Books, Articles and Research

The impact of Consumer-Operated Services on Empowerment and Recovery of People With Psychiatric Disabilities
This study investigates the correlation between the amount of recovery services offered and the degree of recovery attained. A total of 1,824 people with psychiatric disabilities were studied, some of whom had received peer support services in the last four months. Although peer support showed a significant correlation to recovery, there was not a strong enough association to suggest causation.

Mental health Stigma among Adolescents: Implications for School Social Workers
This study investigated adolescents with a mental health problem and their experience of stigma at school. Study results emphasize the important role school social workers, school administrators, and teachers can play by learning how to help adolescents with mental health problems succeed and overcome stigma.

Adaptability and resiliency of Military families during reunification: Initial steps of a longitudinal study
"This study attempts to identify factors that increase or decrease the risk of family problems following the initial ""honeymoon"" period that occurs upon a service member's return. "

Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment
This study compared the effectiveness of the Vet-to-Vet program, a peer education and support program, and standard care without peer support on measures of recovery orientation, confidence, and empowerment. Study results suggest that participation in peer support may enhance personal well-being, as measured by both recovery-oriented and more traditional clinical measures.

Tools to Reduce Stigma of Mental Illness
The study, summarized in this article, piloted the use of "Narrative Enhancement Cognitive Behavioral Therapy" which was developed by Prof. Philip Yanos of City University of New York, Prof. David Roe, chair of the department of community mental health at the University of Haifa and Prof. Paul Lysaker of Indiana University School of Medicine. The results showed that subjects did experience higher self-esteem and a higher quality of life after using these tools to combat negative self perceptions (self-stigma).

Stigma experience among adolescents taking psychiatric medication
This study found that adolescents with a diagnosed mental health problem experienced stigma as a result of taking their psychiatric medications. Specifically, they experienced secrecy and shame, and they limited their own social interactions. Only four of the 40 adolescents in the study experienced no negative self-perception as a result of taking the medication. The study also found that family members and school environments can accentuate the experience of stigma or serve as a protection against it.

Brief Report: Self Stigma, Empowerment, and Percieved Legitimacy of Discrimination Among women with Mental Health Issues
"This brief report summarizes a study that sought to understand why some women with mental health problems experience negative self-perceptions while others do not. The study found that perceived legitimacy of discrimination may be a crucial determinant of a person's response to stigma. "

Recovering in mental illness broadening our understanding of wellness
This book, aimed at mental health clinicians and advocates, examines what recovery means from a variety of perspectives including qualitative studies that include mental health consumers' subjective experiences. Its goal is to inform the work of professionals interested in developing a better understanding of recovery and learning how they can work with consumers to support them in their recovery.

Public beliefs about and attitudes towards people with mental illness: a review of population studies
This article reports on a review of 62 studies conducted between 1990 and 2004 that examined attitudes concerning people with mental health problems. Many of the studies were conducted in Europe. The review concluded that significant progress has been made in attitude research in psychiatry during this time period. However, much work remains to provide a sound research base for developing evidence-based interventions aimed at reducing negative perceptions and improving attitudes towards people with mental health problems.

"Finding and keeping work: specifying the issues, activities, roles and supports needed for those with
This paper is written for those trying to create programs for people with mental health problems who are looking for employment or seeking support to retain employment. The paper suggests that a holistic approach is preferred and offers individualized or customized strategies for supporting consumers in this situation.

Social inclusion and recovery: A model for mental health practice
This book, written by two mental health professionals who are also mental health consumers, focuses on how important it is for mental health professionals to work with consumers/survivors in a way that helps consumers/survivors live as fully participating members of the community. The book includes personal stories and explores the important supportive and facilitative roles that mental health professionals play as allies in the recovery process.

The Department of Defense plan to achieve the vision of the DoD task force on mental health: A report to congress
This document, written and presented to Congress in September 2007, describes the Department of Defense's plan to address the categories of recommendations in the mental health task force?s vision of change through a focus on six key areas: (1) leadership, culture, and advocacy; (2) access to care; (3) quality of care; (4) resilience building and stigma reduction; (5) surveillance, research, and evaluation; and (6) care transition and coordination.

Mental health and social inclusion journal
This journal focuses on promoting social inclusion for people who have mental health problems and includes ways people can enjoy fuller lives in their local communities. Journal articles explore housing, finance, spirituality, cultural diversity, friendships, and relationships and enable readers to stay up to date on innovative approaches, best practices, difficulties, dilemmas, and possible solutions.

Q&A: First lady Rosalynn Carter on America's mental health crisis
TIME interviewed Former First Lady Rosalynn Carter, advocate for improving the mental health system and ending the negative perceptions that keep many people from getting proper care. In the interview, Mrs. Carter comments on topics including psychiatric drugs for children and the needs of returning service members.

Within our reach: Ending the mental health crisis
This book, written by former first lady Rosalynn Carter with Susan Golant and Kathryn Cade, offers an assessment of the current state of mental health. The book focuses on both the progress Mrs. Carter has seen during her 35 years of advocacy and the serious issues that must still be addressed before the mental health system can adequately meet the needs of people with mental health problems.

Family network support and mental health recovery
This study sought to determine which aspects of the family support network are perceived by mental health consumers/survivors as most important to their recovery process. Study findings revealed that support and reciprocity among family members are important dimensions of a personal support network that aids in the recovery process.

IAVA and Ad Council launch historic campaign
This press release announces the launch of a historic public service announcement (PSA) campaign. Through a partnership of IAVA and the Ad Council, this groundbreaking, multiyear effort seeks to ease the readjustment for service members returning home from Iraq and Afghanistan. The PSAs direct viewers to the first and only online community exclusive to Iraq and Afghanistan veterans, www.CommunityofVeterans.org. The social networking site offers a unique platform for veterans to connect with one another confidentially and serves as a portal for comprehensive mental health resources.

Pillars of peer support: Transforming mental health systems of care through peer support services
This report summarizes the results and findings of the Pillars of Peer Support Services Summit, held at The Carter Center in November 2009. The Summit brought together representatives from States that currently provide formal training and certification for peer providers working in mental health systems. The purpose was to examine the multiple levels of support States need to provide in order to create a strong and vital peer workforce that is able to engage in mental health systems transformation.

Self-stigma common in schizophrenia, linked to empowerment
This study describes the level of self-stigma, stigma resistance, empowerment, and perceived discrimination reported by mental health service users with a diagnosis of schizophrenia or other psychotic disorder across 14 European countries. Based on the results of their research, the researchers hypothesized that interventions to enhance empowerment and social contact may have a role in reducing self-stigma.

Understanding and influencing the stigma of mental illness
This article identifies three types of negative perceptions of mental health problems that may prevent consumers from accomplishing recovery-related goals. The article also identifies ways to address these barriers.

Stigma keeps some Latinos from depression treatment
This article summarizes the results of a recent study of low-income Latinos experiencing depression. The study finds that Latinos with negative perceptions of mental health problems are less likely to take medication, keep scheduled appointments, and effectively manage their mental health problems.

Evolving definitions of mental illness and wellness
This article stresses the importance of adopting a more integrated view of mental and physical wellness and translating this view into concrete changes to our country's overall care delivery model. The article discusses the positive benefits that can be achieved through implementing linked approaches.

"The mental health consumer movement: Implications for
This paper examines the consumer movement and the unique problems rural communities face in enhancing services to consumers. It finds that the consumer movement has great potential to positively impact rural service delivery.

"Mental health recovery: What helps and what hinders?
This report covers research findings about the factors that can help consumers recover, as well as the factors that can negatively influence consumers and ultimately hinder their recovery. The researchers' long-term goal is to develop a core set of systems-level indicators to measure critical elements and processes of mental health service environments that facilitate recovery.

Words used to describe substance-use patients can alter attitudes, contribute to stigma
This article discusses recent research findings about the impact of language on providers' perception of people with alcohol and substance abuse problems.

Self-stigma and coming out about one's mental illness
Self-stigma can undermine the self-esteem and self-efficacy of people with serious mental health problems. Investigators hypothesized that coming out about one's mental health problems would mediate the effects of negative self perceptions on one's quality of life. This study compares coming out to other approaches of controlling negative self perceptions, and investigators discuss implications for how coming out enhances one's quality of life.

Mental health issues and the media: An introduction for health professionals
Morris provides students and professionals in nursing and allied professions, psychiatry, psychology, and related disciplines with an introduction to the ways in which the media shapes our attitudes about mental health issues. Covering the press, literature, film, television, and Internet, this comprehensive text includes practical advice and recommendations on how to combat negative images for service users, healthcare workers, and media personnel.

Attitudes of mental health professionals about mental illness: A review of the recent literature
Investigators identified and reviewed empirical studies of the attitudes of mental health professionals published since 2004. Most of these studies revealed overall positive attitudes among mental health professionals. However, investigators also found evidence of negative attitudes and expectations, particularly with respect to social acceptance of people with mental health problems. Results indicate a need for greater research attention to mental health professionals' views and for improved attitudes among caregivers.

Perpetuating stigma? Differences between advertisements for psychiatric and non-psychiatric medication in two professional journals
This article details an examination of advertisements aimed at health professionals to establish whether there are any differences between advertisements for psychiatric medications and advertisements for non-psychiatric medications. The research showed that a distinction between mental health problems and other forms of ill health is clearly being maintained in medication advertisements; that this has the potential to result in or perpetuate negative and inaccurate perceptions, among both professionals and the public; and that this has troubling implications in light of the debates surrounding direct-to-consumer advertising.

How etiological explanations for depression impact perceptions of stigma, treatment effectiveness, and controllability of depression
Controversy exists regarding how etiological explanations for depression, particularly biological explanations, influence negative perceptions of depression, perceived controllability of depression, and perceived effectiveness of depression treatments. This study evaluates how biological and psychosocial explanations for depression relate to these variables. Negative perceptions of depression appear more meaningfully related to individuals' personal experiences with depression than to etiological explanations for depression, yet etiological models appear to have important implications for treatment preference and perceived controllability of mood.

Recovery in our words: A book of possibilities and hope
Townsend and Griffin offer consumers a planned approach to taking control of mental health problems and interactions with treatment professionals.

Shunned: Discrimination against people with mental illness
Thornicroft's book explores how negative perceptions affect the lives of people with mental health problems.

Six out of ten of Britons 'find it difficult to cope mentally'
A recent survey commissioned by Together, a British mental health charity, found that 62% of British respondents report having had difficulty coping mentally at least once in their lives.

More us than them: positive depictions of mental illness on Australian television news
This 2007 study reviewed television news coverage of mental health issues, including self-depictions from people with mental health problems and views expressed by mental health experts and politicians. Investigators conducted a broad-ranging content and frame analysis of mental health problems as depicted in the Australian television news media. The study supports the importance of involving people with histories of mental health problems in news coverage.

Determinants of minority mental health and wellness
This compilation of articles examines social, cultural, and economic factors that impact the mental wellness of people of color in America.

The Importance of Community Development For Health and Well-Being
This report examines the key role that environmental and community forces play in promoting health and preventing disease. In addition, the authors assert that social and public works programs will be more successful if people living in impacted neighborhoods are afforded the opportunity to participate in the creation and management of the initiatives that affect them.

Evaluation of a middle school mental health education program: Executive summary
Wahl details his findings that the "Breaking the Silence" curriculum may help prevent the formation of negative attitudes and foster more accurate understanding and acceptance of people with psychiatric disorders among middle school aged children.

A meeting of international mental illness stigma & discrimination leaders: Executive summary with
In June 2009, the Carter Center assembled a group of mental health consumers, leading international researchers in the field, Federal program directors, journalism fellowship advisory board members, university professors, and mental health professionals to identify key challenges to measuring stigma, as well as next steps to improve future anti-stigma initiatives. This document summarizes conference findings and includes an attachment (III) that outlines the action plan and next steps for moving forward with these efforts.

Action towards healthy living-for all
This journal article suggests that remedial measures are necessary to ensure that public policies become more closely aligned with the findings of biomedical and social research regarding the key essentials of health and well-being.

Fair society, healthy lives: Strategic review of health inequalities in England post 2010
This paper describes British issues in health equity, social determinants of health, and UK-style societal interventions in both mental health and overall health with mental health playing a critical role.

EMCI think tank: Mental healthcare media blueprint
This document details the recommendations from a 2008 roundtable discussion brought together leaders from entertainment, media, and mental health to discuss potential strategies to change the national dialogue regarding mental health problems.

Mental health, resilience and inequalities
This report explores the evidence that mental health influences a very wide range of outcomes for individuals and communities. These include healthier lifestyles, better physical health, improved recovery from illness, fewer limitations in daily living, and other factors.

Effects of school-based interventions on mental health stigmatization: A systematic review
The authors conducted a systematic review of the published and unpublished scientific literature concerning the benefits and harms of school-based interventions, which were directed at students 18 years of age or younger to prevent or eliminate such stigmatization because of mental health problems.

Media, mental health and discrimination: A frame of reference for understanding reporting trends
This paper describes a theoretical tool to help identify mental health stigma in media reports. The author contends stigmatizing portrayals of mental health problems are often missed by existing content analysis methodologies.

Notes from roundtable session on stigma in mental health and addiction
This report outlines the findings of a 2008 mental health stigma conference sponsored by the Mental Health Commission of Canada and the Hotchkiss Brain Institute.

Pathways to recovery: A strengths recovery self-help workbook
This resource provides a guide to help consumers and consumer facilitators implement a mental health recovery-based approach to the management of mental health problems.

Work transitions for peer support providers in traditional mental health programs: unique challenges and opportunities.
Peer support is gaining recognition as a valuable component of mental health service delivery and as a meaningful employment opportunity for mental health consumers. Despite the potential benefits of peer support, there continue to be many barriers to the development and funding of peer positions. This article reports on the results of a multisite project whose goal was to build capacity for employment of trained peer providers in local, community-based mental health programs.

Implementation of mental health parity: lessons from California.
This article reports the experiences of health plans, providers, and consumers with California's mental health parity law and discusses implications for implementation of the 2008 Federal parity law.

Integrating Wellness, Recovery, and Self-management for Mental Health Consumers.
Three distinct, yet interrelated, terms—wellness, recovery, and self-management—have received increasing attention in the research, consumer, and provider communities. This article traces the origins of these terms, seeking to understand how they apply, individually and in conjunction with one another to mental health consumers. They share a common perspective that is health centered rather than disease centered and that emphasizes the role of consumers, as opposed to professional providers, as the central determinants of health and well-being.

Evaluating the effectiveness of a consumer delivered anti-stigma program: replication with graduate-level helping professionals.
This study evaluated the consumer-delivered anti-stigma presentation In Our Own Voice (IOOV) with Masters of Social Work (M.S.W.) students, replicating a previous study with undergraduates. Thirty M.S.W. students completed pre- and post-presentation surveys to measure changes in attitude, knowledge, and social distance after the presentation. The results of this study further support the effectiveness of IOOV and indicate that graduate-level helping professionals can benefit from anti-stigma programs. Future research should go beyond self-report knowledge and attitude evaluation, test the efficacy of the components of the IOOV program (video, contact with presenters), and test the lasting effects of the program.

"Using Situation Testing to Document Employment Discrimination Against Persons with Psychiatric Disabilities"
Many individuals with psychiatric disabilities are unemployed or under-employed, with detrimental consequences for their lives and mental health. Although prior research suggests that stigmatization and discrimination contribute to this outcome, the exact extent of such employer behavior has remained largely undetermined. This article reviews the employment situation of persons with psychiatric disabilities, considers traditional ways to analyze the role of discrimination, and proposes situation testing as a new methodology overcoming many limitations of prior research.

Recovering Consumers and a Broken Mental Health System in the United States: Ongoing Challenges for Consumers/ Survivors and the New Freedom Commission on Mental Health. Part I: Legitimization of the Consumer Movement and Obstacles to It.
This article is the first of a two-article series that examines how multiple counteracting forces have situated the psychiatric consumer movement today, either propelling it or trying to reverse its achievements in shaping the production of mental health services. This part of the series describes how professionals came to embrace consumer/survivor perspectives, as well as attempts of oppositional forces to de-legitimize the movement's gains early in federally funded initiatives of consumer-run demonstration projects.

On our own: patient-controlled alternatives to the mental health system
This seminal work written in 1978 helped inspire the mental health self-help advocacy movement. The author used her negative experiences in public and private psychiatric hospitals to imagine a system that is consumer driven and directed.

Firewalkers: Madness, Beauty & Mystery
VOCAL Virginia used grant funding from SAMHSA's Campaign for Mental Health Recovery to produce a living anthology of stories of people who have experienced the turbulence of a mental health crisis. A guide to radically rethinking mental health, Firewalkers redefines mental illness as "a journey of emotional turbulence, crazy blessings, ecstatic visions, and mad gifts."

Good Practices for Combating Social Exclusion of People with Mental Health Problems
This document tracks the progress of "Good Practices for Combating Social Exclusion of People with Mental Health Problems," a project of Mental Health Europe (EU). The initiative has used a corresponding Web site as a primary strategy to help promote and disseminate strategies to increase social inclusion of Europeans with mental health problems.

More Social Inclusion For People With Mental Health Problems, UK
This article chronicles an effort by the British government's Health Ministry to promote social inclusion for people with mental health problems. The national directive targets vocational opportunities, social inclusion, and women-focused services.

Social Inclusion as a determinant of mental health and wellbeing
This Research Summary was developed as part of the VicHealth Mental Health Promotion Plan in 2005 to provide an overview of the impact of social inclusion on mental health.

Vision and Progress: Social Inclusion and Mental Health
This report examines the progress of the National Social Inclusion Programme as it works to implement the activities outlined by the 2004 Mental Health and Social Exclusion Report. Details are given on the progress made so far and on the work still to be done.

Mental Health and Social Exclusion: Social Exclusion Unit Report
This report examines the impact mental health problems have on increasing social exclusion. The report also developed a 27-point action plan to address this problem.

Closing the gap in a generation: Health equity through action on the social determinants of health
This report examines the final findings from the World Health Organization's Commission on Social Determinants of Health.

The Social Determinants of Health: How Can a Radical Agenda Be Mainstreamed?
This article is a commentary on the World Health Organization's Report on the Social Determinants of Health (SDOH).

Crisis Residential Facilities Healthier Than Psychiatric Hosptitals? - Study Finds More Mental Health Improvements At Consumer-Managed Program
This article discusses a study that examined the effectiveness of a consumer-managed facility. The consumer-managed facility showed better outcomes for participants and better cost efficiency than a larger, county-run facility.

A randomized trial of a mental health consumer-managed alternative to civil commitement for acute psychiatric crisis
This experiment compared the effectiveness of an unlocked, mental health, consumer-managed, crisis residential program (CRP) with the effectiveness of a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.

History of Childhood Maltreatment Linked to Higher Rates of Unemployment, Poverty: Outcomes of Aubuse and Neglect Impost Significant Cost to Individual and Society
This article discusses the results of a study that examined the long-term impacts of childhood maltreatment, both for the individual and for society.

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study
A significant number of people with mental illness do not use mental health services to receive treatment for their symptoms. This study examined the hypothesis that social network and social support affect mental health service use. Increased contact with the social network and higher levels of social support were associated with greater use of general medical services. However, more social support was associated with use of fewer services within the specialty psychiatric sector.

Coping With Thoughts of Suicide: Techniques Used by Consumers of Mental Health Services
Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts.

The military's war on stigma
In this article the author addresses the stigma that is felt by many service members of the United States' Armed Forces. The author also shares information on the stigma reduction efforts being implemented by the Deparment of Defense.

The meaning and importance of employment to people in recovery from serious mental illness: Results of a qualitative study
Given the high rates of unemployment and underemployment among individuals with psychiatric disabilities, only a small number of studies have investigated the role work has in the lives of people who have been successful vocationally during their recovery from serious mental illness. This study sought to add to existing literature by determining how individuals perceive work and its effect on their recovery.

Effects of culturally relevant psychoeducation for Korean American families of persons with chronic mental illness
The goal of this study is to identify culturally relevant treatment methods and to assess the effects of family psychoeducational intervention for Korean Americans who had a family member with mental illness.

Relationships between stigma, depression, and treatment in white and African American primary care patients
This study examined the relationships among depression, mental health stigma, and treatment in African American and white primary care patients.

So I wouldn't feel like I was excluded: The learning experience in computer education for persons with psychiatric disabilities.
This paper describes an exploratory, qualitative examination of factors that aid in the acquisition of computer skills by 12 adults across 2 settings: a structured, professionally-taught program and a less structured peer-taught setting. These pilot findings highlighted the importance to teaching effectiveness of striking a balance between flexibility and structure, with computer knowledge having broader implications for social inclusion.

Metaphorical stores for education about mental health challenges and stigma
In this article, the author shares his experience using metaphorical stories when presenting to audiences. Various fables and other types of metaphorical stories are used in his presentations to bridge the gap of knowledge and to enable communication.

Language and the recovery advocate: Why we worry about words
In this article the author addresses the need for a "recovery-oriented vocabulary" in order to support recovery efforts and reduce the discriminatory policies that exist in communities.

Creating change: Using the arts to help stop the stigma of mental Illness and foster social integration
In this article the author hopes to create a passion for change and suggest a way that everyone can help stop stigma. However, research is needed; a design for a study to test this hypothesis is described.

Social exclusion in clients with comorbid mental health and substance misuse problems
A case-control study to examine aspects of social exclusion between service users who have comorbid diagnoses and those with a single diagnosis. Samples were drawn from the service users of a mental health Trust in the South-East of England, from both Adult Mental Health (n = 400) and Drug and Alcohol services (n = 190). Data were collected from Care Programme Approach assessment forms and medical records.

Social exclusion and mental health: Conceptual and methodological review
The aim of this study was to conduct a conceptual and methodological review of social exclusion, focusing initially on the origins and definitions of the concept and then on approaches to its measurement, both in general and in relation to mental health.

What to do when you think an employee may need mental health help
This fact sheet list the steps you should take when you think an employee may need mental health help. Steps on education, language and encouraging dialogue are dicussed.

Mental illness and employment discrimination
This review summarizes recent evidence pertaining to employment-related stigma and discrimination experienced by people with mental disabilities.

Employment equity and mental disability
Recent research on the civil rights issue of employment equity for people with psychiatric disabilities is reviewed.

Involving consumers in the development of a psychoeducational booklet about stigma for black mental health clients
This article documents the process of developing a consumer-derived psychoeducational booklet for Black adults contemplating mental health treatment. Black mental health consumers provided the content for the booklet through qualitative interviews about their experiences and then provided feedback once it was developed.

Don't call me nuts! Coping with the stigma of mental illness
Don't Call Me Nuts! is a handbook for persons with mental illness. In its pages are discussions about dealing with self-stigma, knowing when or whether to disclose a mental illness, seven ways to foster personal empowerment, and legal and political remedies. The book explores the public's reaction to stigma through the methods of contact, education, or protest.

The self-stigma of mental illness : Implications for self-esteem and self-efficacy
The relationships between elements of a self-stigma model and self-esteem, self-efficacy, and depression are examined in this study. Self-stigma is distinguished from perceived stigma (stereotype awareness) and presented as a three-level model: stereotype agreement, self-concurrence, and self-esteem decrement.

Predictors of depression stigma
The aim of this study was to investigate and compare the predictors of personal and perceived stigma associated with depression.

Stigmatization and self-esteem of persons in recovery from mental illness: The role of peer support
This article studies whether peer support among clients can moderate this negative link, and to what extent. Following the buffering hypothesis on stress and social support, it was expected that the association between stigmatization and self-esteem would be less among persons experiencing greater peer support.

Ward features affecting stigma experiences in contemporary psychiatric hospitals: A multilevel study
In this article, a multilevel design is used to explore the link between characteristics of the treatment context and stigma experiences, controlling for client characteristics. In terms of policy, this kind of study could highlight factors in the immediate treatment that could be changed to reduce stigma experiences for clients of mental health services.

Stigma as related to mental disorders
The authors begins this review with a multidisciplinary discussion of mechanisms underlying the strong propensity to devalue individuals displaying both deviant behavior and the label of mental illness. The article concludes with a brief review of multilevel efforts to overcome mental illness stigma, spanning policy and legislation, alterations in media depictions, changed attitudes and practices among mental health professionals, contact and empathy enhancement, and family and individual treatment.

Reliability of a composite measure of social inclusion for people with psychiatric disabilities
This study aims to assess the reliability of the components of a proposed composite measure of social inclusion for people with psychiatric disabilities. The interview covered sociodemographics, domain specific socially valued role functioning, social support, stigma experiences, integration within the immediate psychosocial rehabilitation community, and integration within the wider neighborhood community.

Overcoming stigma: Involving families in medical student and psychiatric residency education
The primary purpose of this article is to present a possible mechanism for increasing communication about psychiatric matters such as diagnoses, treatment, and stigma between the physicians, including psychiatrists, and the families of persons with mental illness through a NAMI presentation.

Psychosis and the experience of employment
This study explored the experiences of people diagnosed with schizophrenia or schizoaffective disorder in relation to paid employment. Eight participants with experience of paid employment were interviewed. The data were analyzed using Interpretative Phenomenological Analysis (IPA) [Smith et al. (In: Murray, Chamberlain, editors) Qualitative health psychology, 1999].

Genetic attribution for schizophrenia, depression, and skin cancer: Impact on social distance
In this study it was predicted that both genetic attribution for illness and type of illness would be related to a desire for social distance. There was a significant interaction between illness type and genetic attribution for illness, with an increase in willingness to interact when schizophrenia was described as genetically caused and a decrease in willingness to interact when major depression was described as genetically caused.

Reducing stigma by meeting and learning from people with mental illness
This study examines the effects of a public education program, developed in large part by consumers of mental health services, on the attitudes of high school students toward people with mental illnesses. A 1-hour informational session developed and facilitated by consumers of mental health services can significantly affect the attitudes of adolescents toward people with major mental illnesses.

Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia
In this article, the authors research suggests global self-esteem among persons with schizophrenia may be negatively affected by stigma or stereotyped beliefs about persons with severe mental illness. Less clear however, is whether particular dimensions of self-esteem are linked to particular domains of stigma.

'I'd rather not take Prozac': Stigma and commodification in antidepressant consumer narratives
This article explores the idea that narrative is the primary vehicle through which antidepressant consumers negotiate their sense of identity and reality. Antidepressant consumers represent a unique consumer culture because of the stigma that society attaches to mental illness. Recent media attention, including direct to consumer (DTC) advertising, appears to decrease the stigma surrounding antidepressant use while at the same time commodifying and branding them for mass consumption.

Campus mental health: Know your rights
Campus Mental Health: Know Your Rights is a guide for college and university students to the legal rights one has when seeking mental health services. It also explains what can be expected in interactions with mental health service providers and what obligations one might have.

The evaluation of a short group programme to reduce self-stigma in people with serious and enduring mental health problems
This study examined the impact of a 6-week group programme designed to reduce self-stigma in a group of service users with serious and enduring mental health problems. Twenty participants were assessed prior to the commencement of the group and immediately following its cessation. The results record a significant reduction in the stigma following the group and also non-significant increases in the participants' levels of self-esteem, self-acceptance and overall psychological health.

Insight and psychosis: Comparing the perspectives of patient, entourage and clinician
In this study, the authors hypothesized that socio-cultural factors influence insight in patients with schizophrenia. The authors tested this hypothesis through comparison of insight in 18 triads, each composed of a patient, a family member and a clinician. The sample consisted of patients who were first diagnosed with psychosis in the last two years, and who were either immigrants from Africa or the Caribbean Islands, or Canadian born. Insight was assessed by analysis of narratives collected from patients, family members and clinicians for a research project on the negotiation of treatment.

Unmet needs and treatment seeking in high users of mental health services: Role of illness perceptions
The aim of the present study was to investigate how illness perceptions in high users of mental health services were related to unmet needs and treatment-seeking behaviours.

Mental illness is not the same as incompetence: Voting rights, archaic laws, & stigmatizing language
Editorial article written by a registered nurse who provides some insight regarding the voting rights of individuals with mental illness.

Law & psychiatry: Slowing the revolving door: Community reentry of offenders with mental illness.
An article discussing the existing programs that help offenders with mental illnesses reenter the community and the importance of effective collaborations between criminal justice agencies and behavioral health providers.

Psychological distress among Latino family caregivers of adults with schizophrenia: The roles of burden and stigma
This study examined the relation between caregivers' mental health and perceived burden and stigma and characteristics of the patient and caregiver within the Latino community.

Americans attitudes toward mental health treatment seeking: 1990-2003
This study examined recent trends in Americans' attitudes toward mental health treatment seeking and beliefs about the effectiveness of such treatment.

Family views of stigma
The views of 487 members of the National Alliance on Mental Illness (NAMI) concerning stigma were surveyed in 20 different States. Almost all identified stigma as a problem for their mentally ill relatives and for families in general.

Perceived and measured stigma among workers with serious mental illness
This research analyzed the extent to which self-reports of job-related discrimination by persons with serious mental illnesses are associated with econometric measures of discrimination.

The effect of healing gardens and art therapy on older adults with mild to moderate depression.
This study evaluated the effect of garden walks alone, garden walks with guided imagery, and art therapy on mild to moderate depression in older adults. Focus group interviews at the end of the 6-week intervention suggest that all 3 interventions were helpful to participants with mild to moderate depression.

Art, dance, and music therapy.
Art, dance, and music therapy are a significant part of complementary medicine in the twenty-first century. These creative arts therapies contribute to all areas of health care and are present in treatments for most psychological and physiological illnesses. Although the current body of solid research is small compared with that of more traditional medical specialties, the arts therapies are now validating their research through more controlled experimental and descriptive studies. The arts therapies also contribute significantly to the humanization and comfort of modern health care institutions by relieving stress, anxiety, and pain of patients and caregivers. Arts therapies will greatly expand their role in the health care practices of this country in the twenty-first century.

The role of music therapy in psychiatry
Music has soothed the souls of human beings for ages. It also has helped people recover from ailments since ancient times. Today, there is a widespread interest in the use of music therapy in treating psychiatric disorders. This article describes the various types of music therapy in use today and also offers insight into how music therapy can be incorporated into the management of psychiatric disorders and as an element of psychotherapy.

Therapeutic music for patients with psychiatric disorders
Many patients with psychiatric disorders struggle with poor skills in coping, communication, socialization, and self-expression that may result in dysfunctional behavioral, cognitive, and emotional responses. Therapeutic music offers a noninvasive approach to strengthen these skills and effect behavior change. At a regional inpatient psychiatric hospital in Colorado, a program of therapeutic music was developed using Rogers' theory of unitary human beings as the theoretical framework. This article describes the approach used to strengthen coping skills in communication, socialization, and self-expression. Suggestions are made for developing a program of music with similar patient populations.

How important is intrinsic spirituality in depression care? A comparison of white and African-American primary care patients
This study compares the views of African-American and white adult primary care patients regarding the importance of various aspects of depression care.

Pastors' perceptions of mental disorders
Letter to the editor in which a study is discussed where pastors were surveyed on their views of mental illness.

Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States
Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. This article examines the possible role of perceived discrimination in generating that risk.

Sexual orientation and mental health: results from a community survey of young and middle-aged adults
Study designed to assess separately the mental health of homosexual and bisexual groups compared with heterosexuals.

Gender specific correlates of stigma toward depression in a Canadian general population sample.
The objectives of this research were to identify gender specific demographic, clinical, knowledge and attitudinal factors associated with stigma related to depression.  

Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes
The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved.

Reaching out to high school youth: The effectiveness of a video-based antistigma program
This study evaluted the impact on Canadian high school students of a video-based antistigma program portraying real life experiences of individuals with schizophrenia. It also includes lesson plans to guide classroom discussions and active learning.

Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies
The portrayal of mentally ill persons in movies and television programs has an important and underestimated influence on public perceptions of their condition and care. The authors suggest that mental health professionals can fight this source of stigma by increasing their collaboration with patient advocacy groups in monitoring negative portrayals of mentally ill people,

Growing older: The lived experience of older persons with serious mental illness
The purpose of this qualitative paper is to describe, from the consumers perspective, the complex factors involved as persons with serious mental illness grow older in the community.

Mental healthcare for rural seniors. An outreach program in Cedar Rapids, IA, uses an integrated approach to break down barriers to care
Article discussing the Abbe Center for Community Mental Health in the Cedar Rapids, IA, and the work that the Center does in breaking down some of the barriers to mental health services for older adults in rural communities.

Beliefs about mental illness and willingness to seek help: A cross-sectional study
Evidence indicates that older adults underutilize mental health services, but little is known empirically about the perceptions older adults have about mental illnesses and their attitudes about seeking professional help for psychological problems. The present study examined beliefs about mental illnesses and willingness to seek professional help among younger and older persons.

Chapter 5 of "Mental health: A report of the Surgeon General": Older adults and mental health
This chapter of the Surgeon General's report on mental health addresses various areas of interest for the older adult population, specifically considering mental disorders in older people - their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment.

Rural and frontier mental and behavioral health care: Barriers, effective policy strategies, best practices
This report focuses on the following areas: barriers to mental and behavioral health service delivery in rural America, model programs and effective activities for rural America, model policy strategies for rural mental and behavioral health care delivery, the role telehealth should play in service delivery to rural America, and the role that State Offices of Rural Health and other State and local organizations should play in service delivery to rural America.

A survey of preferred terms for users of mental health services.
This survey was conducted to determine how users of mental health services would like to be addressed by professionals. Three hundred two persons participating in a variety of inpatient and outpatient psychiatric programs were surveyed.

What's in a Name? Terms preferred by service recipients
A large multi-site study examining effectiveness of consumer operated service programs as an adjunct to traditional mental health services. Researchers examined individuals' preferred term describing their status as service recipients.

Will filmed presentations of education and contact diminish mental illness stigma?
This study examines the impact of two versions of anti-stigma programs-education and contact-presented on videotape. 

Managing workplace depression: An untapped opportunity for occupational health professionals
An article discussing how occupational health professionals are the most qualified to design and deliver destigmatized, customer-friendly programs and services to help employees who are depressed. Integration of services like benefits, health promotion, EAP, and human resources across a company can lead to an effective, organization-wide depression initiative.

Disclosure conundrum: How people with psychiatric disabilities navigate employment
This qualitative study of people with psychiatric disabilities explored the issues of self-disclosing their mental illness and the complex situations around employment and disclosure.

Effects of an antistigma program on medical students' attitudes toward people with schizophrenia
The purpose of this study was to examine whether an antistigma program which consists of education, contact, and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia.

What is in a name? Professionals and service users' opinions of the Hebrew terms used to name psychiatric disorders and disability
Stigma constitutes the hidden burden of mental disorders. Its ubiquitous presence may be reinforced by iatrogenic factors, such as the terms used to name mental disorders and disability. This preliminary study examines opinions with regard to the use of these terms in Hebrew.

"It's important to be proud of the place you live in": Housing problems and preferences of psychiatric survivors.
This paper reports findings from a series of focus group meetings held with survivors of mental illness to address issues concerning housing preferences and housing needs.

The Carter Center Mental Health Program: Addressing the public health crisis in the field of mental health through policy change and stigma reduction.
This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program?s initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses.

Association between community and client characteristics and subjective measures of the quality of housing
The objective of this study was to examine the relationship between subjective perceptions of the quality of housing among mental health consumers and both client characteristics and objective measures of the client's neighborhood.

Stigma as a barrier to employment: Mental disability and the Americans with Disabilities Act
This study examines the role played by stigma in employers' response to the 1990 Americans with Disability Act (ADA). The article describes employers' experiences with employees with mental disabilities and accommodations, specific employment practices, and attitudes towards those with mental disabilities.

Forgotten policy: An examination of mental health in the U.S. [Brief]
This paper presents strategies and recommendations for improving the current mental health system so that it better addresses the mental health needs of Americans.

Appropriate language in discussing mental illness
A brief article discussing the use of appropriate language, when discussing mental illnesses. Following these suggestions can help to communicate acceptance and understanding.

Diminution of 'self'
This article is adapted from a speech the author gave at the Florida Self-Directed Care conference, in which he addressed how language affects the individual.

Stigma and mental disorder: Conceptions of illness, public attitudes, personal disclosure, and social policy
This article defines stigma and discusses empirical and narrative evidence for stigmatization, as well as historical trends regarding conceptualizations of mental illness.

Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care
This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.

Design and initial results from a supported education initiative: The Kansas Consumer as Provider program
This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers.

Is low self-esteem an inevitable consequence of stigma? An example from women with chronic mental health problems
It often is assumed that membership in a stigmatized group has negative consequences for the self-concept. However, this relationship is neither straightforward nor inevitable, and there is evidence suggesting that negative consequences may not necessarily occur (Psychol. Rev. 96(4) (1989) 608). This paper argues that the relationship has not been sufficiently theorized, and that a more detailed analysis is called for in order to understand the relationship between stigma and the self.

Religion and spirituality in the lives of people with serious mental illness
Although there is some literature that documents the relationship of religiousness and spirituality with health and well-being, far fewer studies have examined this phenomenon for people with serious mental illness. In this study, people with serious mental illness completed self-report measures of religiousness and spirituality.

Challenging stigma and discrimination in communities: A focus group study identifying UK mental health services users' main campaign priorities
This study was conducted to explore mental health service users' views on how campaigns to address stigma and discrimination should prioritise their actions

Employment of individuals with mental disabilities: Business response to the ADA's challenge
This research examines the response of the business community to the Americans with Disabilities Act (ADA) with specific focus on the employment of those with mental disabilities.

Perspectives of people with psychiatric disabilities on employment disclosure
A qualitative study, including a focus group and individual interviews, was conducted to gather data from people with psychiatric disabilities/labels regarding employment disclosure. Major findings include the significant impact of disability identity (does the participant think they have a disability?), and the importance of appropriate job matching as a disclosure strategy.

Structural stigma in state legislation
This article discusses examples of structural stigma that results from state governments' enactment of laws that diminish the opportunities of people with mental illness.

Spiritual psychotherapy a path around a stigma
An article discussing an increase in the involvement of ministries in addressing mental health with their congregations as a means of countering stigma.

Barriers to higher education for individuals with psychiatric disabilites
This qualitative study explored the college experiences of 35 people with psychiatric disabilities, in order to study barriers to higher education.

A family's painful journey
This article discusses the issues faced in Maryland in seeking assistance for children with severe mental illness. It focuses on State budget cuts for wraparound mental health coverage. 

At issue: Stop the stigma: Call mental illness a brain disease
Educating the public that mental illness is a brain disease is a popular strategy for combating mental illness stigma. Evidence suggests that while such an approach reduces blame for mental illness, it may unintentionally exacerbate other components of stigma, particularly the benevolence and dangerousness of stigmas. Researchers propose a balanced approach that combats the various myths about mental illness with factual information.

Stigmatization, discrimination, and mental health: The impact of multiple identity status
The authors present the empirical characteristics of the Experience of Discrimination Scale (EDS) using baseline data from the Center for Mental Health Services-funded, multisite Consumer Operated Services Project. Specific hypotheses focused on the influence of multiple identity status on reports of discrimination. Data indicated that discrimination caused by mental disability was associated with level of psychiatric symptoms and perceived social rejection as a result of mental illness, whereas discrimination for other reasons was associated with broader quality of life and social interaction indicators. The clinical and policy implications of findings are discussed. 

Position statement on employment and rehabilitation for persons with severe psychiatric disabilities
The position statement, developed by NASMHPD, encouraged the integration of employment and recovery goals with service delivery to individuals with mental illnesses. The NASMHPD concluded that State mental health agencies should work to develop tools for appropriate evaluation of plan success in moving covered individuals into employment or partial employment settings.

Protected space, where art comes calling
An article discussing the work of Dr. Janos Marton, a psychiatrist who has worked at creating a refuge where individuals with mental illness can go and create art as part of the therapeutic process. The article also includes notes on an interview with Dr. Marton.

Use of schizophrenia as a metaphor in U.S. newspapers
Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused.

Where postmodern art and schizophrenia intersect
An article discussing a past conference sponsored by the National Alliance of Research on Schizophrenia and Depression (NARSAD). The centerpiece of the event was "Mind Matters," an exhibition of paintings, drawings, prints and sculptures by artists with brain diseases.

Spanish schizophrenic poet lauded
An article discussing the work and accomplishments of Spanish poet, Leopoldo Maria Panero, who also suffers from mental illness.

Faith communities care about mental illness
A brief article discussing a video teleconference, "Mental Illness: Paint a Different Picture," held November 10, 1998, sponsored by United Methodist General Board of Global Ministries Health and Relief, the Board of Church and Society, Pathways to Promise, and United Methodist Communications.

Consumer experience of stigma: A national survey
This article summarizes the results of a nationwide survey of 1,301 mental health consumers concerning their experience of stigma and discrimination.

Danforth residents cool to project group plans to build housing for people with mental illness
A brief article describing the life of an individual with mental illness and her struggles to find appropriate housing.

Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed With bipolar affective disorder
The purpose of this study was to evaluate the effect of concerns about stigma on social adaptation among persons with a diagnosis of bipolar affective disorder.

Childhood revealed: Art expressing pain, discovery and hope
An overview of the book created by the New York University Child Study Center to help people overcome the stigmas attached to child psychiatric illness. The book contains over 100 pieces of art created by children from ages 4 through 18 who have a mental illness or have experienced a difficult life circumstance.

Separate and unequal: The struggle of tenants with mental illness to maintain housing
This article assesses the current state of the law and challenges poverty and disability advocates to marshal new resources and arguments in an effort to secure full tenancy rights for These consumers.

Strategies For success: A consumers' guide to the workplace
This guide was developed for the Access to Real Work project of the Canadian Mental Health Association - National office. It provides hints for new mental health consumer employees, and information on workplace accommodations.

People with psychiatric disabilities, employment, and the Americans with Disabilities Act: Turning policy into practice
This is a report of the proceedings of a two-day roundtable discussion on "People with Psychiatric Disabilities, Employment and the Americans with Disabilities Act (ADA)" held in January 1995.

President's New Freedom Commission on Mental Health
The Commission?s mission was to study the United States mental health service delivery system, including both private and public sector providers. The Commission advised the President on methods to improve the system. The Commission?s goal was to recommend improvements that will enable adults with a serious mental illness and children with a serious emotional disturbance to live, work, learn, and participate fully in their communities.

Housing and mental health: Reducing housing difficulties for people with mental illness
This paper outlines key issues in housing provision for people with serious mental illness and suggests a policy framework. It draws on the limited research available on the housing needs of people with mental illness and on information available from the mental health sector. It is intended to generate discussion and better understanding of the issues in the mental health and housing sectors.

Cultural diversity series: Meeting the mental health needs of gay, lesbian, bisexual and transgender persons. Executive summary
This report provides basic information regarding common mental health concerns of GLBT persons to aid in the development of culturally competent mental health services and supports.

NIMBY and housing for the mentally ill
The third installment of an NPR series on finding homes for people who need support and services. The journalist visits a Pittsburgh, PA neighborhood that feels squeezed between its own needs -- and its duty to others.

Real shame
People with psychiatric disabilities often are shunned. Ensconced in a separate array of interventions that are isolating and insulating, people with psychiatric disabilities also can be discredited with a mental-health specific language. This essay asks the mental health leadership to help align psychiatric disability with other disabilities. The author suggests relational advocacy, advocacy that does not disparage people who experience mood swings, fear, voices and visions.

A new vision of recovery: People can fully recover from mental illness; it is not a life-long process
A brief article in which two views of recovery are discussed, rehabilitation and empowerment views of recovery.

Empowerment and serious mental illness: Treatment partnerships and community opportunities
Two targets of empowerment are discussed in this paper: treatment partnerships and community opportunities. Strategies that enhance treatment partnerships include provider endorsement of recovery rather than promoting an approach that suggests poor prognoses, treatment plans that are collaborative rather than unilateral decision making that is perceived as coercive, and treatment services provided in the person's community rather than geographically or psychological distant institutions.

Social distance from the stigmatized: A test of two theories
This paper tests the relative merits of the theories in explaining perceived social distance that individuals in the study expressed from a wide range of stigmatized conditions representing two general stigma types: the disabled and deviants. The research is based on a sample of professionals and managers in key decisionmaking positions.

Special section on stigma as a barrier to recovery: Introduction
The aim of this special section is to elucidate the adverse effects of stigmatization on the recovery of people with mental illness.

The paradox of self-stigma and mental illness
Published narratives by persons with serious mental illness eloquently describe the harmful effects of stigma on self-esteem and self-efficacy. However, a more careful review of the research literature suggests a paradox; namely, personal reactions to the stigma of mental illness may result in significant loss in self-esteem for some, while others are energized by prejudice and express righteous anger.

Family burden and family stigma in major mental illness
Article discusses the stresses and burdens on families of mentally ill individuals, including stigmatization, and problems in dealing with mental health professionals.

Psychiatric disabilities in postsecondary education: Universal design, accommodations and supported education
This article calls for increased awareness and academic support for students with psychiatric disabilities in postsecondary education. The limited literature in this area is reviewed and the authors correct misunderstandings about these types of disabilities and provide information to increase faculty, administrator, and staff awareness regarding the rights and needs of postsecondary students with psychiatric disabilities. 

Perception of stigma among patients with schizophrenia
This study investigated the relation of symptoms and other patient characteristics with perceived stigmatization in patients with schizophrenia.

Relationship between perceived stigma and depression severity
The purpose of this study was to explore the relationship between perceived stigma and being in treatment for depression and current depression severity.

Implications of educating the public on mental illness, violence, and stigma
This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. 

Stigma and expressed emotion: A study of people with schizophrenia and their family members in China
This study was conducted to explore the factors that mediate patients' emotional and cognitive responses to stigma.

Stigma: the feelings and experiences of 46 people with mental illness: Qualitative study
This study was conducted in order to describe the relationship of stigma with mental illness, psychiatric diagnosis, treatment and its consequences of stigma for the individual.

Trauma victims find art the path to recovery
An article discussing how writing and the visual arts are powerful vehicles for communicating individual and collective experiences of trauma.