What Was the Elimination of Barriers Initiative (EBI)? A SAMHSA initiative to identify and evaluate effective strategies for reducing stigma and discrimination associated with mental illnesses Goal: Achieve a society that promotes acceptance of all persons with mental illnesses The Elimination of Barriers Initiative was launched by the Center for Mental Health Services, (a center of the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration) to identify effective approaches in addressing the stigma and discrimination associated with mental illnesses.

Objectives of the EBI Reduce stigma and discrimination Eliminate barriers to treatment Build public support for concepts of recovery and resiliency Build public support for an array of accessible, quality community-based services Accessible, quality community-based services are a barrier to treatment in many areas. Some towns or counties may lack mental health care providers. Perhaps the mental health care providers that are present are overwhelmed and understaffed. Every person living with mental illnesses should have the same access to quality mental health care in their communities. Communities can work together to improve access.

Pilot EBI States California Florida Massachusetts North Carolina Ohio Pennsylvania Texas Wisconsin

Initiative Design— Strategy and Timeline Multiple strategies: education, contact, and reward approaches Coordinated by Departments of Mental Health 3 education campaigns: General public (all 8 States) Business community (CA, FL, PA, TX, WI) Schools (MA, NC, OH, WI) Pilot implementation period: May 2004–July 2005 Awards program: July 2005 Process evaluation: Fall 2005 EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Initiative Design—Partnership National-State Partnership Committee Diverse group of participants Representatives from Federal government, State mental health departments, non-profits/advocacy groups, academia, and foundations Attended kick-off meeting (January 2003); State Summit (September 2003); ongoing communication via LISTSERV 3 subcommittees: Communications, Partnership, Evaluation EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Initiative Design— Implementation Team Vanguard Communications Communications development and implementation; technical assistance The Gallup Organization Administrative oversight; focus groups James Bell Associates Evaluation The ADS Center and the Mental Health Association of Southeastern Pennsylvania Consumer outreach and advocacy Al Guida Partnership development EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Technical Assistance Each State assigned a Technical Assistance liaison as primary point of contact Regular conference calls Training and technical assistance relating to implementing the EBI Topics included: online marketing; May Is Mental Health Month; multicultural outreach State and Initiative updates LISTSERV for information updates, group discussion 100-page roll-out kit to help with implementation Mini-grants to help States create additional opportunities for contact strategies, additional outreach to diverse audiences EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Evaluation Process and case study evaluation to study Reach, Awareness, and Utilization of EBI Process evaluation tracks usage of all EBI products, including general public, school, and workplace materials In-depth case studies to capture qualitative information on State implementation, including challenges and innovations Site visits to each EBI State Technical assistance tracking database Evaluation results will be used to inform future stigma and discrimination reduction initiatives EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

EBI General Public Portfolio Public Service Announcements Broadcast talent and print models were consumers of mental health services Drop-in articles Featured recovery vignettes in each State Bilingual brochure State-specific bookmarks Web Site In English and Spanish EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Creative Challenges Recovery language “In recovery” vs. “recovery/recovered” “Mental Illness” vs. “Mental Health Problems” Call to action Stats EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Tagline Development Understandable by general public Generate awareness of importance and prevalence Thematically adaptable “It’s part of our workplace” “It’s part of our schools” Positive, strength-based, inclusive EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

EBI Call to Action Directed people to a bilingual toll-free number answered by SAMHSA’s National Mental Health Information Center and offering: Bilingual brochure containing general information about mental health Service referrals Also directed to Web sites www.allmentalhealth.samhsa.gov www.nuestrasaludmental.samhsa.gov EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

State Activities—General Public Campaign Trained to follow up with PSA directors to encourage placement, link to Web site, distribute brochures, etc. Some used their consumer networks and partners to do so; some did so themselves or via a contractor States held launch events between May and October 2004 States were also responsible for distributing drop-in articles, as well as promoting business and schools packages With the assistance of mini-grants, States developed or enhanced existing speakers bureau activities to promote EBI messages Research shows that personal contact with a person with mental illness is effective in reducing stigma

Print PSAs EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Web Sites www.allmentalhealth.samhsa.gov EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State www.nuestrasaludmental.samhsa.gov

TV PSAs EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Radio PSAs EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Overall PSA Results More than 273 million audience impressions Equivalent airtime/advertising value: nearly $3 million Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.

PSA Placement Results—TV Commitments for over 9,589 placements equal to more than 207 million audience impressions as of December 15, 2005 English broadcast: 4,924 placements on 76 stations equal to 171 million audience impressions Spanish broadcast: 1,240 placements on 25 stations equal to 32 million audience impressions Cable: 4,225 pledged placements on 33 systems equal to 3.7 million audience impressions Equivalent airtime value: $1.4 million EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

PSA Placement Results—Radio Commitments for more than 24,000 placements on 250 stations equal to almost 62 million audience impressions through December 15, 2005 22,062 English placements on 224 stations equal to more than 55 million audience impressions 2,069 Spanish placements on 26 stations equal to more than 6.2 million audience impressions Equivalent airtime value: $1.5 million EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

PSA Placement Results—Print Commitments for over 186 placements in 56 publications equal to 4,685,00 audience impressions through December 15, 2005 146 English placements in 36 newspapers equal to 814,700 audience impressions 22 Spanish placements in 11 newspapers equal to 189,700 audience impressions 18 English placements in 9 magazines reaching 3,681,500 readers Equivalent advertising value: $42,600 EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

EBI Schools Portfolio Training curriculum for teacher audience Administrators’ guide Poster Print PSAs Drop-in articles EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

EBI Business Portfolio Resource for HR managers PowerPoint training for managers Top executives’ booklet Poster Print PSAs Drop-in articles EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

The Voice Awards Honor entertainment writers and producers, States, MH advocates in reducing stigma Writers and producers of over 50 productions nominated; 10 received awards Awards also to consumers, States, Brooke Shields, Maurice Benard, Univision, Neil Baer Over 230 attend gala ceremony in L.A. Covered in Variety, The New York Times, L.A. Times and online SAMHSA makes Voice Awards annual event EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

EBI Resource Kit Supports the activities of those who plan to mount a statewide, regional, or local initiative to reduce stigma and discrimination Guidance on planning and implementation Sample materials and templates for development and customization Tactics to enhance and maximize outreach Directories of resources for creating public education materials Both hard copies and electronic files on CD EBI will work to inform the general public, school systems, and businesses through a public education campaign. Some materials planned for this campaign include: TV, radio and print public service advertisements, plus pre-written articles that feature people who have experienced mental illness first-hand Training materials designed to create more accepting environments for people with mental illnesses in schools and businesses A Web site and brochure with information about mental health, stigma and discrimination, plus resources and referral information for your State

Lessons Learned Use a multifaceted approach Use a participatory process Involve consumers Work closely with a smaller subgroup of key partners Involve stakeholders early and often throughout the creative process Identify your audience(s) and speak to them in their own language Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.

Lessons Learned 7. Focus on positive, strength-based messages that demonstrate that recovery is both real and possible 8. Localize and personalize educational strategies 9. Choose a campaign theme that can be tailored to specific audiences Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.

Lessons Learned 10. Develop and implement a comprehensive evaluation 11. Use existing commemorative events 12. Generate and maintain enthusiasm 13. Provide basic training and tools on media outreach 14. Utilize train-the-trainer opportunities Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.

Lessons Learned 15. Provide forums for peer-to-peer information sharing 16. Additional training may be required in the development and ongoing operation of speakers’ bureaus 17. Recognize that messages directed at media gatekeepers may vary from those directed at the general public Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.

Questions or Comments? Paolo del Vecchio Associate Director for Consumer Affairs, CMHS Project Officer 240–276–1946 paolo.delvecchio@samhsa.hhs.gov Richard Gilroy EBI Project Director 202–331–4323 rgilroy@vancomm.com James Bell EBI Evaluation Director 743-243-3017 bell@jbassoc.com Discussion Point: How else could you promote the EBI with materials? Ask the audience to brainstorm other creative ways to get materials distributed in their communities.