Breaking the Stigma of Mental Health 2017nebhc-bohn-ppt.pdf...

Stigma.

1. WORKING WITH OTHERS:
RECOGNIZING AND COPING
WITH STIGMA ASSOCIATED
WITH
MENTAL HEALTH AND
ADDICTIONS
Presented by: Soshia Bohn, LADC & Tommy Newcombe, CPSWS

2. •Definition of stigma
•Types
•Exploring internal and
external stigma
•How stigma affects us
•Skills on how to cope
with stigma; developing a
strengths-based
approach to lead a
positive fulfilling life

3. What words come to mind
when you
hear the word ‘stigma’?
The definition of social stigma according to Luoma, is “the
dehumanization of an individual based on their social
identity or participation in a negative or undesirable social
category,” (pg. 47)

4. Stigma = Prejudice
Krishnamurti: “It is no measure of
health to be well adjusted to a
profoundly sick society.”

5. Exploring Two Types
of Stigma:
External & Internal

6. External Stigma

•Where does stigma start? Whom does
it come from?

•What types of external stigma do you
see?

7. External Stigma:
Interpersonal
Relationships
•The most influential negative perceptions come from
interpersonal relationships: 50% of sufferers of drug addiction
and 40-70% sufferers of mental health symptoms

•Relationships in public: voluntarily choosing to associate with
stigmatized person must be deviant as well

•Family members believe the prison system is the only way to
stop drug addiction, not providing treatment; 58% of 51,000
individuals agreed that addiction is a disease

8. External Stigma-Media
Portrayal
•Media portrayal exaggerates the stigma; reality television
and media only select extreme cases and then amplify it-
skewing the societal perception

•Embellishment of the media=inflated portrayal

•Persons who struggle with addiction often are depicted as
criminals, prostitutes, weak, lazy, and morally corrupt

•Media contributes to the lack of understanding,
decreased compassion, resulting in an increase in stigma

9. External Stigma-Healthcare
•Stereotyped as being untrustworthy
•Pill-shopping
•Reckless
•Feeling of being degraded
•Not receiving care deserved
•Criminalized

10. Yankelovich, Skelly, & White (2013). Kaiser Family Foundation.
Stigma of Mental Illness
“There is still a lot of stigma attached to mental illness”
Agree Disagree
77%
23%
1978
82%
13%
2013

11. Stigma of Mental Illness
% saying would personally feel somewhat/very uncomfortable
Living next
door to
someone with
a mental illness
Working with
someone
with a
mental
illness
If a person with
a mental illness
worked in child’s
school
47%
41%
66%
Yankelovich, Skelly, & White (2013). Kaiser Family Foundation.

12. Facts can become
magnified
unreasonably due to
internal stigma.
Internal Stigma
Public stigma as
described above can
induce ‘self-stigma’
(internalization of
stigmatizing attitudes)

13. Internal Stigma

14. When society looks down on me,
I look down on myself and society.

15. How Stigma Affects
Us
Dimensions include:
Biological
Psychological
Social
Sociocultural

16. Biological Dimensions
•Increased Stress
•Sleeping Difficulties
•Weight Gain/Loss
•Insomnia
•Central Nervous Functioning
•Brain Anatomy

Psychological Dimensions
•Increased mental health symptoms
•Decreased treatment compliance
•Reduced coping efforts
•Withdrawal, isolation
•Decreased personal empowerment & self-
efficacy
•Negative Self-Perceptions; thoughts & beliefs
•Guilt & Shame
•Suppressed true identity

Social Dimensions
Sociocultural Dimensions
•Relationships
•Family
•Social Support
•Belonging
•Love
•Community


•Race
•Gender
•Sexual Orientation
•Socioeconomic status
•Ethnicity
•Culture

17. The effects of
Mental Health
STIGMA
Loss of hope & feelings
of worthlessness Loss of self- esteem
Lack of access to
health services
Danger of being
discriminated
Increased Stress,
Anxiety, &
Fearfulness
Problems continue
to spread
Poor Healthcare
Relationships are hindered
Family breakdown leading
to further isolation
Loss of livelihood
Loss of Reputation
People who need
treatment don’t get it

18. Alarming Facts
•70% of people experiencing mental health disorders
who do not receive any healthcare
o General population is one in four in their
lifetime


•Higher mortality rates than those without mental
illness
oExample: Those who suffer from schizophrenia,
on average, die 25 years sooner than non-
mentally ill individuals


•Three out of five individuals with co-occurring
disorders (asthma, cancer, diabetes, heart disease,
etc.) die at an earlier age due to barriers


•47 % of the general public would not be
willing to work closely with people
diagnosed with depression, and 30 %
would be unwilling to socialize with them
•1999, the surgeon general identified
stigma as the most formidable
obstacle confronting efforts to
improve treatment of mental health
problems […] stigma has killed many
people with addiction and our
nation’s limited desire and resources
to treat such people compound the
problem. (p. e5).

19. S
T
I
G
M
A
R
E
C
O
V
E
R
Y

21. Recovery brings things back in
focus.


Son
Gentle
Intelligent
Kind
Has a criminal record

23. •Readiness to provide actual help
•Increasing knowledge
•Improving attitudes
•Uplifting self-confidence
•Increasing insight
•Involvement with others
•Compassion
•Perceptional, individualized, and experiential
Coping & Helping Each Other
“A person with addiction can recovery if given the proper care
and treatment,
but an addicted person is unlikely to recover alone.”

24. “You ever stopped and thought about how amazing
living in the moment is?
I have spent many years in my own isolated hell chained by
condemning shame and guilt to where when you hit that
kind of bottom it’s nearly impossible to see the present
because the past is so overbearing and the future seemed
predictably frightening. God has given me a second life, a
“new design,” so to speak, and I’ll be damned if I take it for
granted anymore. Smile at everything because there’s a
reason for everything in this design. Forgive more and judge
less because in this design there is endless opportunity to
feel and live by unconditional love. In this design, always help
someone without conditions because God is unconditional.
Take the time to be an instrument of positivity. Breathe in
this chance to really enjoy living in the moment because at
this moment, you have a chance to make a difference.”
--Doug P.--

25. “Freedom is living in the moment.
I explore a purpose that is meaningful
without anxiety and addiction. I get to
walk through my shame with dignity.
I get to stop questioning and start
believing. Living in the moment has
helped me feel and touch humility. I
have finally realized life does not
have to be great for me to be
grateful.”
--Bre C.--

26. Zeus gave Pandora a box and told her not to open
it. Curiosity got the best of her. She opened it and
evil flew out-anger, hate, poverty. She slammed the
box shut, trapping the final evil….hopelessness.
Pandora preserved hope for the world
Hope can be a passive wish OR
it can become active in the form of a plan for
one’s life.
Hope is powerful because it keeps people alive
and motivated.

27. Turning negativity to
positivity:
What could Scarecrow
do?
The Wizard of Oz Concept
What was Scarecrow’s
most famous line?
“I don’t have a brain”
What feelings arise with this
statement?
Self-Doubt, Weakness, & Inferiority
Instructs Dorothy how to take him off the pole &
tricks the apple tree to throw apples at Dorothy
so she can eat
Embarking (accepting) upon the yellow brick road
(the call of the adventure) or refusing to conquer
whatever storm is unsettling in life?

28. •Emphasis on what we don’t want instead of what we do
want:
•When we narrow our vision to focus on only the gap between
what we want and what we have, we lose.
•Energy Field
•A strength mindset generates a positive energy field; maintaining a
deficit mindset generates a negative energy field
•Focus on what IS working
•What we do have versus don’t have
•Strengths in our struggles
•Inner Dialogue
•When inner dialogues are plagued by repeated recognition of
weakness = discouragement
•When inner dialogues are positive & we act on our strengths = sense of satisfaction

29. •3 key factors
1) Positive Awareness
2) Resilient Mindset
3) Sense of empowerment to succeed;
opportunities

•Our strengths play a critical role in maintaining and/or increasing our sense of well-being

30. Recognizing & Using your
Strengths:
Questions to ask yourself
•Do you fight change or embrace it?

•Do you acknowledge and accept your weaknesses and imperfections?
•Managing our weaknesses is taking steps to prevent those
weaknesses from interfering with our strengths
When you change the way you look at
things, the things you look at
change.” –Wayne Dyer

31. Acceptance & Commitment Therapy
(ACT)
Purpose:
oTo create a rich meaning life while accepting
that pain goes with it.

oIncreasing psychological flexibility
•Be in the present moment

oEmbracing & living in the moment
•Steve Hayes “There’s as much life in a
moment of pain as a moment of joy”.

We can learn how to climb more
effectively & efficiently; we
can learn to enjoy the climb;
we can learn how to take a
break, have a rest and
appreciate how far we’ve come
with each view
Living well instead of feeling good
Using Strengths Based with ACT
“Nobody trips over mountains. It is the
small pebbles that cause you to stumble.
Pass all the pebbles in your path and you
will find that you have crossed the
mountain.” –Author Unknown

32. 4 basic principles
1)Hold yourself kindly
oSelf-compassion
oWhat are simple ways that I can be kind and supportive to myself in the midst of my pain?

2)Dropping an anchor
oWhen having painful emotions, thoughts, & feelings—an emotional storm.
oHow do I drop an anchor to stop the storm? = Mindfulness, letting thoughts & feelings flow without being
carried away

3)Take a Stand
oI don’t have to give up on life; I can still stand for something, even when I’m going through something
horrendous
oI can give up on life OR I can stand for something that makes it meaningful-values & committed action

4)Find the treasure
oIt has to come last after the other 3 are in place
oDanger: most try to “find the treasure” as a first line response
o“every cloud has a silver lining” “what does not kill me makes me stronger”
oIf said this; makes experience completely invalidating
oNot trying to pretend pain is not there; there is pain AND there are things I can appreciate
Acceptance & Commitment Therapy
(ACT)

33. RESILIENCE
Maintaining Emotional
Equilibrium
Coping with Stress &
Hardship
Facing Adversity with
Strength

Biological Dimension
•Reduced genetic
vulnerability to stress
•Maintain physical fitness
•Consume a healthy diet
•Maintain physical safety
Psychological Dimension
•Positive Outlook
•Gratitude
•Coping & Problem-Solving
Skills
•Mindfulness
•Emotion Regulation
•Meaning & Purpose in Life
Social Dimension
•Social Support
•Meaningful Social Relations
•Ability to Seek Help From Others
•Connection & Sense of
Belonging
Sociocultural Dimension
•Supportive Social Institutions
•Safe & Caring Communities
•Cultural Connections
•Gender & Racial/Ethnic Equality

35. Resources

Association for Contextual Behavioral Science. Retrieved March 3, 2017 from https://contextualscience.org/

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