Advancement of anti-stigma activities in the Pacific Rim Region

 Pacific Rim College of Psychiatrists

 18th International Congress Yangon Myanmar 26-28 October 2018

 Progress on anti-stigma activities in Australia

 Prof Philip Morris

Bond University Gold Coast, Australia

Australian and New Zealand Mental Health Association

Board Officer PRCP

Brothers and sisters in psychiatry – we are a family of mental health professionals

Our patients are part of our family

Do we want our patients to be made fun of and prevented from reaching their potential?

What can we do about this?

Prevent stigma and discrimination

Stigma

An attitude that negatively defines a person based on one characteristic rather than appreciating the whole person

Vilify

An expression either verbal or written arising out of a negative attitude

Discrimination

An action arising out of stigma and vilification

Where should we direct our attention?

Prof Norman Sartorius – focus on discrimination

Can be defined

Can be identified

Can be measured

Can be outlawed

“I don’t care what you think about me, but don’t stop me because of my mental illness!”

Would our efforts be better directed to fight discrimination?

In Australia it is unlawful to vilify on grounds of religion, race, sex, or sexual preference, but not on grounds of disability or mental illness

Self-stigma can infect the way we view our own work with patients – we need to be positive and proud role models for our patients and the community

The Australian scene

Major players in fight against stigma

Lifeline

Sane Australia

beyondblue – depressive disorders

Black Dog Institute – bipolar and depressive disorders

Phoenix Australia Centre for Posttraumatic Mental Health – PTSD

Government – state and federal

Depressive disorders

Public education – improve understanding and mental health literacy (knowledge and beliefs about mental disorders which aid their recognition, management or prevention)

Key messages

Description of the condition

Depression is an illness – not a ‘weakness’

Stress can trigger it

Predisposition can be inherited

Anyone can succumb, no matter how tough

Patient role models – especially sportsmen and women to get to groups that deny problems (men especially)

Treatment is available

Treatment is effective

We are all responsible for helping affected individuals to get help

Posttraumatic stress disorder

Public education

A more recent intervention

A more limited approach

Initially focused on defence force and ex-service and veteran communities

Expanded to ‘first responders’ and emergency services (police, fire, ambulance)

Now to other front line professionals (doctors, nurses, psychologists) and carers

Description of the condition

PTSD is an illness – not bad behaviour

Many types of trauma can trigger it

Some may be predisposed

Anyone can succumb, no matter how tough

Treatment information not as clear as with depression

Less or no emphasis on other mental illnesses including the psychoses

No general application yet of mental health first aid training

What are the results?

Reports on progress against stigma covering the last 20 years

The Sane Australia Guide to Reducing Stigma 2014

Stigma and discrimination in NSW – A summary of the NSW findings from the National Surveys of Mental Health Literacy and Stigma and National Survey of Discrimination and Positive Treatment 2017

Australian Institute of Health and Welfare – Australia’s welfare 2015

Relationships Australia Neighbour Day 2015

Bottom line

Individuals who disclose their illness are getting more support from family, friends, at work and school/college, neighbours, and the community, and are experiencing less social distance (especially for depression)

But still report avoidance and discrimination (especially for schizophrenia)

Discrimination remains a barrier to employment

Mental health professionals rate long-term outcomes worse and discrimination more likely than public do

Mental health literacy has improved (especially for depression) but stigmatizing attitudes persist

Attitudes to depression (and PTSD) are improving – only 20-25% of public would not want to employ a person with these conditions, public more positive about treatment and antidepressants

Results for schizophrenia concerning – depictions of this condition most stigmatizing, social distance greatest, fewer would employ an individual with this illness, less convinced about treatment or antipsychotics

There is a long way to go, but are we on the right road?

Focus on discrimination

Be honest – some patients can be dangerous – public despises deceit

Wider application of mental health first aid training needed

Thank You