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STIGMA CHANGE ! What and Where is the Evidence?

STIGMA CHANGE ! What and Where is the Evidence?. Patrick Corrigan, Psy.D. Illinois Institute of Technology Chicago Consortium for Stigma Research. The Goals Today. For all stakeholders. Stigma Change is the Goal Many examples What works for whom and where? EVIDENCE. STIGMA CHANGE.

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STIGMA CHANGE ! What and Where is the Evidence?

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  1. STIGMA CHANGE!What and Where is the Evidence? Patrick Corrigan, Psy.D. Illinois Institute of Technology Chicago Consortium for Stigma Research

  2. The Goals Today For all stakeholders • Stigma Change is the Goal • Many examples • What works for whom and where? • EVIDENCE

  3. STIGMA CHANGE • PUBLIC STIGMA • Protest, Education, Contact • SELF-STIGMA • Group identification and support

  4. What’s Out There?Current Programs • World Psychiatric Association • www.worldpsychiatricassociation.org/sections/stigma/index.shtml • Programs by country (N>50) • US SAMHSA's Resource Center • www.stopstigma.samhsa.gov/default.aspx • Programs by state (N>100) • Canada Programs • “…the Commission is launching a major, national 10-year anti-stigma and discrimination reduction campaign. This campaign will be the largest systematic effort to reduce the stigma of mental illness in Canadian history”

  5. RESOURCES

  6. Media Watch Fright Night Scream Park www.nami.org./stigma

  7. Public Service Announcements what a difference a friend makes http://www.whatadifference.samhsa.gov/

  8. Personal Stories

  9. “There's a temptation for the Commission to sprint out of the gate with a mass marketing campaign, but that would be a mistake.” Canadian Mental Health Commission Ahead of the Data!Intervene Now!

  10. The Evidence Where is the evidence? What is evidence? Using evidence to make decisions

  11. Lessons from mental health services research • What works regionally? • Governmental policy/support (SAMHSA) • Supported employment • Assertive community treatment • What works locally? • How does supported employment actually work in Chicago?

  12. Evidence for Stigma Change • What kind of stigma change strategies should Governments/NGOs support? • Education, contact… • Do these strategies work locally? • Chicago, London, Paris • Beijing, Delhi, Riyadh

  13. N=213 StigmatizingAttitudes and Behavioral Intentions Contact: Responsibility Education: Responsibility Control Contact: Dangerousness Education: Dangerousness Attitudes and Intentions @ post and 1 wk f-up

  14. SELECTION CRITERIA • STAKEHOLDER PERSPECTIVE • Participatory Action Research • State of the Evidence • Ratio of Cost to Benefit

  15. Participatory Action Research • PERSPECTIVE: Understanding the broad questions related to stigma change • POLITIC: interest and authority in subsequent stigma change • Who are the stakeholders? diversity

  16. SELECTION CRITERIA • Stakeholder perspective • Participatory action research • STATE OF THE EVIDENCE • Ratio of cost to benefit

  17. Evidence Based Considerations • Dependent measures • ATTITUDES • Physiological change • Information processing • Social behavior • Behavioral intention • BEHAVIOR

  18. Evidence Based Considerations • Dependent measures • Psychometrics (reliability and validity) • Sensitivity • Social desirability

  19. Evidence Based Considerations Reducing discrimination versus affirming actions Not just what does it stop (less prejudice) but what is improved (more work) Specificity Not just whether it “changes” people, put does it change important groups Employers, landlords, health care providers 19

  20. Evidence Based Considerations Effect Size Is the effect noticeable? Does it matter? (social validity) Iatrogenic effects Mental illness is a brain disorder Manuals and Fidelity Need to catalogue interventions Feasibility If you provide it, will they come Fect 20

  21. Example Supported employment: Get more people with mental illness back to work. Get more employers to participate in supported employment. Challenge employer stigma: In Our Own Voice: Telling one’s stories

  22. Example • Dependent measures: • Attitudes • Behavior • Immediate: Participating in supported employment • Hiring people with mental illness • Affirming actions • Specificity • Effect size • Manuals and fidelity

  23. SELECTION CRITERIA • Stakeholder perspective • Participatory action research • State of the evidence • RATIO OF COST TO BENEFIT

  24. Cost-Benefits • The size of the sample • Local or broad • The depth and breadth of effects • Effect size • Specificity • Outcomes (no stigma versus more affirming actions) • The costs of the change strategy • The cost of evaluation

  25. PUTTING IT ALL TOGETHER

  26. Evidence Based Approach • WHO is to be targeted. • WHAT needs to be changed. • HOW will this be changed. • WHEN will change occur. • MEASURE IT

  27. A TOOLKIT For Evaluating Programs Meant to Erase the Stigma of Mental Illness Patrick Corrigan draft Oct 23, 2008

  28. Patrick Corrigan corrigan@iit.edu

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