Transcript Honest, Open and Proud Outline

What’s My Story?
Honest, Open and Proud
Sue McKenzie
WISE Member and Co-Director, Rogers InHealth
Statewide collaboration of
organizations and individuals.
Promote evidence based practices, current research and
outcomes evaluation.
Majority speak from experience of stigma and recovery.
Offer insights, resources, and support for stigma
reduction
GOALS TODAY



Look at the story you have been telling
yourself and others in the context of
challenging stigma
Explore levels and settings of disclosure
Apply decision-making process to you as
one with lived experience, a support person
and/or professional
3
Stigma
Definition:
Stigma
Definition and Types
Stereotype (ideas) > Prejudice (beliefs) >
Discrimination (actions)
In a relationship of power - Oppression
Types:

Internalized Shame

Public

Structural
Language barriers
4
Co-Occurring Stigma
(public and internalized)

Heterosexism

Racism

Sexism

Ableism

Etc.
2011 YRBS data showed LGBT youth in WI had:
- 5X the rate of suicide attempts
- 3X more likely to skip school due to feeling unsafe
- 50% felt like they did not belong at school
Self Stigma
Public Stigma
 self esteem
I am not good
 sense of efficacy
I am not able
So, why try?
Avoidance and apathy
Why Should You Care?
Impact of Stigma on Social Inclusion

Lost employment

Subpar housing

Worse health care

Diminished education opportunities

Alienated from faith community

Coercive treatment
Our Relation To Stigma
 Stigmatizers
 Stigmatized
 De-stigmatizers
Personal Reflection

When am I most likely to notice fear,
condemnation, frustration, anger, etc.
rising within me related to another’s
mental health challenges?
1990-2005 “The Brain Years”
 Impact
of Education?
◦ Know more- “I understand it is an illness”
◦ Blame less- “Its not your fault”
◦ Avoid more- “I don’t want to be around you.”
◦ Less belief in recovery- “You will always be
like this.”

Contact with
people sharing
life in recovery
“I’d like you to meet
Simone, Mike, Linda,
Nneka, Paul, Charles,
Val, Sumi, Denise,
Tim, Mark and Dori”
11
The effects of contact with someone living in recovery with mental
illness versus education about mental illness were greater when
measuring attitudes of avoidance.
pre
3
post
2
1
0
-1
-2
-3
-4
control
group
education:
dangerousness
education:
responsibility
contact:
dangerousness
contact:
responsibility
The effects of contact on attitudes of avoidance were sustained at
the one month follow-up.
pre
3
follow-up
2
1
0
-1
-2
-3
-4
control
group
education:
dangerousness
education:
responsibility
contact:
dangerousness
contact:
responsibility
There is a curtain of
ignorance about resilience
and recovery
Recovery Stories are the Gold of
the Movement
Reversing Self and Public Stigma
Inclusion and Support
 self esteem
I am good
 sense of efficacy
I am able
Public Stigma
I care for myself & others
Motivated engagement
Speak up everyone
Speak up everywhere
Honest, Open & Proud
“strategic disclosure”
Ethics of Strategic Disclosure

Do I encourage one to disclose
◦ WISE and our state collaborators focus on tools to
support careful decision making and disclosure

Do I disclose?
◦ Honest, Open and Proud workbook resource
◦ Professional organizations codes of ethics
◦ Seek supervisory and peer input
Psychiatric Times

(Guthell May, 2010)
Three principles guide ethical aspects of selfdisclosure:
◦ To act for the other’s benefit;
◦ To do no harm; and
◦ In the fiduciary relationship between clinician and patientthe interests and welfare of the patient always predominate.

Intentional self-disclosures may be therapeutic,
supportive and alliance-building; or they may be
seductive, exhibitionistic, care-seeking, and the
like.
Honest, Open and Proud Outline
Lesson 1. The Story You Have Been Telling
Yourself


Assessing self-talk: hurtful and helpful
attitudes and language
Challenging hurtful self-talk with a
strengths-based approach




What are the words I use to describe
situations when I face mental health
challenges (past and present)?
Helpful, hurtful, neutral?
Countering hurtful self-talk with affirming
attitudes of recovery and self-determination
Privacy vs self-stigma
Honest, Open and Proud Outline
Lesson 2. There are Different Ways to Disclose

Pros and Cons of Disclosure

Different levels of Disclosure

To whom might you disclose

How might others respond to your disclosure

Three groups:
◦ Reasons people disclose their mental illness
◦ Costs and benefits of disclosing one’s mental
illness
◦ Costs and benefits of not disclosing

Short and long term benefits

Settings

Your priorities

Your goals in disclosing
Levels of Disclosure

Social Avoidance – avoid situations

Secrecy – work to keep it a secret

Selective Disclosure – share it with select people

Open Disclosure – no longer hide it

Broadcast Your Experience – actively share it to
advocate


Functional- doctor, clergy, supervisor,
teacher, team member, car pool member, etc.
Supportive- characteristics of concern for
others, open-minded, loyalty, kindness, etc.

Empathic Peers

Stigmatizers- to motivate change

Others?


Create general conversation to assess
attitude
How can we do this?


Brainstorm possible responses from others
when one discloses
Role play these responses and what you
would say in return
Honest, Open and Proud Outline
Lesson 3. Telling Your Story

Crafting your story (handout)

SOLIDARITY and peer support
Parent and Peer Support
Organizations

NAMI (parent and peer)

Wisconsin Family Ties (parent)

The Clubhouses (peers- Grand Avenue Club,

Grassroots Empowerment Project (peers)
Yahara, Painting Pathways, Community Corner and
Racine Friendship)
SIX WAYS TO END STIGMA TOGETHER
1. Seek out people with lived experience - listen to their
story.
2. Reinforce & support their resilience & recovery.
3. Wear lime green to create curiosity - be prepared to
speak up.
4. Consider the story you can tell about recovery
5. Share other’s stories – live or in video (Rogersinhealth.org)
6. Bring the conversation to your community – work, civic,
faith, schools
Discussion:
What can I begin to do today?
What can my organization do to support stigma
reduction?