兰德-Changes-in-Mental-Illness-Stigma-in-California-During-the-Statewide-Stigma-and-Discrimination-Reduction-Initiative_11页_308kb

Summary of Changes in Mental Illness Stigma in California During the Statewide Stigma and Discrimination Reduction Initiative

Core Content

The California Mental Health Services Authority (CalMHSA) launched a statewide Stigma and Discrimination Reduction (SDR) initiative under the Mental Health Services Act (Proposition 63) to reduce mental illness stigma. The initiative used a multifaceted approach, including social marketing campaigns, informational resources, media improvements, and educational trainings. The report evaluates the impact of this initiative one year after its launch, using data from the California Statewide Survey (CASS), a longitudinal survey of California adults.

Main Goals of the Initiative

• Increase social inclusion of individuals with mental illness
• Decrease discrimination
• Encourage treatment-seeking behavior

Key Findings

Positive Changes

• Awareness of stigma increased: 27% of Californians reported personal experience with mental health problems at baseline, rising to 36% at follow-up.
• Social acceptance improved: More Californians are willing to socialize with, live next to, and work with people with mental illness.
• Social support increased: There was a 2 percentage point increase in the proportion of adults who provided emotional support to those with mental health issues.
• Awareness of the campaign: Awareness of the "Each Mind Matters" slogan increased from 12% at baseline to 19% at follow-up, with 25% of adults being aware of it across both years.
• Campaign reach: 45% of Californians were potentially reached by the SDR initiative over the two years, with 38% having actual contact with CalMHSA-specific activities.
• Potential for broader impact: The initiative has the potential to reach nearly every Californian through various media and educational efforts.

Negative Changes

• Concealment increased: 3 percentage points more Californians reported they would conceal a mental health problem from coworkers or classmates, though this change was not statistically significant.
• No change in treatment-seeking or recovery beliefs: Beliefs about recovery and treatment effectiveness did not improve from baseline to follow-up.

Methodology

• The CASS survey included 2,006 adults at baseline (May-June 2013) and 1,285 at follow-up (May-September 2014).
• Surveys were conducted in English or Spanish, with additional oversampling of Asian and African American populations.
• The survey used weighted percentages to ensure representativeness.
• McNemar tests were used to compare changes in attitudes and behaviors between baseline and follow-up.

Campaign Activities

Actual CalMHSA Reach

• Documentary: "A New State of Mind: Ending the Stigma of Mental Illness" was shown on California Public Television (CPT) and viewed by 10% of respondents.
• Slogan awareness: "Each Mind Matters" was known by 19% of respondents at follow-up.
• Website visits: Less than 2% of respondents visited the Each Mind Matters website.
• ReachOut.com: A youth-focused platform with online forums and ads, known by 11% of respondents at follow-up.
• Green ribbon: Introduced as a symbol of support, with 5% of respondents wearing it, 13% seeing others wear it, and 6% having conversations about mental illness due to the ribbon.

Potential CalMHSA Reach

• TV documentaries: 26% of respondents watched a documentary on mental illness in the past year.
• News stories: 70% of respondents had seen or heard a news story about mental illness.
• Other media: 68% had seen a movie or TV show with a character having a mental illness.
• Informational resources: 24% received mental health information through various channels.
• Educational presentations: 13% attended presentations or trainings about mental illness.

Implications and Discussion

• The SDR initiative appears to have had a positive impact on public awareness and social acceptance of mental illness.
• However, concealment increased, which may hinder treatment-seeking and support.
• The reach of the initiative was substantial, but repeated exposure was limited, with only 10% of respondents engaging with SDR activities in both years.
• The initiative's effectiveness may be influenced by campaign specifics, such as media use and educational outreach.
• Comparison with other countries shows similar trends in stigma reduction, though results vary by context and implementation.

Conclusion

The California SDR initiative has contributed to a noticeable decrease in mental illness stigma, with substantial increases in awareness and social acceptance. However, concealment concerns and no improvement in treatment-seeking behavior suggest that more work is needed to fully address stigma and its consequences. Continued monitoring and refinement of antistigma messages are essential to further reduce discrimination and improve mental health outcomes.