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1. Ready

What can I do to address stigma?

In recent years, researchers have identified
three effective strategies Rüsch, N., Angermeyer, M. C., & Corrigan, P. W. (2005). Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. European psychiatry, 20(8), 529-539.
to address mental illness stigma:
  1. Education to improve mental health literacy.
  2. Protesting against stigmatizing attitudes, beliefs, images and actions.
  3. Having contact with someone who has personally experienced mental illness.
In the previous lesson, students used storytelling to understand stigma and had the opportunity to virtually “connect” with someone who has personally experienced mental illness. Although it’s different from personal contact,
preliminary evidence Whitley, R., Sitter, K., Adamson, G., & Carmichael, V., (2020). Can participatory video reduce mental illness stigma? Results from a Canadian action-research study of feasibility and impact. BMC Psychiatry, 20(1), 1-12.
suggests that digital storytelling effectively reduces viewer stigma and that, moving forward, digital storytelling should be used in the ongoing effort to reduce mental illness stigma.

This lesson focuses on the educational aspect of stigma reduction by using information to contradict commonly held myths about mental illness.
Education Ontario Centre of Excellence for Child and Youth Mental Health (2012). Evidence In-Sight: Effective stigma reduction strategies in child and youth mental health.
has been identified as an effective strategy for stigma reduction across diverse populations, including police officers, government officials, healthcare providers, and students. In fact,
studies have shown Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., … Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123–1132.
that educational approaches to stigma reduction are the most beneficial for adolescents (as opposed to adults who benefit most from direct contact). Overall, educational interventions, alone or in combination with other interventions, are
consistently associated Griffiths, K., Carron‐Arthur, B., Parsons, A., & Reid, R. (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta‐analysis of randomized controlled trials. World Psychiatry, 13(2), 161–175.
with stigma reduction across a variety of mental disorders.

What are common myths about mental illness?

There is an endless number of stigmatizing beliefs about mental illness, which fuel some of the most common mental health myths.

In their 2016 article, "Myths about Mental Illness", the Canadian Mental Health Association identifies and debunks 10 of the most common mental health myths.
Take a couple minutes to read
CMHA’s explanation Canadian Mental Health Association [CMHA]. (2016, February 27). Myths About Mental Illness. Canadian Mental Health Association.
for why each of these 10 beliefs are, in fact, myths:

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1. Mental illnesses aren’t real illnesses.
Fact: The words we use to describe mental illnesses have changed greatly over time. What hasn’t changed is the fact that mental illnesses are not the regular ups and downs of life. Mental illnesses create distress, don’t go away on their own, and are real health problems with effective treatments. When someone breaks their arm, we wouldn’t expect them to just “get over it.” Nor would we blame them if they needed a cast, sling, or other help in their daily life while they recovered.
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2. Mental illnesses will never affect me.
Fact: All of us will be affected by mental illnesses. Researchers estimate that as many as one in five Canadians will experience a mental health problem or illness in any given year. You may not experience a mental illness yourself, but a family member, friend, or co-worker will likely experience challenges.
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3. Mental illnesses are just an excuse for poor behaviour.
Fact: Some people who experience mental illnesses may indeed act in ways that are unexpected or seem strange to others. We need to remember that the illness, not the person, is behind these behaviours. No one chooses to experience a mental illness. People who experience a change in their behaviour
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4. Bad parenting causes mental illnesses.
Fact: No one factor can cause mental illnesses. Mental illnesses are complicated conditions that arise from a combination of genetics, biology, environment, and life experiences. Family members and loved ones do have a big role in support and recovery.
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5. People with mental illnesses are violent and dangerous.
Fact: Some people try to predict violence, so they know what to avoid. However, the causes of violence are complicated. Researchers agree that mental illnesses are not a good predictor of violence. In fact, if we look at mental illnesses on their own, people who experience mental illness are no more violent than people without a mental illness. Excluding people from communities is linked to violence. And people with mental illnesses are often among those who are excluded. It’s also important to note that people who experience mental illnesses are much more likely to be victims of violence than to be violent.
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6. People don’t recover from mental illnesses.
Fact: People can and do recover from mental illnesses. Today, there are many different kinds of treatments, services, and supports that can help. No one should expect to feel unwell forever. The fact is, people who experience mental illnesses can and do lead productive, engaged lives. They work, volunteer, or contribute their unique skills and abilities to their communities. Even when people experience mental illnesses that last for a long time, they can learn how to manage their symptoms so they can get back to their goals. If someone continues to experience many challenges, it may be a sign that different approaches or supports are needed.
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7. People who experience mental illnesses are weak and can’t handle stress.
Fact: Stress impacts well-being, but this is true for everyone. People who experience mental illnesses may actually be better at managing stress than people who haven’t experienced mental illnesses. Many people who experience mental illnesses learn skills like stress management and problem-solving so they can take care of stress before it affects their well-being. Taking care of yourself and asking for help when you need it are signs of strength, not weakness.
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8. People who experience mental illnesses can’t work.
Fact: Whether you realize it or not, workplaces are filled with people who have experienced mental illnesses. Mental illnesses don’t mean that someone is no longer capable of working. Some people benefit from changes at work to support their goals, but many people work with little support from their employer. Most people who experience serious mental illnesses want to work but face systemic barriers to finding and keeping meaningful employment.
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9. Kids can’t have a mental illness like depression. Those are adult problems.
Fact: Even children can experience mental illnesses. In fact, many mental illnesses first appear when a person is young. Mental illnesses may look different in children than in adults, but they are a real concern. Mental illnesses can impact the way young people learn and build skills, which can lead to challenges in the future. Unfortunately, many children don’t receive the help they need.
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10. Everyone gets depressed as they grow older. It’s just part of the aging process.
Fact: Depression is never an inevitable part of aging. Older adults may have a greater risk of depression because they experience so many changes in roles and social networks. If an older adult experiences depression, they need the same support as anyone else.

Why is it important to address stigma?

Regardless of age, race, gender, profession, status, or country, stigma is
consistently cited Gary, F. (2005). Stigma: Barrier to Mental Health Care Among Ethnic Minorities. Issues in Mental Health Nursing, 26(10), 979–999.

Sharp, M., Fear, N., Rona, R., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L. (2015). Stigma as a Barrier to Seeking Health Care Among Military Personnel with Mental Health Problems. Epidemiologic Reviews, 37(1), 144–162.

Eisenberg, D., Downs, M., Golberstein, E., & Zivin, K. (2009). Stigma and Help Seeking for Mental Health Among College Students. Medical Care Research and Review, 66(5), 522–541.
as a major barrier to mental health care. For adolescents,
accurate mental health knowledge Chandra, A., & Minkovitz, C. (2007). Factors that Influence Mental Health Stigma Among 8th Grade Adolescents. Journal of Youth and Adolescence, 36(6), 763–774.
is crucial to developing a more positive mental health attitude and enhancing their willingness to seek care. Moreover, it is known that educational interventions are best implemented as
school-based services Sanchez, A., Cornacchio, D., Poznanski, B., Golik, A., Chou, T., & Comer, J. (2018). The Effectiveness of School-Based Mental Health Services for Elementary-Aged Children: A Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 57(3), 153–165.
because school-based services are more accessible, and perceived as more acceptable by families, than community services.

Where can I learn more?

Centre for Addiction and Mental Health – Addressing Stigma

TED Talk – Imagine There Was No Stigma to Mental Illness

National Alliance on Mental Illness – 9 Ways to Fight Mental Health Stigma

Stigma-free Society – Canadian Charity dedicated to combatting stigma of all kinds

Psychology Today – Overcoming the Stigma of Mental Illness: Embracing our fears and increasing our empathy

neaToday – Are Schools Ready to Tackle the Mental Health Crisis?

What will students learn?

By the end of this lesson, students will be able to…

  • Recognize the most common myths about mental illness
  • Identify personal attitudes and beliefs about mental illness that are inaccurate and/or stigmatizing
  • Use evidence to debunk the most common myths about mental illness
  • Remain open-minded, accepting, respectful and inclusive towards someone with a mental illness
References
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Canadian Mental Health Association [CMHA]. (2016, February 27). Myths About Mental Illness. Canadian Mental Health Association.

Chandra, A., & Minkovitz, C. (2007). Factors that Influence Mental Health Stigma Among 8th Grade Adolescents. Journal of Youth and Adolescence, 36(6), 763–774.

Eisenberg, D., Downs, M., Golberstein, E., & Zivin, K. (2009). Stigma and Help Seeking for Mental Health Among College Students. Medical Care Research and Review, 66(5), 522–541.

Gary, F. (2005). Stigma: Barrier to Mental Health Care Among Ethnic Minorities. Issues in Mental Health Nursing, 26(10), 979–999.

Griffiths, K., Carron‐Arthur, B., Parsons, A., & Reid, R. (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta‐analysis of randomized controlled trials. World Psychiatry, 13(2), 161–175.

Ontario Centre of Excellence for Child and Youth Mental Health (2012). Evidence In-Sight: Effective stigma reduction strategies in child and youth mental health.

Rüsch, N., Angermeyer, M. C., & Corrigan, P. W. (2005). Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. European psychiatry, 20(8), 529-539.

Sanchez, A., Cornacchio, D., Poznanski, B., Golik, A., Chou, T., & Comer, J. (2018). The Effectiveness of School-Based Mental Health Services for Elementary-Aged Children: A Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 57(3), 153–165.

Sharp, M., Fear, N., Rona, R., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L. (2015). Stigma as a Barrier to Seeking Health Care Among Military Personnel with Mental Health Problems. Epidemiologic Reviews, 37(1), 144–162.

Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., … Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123–1132.

Whitley, R., Sitter, K., Adamson, G., & Carmichael, V., (2020). Can participatory video reduce mental illness stigma? Results from a Canadian action-research study of feasibility and impact. BMC Psychiatry, 20(1), 1-12.

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