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Stigma is one of the major barriers to care for people with mental
health and related disorders. Stigma includes negative beliefs
about and hostile perceptions towards others, shame and
self-stigma, discriminatory practices in hiring, promotion and
recognition of people who suffer from mental health challenges, and
structural and organizational policies and processes that result in
inequalities for people who have mental health challenges. Stigma
has been recognized as a significant factor in the well-being of
people with mental health and related problems and can be more
debilitating than the direct effects of mental health problems
themselves. The Mental Health Commission of Canada (MHCC) was
established to conduct policy reviews and to promote initiatives
related to mental health. The Opening Minds program of the MHCC is
the largest systematic effort in Canadian history to reduce stigma
related to mental illnesses. The program has adopted the systematic
development, evaluation and deployment of targeted programs based
on theories of change, best practices and available research
evidence as a model for stigma reduction. The Stigma of Mental
Illness is an important vehicle to communicate conceptual issues in
the field of stigma reduction, to document the work done to date
within the MHCC Opening Minds program, and to offer practical
strategies to broaden the scope and utility of the work for
different contexts, cultures, and countries. This volume will be a
global interest, given the growing importance of stigma reduction
related to mental disorders and related problems.
In 2012, Paradigms Lost critically examined the key paradigms used
in programs aiming to prevent or reduce the stigma attached to
mental illness. Today, many programs addressing stigma have been
successfully developed or improved using the notions and
recommendations presented in that volume. Paradigms Lost, Paradigms
Found builds on the lessons of the first edition and adds new
approaches to reducing the stigma related to mental illness. It
brings together the latest theory and experience in the field to
provide effective recommendations for addressing stigma in its
various forms. This second edition also presents targeted programs
used by different social groups and explores future directions in
stigma prevention, including evolving techniques for the digital
age. Integrating experience with modern technology, Paradigms Lost,
Paradigms Found provides evidence and inspiration for mental health
advocates seeking to prevent or reduce stigma of mental illness and
protect the rights of people with mental and substance use
disorders.
Paradigms Lost challenges key paradigms currently held about the
prevention or reduction of stigma attached to mental illness using
evidence and the experience the authors gathered during the many
years of their work in this field. Each chapter examines one
currently held paradigm and presents reasons why it should be
replaced with a new perspective. The book argues for enlightened
opportunism (using every opportunity to fight stigma), rather than
more time consuming planning, and emphasizes that the best way to
approach anti-stigma work is to select targets jointly with those
who are most concerned. The most radical change of paradigms
concerns the evaluation of outcome for anti-stigma activities.
Previously, changes in stigmatizing attitudes were used as the best
indicator of success. Paradigms Lost and its authors argue that it
is now necessary to measure changes in behaviors (both from the
perspective of those stigmatized and those who stigmatize) to
obtain a more valid measure of a program's success. Other myths to
be challenged: providing knowledge about mental illness will reduce
stigma; community care will de-stigmatize mental illness and
psychiatry; people with a mental illness are less discriminated
against in developing countries.
Paradigms Lost concludes by describing key elements in successful
anti stigma work including the recommended duration of anti-stigma
programmes, the involvement of those with mental illness in
designing programmes, and the definition of programmes in
accordance with local circumstances. A summary of weaknesses of
currently held paradigms and corresponding lists of best practice
principles to guide future anti-stigma action and research bring
this insightful volume to an apt conclusion.
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