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Summary
Pages 1-14

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From page 1...
... . Today, trained peer specialist service programs are integrated into community mental health services, and helping others is a recognized component of recovery.
From page 2...
... , the 1999 Surgeon General's Report on Mental Health, the ADA Amendments Act of 2008 that expanded protections under the ADA, the Mental Health Parity and Addiction Equity Act of 2008, and protections included in the Affordable Care Act of 2010, as well as other federal-level disability nondiscrimination laws. Over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances.
From page 3...
... The committee also offers a set of conclusions and recommendations about successful stigma change campaigns, how best to encourage people to seek treatment and supportive services for themselves or others, and the research needed to inform and evaluate these efforts in the United States. PUBLIC KNOWLEDGE AND NORMS In 1950, the first major national study of public stigma was launched followed by three congressionally mandated studies in 1955, 1956, and 1976 that documented an extreme lack of public knowledge about the nature and causes of mental illness and a deep unwillingness to discuss mental illness.
From page 4...
... There is greater public awareness of the stigma associated with both mental and substance use disorders yet public stigma persists at a high level. Data show marked differences across behavioral health conditions: schizophrenia and substance use disorders are more highly stigmatized than other mental disorders; few stigma studies focus specifically on substance use disorders.
From page 5...
... Despite ongoing and successful efforts to educate media professionals about behavioral disorders, stereotypes of violently mentally ill people are perpetuated in media and social media reports of incidents of mass violence and in public discourse about mental illness. Social media can be a source of stigma or a means of promoting affirming and inclusive attitudes.
From page 6...
... Communication campaigns can be effective but tend to fail for two reasons: failure to identify well-defined goals and objectives for the campaign and failure to reach the intended audience or audiences in a sustained or adequately frequent manner. Protest and advocacy strategies serve to expand the stakeholder base, garner support, and provide a forum for consensus.
From page 7...
... Relevant stakeholder groups would include the following: • consumers in treatment for mental and substance use disorders and consumer organizations; • families and others whose lives are touched by mental illness or substance use disorders, including suicide-attempt survivors and loss survivors; • relevant private sector leadership, including major employers; • relevant foundations and nongovernmental organizations; • advocates and advocacy groups, including civil rights and dis ability law experts; • insurance companies and pharmaceutical manufacturers; • journalists and others in the news media, including public health media experts; • health and behavioral health care providers and administrators, including protective services and social services providers; • health professional education institutions and professional associations; • academic researchers, including suicide prevention experts and researchers; • law enforcement officials and first responders; and • representatives of federal, state, and local governments. Early tasks would include the following: • Identify a lead organization to serve as convener of stakeholders.
From page 8...
... Given the importance of reducing stigma in these areas, early efforts could focus on development of a communications campaign or to target policy and decision makers to challenge specific laws, policies, and regulations that discriminate against people with mental and substance use disorders. Such a campaign could develop evidence-based public service announcements to hold in readiness for tragic events, such as mass violence, suicide by school and college students, and suicide clusters.
From page 9...
... RECOMMENDATION 3: The Substance Abuse and Mental Health Services Administration should conduct formative and evaluative research as part of a strategically planned effort to reduce stigma. SAMHSA's ongoing program of research on social norms and communications practices could coordinate with national efforts to achieve common goals and objectives.
From page 10...
... An evaluation plan should include and support community-based participatory research that is based on the principle of partnership, in which community partners act as co-learners with academic partners rather than helpers or recipients. This approach involves community stakeholders from the outset to define both the change targets and the intervention strategies, as well as in the conduct of the research itself.
From page 11...
... In adults, the efficacy of contact-based programs is greater than that of education programs alone across a range of specific target audiences, such as health professionals, college students, and police, but evidence shows that onetime contact is not as effective as repeated contact. In contrast, education programs are effective in changing stigmatizing attitudes among adolescents.
From page 12...
... Most research on the outcomes of peer services has focused on quality-of-life measures. Few data are available about the costs and benefits of these programs, although the research suggests that people who use peer support services are more likely to use other behavioral health services of all kinds, including professional services and prescription drugs, which may lead to improved outcomes.
From page 13...
... No single agency can implement an effective national strategy, but SAMHSA brings specific and unique strengths including well-established stakeholder relations, commitment to the recovery model, and a history of promotion and implementation of prevention and early intervention strategies. Early objectives of a national strategy will include consensus building across a range of issues, design of cost-sharing arrangements, development and implementation of a research strategy including a system for monitoring change in public attitudes, and mechanisms for disseminating information to inform future anti-stigma interventions.


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