What says the dodo bird? - The Kennedy Forum...
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Patrick Corrigan Illinois Institute of Technology What says the dodo bird?
Transcript of What says the dodo bird? - The Kennedy Forum...
Patrick Corrigan
Illinois Institute of Technology
What says the dodo bird?
STOP
Stigma is Bad◦Public stigma
◦Self-stigma
Not all ways to address stigma work!
◦Unintended consequences
Direction for change5
6
Funded by the U.S. NIMH since 2001
Collection of more than 20 research and consumer groups from across US
WWW.NCSE1.ORG
UNINTENDED
CONSEQUENCES
Everybody
has won and
all must have
prizes!
PsychoanalysisCognitive Therapy
BEAT RACISM
DON’T ASK
DON’T TELL
BEAT HOMOPHOBIA
“THE POOR!”
“THE WEAK!”
“THE LEAST IMPORTANT!”
“THE POOR!”
“THE WEAK!”
“THE LEAST IMPORTANT!”
“Whatsoever you do to the least of my brethren,
that you do unto me!”
John
BESTOW
EMPOWER
1515
N=213
Stigmatizing Attitudes and
Behavioral Intentions
Education:
Responsibility
Contact:
DangerousnessEducation:
Dangerousness
Contact:
Responsibility
Control
Attitudes and Intentions @ post and 1 wk f-up
-2.5
-2
-1.5
-1
-0.5
0
0.5
1
1.5
control ed:danger ed:respon ct:danger ct:respon
pre
post
0.3
0.35
0.4
0.45
0.5
0.55
0.6
0.65
Pos Neg
Control
Education
Protest
Contact
6.8
7.3
7.8
8.3
8.8
9.3
9.8
10.3
10.8
control ed:danger ed:respon ct:danger ct:respon
pre
f-up
0
1
2
3
4
5
6
7
8
low mod high
stigma change
0
1
2
3
4
5
6
7
8
low mod high
stigma change
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18
20
In the movies
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In the newspapers
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In advertising
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30
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Trenton State Hospital
has fire.
DANGER
Phelan, Link et al
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0%
20%
40%
60%
80%
100%
1956 1996
danger
DANGER
Phelan, Link et al
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0%
5%
10%
15%
20%
25%
30%
35%
40%
1956 1996
danger
DANGER
Phelan, Link et al
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0%
5%
10%
15%
20%
25%
30%
35%
40%
1956 1996
danger
DANGER
Phelan, Link et al
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0%
5%
10%
15%
20%
25%
30%
35%
40%
1956 1996 2006
danger
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Public
stigma
Self-
stigma
Label
avoidance
Structural
stigmastereotype
prejudice
discrimination
Structures
-----------types-----------
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STEREOTYPES◦ All Irish Americans are drunks and beat their wives.
PREJUDICE
◦ That’s right. They’re drunks and I loathe them.
DISCRIMINATION
◦ So, don’t: hire, rent, or befriend them
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STEREOTYPES◦ People with MI are: weak, dangerous….
PREJUDICE◦ They are bad because: scary, shameful.
DISCRIMINATION◦ So, don’t: hire, serve, or rent to them
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Public
stigma
Self-
stigma
Label
avoidance
Structural
stigmastereotype
prejudice
discrimination
Structures
-----------types-----------
Lost employment
Subpar housing
Worse health care
Worse educational opportunities
Diminished legislative support
Alienated faith communities
Coercive treatment
PTCA: percutaneous transluminal
coronary angioplastyDruss et al., 2000
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Public
stigma
Self-
stigma
Label
avoidance
Structural
stigmastereotype
prejudice
discrimination
Structures
-----------types-----------
Decreased self-esteem◦ I am not worthy
Decreased self-efficacy◦ I am not able
Why try?!◦ I am not worthy of a good job
◦ I am not able to live alone
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Public
stigma
Self-
stigma
Label
avoidance
Structural
stigmastereotype
prejudice
discrimination
Structures
-----------types-----------
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seekers
non-seekers
45%
Label Avoidance
Epidemiological Catchment Area, National Co-morbidity Survey, NCSII
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users
non-users
22%
Corrigan, P.W. (2004). How stigma interferes with mental health care.
American Psychologist, 59, 614-625
Canadian
Community
Health
Survey
Label Avoidance
No treatment◦Do not seek care
◦Do not stay in treatment ◦Do not fully participate
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Protest Education Contact
Media-
based
In vivo
vehicle
-------processes--------
EDUCATION: ◦ contrasting myths (people are to blame)
◦ with facts (serious mental illness biological)
CONTACT◦ Meeting people and their stories of recovery
EASY STUFF:Just change the words!
Just cure the disease!
Leprosy to Hansen’s Disease
Dementia to Alzheimer’s
Mental Retardation to Intellectual Disability
Mania to Bipolar Illness
Japan: Seishin-Bunretsu-Byo to togo shitco sho
Korea: Jeongshin-bunyeol to Johyun-byung
Hong Kong: Jing Shen Fen Lie to Si Jue Shi Tiao
Singapore, China
“mind split disease” “integration disorder”
“attunement disorder”“mind splitted disorder”
“dysfunction of thought
and perception”“splitting of the mind”
Sartorius et al., 2014
The Data◦ Japan: mixed findings (Takashi et al., 2009, 2011)
◦ Relationship between name recognition and recovery (Sato in preparation, 2014)
◦ Hansen’s Disease (Oliveria et al., 2003; Van Brakel et al., in press)
Perpetuates the difference
Prejudice and discrimination more than words.◦ MODERN RACISM
It Looks easy:
NIMH and other funders decrease support
Advocacy groups: No longer a problem
KNOWLEDGE IS GOLD:
Educate stigma away!
75% US school districts
43 countries
RESEARCH
Uncertain effects No effects
RTI (1994) Cal Dept Ed (1995)
U Maryland (1998)
Worse effects APA (1999)
Indiana U (1992)
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Protest Education Contact
Media-
based
In vivo
vehicle
-------processes--------
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Protest Education Contact
Media-
based
In vivo
vehicle
-------processes--------
EDUCATION
RECOVERY
HIRE THEM?
RENT TO THEM?
EQUAL HEALTH CARE?
Sixteen representative samples of nation-defined populations
230 to 6000 Ss
Response rates: 65-85%
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
0
10
20
30
40
50
60
70
1990 1994 1998 2002 2006
Sz
Dep
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Inherited/Genetic
META-ANALYSIS FINDINGS: CAUSE
0
10
20
30
40
50
60
70
80
1990 1994 1998 2002 2006
Sz
Dep
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Brain Disease
META-ANALYSIS FINDINGS: CAUSE
0
10
20
30
40
50
60
1990 1994 1998 2002 2006
Sz
Dep
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Co-worker
META-ANALYSIS FINDINGS: ACCEPTANCE
0
10
20
30
40
50
60
1990 1994 1998 2002 2006
Sz
Dep
Schomerus, Schwann, Holzinger, Corrigan, Grabe, Carta, & Angermeyer, 2011
Neighbor
META-ANALYSIS FINDINGS: ACCEPTANCE
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Protest Education Contact
Media-
based
In vivo
vehicle
-------processes--------
PROTEST
PROTEST:The Pros and CONs!
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Protest◦Review stigmatizing images
◦Shame on you for thinking that way
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Beware the rebound effect
the white bear
NAMI - stigmabusters
The
JASONUTThe CRAZY
FACE
The SUICIDE
SQUEEZE
Located in Campbell and San Jose
California
Join the national on-line food fight.
Help turn lemon donuts into lemonade.
Join the national on-line food fight.
Help turn lemon donuts into
lemonade.
I'm an advocate of equal rights and a more tolerant world toward all people of different races, religion, gender, and sexual orientation; but that is it. Any thing else is just moronic.
Stan Rezaee, Aug, 2009
FRANCHISEOPPORTUNITIES
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Protest Education Contact
Media-
based
In vivo
vehicle
-------processes--------
CONTACT
CONTACT vs EDUCATIONThe Pros and CONs!
We are focused on encouraging EVERYONE TO
SPEAK OUT and share their story of being
affected by mental illness. The more everyone
shares, the more we can learn from each other
and find solutions to overcome our common
challenges.
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Contact
“Meet Bob Lundin”
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Bob’s story◦ My name is ______ and I have a severe mental
illness called schizo-affective disorder
◦ My childhood was not unusual…
◦ Unfortunately, my mental illness was
traumatic. It did not go away quickly…
◦ Despite these problems, I have achieved several accomplishments.
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
overall attitudes behavior
education
contact
p<.05 p<.05p<.05
CORRIGAN ET AL., 2012
WHAT’S THE GOALMore service seeking!
Less discrimination!
30 to 66% do NOT seek treatment
People with all disorders
All treatments
People don’t go to treatment to avoid STIGMA.
Decrease stigma: increase care seeking
PARITY!
Stigma undermines employment, housing, health goals
Decrease stigma: decrease care seeking –increase opportunities – promote recovery
Does the push for care seeking make discrimination worse?
PENETRATION:
>60% of Australians recognize
IMPACT:
increase mental health literacy
care seeking ???
since 2000
UNINTENDED CONSEQUENCES
• Brain Disease
• Difference
• Broken
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8.5
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9.5
10
10.5
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beyondblue recovery
pre
post
SIMILARITY
TargetedLocalCredibleContinuousContact
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Corrigan, 2011
Landlords
Health care professionals
Teachers
Legislators
Employers
x
CHICAGO:
the heart and
brains of Illinois
ILLINOIS
Does it
play in
PEORIA?
CityOfficeChurch, synagogue, mosque
School
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101
Good stigma change
credible
continuous
Contact with whom?
Example◦Military (PTSD)◦Other enlisted membersMarines from marinesSailors from sailors
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Once is not enough
And cannot be carbon copies
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TargetedLocalCredibleContinuousContact
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The GRAND PLAN
Come out everyone
Come out everywhere
Come out Mad
Come out Proud
Thurgood
Marshall
Effect
LGBT agenda◦ Confusing
◦ Objectionable
◦Honest, Open, Proud
Three Lessons
◦Consider the pros and cons of disclosing
◦ There are different ways to disclose
◦ Telling your story
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