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Title: PowerPoint Presentation - 72x48 Poster Template


1
Those who do not have power over the stories
that dominate their lives, power to retell them,
rethink them, deconstruct them, joke about them,
and change them truly are powerless because they
cannot think new thoughts.
Salman Rushdie
Prepared by Neasa Martin, Constance McKnight
Joan Edwards Karmazyn for the NNMH
Stigma Discrimination
Self-Stigma
Key Messages
Importance of Peer Support
  • Research (although limited) confirms
    peer-support
  • Is highly valued by consumers who participate.
  • Builds group identification reduces
    self-stigma.
  • Significantly reduces hospitalizations (number
    duration), decreases symptom distress, use of
    emergency other expensive medical services.
  • Increases social contacts, builds supportive
    networks enhances quality of life.
  • Helps to re-frame distressing experiences
    positively. Normalizes the experience of mental
    ill-health.
  • Supports disclosure neutralizes self-stigma.
  • Empowers people by participating in advocacy,
    education by providing support to others.
  • Supports recovery. Helps people learn
    self-management strategies, awareness of
    resources how to navigate professionally run
    services.
  • Participation in systemic advocacy strengthens
    self-efficacy, empowerment promotes recovery.
  • Consumer employment within mental health services
    reduces stigma discrimination amongst health
    care providers.
  • Peer-support identifies solutions supports
    systemic change. Consumers hold stakeholders
    accountable.
  • Consumer-led economic development initiatives
    affirms capacity to work reduces pessimism re
    recovery.

Stigma is real, damaging pervasive. More
painful than mental-ill health. It continues long
after symptoms resolve. Stigma takes many forms
Public stigma is the harm caused when the
public endorses the prejudice discrimination of
mental illness. Courtesy stigma is the
devaluation experienced by caregivers
professionals. Discrimination is the external
behaviour institutional arrangements that deny
people rights or limit their social inclusion.
  • Outcome of anti-discrimination programming MUST
  • Promote human rights including policies,
    practices laws.
  • All stakeholders work to remove systemic
    barriers.
  • People are seen as citizens not problems to be
    solved.
  • Mental ill-health is framed as part of our
    shared humanity - NOT a disease of the brain.
  • Focus on enhancing social inclusion quality of
    life
  • Housing, employment, education training, income
    security, safety, improved health mental
    health, recovery-focused care, stop
    discrimination, supportive communities, access
    to mainstream services
  • Consumers MUST lead anti-discrimination programs
  • Because this reflects best practice enhances
    success.
  • They understand the issues provide the army
    for battle.
  • Funding of empowerment / support programs is
    critical
  • For the success of anti-discrimination
    programming.
  • To reduce self-stigma, promote recovery
    improve QOL.
  • For achieving systemic change.
  • Building a research evidence-base is essential
    but
  • Reflect consumer priorities in publicly funded
    research.
  • Includes participatory-action qualitative
    research design.
  • Consumers are agents NOT objects in research
    delivery
  • Knowledge is share in accessible meaningful
    ways.
  • Self-stigma is the harm caused when people
    internalize negative stereotypes impacting
    self-esteem self-efficacy. Results in
    self-blame, feeling hopeless helpless. Limits
    recovery increases risk of suicide.
  • Label avoidance self-stigma leads to people
    avoiding labeling by not accessing mental health
    services.
  • Who suffers from self-stigma?
  • People who identify with their diagnostic
    label, are aware of agree with stereotypes,
    those who fear disclosure, are socially isolated
    fail to pursue work, housing, civic
    participation entitlements. Those with high
    disease awareness but lack a positive group
    identification.
  • What protects people from self-stigma?
  • Rejection of stereotypes de-emphasizing
    diagnostic labels. Group identification,
    participation in the fellowship of
    peer-support/self-help. A commitment to
    recovery. Empowerment righteous anger.
    Reframing experience positively. Finding meaning
    purpose. Building self esteem self-efficacy.
    Developing a sense of mastery.
  • Self-stigma circuit breakers
  • By increasing visibility of people with mental
    health issues. Building peer support networks.
    Affirming human rights. Challenging negative
    attitudes stereotypes. Promoting systemic
    changes reflecting recovery practices.
    Participating in public education activities.
    Self-disclosing to inspire others give hope.

Impacts Every Area of Life
  • Social exclusion Unemployment, ? Education, ?
    persistent poverty. Social isolation, ?
    Friendships, ? withdrawal of family. ? Negative
    portrayal by media (blame, violent, incompetent,
    impulsive). Harm to families.
  • ? Loss of human rights Use of seclusion,
    restraint , involuntary treatment. Denial of
    housing, insurance, public office, mortgages,
    loss of parental rights. Increased risk
    containment ? criminalization, re-institutionaliza
    tion in prison. Policy funding neglect by
    governments.
  • Impact on health care Pessimism focus on
    limitations. Under funding of mental health
    services. Less choice access to recovery/ rehab
    services. Poor medical care, ?chronic illness, ?
    lifespan (?10 years).

Diagnostic Labeling Stigma
How is Stigma Formed / Stopped
Under Funding is Discriminatory
Illness like any other does not work Framing
mental illness as biologically based, genetically
influenced chemically mediated disease of the
brain increases pessimism regarding recovery,
desire for social distance, tolerance for
coercive treatment public acceptance of the
violation of peoples human rights. This
approach does reduce blame and the public is
more supportive of treatment. BUT they are also
more fearful of people with mental illness who
they see as having no control and are therefore
more dangerous. This leads to rejection social
distance. There is less stigma when Mental
health problems are seen as part of our shared
humanity an understandable consequence of life
circumstances. When there is less emphasis
placed on medications, hospitalization medical
treatment. Supports are provided in the
mainstream community. More public acceptance
when government(s) fund treatment services.
  • Three inter-related problems
  • A lack of knowledge ? ignorance
  • Ignorance ? prejudice negative emotions
  • Prejudice ? avoidance discrimination
  • Three-pronged solution
  • Education (by consumers, about their
    experience - not illness, targeting the
    influential, emphasizing rights promoting hope,
    recovery inclusion)
  • Positive contact (with consumers who disabuse
    myths, between peers, when there is a shared
    goal)
  • Protest (fighting inequities, demanding rights,
    fighting negative media, seeking systemic
    changes)
  • Need to focus on discrimination Information
    alone does not change attitudes. Changing
    attitudes may not change behaviour or improved
    quality of life. Focusing on empowerment, rights
    social inclusion DOES improve QOL. Work at a
    systems level with all stakeholders to improve
    policies, practices, laws their enforcement.

Research reflects Robust consumer leadership
as an internationally recognized best practice
in reducing discrimination. Peer support group
identification is critical to overcoming
self-stigma improving quality of life. Reducing
self-stigma removes a barrier to pursuing
treatment, work, friendships enhances recovery.
Peer-support is recognized in Canada
worldwide as a best practice in mental health
service delivery. It works is cost
effectiveness. Consumer leadership drives
systemic transformation peer-support builds
consumer leadership. In Canada peer-driven
services are under-funded devalued. This is
systemic discrimination.
For Further Information
National Network for Mental Health 55 King St.
Suite 604 St Catharines, ON L2R 3H5 Toll Free
(888) 406-4663 Phone (905) 682-2423 Fax (905)
682-7469 http//www.nnmh.ca/
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