In a 2005 article in Canadian Public Policy, Dr. Heather Stuart from the Department of Community Health and Epidemiology at Queen's University in Kingston, Ontario, provides 10 tips for developing an effective campaign against stigma and discrimination. Her main conclusion is that generic campaigns are ineffective, and that programs must focus on select groups. Fortunately, this is exactly what the Mental Health Commission of Canada is doing with its Opening Minds campaign.
1. Aim for improvements in the lives of people with mental disorders and their families. Improvements in mental health literacy in the general public are inconsequential if they do not also translate into a greater sense of social responsibility and social justice, community tolerance, and social inclusion for individuals and families who live with mental disorders.
2. Involve people with mental illness and their family members in all aspects of program development, evaluation, and communication so that programs address the most meaningful aspects of stigma and discrimination.
3. Accept that education modifies literacy, and sometimes attitudes, but rarely behaviour - and keep in mind that real change is contingent on behavioural change.
4. Programs that are modest in scope - that is, targeted to a specific audience; capable of delivering complex and emotionally charged interventions; and sustainable - enjoy a greater chance of success. Campaigns that are generic, that is, impersonal, literacy-based, targeted at the general public, short lived and expensive, are largely ineffective and discouraging for all involved. They may also impart the false message that psychiatric stigma and discrimination cannot be beaten.
5. Recognize that there is no such thing as the general population when it comes to stigma reduction. One size does not fit all. Target programs to the needs of explicitly defined subgroups and deliver them in carefully focused ways.
6. Think big, but start small. Target the things that can be controlled (such as local policies and practices) and leave alone the things that can't (such as negative views).
7. Accumulate small successes. Not only do these provide momentum for program activities, they create a sense of possibility and prevent burnout. Accumulated successes also create a platform for sustainability and reinforce the message that stigma and discrimination can be beaten.
8. Use the media as allies in the process rather than as objects of intervention or the sole means of transmitting messages.
9. Build on the work of others in Canada, other countries, and internationally; cooperate, communicate, and coordinate.
10. Contribute to Canada's store of best-practice knowledge; first through careful program development, then by rigorous self-evaluation, and finally through scholarly communication.
Stuart also led the development of the Schizophrenia: Open the Doors Training Manual for the World Psychiatric Association's Global Program to Fight Stigma and Discrimination Because of Schizophrenia. The manual summarizes the steps to follow to set up and evaluate anti-stigma interventions, illustrated with experiences from countries participating in this program.
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