Attitudes and Mental Health – what the research tells us Mary Van Lieshout Head, Research and Standards Development 23 April 2010 “People with disabilities regularly identify societal attitudes as the most potent and negative stressor in their lives” Voh 1993

The evidence base.. Surveys commissioned by the National Disability Authority and undertaken by Statistical Consulting, Dublin, in 2001, Int’l Review of Effective Strategies to improve attitudes 2003 NDA Literature Review on Attitudes to Disability 2007 National Disability Survey (CS0) 2006 Red C survey (NDA) 2009 Key design challenge in attitudes research: reduction of social desirability bias.

Have you got attitude? Attitudes are relatively stable mental positions held toward ideas, objects or people; Attitudes are a combination of beliefs and feelings that predispose a person to behave a certain way; Research focuses on attitude formation, change and the circumstances in which attitudes predict behaviours; Gender, age and range of cultural factors influence attitudes, and evidence is of hierarchy of disability.

Some theories on negative attitudes towards disability From early age we are socialised into thinking about normal and not normal; bodies are pressured to conform to an ideal; when peoples’ functioning or biological composition does not fall within these standards, they are deemed inferior and excluded (Devine, 1997) Vulnerability to illness and death are feared and unconsciously that fear is projected onto people with disability (Gleeson, 2006) People with disabilities commonly considered in need of care, ‘pathetic figures in need of pity, charity’ (Funk, 1987)

Generally speaking.. While negative attitudes to disability persist there is also evidence that attitudes to disability are improving in Ireland and worldwide There is a clear relationship between attitudes and personal experience of disability as found in two national studies by NDA When appropriate supports are provided employers express positive attitudes toward workers with ID and mental health difficulties While attitudes to disability are improving, positive attitudes towards people with mental health problems lag behind…

NDA surveys of public attitudes  Only 36% agreed that children with mental health difficulties should be in the same school as other children. 21% would object if children with mental health difficulties were in the same class as their child. (2006)  Only 7% of respondents thought employers were willing to employ people with mental health difficulties. Respondents also said they would be least comfortable having people with mental health difficulties as work colleagues.  More people (17%) expressed levels of discomfort with people with mental health difficulties living in the neighbourhood than any other type of disability

How comfortable are you working with people with disabilities? Physical Impairment 8.85 Hearing Impairment 8.69 Visual Impairment 8.57 Intellectual disability 8.25 Mental health problem – 10 Scale 1= uncomfortable 10 = Comfortable

Q7 Do you agree or disagree that people with the following disabilities should attend the same school as children without disabilities? Strongly Neither agree Strongly agree Agree nor disagree Disagree disagree Total % % % % % mental health difficulties intellectual or learning disabilities physical disabilities visual or hearing disabilities

Same right to enjoy Sexual Relationships? 90% agreed that people with visual/hearing impairments have the same rights as others to enjoy sexual relationships 87% agreed regarding those with physical disabilities 75% intellectual or learning disabilities 61% agreed for those with mental health difficulties

People with disabilities should have children if they wish? 87 % agreed people with visual/hearing impairments should have children 84% agreed re people with physical disabilities 64% agreed for people with intellectual/learning impairments

% Adults who strongly disagree that those with disabilities should have children if they wish… (In 2006, less than half, ( 41% ) of respondents believed people with mental health difficulties should have children)

63% of adults whose main disability was mental health experienced difficulty in participation due to the attitudes of others compared to next highest level among those with ID (49%) CSO % of adults with mental health difficulties experienced negative attitudes when looking for work 11% encountered negative attitudes at work 4% encountered such attitudes at school 52% reported difficulties in ‘taking part in community life’ Around 25% of those with emotional, psychological and mental health difficulties feel “most people can be trusted” compared with an overall average of 32%

Adults with disability (%) who curtail their participation due to negative attitudes of others (CSO 2010) Main disabilityNeverSometimesFrequently /Always Seeing83152 Hearing79164 Speech61328 Mobility and Dexterity Remembering Intellectual Mental Health Pain82135 Breathing84114

NDA work in this area... Commitment to regular monitoring of public attitudes Research programme on quality in services for those with mental health difficulties (recovery approach); suicide; mental health and ethnicity; Partnership with BCI on research on representation of people with disabilities in media Intensive focus in NDA on promoting employment of people with disabilities: 3% target, leadership research, collaboration with HSA on safe work environments Extensive work programme with all government departments promoting inclusive and accessible public services for people with disabilities

The answer? Multi-sectoral collaboration on combination of strategic interventions Legislate against discrimination Interventions that tackle negative attitudes directly through disability awareness training Awareness campaigns promoting positive attitudes, anti-stigma Interventions which promote personal contact with pwd in social, educational, employment spheres People with disabilities are likely best leaders

thank you.