COMBATING THE STIGMA OF
MENTAL ILLNESS FROM THE
INSIDE OUT
Melissa Bartsch, Ph.D.
Presented as par t of Innovati ons 2.0
ACPA - Indianapolis, 2014
ORIGIN STORY
 Providing clinical supervision
 Teaching practicum
 Conversations with clients
 Reflections on my own training
MENTAL HEALTH STIGMA
 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)
MORE ON STIGMA…
 Stigmatizing attitudes (Corrigan & Penn, 1999)
 Fear and exclusion
 Authoritarianism
 Benevolence
 Trained professionals within mental health have stereotypes
about mental illness (Lyons & Ziviani, 1995)
LEVELS OF INTERVENTION
 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)
OUR TRAINING
 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
GOALS
 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
TRAINING STRUCTURE
 Two groups of 3
 3-hour training
 Experiential activities and dialogue
 Rules and debriefing
 Exploration vs. shame
 Agree to disagree
STEREOT YPES AND MESSAGES
 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?
CONTINUUM
 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?
A TRAINEE’S PERSPECTIVE
 “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 =).”
ANOTHER TRAINEE’S PERSPECTIVE
 “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.”
COMMUNIT Y INTERVENTION
 Be flexible
 Time devoted to discussion versus activities
 Tailor training to audience
 Mindfulness of basic knowledge level
 Language
 Room for debriefing
QUESTIONS FOR THE AUDIENCE
• 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?
REFERENCES
Byrne, P. (2000). Stigma of mental illness and ways of diminishing it.
Advanc es 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 inter feres with mental health
care. American Psychologist, 59 (7), 617-625.
Couture, S.M. & Penn, D.L. (2003). Interper sonal contact and
the stigma of mental illness: A review of the literature.
Journal of Mental Health , 1 2 (3), 291-305.
Lyons, M. & Ziviani, J. (1995). Stereotyp es, stigma, and mental Illness:
Learning from fieldwork experiences. The American Journal of
Occupation al Therapy.
Mann, C. E. (2010). In a Stranger's Shoes: Reduc ing mental illness
stigma through per spec tive -taking. Unpublished doctoral
disser tation, Univer sity of Tennessee, Knoxville, TN.
Retrieved June 1 , 201 2, from Disser tations and Theses
database.
RECOMMENDED WEBSITES
 Changing Minds Campaign
 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
 SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)
 http://www.stopstigma.samhsa.gov/