Norman Sartorius

Heather Stuart

Preceded by Paradigms lost: fighting stigma and the lessons learned / Heather Stuart, Julio Arboleda-Flâorez, Norman Sartorius. c2012.

Lessons Learned in the Fight Against the Stigma of Mental Illness

Paradigms Lost, Paradigms Found

Keith Dobson

Prejudice and Discrimination Related to Mental Illnesses /Keith S. Dobson and Heather Stuart --Prejudice and Discrimination Related to Substance Use Problems /Shu-Ping Chen and Heather Stuart --Best and Promising Practices in Stigma Reduction /Heather Stuart --Measuring Structural Stigma /Thomas Ungar and Stephanie Knaak --Assessment of Mental Health Stigma in the Workplace /Keith S. Dobson and Andrew C.H. Szeto --Measuring Opioid-​Related Stigma /Stephanie Knaak and Heather Stuart --Stereotype and Social Distance Scales for Youth /Michelle Koller and Heather Stuart --Opening Minds Stigma Scale for Health Providers /Stephanie Knaak and Scott Patten --Best Practices in Antistigma Programming Targeting Youth /Michelle Koller and Heather Stuart --Stigma Reduction in Postsecondary Settings: Moving From Individual Initiatives to Holistic Mental Health Approaches /Andrew C.H. Szeto and Brittany L. Lindsay --Stigma Reduction in the General Workplace /Dorothy Luong and Bonnie Kirsh --Reducing the Stigma of Mental Illness in First Responders /Beth Millard --Stigma Reduction for Healthcare Workers /Biana Lauria-Horner --Stigma Reduction for Substance Use and Opioids /Stephanie Knaak and Heather Stuart --Media Programs /Rob Whitley --Dissemination and Implementation Science in Stigma Programs /Keith S. Dobson and Heather Stuart --Future Directions of Stigma Reduction: Lessons Learned /Heather Stuart and Keith S. Dobson.

Models and Methods of Stigma Reduction

The Stigma of Mental Illness

Stigma is one of the major barriers to care for people with mental health and related disorders. Stigma includes negative beliefs about and hostile perceptions towards others, shame and self-stigma, discriminatory practices in hiring, promotion and recognition of people who suffer from mental health challenges, and structural and organizational policies and processes that result in inequalities for people who have mental health challenges. Stigma has been recognized as a significant factor in the well-being of people with mental health and related problems and can be more debilitating than the direct effects of mental health problems themselves. The Mental Health Commission of Canada (MHCC) was established to conduct policy reviews and to promote initiatives related to mental health. The Opening Minds program of the MHCC is the largest systematic effort in Canadian history to reduce stigma related to mental illnesses. The program has adopted the systematic development, evaluation and deployment of targeted programs based on theories of change, best practices and available research evidence as a model for stigma reduction. The Stigma of Mental Illness is an important vehicle to communicate conceptual issues in the field of stigma reduction, to document the work done to date within the MHCC Opening Minds program, and to offer practical strategies to broaden the scope and utility of the work for different contexts, cultures, and countries. This volume will be a global interest, given the growing importance of stigma reduction related to mental disorders and related problems.

Julio Arboleda-Florez

Paradigms Lost challenges key paradigms currently held about the prevention or reduction of stigma attached to mental illness using evidence and the experience the authors gathered during the many years of their work in this field. Each chapter examines one currently held paradigm and presents reasons why it should be replaced with a new perspective. The book argues for enlightened opportunism (using every opportunity to fight stigma), rather than more time consuming planning, and emphasizes that the best way to approach anti-stigma work is to select targets jointly with those who are most concerned. The most radical change of paradigms concerns the evaluation of outcome for anti-stigma activities. Previously, changes in stigmatizing attitudes were used as the best indicator of success. Paradigms Lost and its authors argue that it is now necessary to measure changes in behaviors (both from the perspective of those stigmatized and those who stigmatize) to obtain a more valid measure of a program's success. Other myths to be challenged: providing knowledge about mental illness will reduce stigma; community care will de-stigmatize mental illness and psychiatry; people with a mental illness are less discriminated against in developing countries. Paradigms Lost concludes by describing key elements in successful anti stigma work including the recommended duration of anti-stigma programmes, the involvement of those with mental illness in designing programmes, and the definition of programmes in accordance with local circumstances. A summary of weaknesses of currently held paradigms and corresponding lists of best practice principles to guide future anti-stigma action and research bring this insightful volume to an apt conclusion.

Heather Stuart

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