1. Melissa Bartsch, Ph.D. Presented as part of Innovations 2.0 ACPA- Indianapolis, 2014 COMBATING THE STIGMA OF MENTAL ILLNESS FROM THE INSIDE OUT

2.  Providing clinical supervision  Teaching practicum  Conversations with clients  Reflections on my own training ORIGIN STORY

3.  Negative effects (Couture & Penn, 2003)  Low self-esteem  Discrimination (employability, leasing)  Reluctance to seek treatment  Perceived as being responsible for mental illness  Exclusion  Identified as the number one barrier to mental health treatment by the U.S. Surgeon General (1999) MENTAL HEALTH STIGMA

4.  Stigmatizing attitudes (Corrigan & Penn, 1999)  Fear and exclusion  Authoritarianism  Benevolence  Trained professionals within mental health have stereotypes about mental illness (Lyons & Ziviani, 1995) MORE ON STIGMA…

5.  Education (Corrigan & Penn, 1999)  Personal info about the individual with mental illness  Directly attack myths  Involve discussion  Increase empathy through simulations  Contact (Corrigan, 2001)  Perspective-taking (Mann, 2010)  Protest (Corrigan & Penn, 1999) LEVELS OF INTERVENTION

6.  Modeled after UT’s Safe Zone training curriculum  Incorporated effective destigmatization education  Second-year Counseling Psychology doctoral students  Experiential Activities  Stereotypes and Messages  Continuum  Storyboards  Reaction/reflection paper written after the training OUR TRAINING

7.  Goals  Become a mental health ally (inside and out)  Among peers and colleagues  On campus  In session  In the community  Become inclusive, affirming, and broadening prospective  Facilitate dialogue regarding interaction between personal beliefs and professional behavior  Discuss ways in which beliefs impact therapy GOALS

8.  Two groups of 3  3-hour training  Experiential activities and dialogue  Rules and debriefing  Exploration vs. shame  Agree to disagree TRAINING STRUCTURE

9.  Diagnoses on large notepad around the room  Bipolar Disorder, BPD, Alcohol Dependency, Amphetamine Abuse, GAD, Anorexia, Adjustment Disorder  Instructions: List messages received or things believed/heard about each  Time: 2 minutes per sheet  Discussion Questions:  What stands out?  What was surprising? STEREOTYPES AND MESSAGES

10.  Strongly Agree to Strongly Disagree  Instructions: Stand on the continuum after each of the following questions:  I would be comfortable referring my clients for medication  I would tell my friends I’m in therapy  I would be in a relationship with someone who has Bipolar Disorder  Discussion Questions:  Do you notice any discrepancies regarding what’s o.k. for clients and not o.k. for you?  How did I get to this place on the continuum? CONTINUUM

11.  “I think what really stuck with me was writing down our stereotypes for certain diagnoses. I became really aware how we, as mental health professionals, talk about our clients in sometimes negative ways, and how labels can be damaging because of stigma. After that class, I remember making conscious efforts to talk about my clients as if they were healthy individuals experiencing life difficulties, rather than disordered or diseased people. It was just fun to do, too. Way better than just getting a lecture on stigma =).” A TRAINEE’S PERSPECTIVE

12.  “One thing that sticks to my mind is that through this activity I was able to acknowledge how my expectations of others as clients is different from my own expectations as a client. It helped me realize that I have my own bias towards others, especially those with psychological disorders, even if these biases are somewhat unconscious. It also provided a more experiential understanding of the fears and stigma tied to psychotherapy and psychotropic medication that many clients probably feel when making the decision to seek help.” ANOTHER TRAINEE’S PERSPECTIVE

13.  Be flexible  Time devoted to discussion versus activities  Tailor training to audience  Mindfulness of basic knowledge level  Language  Room for debriefing COMMUNITY INTERVENTION

14. What efforts are being made on your campus to combat mental health stigma? How might you adapt this destigmatization training to fit your needs? What sorts of things are you doing on your campus to combat mental health stigma? What might be some of the challenges of implementing this sort of training with other professions? QUESTIONS FOR THE AUDIENCE

15. Byrne, P. (2000). Stigma of mental illness and ways of diminishing it. Advances In Psychiatric Treatment, 6, 65-72. Corrigan, P. & Penn, D (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765-776. Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 617-625. Couture, S.M. & Penn, D.L. (2003). Interpersonal contact and the stigma of mental illness: A review of the literature. Journal of Mental Health, 12(3), 291-305. Lyons, M. & Ziviani, J. (1995). Stereotypes, stigma, and mental Illness: Learning from fieldwork experiences. The American Journal of Occupational Therapy. Mann, C. E. (2010). In a Stranger's Shoes: Reducing mental illness stigma through perspective-taking. Unpublished doctoral dissertation, University of Tennessee, Knoxville, TN. Retrieved June 1, 2012, from Dissertations and Theses database. REFERENCES

16.  Changing Minds Campaign  http://www.rcpsych.ac.uk/campaigns/changingminds/wh atisstigma/mentaldisorderschallenging.aspx http://www.rcpsych.ac.uk/campaigns/changingminds/wh atisstigma/mentaldisorderschallenging.aspx  National Alliance for the Mentally Ill (NAMI)  http://www.nami.org/template.cfm?section=fight_stigma http://www.nami.org/template.cfm?section=fight_stigma  SAMHSA’s Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health (ADS Center)  http://www.stopstigma.samhsa.gov/ http://www.stopstigma.samhsa.gov/ RECOMMENDED WEBSITES