Peer Support Specialists and Stigma-Reduction Interventions

Peer Support Specialists are on the frontline of fighting stigma in all of its forms.

 Stigma has been defined as “the prejudice and discrimination directed at a group by the population,” and includes “negative attitudes held by members of the public about people with devalued characteristics” (Corrigan et al., 2015).

 Self-stigma is similar to stigma, but has a key difference. Defined as “what occurs when people internalize negative public attitudes”, self-stigma starts with simple awareness of negative views held by others (family, friends, people in the media, etc.) and then moves to the person internally agreeing with those views, and then applying those views to themselves in a way that reduces their life.

 Stigma and self-stigma are common and destructive.   They distort our understanding of mental illness, and are associated with reduced willingness to seek treatment and reduced hope of recovery.  Stigma is most destructive when it is unrecognized. As a Peer Support Specialist, one of your key roles is to identify and fight stigma in every setting, regardless of whether it is public stigma or self-stigma. Your clients may not know the concepts and may not see stigma in themselves or others. Be active in educating them about the destructive nature of stigma.  Recruit them in fighting it in their environment and in their own mind.

 Education is the key strategy for changing stigma and self-stigma.  Common strategies include:

1.     Create venues to discuss both stigma and self-stigma with clinicians.  Educational classes, grand rounds, web-based seminars are among the types of common educational settings that clinicians participate in regularly.  They will know about the concept of stigma, but often won’t have had the opportunity to talk about how stigma influences them, their clients, and their community.  As a Peer Support Specialist, you are in a strong position to organize and lead an educational event to raise awareness among clinicians, administrators, and other Peer Support Specialists.

 2.     Create venues to discuss both stigma and self-stigma with clients.  Psychoeducation is a common part of recovery-oriented treatment.  Including a seminar or even a weekly discussion group focusing on stigma and self-stigma will help raise awareness among clients.  Draw clinicians into leading these sessions to help reinforce their learning.

 3.     Use your advocacy skills to identify and confront stigma when you see it in your own organization, clinical team, and your clients.  Many of the elements of stigma are subtle and so your efforts to make them more obvious will help others to see and change them. 

 4.     Engage your clients in the work of advocating against stigma.  Research shows that most mental health clients report experiencing the effects of stigma and discrimination.  Helping them to be ready to respond and advocate for themselves when they face discrimination is a good way to prepare them, and to help them fight off self-stigma.  Corrigan and associates (2015) suggest that education is helpful, but contact – meeting someone who identifies as having a mental illness -- has the biggest impact.  Again, your role as a Peer Support Specialist is key.

 5.     Look for, and point out subtle messages in language, rules, and small behaviors.  It is the subtle messages that are the hardest to recognize and fight.  Be familiar with guides to ‘recovery-oriented language’ and use them to find and point out the subtle ways that stigma influences the way clinicians talk, act, and organize clinical settings.

Mental illnesses directly damage our client’s lives.  Our community’s response to mental illness in terms of stigma, adds to the damage.  We can successfully treat the illness and miss the damage done by the stigma.  As a Peer Specialist, embrace your natural role in leading the charge against stigma.

REFERENCES

 Corrigan, P. W., Larson, J. E., Michaels, P. J., Buchholz, B. A., Del Rossi, R., Fontecchio, M. J., ... & Rüsch, N. (2015). Diminishing the self-stigma of mental illness by coming out proud. Psychiatry Research, 229(1-2), 148-154.

 KEY WORDS: Peer Support Specialist, Stigma, Stigma Reduction, Recovery, Peer Support, Peer Support Training, Peer Support Certification, Peer Support Jobs