1/31/2014 Opening Minds Changing How We See Mental Illness A presentation to: Global Alliance Against Stigma London, UK September 2013 Opening Mind Projects 109 partners 49 active projects 29 completed projects Healthcare Providers (Some are national in scope) /2 1
Healthcare Program Update / 3 We are evaluating programs, with the goal of replicating effective ones across Canada 9 evaluation reports complete 12 evaluation reports near completion Several longer term research projects underway Programs are in universities training doctors, psychiatric nurses, occupational therapists and pharmacists Anti-stigma programs in hospitals and healthcare settings, for healthcare workers focus on contact-based education Skills training for doctors and other healthcare workers, with shorter contact-based sections Online program for family doctors Program Impact & Knowledge Transfer: Successful Healthcare Program Central LHIN Vancouver Island Health Authority BC New DVD Alberta Health Seminar AB NS PEI CPA CMA IWK Central East LHIN BC Interior Health Kamloops Williams Lake Kelowna Central LHIN Phase II Yellowknife School Pilot Project Castlegar Cranbrook / 4 Salmon Arm Penticton 2
What made a difference? / 5 Evaluation Results from first successful program Surveys were conducted before and after the program. AFTER THE PROGRAM 34% increase in participants who believed their workplace was not free of stigma 20% increase in participants who agreed healthcare providers should be advocates for people with mental illness 35% increase in participants who agreed it is the healthcare providers responsibility to encourage recovery in people with a mental illness / 6 3
Don t know why / 7 Conclusions from program evaluation: Mental Illness and Addictions: Understanding the Impact of Stigma Great starting place for organizations to reduce stigma One of our principles is not to recreate the wheel A few positive changes were not maintained at three months follow-up Need for further training programs such as booster sessions or organizational changes to reduce stigma Phase II evaluation nearing completion preliminary positive results / 8 4
BC Interior: Proportion of correct (non-stigmatizing responses) / 9 Comparing Healthcare Programs Opening Minds now has enough data collected from over 17 programs to draw comparisons Created chart called a Forest Plot to compare programs 15 programs show statistically significant improvements Only 2 programs did not show positive results Individual programs achieve different levels of success in reducing stigma Programs with best results aren t necessarily similar in length, content and delivery / 10 5
Next Step: Logic Model of Key Ingredients Researchers added qualitative component to examine healthcare programs in greater depth to develop logic model for effective programs Programs differ in terms of: program goals; length; intensity / type of social contact provided; program components; target audience; mode of delivery; and other factors Some programs show more positive evaluations and some show more sustained changes over time Hints on potential key ingredients / 11 Potential Key Ingredient #1 1. When individuals with lived experience provide contactbased education by telling their story, they must demonstrate both recovery and competence Quote: It s important for healthcare providers to see that recovery is really possible. I think it works even better when they can see recovery in action. Getting up there and telling your story in a positive way evokes admiration and shows competence. It allows the [healthcare provider] audience to see that recovery is real. This changes [healthcare providers ] perceptions of people with mental illness because the stereotype is that people with mental illness aren t supposed to be competent or capable or funny or likeable. [person with lived experience / program presenter] / 12 6
Potential Key Ingredient #2 2. Teach healthcare providers skills so they know what to do Practice Support Program (PSP) on Mental Health created in British Columbia through BCMA This program will be delivered in Nova Scotia to doctors as part of a randomized control trial, so we establish how it reduces stigma Online Family Doctors CME accredited program Now housed on Memorial U website, allowing evaluation Now accessible by all Canadian doctors and other healthcare providers Cognitive Behavioural Interpersonal Skills training (CBIS) Interim evaluation results of program delivered by VIHA(Vancouver Island Health Authority) show it reduces stigma, and greater positive change occurs over time / 13 Potential Key Ingredient #2 Quote: Many of the questions that come up in discussion period are about what can I do? how can I help? Healthcare staff are looking for answers to these questions the message I like to communicate about what they can do is twofold: watch how you speak --just because someone is in distress doesn t mean they can t hear what is being said about them. Also, small things make a big difference : listening, talking, small gestures of kindness, and talking with respect are all very positive. These things stay with people for a long time. It gives them hope and it gives them validation. [person with lived experience (program presenter) interview] / 14 7
Potential Key Ingredient #3 / 15 3. One-off programs rarely deliver sustained positive change Many interventions show partial regression back towards being more stigmatizing at follow-up (one to three months later) and that is stopped when boosters are delivered Regression also doesn t occur when more intensive programs are delivered, usually over longer timeframe Quote: People need boosters, reminders. This is the feedback we ve gotten from healthcare providers as well. One great workshop might make us all warm and fuzzy but it might not last. Getting periodic reminders is likely to work much better. We all need to be reminded. [program lead interview] Potential Key Ingredient #4 Importance of institutional support: Quote: Make it easy for people to come. This is where getting institutional buy-in is so important. There is a constant struggle for priority so if you don t have leadership on board getting behind what you are trying to do, you won t get the funds you need. And you won t get the participation. The two sessions that were our most successful were ones where we had the executive director on board. They sent out the message to the entire staff and set aside the time and resources for people to come. That s when we got people. These were very good sessions with good uptake. [program lead interview] / 16 8
Healthcare programs looking ahead Skills programs for family doctors: Delivery and analysis in randomized control trial Online tool for family doctors: Now available to all doctors across Canada Evaluation to occur this year Online tool for nurses in negotiation Looking for ways to replicate four effective university programs Pharmacy School, Medical School, Occupational Therapy, Psychiatric Nursing Key Ingredients model and toolkits for effective programs / 17 The Opening Minds Legacy New knowledge Learn the scope of stigma experienced by people with lived experience Ingredients for success Tools that can be broadly disseminated Effective programs and toolkits Measurement instruments Outreach across Canada to promote effective programs Expand effective leadership and practice networks Foster renewed optimism that stigma can be beaten and recognition that we all have a role to play / 18 9
Thank you Contact us: info@mentalhealthcommission.ca Visit: www.mentalhealthcommission.ca Follow us: The views represented herein solely represent the views of the Mental Health Commission of Canada. Production of this document is made possible through a financial contribution from Health Canada. Les opinions exprimées aux présentes sont celles de la Commission de la santé mentale du Canada. La production de ce document a été rendue possible grâce à la contribution financière de Santé Canada. / 19 10