What says the dodo bird? Patrick Corrigan Illinois Institute of - - PowerPoint PPT Presentation

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What says the dodo bird? Patrick Corrigan Illinois Institute of - - PowerPoint PPT Presentation

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What says the dodo bird? Patrick Corrigan Illinois Institute of Technology STOP Stigma is Bad Public stigma Self-stigma Not all ways to address stigma work! Unintended consequences Direction for change 5 6 Funded by

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Patrick Corrigan Illinois Institute of Technology

What says the dodo bird?

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STOP

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 Stigma is Bad

  • Public stigma
  • Self-stigma

 Not all ways to address stigma work!

  • Unintended consequences

 Direction for change

5
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SLIDE 6 6
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SLIDE 7  Funded by the U.S. NIMH since 2001  Collection of more than 20 research and

consumer groups from across US

 WWW.NCSE1.ORG  corrigan@iit.edu
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UNINTENDED CONSEQUENCES

Everybody has won and all must have prizes!

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SLIDE 9 Psychoanalysis Cognitive Therapy
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BEAT RACISM

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DON’T ASK DON’T TELL

BEAT HOMOPHOBIA

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“THE POOR!” “THE WEAK!”

“THE LEAST IMPORTANT!”

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“THE POOR!” “THE WEAK!” “THE LEAST IMPORTANT!” “Whatsoever you do to the least of my brethren, that you do unto me!” John

BESTOW

EMPOWER

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SLIDE 15 15 15 N=213

Stigmatizing Attitudes and

Behavioral Intentions Education: Responsibility Contact: Dangerousness Education: Dangerousness Contact: Responsibility Control Attitudes and Intentions @ post and 1 wk f-up

  • 2.5
  • 2
  • 1.5
  • 1
  • 0.5
0.5 1 1.5 control ed:danger ed:respon ct:danger ct:respon pre post 0.3 0.35 0.4 0.45 0.5 0.55 0.6 0.65 Pos Neg 6.8 7.3 7.8 8.3 8.8 9.3 9.8 10.3 10.8 control ed:danger ed:respon ct:danger ct:respon pre f-up 1 2 3 4 5 6 7 8 low mod high stigma change 1 2 3 4 5 6 7 8 low mod high stigma change
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In the movies

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In the newspapers

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In advertising

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Trenton State Hospital has fire.

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SLIDE 33 33

Ro Roaste asted d Nu Nuts ts

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DANGER

Phelan, Link et al

34 0% 20% 40% 60% 80% 100% 1956 1996 danger
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SLIDE 35  DANGER

Phelan, Link et al

35 0% 5% 10% 15% 20% 25% 30% 35% 40% 1956 1996 danger
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SLIDE 36  DANGER

Phelan, Link et al

36 0% 5% 10% 15% 20% 25% 30% 35% 40% 1956 1996 danger
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SLIDE 37  DANGER

Phelan, Link et al

37 0% 5% 10% 15% 20% 25% 30% 35% 40% 1956 1996 2006 danger
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SLIDE 38
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SLIDE 39 39

Public stigma Self- stigma Label avoidance Structural stigma

stereotype

prejudice

discrimination S t r u c t u r e s

  • --types

types--

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SLIDE 40 40  STEREOTYPES
  • All Irish Americans are drunks and

beat their wives.

 PREJUDICE
  • That’s right. They’re drunks and I

loathe them.

 DISCRIMINATION
  • So, don’t: hire, rent, or befriend them
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SLIDE 41 41  STEREOTYPES
  • People with MI are: weak,

dangerous….

 PREJUDICE
  • They are bad because: scary,

shameful.

 DISCRIMINATION
  • So, don’t: hire, serve, or rent to them
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SLIDE 42 42

Public stigma Self- stigma Label avoidance Structural stigma

stereotype

prejudice

discrimination S t r u c t u r e s

  • --types

types--

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SLIDE 43  Lost employment  Subpar housing  Worse health care  Worse educational opportunities  Diminished legislative support  Alienated faith communities  Coercive treatment
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SLIDE 44 PTCA: percutaneous transluminal coronary angioplasty Druss et al., 2000
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SLIDE 45 45

Public stigma Self- stigma Label avoidance Structural stigma

stereotype

prejudice

discrimination S t r u c t u r e s

  • --types

types--

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SLIDE 46  Decreased self-esteem
  • I am not worthy
 Decreased self-efficacy
  • I am not able
 Why try?!
  • I am not worthy of a good job
  • I am not able to live alone
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SLIDE 47 47

Public stigma Self- stigma Label avoidance Structural stigma

stereotype

prejudice

discrimination S t r u c t u r e s

  • --types

types--

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SLIDE 48 48 seekers non-seekers

45%

Label Avoidance

Epidemiological Catchment Area, National Co-morbidity Survey, NCSII
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SLIDE 49 49 users non-users

22%

Corrigan, P.W. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614-625 Canadian Community Health Survey

Label Avoidance

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No treatment

  • Do not seek care
  • Do not stay in treatment
  • Do not fully participate
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Protest

Education Contact

Media- based In vivo

v e h i c l e

  • --processes

processes--

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SLIDE 52  EDUCATION:
  • contrasting myths (people are to blame)
  • with facts (serious mental illness biological)
 CONTACT
  • Meeting people and their stories of recovery
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SLIDE 53

EASY STUFF:

Just change the words! Just cure the disease!

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SLIDE 54  Leprosy to Hansen’s Disease  Dementia to Alzheimer’s  Mental Retardation to Intellectual Disability  Mania to Bipolar Illness
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SLIDE 55  Japan: Seishin-Bunretsu-Byo to togo shitco sho  Korea: Jeongshin-bunyeol to Johyun-byung  Hong Kong: Jing Shen Fen Lie to Si Jue Shi Tiao  Singapore, China “mind split disease” “integration disorder” “attunement disorder” “mind splitted disorder” “dysfunction of thought and perception” “splitting of the mind” Sartorius et al., 2014
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SLIDE 56  The Data
  • Japan: mixed findings (Takashi et al., 2009, 2011)
  • Relationship between name recognition and

recovery (Sato in preparation, 2014)

  • Hansen’s Disease (Oliveria et al., 2003; Van Brakel et al., in press)
 Perpetuates the difference  Prejudice and discrimination more than words.
  • MODERN RACISM
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It Looks easy: NIMH and other funders decrease support Advocacy groups: No longer a problem

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KNOWLEDGE IS GOLD: Educate stigma away!

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75% US school districts 43 countries

RESEARCH Uncertain effects No effects RTI (1994) Cal Dept Ed (1995) U Maryland (1998) Worse effects APA (1999) Indiana U (1992)
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Protest

Education Contact

Media- based In vivo

v e h i c l e

  • --processes

processes--

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SLIDE 61 61

Protest

Education Contact

Media- based In vivo

v e h i c l e

  • --processes

processes--

  • EDUCATION
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RECOVERY

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RECOVERY

HIRE THEM? RENT TO THEM? EQUAL HEALTH CARE?
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SLIDE 65  Sixteen representative samples of nation-

defined populations

 230 to 6000 Ss  Response rates: 65-85% Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
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10 20 30 40 50 60 70 1990 1994 1998 2002 2006 Sz Dep

Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

Inherited/Genetic

META-ANALYSIS FINDINGS: CAUSE
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10 20 30 40 50 60 70 80 1990 1994 1998 2002 2006 Sz Dep

Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

Brain Disease

META-ANALYSIS FINDINGS: CAUSE
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10 20 30 40 50 60 1990 1994 1998 2002 2006 Sz Dep

Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

Co-worker

META-ANALYSIS FINDINGS: ACCEPTANCE
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10 20 30 40 50 60 1990 1994 1998 2002 2006 Sz Dep

Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011

Neighbor

META-ANALYSIS FINDINGS: ACCEPTANCE
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Protest

Education Contact

Media- based In vivo

v e h i c l e

  • --processes

processes--

  • PROTEST
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PROTEST:

The Pros and CONs!

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Protest

  • Review stigmatizing images
  • Shame on you for thinking

that way

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Beware the rebound effect

the white bear

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NAMI - stigmabusters

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SLIDE 76 The JASONUT The CRAZY FACE The SUICIDE SQUEEZE

Located in Campbell and San Jose California

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SLIDE 77 Join the national on-line food fight. Help turn lemon donuts into lemonade.

Join the national on-line food fight. Help turn lemon donuts into lemonade.

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I'm an advocate of equal rights and a more tolerant world toward all people of different races, religion, gender, and sexual orientation; but that is it. Any thing else is just moronic.

Stan Rezaee, Aug, 2009
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FRANCHISE

OPPORTUNITIES

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Protest

Education Contact

Media- based In vivo

v e h i c l e

  • --processes

processes--

  • CONTACT
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CONTACT vs EDUCATION

The Pros and CONs!

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We are focused on encouraging EVER

ERYON YONE TO TO SPE PEAK AK OUT and share their story of being

affected by mental illness. The more everyone shares, the more we can learn from each other and find solutions to overcome our common challenges.

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Contact

“Meet Bob Lundin”

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Bob’s story

  • My name is ______ and I h

I have ve a severe mental

illness called schizo-affective disorder

  • My ch

childhood ldhood was not unusual…

  • Unfortunately, my mental illness was

traumatic.

  • aumatic. It did not go away quickly…
  • Despite these problems, I h

I have ave ac achieved ieved

several accomplishments.

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SLIDE 85 0.1 0.2 0.3 0.4 0.5 0.6 0.7
  • verall
attitudes behavior education contact p<.05 p<.05 p<.05 CORRIGAN ET AL., 2012
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WHAT’S THE GOAL

More service seeking! Less discrimination!

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SLIDE 87  30 to 66% do NOT seek treatment  People with all disorders  All treatments  People don’t go to treatment to avoid STIGMA.  Decrease stigma: increase care seeking

PARITY!

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SLIDE 88  Stigma undermines employment, housing,

health goals

 Decrease stigma: decrease care seeking –

increase opportunities – promote recovery

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SLIDE 89  Does the push for care seeking make

discrimination worse?

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SLIDE 90 PENETRATION: >60% of Australians recognize IMPACT: increase mental health literacy care seeking ??? since 2000
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UNINTENDED CONSEQUENCES

  • Brain Disease
  • Difference
  • Broken
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SIMILARITY

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TLC 3

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Targeted Local Credible Continuous Contact

94 Corrigan, 2011
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Landlords Health care professionals Teachers Legislators Employers

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x

CHICAGO: the heart and brains of Illinois

ILLINOIS

Does it play in PEORIA?

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City Office Church, synagogue, mosque School

10
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Good stigma

change

 credible  continuous

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 Contact with whom?  Example

  • Military (PTSD)
  • Other enlisted members

 Marines from marines  Sailors from sailors

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Once is not enough And cannot be carbon

copies

10 3
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Targeted Local Credible Continuous Contact

10 4
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The GRAND PLAN

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Come out everyone

Come out everywhere

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Come out Mad

Come out Proud

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SLIDE 108 Rod Steiger Mike Wallace Margot Kidder Patty Duke
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Thurgood Marshall Effect

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SLIDE 113  LGBT agenda
  • Confusing
  • Objectionable
  • Ho

Hone nest, t, Op Open, n, Proud

  • ud
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 Three Lessons

  • Consider the pros and cons of

disclosing

  • There are different ways to disclose
  • Telling your story
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Clifford Beers - 1909

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National Center on Stigma and Empowerment

www.ncse1.org corrigan@iit.edu

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