HEADSTRONG: TOGETHER
BY DESIGN
CMHA CONFERENCE
September 30, 2016
Toronto, ON
2
Introductions and Objectives
• Brief historical overview
• The HEADSTRONG Summit program
– Community Coalition development
– Speaker training process
– Student lead school based activities
• What the research tells us
Headstrong National Launch
November 2014
3
Brief Historical Background
• Launched at National Youth Summit November
2014
• 2015: 19 Regional Coordinators delivered 32
regional summits and 4 provincial events
• 2015: 500 schools, 6000 participants estimated
reach of 200,000
• Toolkits: Your Speaker’s Story; Telling Your Personal
Story; Youth Stigma Summit; School Based
Activities
• Headstrong Final Report 2015
• Coordinator Training east and west
4
Brief Historical Background
• Regional Coalition Development
• 2016 Toolkits: Breakout Room Facilitator training;
Volunteer training; Headstrong Committee
development
• First Nations Rural Summit scheduled for Oct. 2016
• Provincial partnerships
• Collaboration with Stan Kutcher
• Ongoing coordinator support for local funding and
sustainability
5
Why MHCC Works to Reduce Stigma
7 Million Canadians
will experience a
mental health
problem this year
Many people living
with a mental illness
say the stigma they
face is worse than
the illness itself
Males and females are
equally affected by
mental health problems
40% of Canadian
parents would not tell
anyone if their child had
a mental illness
75% of young
Canadians with a
mental health problem
do not seek help
• Almost 60% of youth who
sought treatment in the
last year say they have
been affected by stigma
Youth are a
High Risk
Group
Percentage/age of people who reported
experiencing stigma in the past year
12-month Stigma Impact by Age Group for Those Treated for a Mental
Health Condition in Past Year who Reported Some Stigma
Weighted % of 752
•
•
•
•
•
The majority of mental
disorders begin during
youth so they are at high
risk for stigma
Youth are interested in
mental disorders, stigma,
and are willing to learn
Youth bring a sense of
social justice to the table
that is important in
fighting stigma
Access to youth in school
makes targeted programs
feasible
CTF survey showed that
teachers want mental
health to be a priority
60
50
40
30
20
10
0
< 25 years
26-45 years
> 45 years
(Source: Rapid Response Survey (n~10,000), Opening Minds, MHCC & Statistics Canada,
Opening Minds Supplement, Canadian Journal of Psychiatry, 2014)
Why did Opening Minds choose HEADSTRONG?
Out of many programs evaluated, we looked for something that:
1.Had positive evaluation results in reducing stigma
2. Potential to reach and inspire a large number of youth across Canada, in
many different geographic areas
3. Was complimentary to mental health education programs already in
existence in different schools and provinces
4. Would include and empower youth
HEADSTRONG is a day-long summit program where many
schools sent representative students (with a teacher) to:
• hear stories about living with a mental illness
• challenge own beliefs
• plan anti-stigma activities to take back to their own
student populations
8
Durham TAMI Coalition
Established 2002
Summit Model introduced 2004
Contact based work includes 3 summits per school year plus in-class
modules
2007 Minister’s Award for Innovation in Health Promotion
2007 OHA IBM Leading Practices Award
2012 MHCC 5th Anniversary Partnership Award
Total population Durham Region: 653,600
Total population 15-19 year olds: 23,713
2015/16 Totals for Durham TAMI: 2,458
Current total number Durham TAMI participants: 58,027
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MENTAL HEALTH CONTINUUM
Optimal Mental Health
Optimal Mental
Health with a
Mental Health
Illness (diagnosed)
Optimal Mental
Health without a
Mental Illness
Serious Mental Illness
Poor Mental
Health with a
Mental Illness
(diagnosed)
Poor Mental Health
without a Mental
Illness
Poor Mental Health
No Symptoms of Mental
Illness
What words does society use to describe
people living with mental illness?
LOSER
WEIRD
DANGEROUS
WEAK
RETARD
HOPELESS
HELPLESS
ANGRY
PSYCHO
FRIGHTENED
SAD
HOPELESS
CRAZY
ALONE
FREAK
ME
ASHAMED
Megan—A Personal Story
12
Porcupine Map
Revisited
13
Headstrong
Community Coalition Development
Heightened effectiveness and community voice
Cross sector representation especially from education
and mental health
Increased access to resources
o Funding/donations
o Speakers/speaker training
o Venue/logistical support
Enhanced legitimacy
Improved overall community organization and working
relationships
14
Cross Sector Partnerships
Youth Mental Health
• Inpatient/Outpatient
• Transition workers
• Social Work; Guidance; Psychology
Education
• Board/District Rep
• Mental Health Leads
Regional/Provincial Health Authorities
Youth Advisory Groups
Addictions; Youth Justice; Public Health; CMHA’s
Special Needs; Crisis Centre; Boys and Girls Clubs
15
FNMI Rural Summit
“Stronger Together”
• Oct 4th, 2016, Mount Royal University
• Tsuu T’ina Nation, Siksika Nation, Bearspaw,
Wesley & Chiniki First Nations, Kainai First
Nation, Foothills School Division, Rockyview
School Division, Palliser School Division, Christ
the Redeemer School Division
• Over 200 youth, 8 amazing lived experience
speakers and a packed day of stigma challenging
activities and inspiration
• Featuring Drezus
•
https://www.youtube.com/watch?v=9TXT1dDXoDI
Expectations of Membership
Terms of Reference
Goals and Objectives
Duties and responsibilities
Executive Structure
Subcommittee structure
17
The Sustainable Summit Model
2016
Region
Students
Teachers
Schools
Potential
Reach
Edmonton
135
32
30
21,000
Thompson
220
20
12
8,400
Sydney
40
4
2
1,400
Cornwall
80
20
20
14,000
Ottawa
150
30
30
21,000
100
70,000
HOCKEY
TALKS
Vancouver
TOTAL
1500
200
135,800
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Headstrong Summits Sept /16- Dec. /16
Region
Students
Teachers
Schools
Potential
Reach
Ottawa
150
30
30
21,000
Regina
100
25
15
10,500
Edmonton
150
30
25
17,500
Stony Plain
100
20
10
7,000
Sarnia
100
20
15
10,500
Peel
150
30
30
21,000
Cornwall
120
20
15
10,500
Calgary
FNMI
200
30
40
20,000
Southern
AB
120
30
16
8,000
BC
750
120
150
105,000
Cape Breton 100
20
15
10,500
Pictou NS
20
10
7,000
TOTAL
120
220,150
19
Ottawa Headstrong Summit 2016
EVALUATION RESULTS
3 Keys to a successful Summit
• Education: Participants hear inspiring stories of hope
from people who have recovered or are managing a
mental illness. This is known as contact-based
education.
• Action planning: Students work together to plan
awareness activities to take back to their own schools.
Both students and school staff are provided with toolkits
and student resources that include action guides and
activity starters
• Contact: Summits connect students, teachers, school
administrators, persons with lived experience, and
community mental health professionals. Students
experience first-hand the importance of networking,
and they learn who they can turn to for support in
planning their own anti-stigma activities.
Recovery is Real
Headstrong Speaker Training
The Process of Becoming a HEADSTRONG
Speaker is Individual
Application
Process
Consideration of
Sharing My Story
Writing
Story
Shadowing
at schools
Speaking
in Schools
For one person the process may look like
this…
1 week
2 months
1 month
3 months
For another person it may look like this…
2 months
2 days
3 months – lots of edits
2 weeks
We have learned that this process is as individual as the experience of recovery and potential
speakers may decide at any point that they need to pause or change their mind. We have also
learned that the support we provide during this process varies.
Evaluating HEADSTRONG
Dr. Stephanie Knaak, Opening Minds Research Associate
(Healthcare Provider Programs and HEADSTRONG)
24
How we Evaluate HEADSTONG
• Process metrics (summit characteristics: number of schools,
students, demographic characteristics of students, etc.)
• Youth Stigma Evaluation Survey
– 11 item stereotype scale; 11 item social acceptance scale
– Pre and post assessment
•
Fidelity to program agenda, speaker training guidelines
•
In development: Measures/processes to track and evaluate
in-school activities
SOCIAL ACCEPTANCE
social acceptance: includes both social distance and social responsibility
1. I would be upset if someone with a mental illness always sat next to me in class
2. I would not be close friends with someone I knew had a mental illness
3. I would visit a classmate in the hospital if they had a mental illness
4. I would try and avoid someone with a mental illness
5. I would not mind if someone with a mental illness lived next door to me
6. If I knew someone had a mental illness I would not date them
7. I would not want to be taught by a teacher who had been treated for a mental illness
8. I would tell a teacher if a student was being bullied because of their mental illness
9. I would stick up for someone who had a mental illness if they were being teased
10. I would tutor a classmate who got behind in their studies because of their mental
illness
11. I would volunteer my time to work in a program for people with a mental illness
26
SOCIAL ACCEPTANCE
Proportion of students who met the 80% threshold of success on the Social
Acceptance Scale at pre and post test: All summits
100%
Pre
90%
Post
80%
70%
60%
50%
40%
30%
20%
10%
0%
8
102
17
14
22
24
20
4
1
5
100
11
2
7
9
10*
23
19
Summit ID
27
21
13
101
12
15
6*
Fidelity Matters
Proportion of students across the
threshold of success on acceptance scale:
pre and post summit
Social Acceptance
30%
25%
20%
15%
11.3%
10%
4.3%
5%
0%
Strong fidelity to
program agenda and
speaker training
100%
95%
90%
85%
80%
75%
70%
65%
60%
Weaker fidelity to
program agenda and
speaker training
73.2%
65.1%
69.4%
Strong fidelity to program Weaker fidelity to
agenda and speaker
program agenda and
training
speaker training
amount of change
k=24
84.5%
pre-test
Post-test
k=24
28
STEREOTYPED ATTRIBUTIONS
controllability of illness, potential for recovery, and potential for violence and unpredictability
1.
Most people with a mental illness are too disabled to work
2.
People with a mental illness tend to bring it on themselves
3.
People with a mental illness often don’t try enough to get better
4.
People with a mental illness could snap out of it if they wanted to
5.
People with a mental illness are often more dangerous than the average person
6.
People with a mental illness often become violent if not treated
7.
Most violent crimes are committed by people with a mental illness
8.
You can’t rely on someone with a mental illness
9.
You can never know what someone with a mental illness is going to do
10. Most people with a mental illness get what they deserve
11. People with serious mental illnesses need to be locked away
29
STEREOTYPED ATTRIBUTIONS
Proportion of students who met the 80% threshold of success on the Stereotype
Scale at pre and post test: All summits
100%
90%
Pre
Post
80%
70%
60%
50%
40%
30%
20%
10%
0%
11
102
100
7
*small sample size n<30
9
8
2
13
14
22
20
4
24
17
6*
15
1
21
Summit ID
30
5
23
101
12
10*
19
Fidelity Matters
Stereotype Attributions
30%
25%
24.9%
20%
16.6%
15%
10%
5%
0%
Strong fidelity to program agenda and speaker training
Weaker fidelity to program agenda and speaker training
amount of change
k=24
31
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Conversation Café
“Drive Through Version”
Question
1. What would it take for Headstrong to grow in
your community?
2. How can you ensure fidelity to the program?
33
Questions?
Thank you
Contact us: [email protected]
Visit: www.mentalhealthcommission.ca
http://www.mentalhealthcommission.ca/English/initiatives/11876/headstrong
http://www.mentalhealthcommission.ca/Francais/initiatives/11876/la-tetehaute)
Follow us:
The views represented herein solely represent the views of the Mental Health Commission of Canada.
Production of this document is made possible through a financial contribution from Health Canada.
Les opinions exprimées aux présentes sont celles de la Commission de la santé mentale du Canada.
La production de ce document a été rendue possible grâce à la contribution financière de Santé Canada.