Stigma and Youth - queensu.ca€¦ · At the close of this presentation, you will have a better...
Transcript of Stigma and Youth - queensu.ca€¦ · At the close of this presentation, you will have a better...
Stigma and its Consequences for Youth
HeatherStuart,ProfessorandBellCanadaMentalHealth&ResearchChair,Queen’sUniversity,Canada;SeniorConsultant,OpeningMinds,MentalHealthCommissionofCanada
Stigma is a growing policy issue world-wide
Stigma a key barrier to mental health and mental health reform. The fight against stigma and its consequences is the most important challenge of our time.
World Health Organization, World Health Report 2001; World Psychiatric Association, Open the Doors, Sartorius, 2002; World Association of Social Psychiatry, Kobe Declaration, 2004; Kirby Commission, Canada, 2005.
LearningObjectives
Atthecloseofthispresentation,youwillhaveabetterunderstandingof:• thestigmaprocessasitpertainstopeoplewithamental
illness• Theimplicationsofstigmatizationfortheself,family
members,andbroadersystems• Theimportanceoftargetinganti-stigmaeffortstoyouth
ATourofTerms
Prejudice• Anegativeattitudethatisresistanttochange• Reflectsnegativestereotypiccharacterizations
Discrimination• Unfairandunjusttreatment
Stigmatization• Notamarkoranattitude,butacomplexsocialprocess
involvingprejudiceanddiscrimination• Onlypowerfulgroupscanstigmatize• Embeddedinasocialjusticeframework
Literacy• Knowledgeaboutsymptomsofmentalillnesses,their
treatments,andavailableservices• Maybeadverselyaffectedbystigma
Escher: Tower of Babel
TheNatureofStigma
• StructurallyImposed– Socialandorganizationalstructures– Overtandcovert
• Sociallyimposed– Individualandgroupinteractions
• Self-imposed– Internalizedstereotypes
GeneralConsequencesofStigma
HumanRightsViolations• Socialmarginalization&exclusion• Inequitableaccesstohealthandsocialservices• Unemployment&under-employment• Poverty&disadvantage• Lackofstableorsafehousing• Prematuremortality(allcause)
Stigmareverberateswidely….
• Amongpeoplewithamentalillness• Familymembersandfriends• Mentalhealthprofessionals• Mentalhealthdeliverysystems• Mentalhealthresearchcommunity• Businessesandworkplaces• Educationalsystems
WhyFocusonYouth?
• Youthathighriskformentalhealthproblems/illness• Mostinternationalanti-stigmaprogramstargetyouth• OpeningMindsAnti-stigmaInitiative– youthamongthefirst
targetgroupsaddressed• Canadianyouth,atparticularlyhighriskofmentalhealthproblems
12-monthStigmaImpactbyAgeGroup(weighted%ofthosetreatedforamentalhealthconditioninthepastyearwhoreportedsomestigmaimpact)
Canadian Youth Service Users Report Greater Stigma Impact
Source: Statistics Canada, Rapid Response Survey, 2011, Funded by Opening Minds, Mental Health Commission of Canada
Studentshaveleverage
Stereotypes begin early…
Mediasocializationbeginsearly
• Televisionasteacher– TVoccupiesmoretimethananyotheractivity– Bythetimechildrengotoschooltheyhavewatchedtheequivalentofthree
schoolyearsofTV– Bythetimetheyareadults,theyhavewitnessedmanythousandmediamurders
involvingsomeonewhoismentallyill
• Mediaimagesteachchildren– Howtothinkaboutmentalillness&treatments– Whatwordstousetorefertomentalillness– Howtoreacttopeoplewhoarementallyill– Whatwillhappentothemiftheybecomementallyill– Whethertofeelembarrassedashamed,orguiltyiftheyhaveamentalillness
Programsaimedatchildrenunder10
• 50%ofprogramsaimedatchildrenunder10containreferencestomentalillness
• Oneinfivemaincharactersareportrayedasmentallyillorunbalanced
• Mentallyillcharactersareobjectsofamusement,derision,&fear
• Disparagingtermsareusedtolinkmentalillnesstolossofcontrol
• Denigratinglanguageisusedtosegregate&alienate
DisneyCartoons
85%containverbalreferencestomentalillnessorcharactersthatactin‘crazy’ ways
• Dumbo’smadelephantmotherwaskilled
• Belle’sfatherinBeautyandtheBeastwascrazyandneededtobelockedup
• HyenasintheLionKingweredepictedascrazyandthecraziestbititsownleg
HighSchoolStereotypes
Source:YouthPilotProjects,OpeningMinds,MentalHealthCommissionofCanada,2013
Stigmaentrenchedbyadulthood
StigmaDonna, Canada, 2003
Schoolsareanimportantinterventionpoint
• Themajorityofmentaldisordersbeginduringyoungadulthoodsoyouthareahighriskgroupforstigma
• Studentsareinterestedinmentalhealthandeagertolearn
• Accesstoyouthinschoolsmakestargetedprogramsfeasibleandcost-effective
• Studentsbringasenseofsocialjusticetothetablethatisimportantinfightingstigma
• Schoolscancreatementallyhealthyenvironmentsandmodelnon-stigmatizingbehaviours
Yet…
•Traditional school-based public health programs avoid mental health issues•School bullying and violence is an increasing problem•Mental health education seen as outside of the mandate of “education”•Materials often outdated and inaccurate•Teachers do not feel confident to provide materials (need training)•Links to the mental health community are often weak
Stigmareductionshouldbeanimportanteducationalgoal
• Schoolcurriculamustroutinelyaddressmentalhealthandmentalillness
• Contact-basededucationreducesstereotypesandsociallydistancingintentions
• Weneedtothinkaboutwaysofcreatingmentallyhealthyschoolswherestigmadoesnotimpededisclosureandhelp-seeking
• Wecanempowerstudentstoactivelypursueanti-stigmaprogramming
HeadstrongSummits
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Asummitbringstogetherstudentsfromvariousschools,alongwithschoolstaff(teachersandadministrators),tolearnaboutmentalhealthproblemsandmentalillnessesandstigma,andtochallengethestereotypesandmisconceptionsthatfuelstigma.Studentslearntoleadanti-stigmainterventionsintheirownschoolsandcommunities.
Source:MentalHealthCommissionofCanada,OpeningMindsAnti-stigmaInitiative
• ContactBasedEducation(TalkingAboutMentalIllnessPrograms)inHighSchoolsWork
• ResultsfromOpeningMindsYouthPilotProjectsshowsthatinterventions—thoughheterogeneous—tendtohaveapositive(moderate)effectonattitudesandbehaviouralproxies
Source:KollerandStuart,2016
ForestPlotofEffects
Itistimeto…
• Advocateforanti-stigmaprogramminginschools
• Supportlocaladvocacygroups(suchasTAMI-likeprograms)inprovidingcontactbasededucation
• Helpteachyouthbecriticalofstereotypicalimagesofmentalillness
• Helpyouthlookatthingsthroughamentalhealthlensandaskiftheyarefair
• Empoweryouthtobeanti-stigmaadvocates
• Helpteacherstogaintheskillsandconfidenceneededtoincludementalhealthandillnessintolessonplans
TakeHomeMessages• Threelevelsofstigma– structural,public,self• Stigmahasimportanthealthandsocial
outcomesforpeoplewithamentalillness,thosearoundthem,andmentalhealthsupportsystems
• Itisimportanttotargetanti-stigmaeffortstoyouth
• Schoolsareanexcellentpointofentry• Wecanalladvocateforschoolbasedanti-
stigmaprograms