Painted Brain Outcome Evaluation
Patrick J. Michaels and Blythe A. Buchholz
National Consortium of Stigma and Empowerment
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This study evaluated Painted Brain’s public stigma reduction program. Its impact
on audience members was assessed with measures administered immediately before and
after each presentation. Data was collected from five separate Painted Brain presentations
facilitated on the following dates: 9/11/2013, 10/18/2013, 12/9/2013, 1/22/2014, and
3/22/2014. Demographically, participants (N = 168) were about 26 years of age (SD = 6.9)
and 86.3% women. In terms of ethnicity, participants were Asian (27.4%), Caucasian
(33.3%), Latino (24.4%), and other/multiple (14.9%). Regarding education, participants
had completed some high school (9%), earned a high school diploma (3.8%), completed
some college (5.1%), or earned a bachelor’s (55.1%) or graduate degree (26.9%).
The impact of Painted Brain’s presentation was assessed by changes from pre-test
to post-test outcome measures. Stigmatizing attitudes were assessed with the nine-item
Attribution Questionnaire (AQ-9) to ascertain participants’ cognitive, affective, and
behavioral reactions to a person with schizophrenia. An example AQ-9 item is, “How
dangerous would you feel Harry is?” A second questionnaire, the three-item Recovery
Scale (RS-3), assessed participants’ attitudes toward people with mental health conditions’
capabilities to overcome psychological challenges. An example RS-3 item is, “People with
mental illness are hopeful about their future.” A third questionnaire, the three-item
Empowerment Scale (ES-3), assessed participants’ perceptions of empowerment among
people with mental illness. An example ES-3 item is, “I feel people with mental illness are
persons of worth, at least on an equal basis with others.” Finally, the four-item Care
Seeking Questionnaire (CS-4) assessed participants’ willingness to seek out mental health
services if they were experiencing impairing anxiety and/or depression. An example CS-4
item is, “I would speak to a psychiatrist if I were significantly anxious or depressed.” Sum
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scores were computed for each aforementioned scale. Total scores can range on each
measure as follows: AQ-9 (9 to 81), RS-3 (3 to 27), ES-3 (3 to 27), and CS-4 (4 to 36). For
the AQ-9, higher total scores represent greater stigmatizing attitudes; however, higher total
scores on the RS-3, ES-3, and CS-4 represent more positive attitudes toward the described
constructs (scores on these scales were reverse coded).
Results
Internal consistency evaluations were run to assess each scale’s psychometrics
using pre-test data from all participants. Adequate Cronbach’s Alphas were obtained for
the ES-3 ( = 0.93), AQ-9 ( = 0.80), and CS-4 ( = 0.75); analysis revealed a fair alpha
value for the RS-3 ( = 0.62). These results support the reliability and validity of each
outcome measure.
Graph 1 summarizes means and repeated measures ANOVA results for participants
who completed pre- and post-test measures. Participants demonstrated a significant
reduction in stigmatizing attitudes as measured by the AQ-9 [F (1, 167) = 33.87, p < .001],
improved attitudes about the ability of people with mental health conditions to recover via
the RS-3 [F (1, 167) = 44.81, p < .001], in addition to improved opinions regarding their
empowerment on the ES-3 [F (1, 167) = 26.39, p < .001]. Participants also demonstrated an
increased willingness to seek out mental health services themselves if distressed [F (1,
167) = 16.02, p < .001].
Conclusion
This study examined the immediate benefits of attending a Painted Brain stigma
reduction program by administering questionnaires immediately before and after each
presentation. Results revealed Painted Brain presentations successfully reduced
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participants’ stigmatizing attitudes and increased affirming attitudes regarding
empowerment over and recovery from mental health conditions. Attendees also reported
a greater willingness to seek mental health services and supports if experiencing
psychological challenges.
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Graph 1. Immediate benefits conferred to participants attending Painted Brain’s
presentation.
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Pre-Test
15
Post-Test
10
5
0
AQ-9
RS-3
ES-3
CS-4
AQ-9 = Attribution Questionnaire 9-Item; RS-3 = Recovery Scale 3-Item; Empowerment
Scale 3-Item; CS-4= Care Seeking Questionnaire 4 Item.
Significance levels: * = .05, ** = .01, *** = .001
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