Lifespan De-Stigmatization 1 5/28/2013 Primary Research Conducted - - PDF document

5/28/2013 1

Lifespan Stigma and Discrimination Reduction Research Results

Scott Rose, Principal Norma Rivera, Social Marketing Director

Runyon Saltzman & Einhorn

Larry Bye, Senior Fellow, Public Health Research

NORC

Lifespan – De-Stigmatization

5/28/2013 2

Primary Research Conducted

• 11-13 Year Olds (Inoculation):

– More than 600 middle school students responded to a 28- question survey (English and Spanish)

• 14-24 Year Olds (Mobilization):

– ReachOut.com surveys fielded to ReachOut users

• 25+ (Decision Makers):

– More than 1,000 decision-makers age 25 or older responded to a baseline survey (English and Spanish)

Survey of Children Aged 11-13

• Objective:

– Assess baseline level of knowledge about mental illness and stigma/discrimination

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Survey Methods

• n=633 11-13 year-olds
• One quarter African American, Hispanic, Asian/Pacific Islander, and

Non-Hispanic Whites/Others

• Data were collected in shopping malls with parental consent
• Locations and completed interviews roughly mirror California

population distribution (sites included: Greater LA, Bakersfield, Central Coast,

Fresno/Merced, Sacramento, Stockton, Modesto, etc.)

• Data were collected in English and Spanish during February and

March 2012

• Part of survey was self-administered and part interviewer-

administered

Common Points of Information

• Determined 28 common points of information

to develop the survey

• Consulted with:

– NAMI California – SAMHSA – Dr. Susan Keys – Dr. Sergio Aguilar-Gaxiola

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Main Findings

• Rather low knowledge level; lots of room for

improvement

• Of 28 knowledge items, average number # of

correct responses was 48%

• 12 year olds and Non-Hispanic Whites were

more likely to give correct answers

What Is Mental Illness? What is its Cause?

• 86% agree that mental illness is a condition

that changes a person’s thinking, feelings and moods

• 83% reject notion that it is caused by laziness

and selfishness

• Only 45% know that causes are not fully

understood

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The Behavior of People Experiencing a Mental Illness

• 53% agree that people are more likely to hurt
• thers
• 76% believe people are more likely to act in

ways you don’t expect

• Only 43% reject notion that people are not

likely to have children

Treatment

• Only 50% agree that people often get better after

going to the doctor

• About 60% reject the notion that people often get

better but only for a few weeks or months

• 63% reject notion that women are more likely than

men to get better

• 52% agree that people are required to take medicine

and get counseling for the rest of their lives

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Post Treatment Success

• About 60% reject notion that once treated,

people often get into trouble with the law

• About 60 % agree that once treated, people

lead active, productive lives

• Only 40% reject the idea that once treated,

people are required to live and work only in certain places

Stigma and Discrimination

• 61% agree that mental illness is common in U.S
• 67% disagree that people can be jailed
• 80% agree that people should be able to have jobs, housing, and

education just like everyone else

• Only 46% disagree that it is currently legal to deny housing to

people

• Only 44% disagree that mental illness is more common in some

racial groups

• 54% agree that people have to pass a mental health test before

that can work at some jobs

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Survey of Teen/Young Adult Population (14-24 Year Olds)

• Self-administered survey of CA

ReachOut.com users aged 13 and

• lder
• Conducted by Inspire USA

Foundation, March 2012

• 2013 user survey is ongoing and will

be accompanied by NORC survey of household population

Objectives

• Assess:

– Demographics of visitors – Frequency/patterns of use – Personal wellbeing, psychological distress – Help-seeking knowledge, preferences and behavior – Mental health literacy and stigma/discrimination KAB – Impressions of ReachOut.com

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Survey Methods

• Self-administered survey of CA ReachOut.com users
• 50% were first time visitors; most of others had first

visit in last few months

• Most common reason for visiting: seeking help but

also “checking out what’s new,” hearing stories, and looking for information

• Significant number of frequent visitors and people

who spend a lot of time on the site

Findings

• Vast majority self- assessed knowledge of mental

illness as very good (32%) or good (43%)

• 83% agreed that anyone can experience a mental

illness

• 51% would not want others to know if they

experienced a mental illness

• 76% believe people can recover and lead successful

lives

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Willingness to Interact with People Experiencing a Mental Illness

• Make small talk with the person at a party: 5.42
• Spend an evening hanging out with the person: 5.41
• Make friends with that person: 5.57
• Have person work closely with you on a school or work

assignment: 5.07

• 1= totally unwilling; 7=totally willing

Survey of California Adult Influencers Aged 25+

• Assessed knowledge, attitudes and behaviors related

to issues of stigma and discrimination

• Conducted in the winter of 2012 as part of the Stigma

Discrimination Reduction Social Marketing Program

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Survey Objectives

Goal

• Assess knowledge, beliefs and behaviors prior to launch of SDR

campaign

Objectives

• Assess:

– Stereotypes toward people experiencing mental illness – Basic attitudes: comfort talking to people, likelihood of feeling shame and rejection, existence of discrimination

Survey Objectives continued

• Assess:

– Interest in learning more and being supportive – SDR actions in last 12 months – Willingness to engage on SDR issue – Willingness to accept in specific roles – Change in personal acceptance – Change in social norms

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Survey Methods

• The survey was fielded by Knowledge Networks
• Panel members from California 25 years or older were invited to
• participate. Everyone had to speak English or Spanish.
• Panelists were screened to ensure that they were part of one or more of

the following groups:

• A total of 1,067 surveys were completed
• Landlords
• People who work with patients

in a health care setting

• People who work in any part of

the criminal justice system

• Teachers
• Managers who make hiring or firing

decisions

• Caregivers to the elderly
• Friends and family of persons

experiencing mental health challenges

Stereotypes About People Experiencing a Mental Health Challenge

• Two thirds believe people diagnosed with a mental illness

can contribute to society, a positive finding

• Majority are ambivalent about “once ill, always ill” idea –

don’t know what to believe; population as a whole leans toward disagreement (mean = 3.4)

• Majority are ambivalent about the dangerous stereotype
• Large numbers believe people with mental illness should

“just stop feeling sorry for themselves;” population as a whole leans toward disagreement (mean = 3.0)

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Stereotypes About People Experiencing a Mental Health Challenge Stereotypes About People Experiencing a Mental Health Challenge

• Almost 8 in 10 disagree that “people with a mental illness
• nly have themselves to blame,” which is a positive finding
• Another positive finding: Majority believe “anyone can

experience mental illness,” although more than one third are ambivalent

• Large number are ambivalent about ability “to get

themselves under control” and whether “except for their illness, people with a mental illness are just like everyone else.”

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Stereotypes About People Experiencing a Mental Health Challenge

Bottom Line About Stereotypes

• They are prevalent

– On 5 of the 8 measures, majority either hold negative or ambivalent views

• Ambivalence more prevalent than hardened

negative views

– The average across the 8 measures: 9% negative, 49% positive, 42% ambivalent

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Attitudes Toward Mental Health Challenges

• Only a bare majority accept that

discrimination exists

• Most are comfortable talking to someone

experiencing mental illness

• Large majority are not sure about shame and

rejection

Attitudes Toward Mental Health Challenges

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Willingness to Accept in Specific Roles

• Almost two-thirds were unwilling to accept people

experiencing schizophrenia in any role

• „

Most were willing to accept people experiencing mental illness in some roles

• „

Respondents were evenly split between accepting people ill with substance abuse – almost half were willing to accept them in some roles and almost half were unwilling to accept them in any role

Willingness to Accept in Specific Roles

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Change in Personal Acceptance and Social Norms

• Considerable ambivalence about whether change is

taking place; far more agree it is, however.

Behaviors: In the Last 12 Months, Have You Done Any of the Following?

• Many report positive behaviors in the last 12

months on an aided basis

• 49% reported taking one or more of these

actions

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Behaviors: In the Last 12 Months, Have You Done Any of the Following? Willingness to Engage on Issue in the Future

• The findings are generally positive with respect

to willingness to engage on the issue

• Ambivalence is more the problem than

unwillingness

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Willingness to Engage on Issue in the Future

Segmentation Analysis Looking Across All Study Measures

Main Finding: There are subtle differences in beliefs and behaviors across all the influencer audience segments

– Segments more likely to report positive beliefs and behaviors: those in close contact, Whites, African Americans – Close contact group is not a surprise given research pointing to the efficacy of contact as an attitude change strategy – Asian/Pacific Islanders are more likely to report negative beliefs and behaviors – There was no clear pattern with regard to the other race/ethnic, gender, age and educationally defined segments

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Segmentation Analysis Looking at Those with Ambivalent Attitudes

• Given large ratio of ambivalent to negative

influencers, campaign strategists made decision to target the ambivalent

• Main Finding from Analysis: Ambivalence is fairly

evenly dispersed across audience segments

• Only Real Differences: Asian/Pacific Islanders are

somewhat more likely to be ambivalent; Spanish speakers are least likely

Campaign Inputs

• Primary & Secondary

Research

• Counties
• CalMHSA
• Strategic Council
• SDR Consortium
• Consumers
• Subcontractors
• PEI Partners
• California

Reducing Disparities Project

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Applied Learnings

• Parents & Caregivers (0-8 year olds):

– Developed Latino Family Forums – Media relations related to the Latino Family Forums – Developed a partnership with Univision – Working to develop a culturally and literacy-appropriate consumer- facing SDR resource that contains highly relevant and accessible information for parents of Latino children ages 0-8, such as personal stories, tips, challenges and advice. Example wellness resources include:

• Fotonovela
• Book or series of booklets/pamphlets
• Newspaper inserts (La Opinión, Vida en el Valle and community newspapers)
• Interactive website

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Applied Learnings

• Inoculation (9-13 year olds):

– Expanded target audience age from 11-13 year olds to 9-13 year olds – Included Spanish-language website and advertising – Developed educational interactive website instead of game – Integrated school-based performances – Engaged child development experts to review and vet all materials – Working to engage rural schools to review concepts and TETRIS trained schools to receive the school-based performances

Applied Learnings

• Mobilization (14-24 year olds):

– Developed Spanish ReachOutHere forums – Refined messaging according to ad performance – Establish rural outreach activities – Developed ReachOutHere toolkits – Customized all materials for counties, partners, colleges and community based organization – Used Transition Age Youth for photo and voice talent

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Applied Learnings

• Decision-Makers (25+):

– Consortium guidance in the development of the documentary – Developed outreach plans for API, LGBTQI, African American, Native American and Latino communities – Speakers Bureau capacity building – Implemented a grant program aimed at reaching rural communities – Development of comprehensive website, EachMindMatters.org