U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration National Efforts to Address Stigma and Discrimination Chris Marshall, Consumer Affairs Specialist, SAMHSA/CMHS
SAMHSA Lead federal agency on SA and MH Lead federal agency on SA and MH SAMHSA SAMHSA – Center for Mental Health Services – Center for Substance Abuse Treatment – Center for Substance Abuse Prevention
Prevalence of Mental and Other Illnesses Estimated number of millions of Americans affected Sources: Cancer, National Cancer Institute (2001 data); diabetes and heart disease, National Center for Health Statistics (2002 data); mental illnesses, Substance Abuse and Mental Health Services Administration (any given year). 23
An estimated 22 percent of Americans ages 18 and older have a diagnosable mental health problem But... The majority of those with a diagnosable mental health problem do not seek treatment
Stigma: a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses Source: Achieving the Promise: Transforming Mental Health Care in America
Internalizing Stigma Embarrassment, Shame, Isolation Embarrassment, Shame, Isolation Nearly two-thirds of all people with diagnosable mental health problems do not seek treatment (Regier et al., 1993; Kessler et al., 1996). Nearly two-thirds of all people with diagnosable mental health problems do not seek treatment (Regier et al., 1993; Kessler et al., 1996).
Public Attitudes Surveys since the 1950s Surveys since the 1950s Mental illness as stigmatized condition Mental illness as stigmatized condition No scientific understanding No scientific understanding Unable to identify persons with MI Unable to identify persons with MI Could not distinguish between MI and worry Could not distinguish between MI and worry Fear of unpredictable violence Fear of unpredictable violence
MacArthur Mental Health Module, General Social Survey, 1996 Greater scientific understanding Greater scientific understanding Able to distinguish between MI and worry Able to distinguish between MI and worry Mix of biological and psychological stress Mix of biological and psychological stress Social stigma unchanged Social stigma unchanged Belief that violence associated with mental illnesses nearly doubled Belief that violence associated with mental illnesses nearly doubled
Stigma is widespread in the US Stigma is widespread in the US Most pervasive barrier to mental health Most pervasive barrier to mental health Cluster of negative attitudes and beliefs Cluster of negative attitudes and beliefs Leads others to fear, reject, and avoid Leads others to fear, reject, and avoid Deters public from wanting to pay for care Deters public from wanting to pay for care Low self-esteem, isolation, and hopelessness Low self-esteem, isolation, and hopelessness
Reducing Stigma Public Education Campaigns Public Education Campaigns Reward / Protest Reward / Protest Contact Approach Contact Approach
History of National Efforts Spring to Action 2001 Spring to Action 2001 EBI and ADS Center EBI and ADS Center President’s New Freedom Commission on Mental Health President’s New Freedom Commission on Mental Health SAMHSA National Anti-Stigma Campaign SAMHSA National Anti-Stigma Campaign
SAMHSA Programs to Address Stigma ADS Center (Resource Center to Address Discrimination and Stigma) ADS Center (Resource Center to Address Discrimination and Stigma) EBI (Elimination of Barrier Initiative) EBI (Elimination of Barrier Initiative) NASC (SAMHSA’s National Anti-Stigma Campaign) NASC (SAMHSA’s National Anti-Stigma Campaign)
Help States, organizations, individuals design and implement anti-stigma initiatives Gather and maintain best information, policies, research, practices, and programs to counter stigma and discrimination Actively disseminate anti-stigma and discrimination information and practices
Technical Assistance Training Teleconferences Informational Updates Web site Database Collaboration with EBI and NASC
Web site: stopstigma.samhsa.gov Telephone:
EBI Eight State Demonstration Eight State Demonstration Test Public Education Messages Test Public Education Messages Reduce stigma and discrimination associated with mental illnesses using tools such as public education and contact Reduce stigma and discrimination associated with mental illnesses using tools such as public education and contact Provide Evidence-base for National Campaign Provide Evidence-base for National Campaign
EBI Goal: Achieve a society that promotes acceptance of all persons with mental illnesses
EBI Pilot States Ohio Ohio Pennsylvania Pennsylvania Texas Texas Wisconsin Wisconsin California California Florida Florida Massachusetts Massachusetts North Carolina North Carolina
SAMHSA National Anti-Stigma Campaign National, 3-year, public service campaign to reduce the stigma of mental illness National, 3-year, public service campaign to reduce the stigma of mental illnessGoals: Improve the general understanding of mental illnesses Improve the general understanding of mental illnesses Promote recovery Promote recovery Encourage help-seeking behavior across the age span Encourage help-seeking behavior across the age span
Recovery is a process or a journey, sometimes lifelong, through which a person achieves independence, self-esteem, and a meaningful life in the community
SAMHSA National Anti-Stigma Campaign Target Audiences: General Public General Public –Specific Sectors Older Adults Older Adults Ethnic and Racial Minorities Ethnic and Racial Minorities Rural Communities Rural Communities
SAMHSA National Anti-Stigma Campaign Campaign Workgroup Campaign Workgroup Research and Analysis Research and Analysis Strategic Marketing Plan Strategic Marketing Plan Campaign Web site Campaign Web site Regional Meetings Regional Meetings
SAMHSA National Anti-Stigma Campaign Creative Development and Production Creative Development and Production Campaign Distribution Campaign Distribution Campaign Kickoff Meetings Campaign Kickoff Meetings Media Monitoring Media Monitoring Tracking and Evaluation Tracking and Evaluation
Contact Information Chris Marshall Center for Mental Health Services SAMHSA 1 Choke Cherry Road, Room Rockville, MD Phone: