Facilitator: Richard Krzyzanowski
Consumer Employment Support Specialist, Center of Excellence;
Chair, Orange County Stigma Elimination Task Force;
Client & Family Leadership Committee of the
California Mental Health Services Oversight & Accountability Commission
Panel Presenters
George Nguyen, President, OC Association for Vietnamese Mental
Health Awareness and Support
Melody Marler, Adult Mental Health Services- Recovery Center North,
OC HCA/BHS
Jenny Monge, OC Mental Health Board Arts Committee, NAMI OC
Gregory Wright, Mental Health Board, NAMI OC Family-to-Family
Trainer
Definition of Culture
 “Culture” refers to the shared attributes of a group
of people.
 People can share a culture, regardless of their
“race” (= socio-biological category associated with
visible physical characteristics such as hair, skin
tone) or ethnicity (= heritage of a particular
group)
Definition of Culture
 “Culture” is broadly defined as a common heritage
or learned set of beliefs, norms, and values (U. S.
Department of Health and Human Services, 2001)
 Example: people who work for a particular
organization or participate in a social group may
share the same cultural attributes.
Facts About Mental Health
 Mental health issues affect almost every family in
America.
 People with mental health issues can and often do
recover with the support of their peers, family,
friends and communities, and by working with
mental health professionals for proper diagnosis,
treatment and medication.
Facts About Mental Health
 Recovery can be achieved via tapping into
inner strength, resilience, spirituality, self-help
strategies (self-responsibility and selfdetermination), family/peer/community supports,
and a sense of connection with other people and
society.
 People with mental health issues can and do make
important contributions to our family and
community systems, as well as to the mental health
professions.
Hope
Empowerment
Self-determination
Freedom of Choice
Knowledge of Rights
Self-Confidence
Self-Advocacy
Responsibility
Developing Peer & Other Support Systems
Stigma: Some definitions
 “A mark of disgrace or infamy; a stain or reproach,
as on one's reputation.”
 “An attribute, behavior, or reputation which is
socially discrediting in a particular way: it causes
an individual to be mentally classified by others in
an undesirable, rejected stereotype rather than in
an accepted, ‘normal’ one.”
Confounding facts and fallacies
A social set of attitudes with institutional
implications
Not always negatively phrased or ill-intentioned
Paternalism
Self-stigma
 Self-stigma is defined as negative attitudes about
mental illness and its treatment that are held by the
individual with the stigmatized condition.
 Self-stigma has recently been cited as a major public
health concern, contributing to decreased
treatment seeking, lowered self-esteem, and lowered
self-efficacy.
 Self-stigma is the prejudice which people with mental
health issues turn against themselves.
Stigma and Its Negative Impacts
 Stigma is one of the most prevalent and
persistent obstacles hindering the
transformation of any mental health system and
of attitudes in the community.
 Many clients still underutilize mental
health services and remain un-served in part
because of the stigma against people with
mental health issues.
Stigma and its negatives
 Fear of discrimination is the key barrier that
keeps many people from revealing symptoms and
seeking help, services and treatment.
 Stigma leads to low self-esteem, a sense of being
misunderstood, hopelessness, shame and guilt.
 Stigma also deters people from socializing or
working with, renting to, or employing mental
health clients.
Stigma: Two recent studies
 Corrigan, P.W. (2005). On the stigma of mental
illness: Practical strategies for research and social
change. Washington, D.C.: APA.
 Pescosolido, B.A., Jensen, P.S., Martin, J.K., Perry,
B.L., Olafsdottir, S., & Fettes, D. (2008). Public
knowledge and assessment of child mental health
problems: Findings from the National Stigma
Study—Children. Journal of the American
Academy of Child & Adolescent Psychiatry, 47,
339–349.
Confronting Stigma
 "If you focus on the competence of people with mental
illness, that tends to lead to greater tolerance.”
--- Pescosolido
 Contact with people who have mental health issues
tends to decrease stigma
 Meeting people who have mental health issues
weakens people's tendency to link mental illness and
violence.
Client Culture: A Definition
 Client culture shares some common attributes in that the
life conditions or disability of a client, the attitudes and
practices of the health care system, and ethnic/cultural
contexts in many ways affect and mold the values, beliefs
and lifestyles of the client as well as his/her family
system.
Sharing Cultures
As lives are shared, each gains a new
value …
Culturally Competent Practice
 From a culturally competent practice and
perspective, (Cross et al.,1989), systems,
agencies and professional providers of
services to clients/consumers would
utilize a set of congruent values, practice
skills, attitudes and policies in working
effectively together in cross-cultural
situations.
Culturally Competent Health Care Providers
 Provider’s awareness of his/her own cultural
values and biases is the pre-requisite for being
able to accept and embrace similarities and
differences of client’s worldviews in order
to become effective.
 Accurate understanding of the life change
events and illness of clients, their cultural and
family systems would lead to a comprehensive
understanding of client’s development,
emotional, functional and cognitive process and
behaviors.
Effective Mental Health
Care Delivery
With a best-practice s approach, Mental Health
Care Providers:
 Respect persons with mental health issues
 Understand and attend to clients’ real needs
 Incorporate wellness into care and work to create
and maintain a continuous, healing relationship
Effective Mental Health Care Delivery
 Show respect in the form of active listening, take
complaints seriously, evaluate and re-evaluate if
necessary, attend to thorough follow-ups, being
patient and kind with effective communication
 Coordinate with other professional providers to
deliver and link necessary care from housing to
community-based supports in a timely manner
 Are congruent and self-reflective with the ability to
acknowledge one’s own limitations
 Advocate on behalf of clients
Toward a Transformed
Mental Health System
Build a path toward increasing respect for human
dignity and thoughtful understanding of our clients,
their families, and cultural & contextual systems with
more humanity, compassion and acceptance
Gain a deeper awareness of family systems, cultural
context as well as quality care delivery within our
health care systems