2. 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.

3. 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.

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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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
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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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.

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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.

28. 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.

29. 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.

30. 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.

31. Questions or Comments?
Paolo del Vecchio Associate Director for Consumer Affairs, CMHS Project Officer 240–276–1946
Richard Gilroy EBI Project Director 202–331–4323
James Bell EBI Evaluation Director
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.