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