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STIGMA CHANGE! What and Where is the Evidence?
Patrick Corrigan, Psy.D. Illinois Institute of Technology Chicago Consortium for Stigma Research
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The Goals Today EVIDENCE Stigma Change is the Goal
Many examples What works for whom and where? EVIDENCE For all stakeholders
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STIGMA CHANGE PUBLIC STIGMA SELF-STIGMA Protest, Education, Contact
Group identification and support
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What’s Out There? Current Programs
World Psychiatric Association Programs by country (N>50) US SAMHSA's Resource Center Programs by state (N>100) Canada Programs “…the Commission is launching a major, national 10-year anti-stigma and discrimination reduction campaign. This campaign will be the largest systematic effort to reduce the stigma of mental illness in Canadian history”
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RESOURCES
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Media Watch Fright Night Scream Park
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Public Service Announcements
what a difference a friend makes
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Personal Stories
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Ahead of the Data! Intervene Now!
“There's a temptation for the Commission to sprint out of the gate with a mass marketing campaign, but that would be a mistake.” Canadian Mental Health Commission Ahead of the Data! Intervene Now!
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The Evidence Where is the evidence? What is evidence?
Using evidence to make decisions
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Lessons from mental health services research
What works regionally? Governmental policy/support (SAMHSA) Supported employment Assertive community treatment What works locally? How does supported employment actually work in Chicago?
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Evidence for Stigma Change
What kind of stigma change strategies should Governments/NGOs support? Education, contact… Do these strategies work locally? Chicago, London, Paris Beijing, Delhi, Riyadh
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N=213 Stigmatizing Attitudes and Behavioral Intentions Contact:
Responsibility Education: Responsibility Control Contact: Dangerousness Education: Dangerousness Attitudes and post and 1 wk f-up
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SELECTION CRITERIA STAKEHOLDER PERSPECTIVE State of the Evidence
Participatory Action Research State of the Evidence Ratio of Cost to Benefit
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Participatory Action Research
PERSPECTIVE: Understanding the broad questions related to stigma change POLITIC: interest and authority in subsequent stigma change Who are the stakeholders? diversity
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SELECTION CRITERIA Stakeholder perspective STATE OF THE EVIDENCE
Participatory action research STATE OF THE EVIDENCE Ratio of cost to benefit
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Evidence Based Considerations
Dependent measures ATTITUDES Physiological change Information processing Social behavior Behavioral intention BEHAVIOR
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Evidence Based Considerations
Dependent measures Psychometrics (reliability and validity) Sensitivity Social desirability
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Evidence Based Considerations
Reducing discrimination versus affirming actions Not just what does it stop (less prejudice) but what is improved (more work) Specificity Not just whether it “changes” people, put does it change important groups Employers, landlords, health care providers 19
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Evidence Based Considerations
Effect Size Is the effect noticeable? Does it matter? (social validity) Iatrogenic effects Mental illness is a brain disorder Manuals and Fidelity Need to catalogue interventions Feasibility If you provide it, will they come Fect 20
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Example Supported employment: Get more people with mental illness back to work. Get more employers to participate in supported employment. Challenge employer stigma: In Our Own Voice: Telling one’s stories
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Example Dependent measures: Attitudes Behavior Affirming actions
Immediate: Participating in supported employment Hiring people with mental illness Affirming actions Specificity Effect size Manuals and fidelity
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SELECTION CRITERIA Stakeholder perspective State of the evidence
Participatory action research State of the evidence RATIO OF COST TO BENEFIT
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Cost-Benefits The size of the sample The depth and breadth of effects
Local or broad The depth and breadth of effects Effect size Specificity Outcomes (no stigma versus more affirming actions) The costs of the change strategy The cost of evaluation
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PUTTING IT ALL TOGETHER
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Evidence Based Approach
WHO is to be targeted. WHAT needs to be changed. HOW will this be changed. WHEN will change occur. MEASURE IT
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For Evaluating Programs Meant to Erase the Stigma of Mental Illness
TOOLKIT For Evaluating Programs Meant to Erase the Stigma of Mental Illness Patrick Corrigan draft Oct 23, 2008
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Patrick Corrigan
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