypes, stigma, and mental Illness: Learning from fieldwork experiences. The American Journal ofOccupational Therapy.

Mann, C. E. (2010). In a Stranger's Shoes: Reducing mental illness stigma through perspective-taking. Unpublished doctoral dissertation, University of Tennessee, Knoxville, TN. Retrieved June 1, 2012, from Dissertations and Theses

database.

REFERENCES

Changing Minds Campaign http://www.rcpsych.ac.uk/campaigns/changingminds/

whatisstigma/mentaldisorderschallenging.aspx

National Alliance for the Mentally Ill (NAMI) http://www.nami.org/template.cfm?section=fight_stigma

SAMHSA’s Resource Center to Promote Acceptance,Dignity and Social Inclusion Associated withMental Health (ADS Center) http://www.stopstigma.samhsa.gov/

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