News

Wearing Lime Green Shoes

Rogers InHealth Wears Lime Green Shoes in Support of Brandon Marshall’s Recent Decision

(Oconomowoc, Wis.) Directors and friends of  Rogers InHealth recently stepped out in lime green shoes to send a message of support to  Brandon Marshall , the Chicago Bears wide receiver who was fined $10,500 for wearing lime green shoes last month.  In light of Monday night’s Bears/Packers game, the move seemed especially timely.

Marshall, is an example of someone who is successfully living in recovery from borderline personality disorder,” Sue McKenzie, co-director of Rogers InHealth, said. “He wore lime green shoes to draw attention to Mental Illness Awareness Week last month. Even knowing he’d be fined was not a deterrent. We feel that took courage, and we celebrate his decision. So, too, Rogers InHealth does its part to reduce the stigma of mental illness through shared video stories of those living in recovery. We want people to know recovery is possible through accessible, coordinated and person-centered care.”

Rogers InHealth supports those living with mental illness through testimonial videos of everyday people living in recovery. The corporation has produced a Video Library featuring the stories of those living with a mental disorder, including schizoaffective disorder, bipolar disorder, depression, addiction, obsessive-compulsive disorder, eating disorders and more.

A key corporation of Rogers Behavioral Health System, Rogers InHealth creates and distributes video stories of recovery  to increase understanding, hope and supportive action by people with mental illness and addiction, their friends and family, professionals and the general public. Through key initiatives to promote effective stigma reduction practices, Rogers InHealth provides collaborative leadership in the quest to eliminate the stereotypes, prejudice and discrimination that make up the stigma of mental health. For more information, check  www.rogersinhealth.org.

The Four C's to Support Recovery


Sue McKenzie, Director, Rogers InHealth

I have had the deep honor of interviewing over 250 amazing people over the last 15 years and sharing their stories on film. My job was to unearth their wisdom so that we might find answers to the questions: “How does one heal? And, What can we do to help?”

The answers I discovered through these stories of recovery are backed up by research in many fields including intrinsic motivation and psychology. They are the four Cs of Curiosity, Control, Competence and Connection.

After experiencing heartbreaking challenges, how do people return full circle to embrace the person they were born to become? How can we foster this? Here’s a summary of what I have learned.

Curiosity
One of the things I found from stories of darkness, suffering, and fear - whether the story was the harm done by others or the experience of illnesses such as anxiety and cancer - was that there was a shift away from the internal fight of “why me?” to eventually arrive at a point where they said to themselves, “this is my present and my response will be to put one foot in front of the other and discover my path to recovery.” This wisdom has been found by many and is included in Dialectical Behavioral Therapy as radical acceptance… accepting what has been as simply your past rather than something that defines you and your future.

How does one move toward this radical acceptance? As people told stories that included childhoods riddled with neglect, abuse and discrimination, I could feel my anger rising, yet I noticed that they talked about their lives with a level of detachment. Somehow they had moved from carrying whatever blame and shame their past elicited to acceptance of it as what it was. Somehow on their path of healing, they cultivated a deep, consistent sense of nonjudgmental curiosity that allowed them to hold their past out and look at it. They moved from judgment to a more constructive curiosity - and in doing so - released the emotional hold of blame.

An example of this can be found in Meggie’s choice to tell her trauma story at the young age of 15, choosing to not let her traumatic experience define her.

As people moved toward this radical acceptance born from nonjudgmental curiosity, they experienced whole new areas of Choice and Control in their lives.

Control
I can hear it now! “But there is so much we cannot control, how much choice do I really have? Anxiety, relationships, behavior patterns - my life is my life, I cannot change it.” Yes, yet the wise people I listened to didn’t remain in that space. They didn’t run from the power to create their life. They discovered and acted within the humble realization of the control they did have. Sometimes moving into the place where you have control requires letting go of old notions of control where you tried to do it all yourself. Denise's story of an eating disorder and OCD offers an excellent example of radical acceptance of what is and vulnerability to control what you can.

So, how did Denise and others get to this realization of their control and the guts to move toward it?

Competence
Being in environments where they could do what they are good at or where people helped them see the steps going up rather than those that were going down made a difference. These small experiences of capability can change us. Cammy shared the turning point in her recovery when she discovered her artistic talent along with her growing sense of competence in facing her mental health challenges.

You can also explore this notion of competence by celebrating the artist in you. I think we are all artists! Where is the artist in you? The artistry of life takes many forms. One of my colleagues once said, “Sue, you are a pathological optimist.” Since I am an optimist, I chose to take that as a compliment! And I choose to use that in my work with Rogers InHealth as we lead a statewide coalition of community organizations-called WISE - to reduce the stigma of mental illness in our state. Optimism is a must and I bring it!

Naming your artistry takes vulnerability. How do you take a step up when your inner voice and others’ may have pointed only to the steps down? It often only takes one person. Any one of us can be that person for others. I asked those with mental illness what allowed them to move from being stuck in their darkness to reaching out for healing and the vast majority said it was a teacher, mentor, family member, nurse or psychiatrist who saw something in them that they couldn't see at the time. So who holds the mirror at such an angle in your life that you can see your competence?

Connection
I love the notion of having a tribe of friends who know you and have been with you in times of doubt, when you have let go of inhibition… times of despair, bad hair and weird clothes, deep discussion and comfortable silence. That is what each of the 250 people I have filmed pointed to as a crucial aspect of their healing, their heroic work in the world, and their wise perspective on life. It was the friends and family members who embodied acceptance and presence.

One young adult, Mike, so touchingly talks about his relationship with his father that was forever changed by his early experience with schizoaffective disorder - for the good! What Mike described was the reality that when we face the darkness – whether it is from emotional, spiritual or physical pain - it is best to take a flashlight with you. Who is your flashlight? Who has stood with you as you have uncovered the person you were born to become? Who are the members of your tribe?

What Can You Do?
Some of you may be thinking not of yourself but of someone you love and are asking, “What can I do? While I know that I cannot fix or control this person, I also cannot walk away!”

We can listen in a way that I call “listening through to resiliency.” By listening, we:

  • offer radical acceptance through non-judgmental curiosity (curiosity)
  • discover a way to connect others to the power within – what they can control (control)
  • create a space for someone to hear his/her own strength (competence)
  • stand in the darkness with them. Because, no one gets the honor of walking with someone into the light if they have not first stood with them in the dark. The experience of sharing that path with another human will form a connection that lasts forever (connection)

I am forever grateful to those who have chosen to share their stories of recovery. My connection to your wisdom will last forever. Rogers InHealth and all who visit our website will be forever changed.

Press Release for Launch

ROGERS INHEALTH SHARES STORIES OF MENTAL HEALTH RECOVERY, HOPE

(Oconomowoc, Wis.) Rogers InHealth, a key corporation of  Rogers Behavioral Health System, has launched a new website – RogersInHealth.org – to help eliminate stigma through self-empowerment and illuminating recovery. Through brief, sharable video accounts on the site, Rogers InHealth offers stories of real people living with mental illness and what they found to be important in their recovery.

According to Co-directors Sue McKenzie, M.A., and Suzette Urbashich, M.S.,  false stereotypes lead some to discriminate (public stigma) and keep others from seeking needed treatment (self stigma). “We can help to change these stereotypes,” McKenzie said, “through videos of real stories of successful recovery and by sharing them with others through social media.”

Mental Illness… More Common Than You Might Think

According to the National Institute of Mental Health (NIMH), 1 in 4 adults experience a diagnosable mental disorder in a given year, with nearly half of them experiencing onset by the age of 14. These statistics mandate the need for early intervention with effective treatment, yet more than half of all affected don’t get the necessary care. This is often due to stigma – which impacts healthcare, policy and funding decisions.

“The video stories on our website can help people see that mental health challenges occur among people just like you and me, and that – with a variety of effective recovery practices – satisfying and productive lifestyles are possible,” McKenzie said. “Many have already shared stories of recovery, and we will be adding more accounts as they are available. Through the videos, we offer specific insights and hope to people living with mental illness and to those who live, work and befriend them.”

Reducing Stigma as a Barrier to Treatment

Among those involved with Rogers InHealth is one of the nation’s top researchers in stigma reduction, Patrick W. Corrigan, PsyD,  a distinguished professor of psychology at the Illinois Institute of Technology in Chicago. Dr. Corrigan is the principal investigator of federally funded studies on rehabilitation, the stigma of mental illness and consumer operated services. He is also involved with the  NIMH-supported National Consortium on Stigma and Empowerment (NCSE).

“For years, we have talked about explaining brain diseases as a way to reduce stigma,” Dr. Corrigan said, “but we are seeing that it is best reduced by people getting to know other people who are living with these disorders. While we would like to be able to have face-to-face contact occur for everyone, reaching people through video stories like the ones Rogers InHealth has created offers promise to reach many more people, especially those who believe they must keep their challenges hidden from others. These videos illustrate that mental health issues AND recovery can happen for anyone.”

Urbashich and McKenzie agree. In fact, the Rogers InHealth tagline – “Illuminate. Empower. Mental Health.” – is centered on the belief that by shining a light on recovery through shared stories, they can amplify the voice of those living in recovery, invite all to take the next steps toward their own mental fitness, and challenge the false notions that lead to discrimination.

“Our goal is to have videos from people of all ages and walks of life who talk about a variety of mental health issues, thereby reducing the stigma that causes so many to remain in isolation,” Urbashich said. “Anxiety, obsessive-compulsive disorder, chemical addiction, eating disorders, depression, bipolar disease, schizophrenia and others are common, and most people with these issues can find effective practices to support recovery. We want to illuminate these practices and show that people with these disorders are not only living satisfying lives but are supporting others to do the same.”

The site features two types of brief videos: individual stories as well as summaries of what has worked successfully for those moving from debilitating illness to living in recovery. The video library “What Works” section includes clips such as how Exposure Ritual Prevention (ERP) therapy helped with anxiety and the “Stories of Recovery” section includes stories such as a pediatrician who discusses parenting her child with OCD, recovery and fighting stigma. The video clips are also organized for those seeking insight into dealing with mental illness in the workplace and helping children who deal with mental health challenges such as anxiety at school.  The blog, which features information by key supporters and researchers, and links to resources are also included.

Read the FULL RELEASE

A key corporation of Rogers Behavioral Health System, Rogers InHealth creates and distributes video stories of recovery to increase understanding, hope and supportive action by people with mental illness and addiction, their friends and family, professionals and the general public. Through key initiatives to promote effective stigma reduction practices, Rogers InHealth provides collaborative leadership in the quest to eliminate the stereotypes, prejudice and discrimination that make up the stigma of mental health. For more information, check www.rogersinhealth.org.

“Coming Out” Might Be Worth It!

Blythe A. Buchholz and Patrick W. Corrigan, Illinois Institute of Technology

Mistaken beliefs about mental illness and the resulting discrimination (together known as stigma) can be as harmful to the person as the illness itself.  One form of stigma called public stigma happens when the general public agrees with stereotypes and socially disapproves of the person. This public stigma causes pain that acts as a barrier to the person’s pursuit of life goals.  Sometimes, the person with mental illness believes the false stereotypes about their experience with mental illness.  This is called self-stigma and causes a significant decrease in the person’s belief that they are good and able and that there is hope for recovery. These false ideas about mental illness and recovery can leave people believing they are not able to achieve their life goals. For these people, seeking therapeutic services is also less likely.

An interesting way to reduce self-stigma is doing what might seem most threatening - sharing one’s experiences with mental illness.  Telling someone about your mental illness can be empowering and may actually increase self-esteem for some people. This can be tricky, however, and it would be good for the advocacy community to develop effective guidance and supports for people wanting to tell their story about their experiences with mental illness. There are some specific practices that people with mental illness could adopt should they decide to “come out proud.”

The Problem of Self-Stigma

Social psychologists have described stigma in terms of:

·      Stereotypes - usually negative beliefs about a group: “people with mental illness are dangerous”

·      Prejudice - agreement with these beliefs leading to a negative feelings about the person: “that’s right; they’re dangerous and I’m afraid of them”  

·      Discrimination - the behavior in response to these beliefs and feelings: “because I’m afraid of them, I’m not going to hire them”

            When people with mental illness take these ideas, feelings and behaviors and apply them to themselves, it may undermine the pursuit of goals, including those related to education and employment.  This has been called the “why try” effect.  “Why try to seek out a job?  I am not worthy of it.”  “Why attempt to learn math?  I don’t have the skills to focus and learn.”  Additionally, people may avoid situations where they believe there is public stigma, which often include academic and work settings, which makes it even harder to achieve life goals and independence.

Identity and Disclosure

            One approach to resolving self-stigma is to identify with others who have mental illnesses.  Individuals who identify with their stigmatized group may report less stress related to prejudice and better self-esteem. This has been found to be true in studies of African Americans, older adults, women, and gay men and lesbians. Sexual orientation is helpful to look at because, like mental illness, it does not show in outward appearance. It is easier to keep it a secret. Keeping this secret and covering up such important aspects of one’s identity can have negative effects on mental and physical health, relationships, employment, and general well-being.  Thoughtful and careful sharing of one’s closet secrets seems to not only reduce these harmful effects, but often leads to a greater sense of personal empowerment and improved self-esteem, while at the same time helping to break down the barrier of public stigma.  

Identifying with Mental Illness

            The relationship between personal identity and self-stigma is complex.  One may think that to identify with a mental illness would lead to more stress, but this is not necessarily true.  Many researchers have found that it may not be identifying with one’s mental illness that leads to more stress, but that the person believes the ideas that others hold are true. Identifying with one’s mental illness can pull together the central experiences of mental illness into the whole of one’s self-image. When the person holds a definition of recoverythat includes a sense of hope, capability, goal attainment, and community, the identification with mental illness can be quite positive. 

Pride and Mental Illness Identity

            Pride emerges from a sense of who one is. In this context, mental illness is an identity in which a person might be proud.  For some people, “I am a person with mental illness,” describes much of their daily experience.  This kind of identity promotes a feeling of authenticity.  Authentic people often have pride in their authenticity and may experience greater self-esteem and well-being.

Some people view mental illness as a central part of their identity, while others may not.  An individual identifying as a member of this group risks being discriminated against (one of the downsides of disclosure); but, at the same time, can lessen the effects of self-stigma on the person with mental illness by offering sources of support and solidarity to cope with any negative or emotionally difficult experiences.

Costs and Benefits of Disclosing

            There are many benefits to disclosure; namely, the improved self-esteem and self-efficacy that promote emotional and mental health,which in turn may improve physical health and well-being. Disclosing might improve relationships and expectations in social and occupational settings. It can promote understanding, present opportunities for support, assistance, and reasonable accommodations, or simply relieve the stress and guilt connected to keeping a secret. There are costs to be considered as well.  Just a few are listed here and vary greatly by person and their environment: risk for physical or emotional harm (hate crimes), discrimination, disapproval or exclusion from others, and self-consciousness.  Costs and benefits can be assessed as both short and long-term outcomes.  The balance of costs and benefits varies greatly for each individual and the setting. For example, coming out at work likely has a different pattern of costs and benefits compared to coming out among one’s friend group.  Weighing the costs and benefits to coming out is a very complex, unique, and personal process; as such, this process, and ultimately his or her decision on whether to come out or not, is one that can really only be made by that individual. 

Strategic Approaches to Disclosure

            Disclosure has different levels from people who choose to stay out of social situations (Social Avoidance), to those who choose to socialize with a variety of people but not share their experiences (Secrecy), to taking a chance and disclosing their mental illness to selected co-workers or neighbors (Selective Disclosure), to those that make no active efforts to try to conceal their mental health history and experiences (Open Disclosure), and finally those who choose to broadly tell their story as a way of educating people about mental illness and reducing stigma (Broadcasting). The goal of the final type of disclosure is to seek out people or groups to share past history and current experiences with mental illness.  People who broadcast their experiences foster their sense of empowerment over the experience of mental illness and related stigma. 

Questions to consider when one has decided to disclose their mental illness include: Who do I want to tell?  Why do I want this person to know?  What about my experience do I want to tell them?  What are some possible outcomes of my disclosure- negative and positive, short- and long-term?  One strategy to “test out” whether a person is potentially a good receiver of disclosure is for the person considering disclosure to strike up a conversation about a recent television show, movie, or other media event that portrayed mental illness in a positive light. They then ask the person what they thought about it, rate the response, and decide if this individual will handle their personal information with respect, understanding, and sensitivity.

Coming Out Proud as a Public Health Program

            Coming Out Proud is a program developed for people to work through the process of disclosure and issues related to identity.  It is a three part program run by facilitators with lived experience, that addresses key issues related to disclosure:  (1) weighing the costs and benefits of coming out;  (2) considering the range of strategic approaches to disclosing; and (3) learning a good approach for formulating personal stories about experiences with mental illness.  Finally, the program presents resources, namely consumer-operated services, which may be great support systems during this process.

The public health value of a coming out program is likely to go beyond self-reported changes of secrecy-related distress, self-stigma, and empowerment.  Since perceptions of and experiences with discrimination lead both to heightened stress responses and poorer health behaviors, it is expected that a successful coming out program may reduce stress responses, including physiological and emotional reactions, with a positive impact on physical health and general well-being.  Finally, a broader coming out movement is likely to reduce public stigma and structural discrimination for people with mental illnesses.

For more information about the Coming Out Proud program and to download a copy of the manual and the companion workbook, please visit the website for the National Consortium on Stigma and Empowerment at www.ncse1.org. Go to the resources tab on the home page.

Editing support: Sue McKenzie, Rogers InHealth

References

1.     Corrigan, P. W., Larson, J. E., & Rüsch, N. (2009). Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry, 8, 75-78.

2.     Link, B., Struening, E., Neese-Todd, S., Asmussen, S., & Phelan, J. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services, 52(12), 1621-1626.

3.     Rüsch, N., Lieb, K., Bohus, M., Corrigan, P. W. (2006). Self-stigma, empowerment, and perceived legitimacy of discrimination among women with mental illness. Psychiatric Services, 57, 399-402.

4.     Wood, A., Linley, P., Maltby, J., Baliousis, M., Joseph, S. (2008). The Authentic Personality: A Theoretical and Empirical Conceptualization and the Development of the Authenticity Scale. Journal of Counseling Psychology.

55(3), 385-399.

 

Adapted from: Corrigan, P. W. and Sokol, K. A. (In press).  Reducing Self-Stigma by Coming Out Proud. American Journal of Public Health. 

Please address correspondence to Patrick Corrigan, Illinois Institute of Technology, 3424 S. State Street, Chicago, IL 60616; corrigan@iit.edu or Sue McKenzie, Rogers InHealth, 34700 Valley Drive, Oconomowoc, WI 53066; smckenzie@rogershospital.org