Elimination of Barriers Initiative (EBI)
June 10, Sacramento, CA

Sylvia Caras, PhD

California launch, by invitation, room set for 75, maybe 30 present including consumers/survivors Paolo del Vecchio, Carmen Lee, Jay Mahler, Sally Zinman, Alice Washington, Sheila La Polla; ED’s of Anne Anrneill-Py, CIMH; CMHA; CA PAI,, NAMI-CA ... No visible disabilities. (Carmen Lee uses hearing aids.)

EBI is a 3 year effort to support and evaluate anti-discrimination in 8 states, to define effective approaches, and to then disseminate nationally, what are barriers to treatment, housing, employment, ... The general thrust towards an evidence-base also underpins this initiative.

States were chose to be geographically and demographically diverse - CA, OH, WI, ....

EBI will develop materials and provide expertise, PSA’s, ... ADS Center www.samhsa.gov/stigma , ...

Strategies: interpersonal contact shown to be most effective ways to reduce discrimination.

Target audiences will be general public, workplace, school administrators (9 - 12). (I’m concerned that targeting schools might be part of the initiative for pre-symptomatic treatment. S.)

3 year project. EBI State Communication Institutes Nov - Dec

Three CA example projects described: Carmen Lee, Stamp Out Stigma - now we can’t keep up with the requests for presentations; Dwayne McQuain, psychiatrist, Didi Hirsch Center, annual Erasing the Stigma Luncheon honoring well-known people like Satcher, Jamison, .... event generating some positive media coverage; Barbara Lurie, Mental Health Media Partnership, entertainment industry resource to create more accurate depictions, Writers’ Guild, www.wga.org has a mental health section listing resources, Larry King had depression-focused show, star/celebrity orientation towards making opinion change, ... ;

Al Guida, Vanguard consultant, public attitudes:

Youth focus groups: "A majority of young people are skeptical that mental health professionals are useful in treating mental illnesses, and harbor suspicions about their value and motives."

People turn first to family friends (51%), then primary care (17%), for help with mental health problems.

Americans want to maintain social distance: more than 68% of Americans are unwilling to have a person with depression marry into their family; 64% are unwilling to have a person with schizophrenia as a close co-worker.

Little evidence that we are making progress in reducing stigma. (Maybe because in our education campaigns, we are not talking about discrimination, prejudice, stereotype And because we insist of segregating mental health from other health. There’s no mention of the economics of the mental health community, the complete unwillingness to integrate the pots of funding. S.)

Buzz in the room among some consumers is that this is about us, without us, this isn’t our message and maybe not how we want to be depicted.

National marketing plan - is goal normalization? options: positive visibility; public awareness, reward-protest, contact. Ohio - kids themselves as presenters, and receiving school credit.


Q: What’s the point of this campaign if we don’t have resources? A: pent-up demand will push funders.

Q: from NAMI and one other in the room (Stephanie) - middle school is too late, we must reach kids in elementary school.

A: There is already a federal children’s program; this initiative won’t duplicate those materials.

In order to have contact, people must disclose. What makes it comfortable to disclose? Is this a risk worth taking? Alice: not just a disclosee, a whole person approach. Paolo: should the feds

Mayberg: we must expand those involved. Suggest who else?

(My own thoughts are that the focus of this campaign is oppositional -- eliminate, barrier, struggle, combat. I’m not hearing words about inclusion, management, recovery, ... The focus seems immediate, about accessing treatment, and not about jobs, homes, social network, recovery. There is some use of the word discrimination but the focus is more on the individual than on the community prejudices. I think it’s no wonder there hasn’t been progress if we insist on talking about stigma and don’t go beyond that. S.)

Workgroup results about what to say and to whom to say it:

People with mental illness can and do recovery (regardless of your beliefs about etiology). Messages should be positive. ...

Repetition is the universal in all campaigns that try to influence the public. Repetition of the same message and the same images carrying that message. Repetition.

(In all states, regardless of the message or method of this media campaign, there will be coverage and attention. That would be a time for groups to also be sending out press releases and messages, either in agreement or disagreement, riding on the wave of what the feds/state have done. S.)

Mayberg: Some of the ideas I heard: Unique experience of difference. Stigma educational campaign. Workforce discrimination campaign. Speaker’s bureaus. Culturally specific outreach. Engage the faith community. Primary care providers.

There are no federal dollars that are coming with this project; there will be product - PSA’s and other materials.

Services are everyone’s responsibility, behavior is no one’s fault. Prevention, early intervention and community services aren’t reimbursed unless a diagnosis is given. Wrong incentives. System fosters dependence, fosters illness. Continuum of mental health and mental illness. networkofcare.org 40% of health information comes from the internet Give people the opportunity to manage their own care..