New intervention to reduce self-stigma among persons with serious mental illness

"Just like wheelchairs and Braille have increased social integration for people with physical handicaps, there is also a need to identify and remove the barriers to community inclusion for people with serious mental illness," says Prof. Roe, Chair of the Department of Community Mental Health, Faculty of Social Welfare and Health Sciences at the University of Haifa who led the study together with his colleagues from the US -- Professors Paul H. Lysaker from Indiana University School of Medicine, Dept of Psychiatry and Philip T. Yanos of the Department of Psychology, John Jay College of Criminal Justice, City University of New York, and from Israel -- Dr. Ilanit Hasson-Ohayon, Yaara Zisman-Ilani and Oren Deri.

Much attention has been given to providing accessibility to all facilities intended for the public, in striving to gain equality for people with physical disabilities. But while the obstacles facing the physically challenged can be relatively easily identified, pinpointing the obstacles that persons with a mental illness must overcome is much harder.

According to Prof. Roe, earlier studies have shown that one of the central obstacles is the negative stigma attached to mental illness by society at large, which is much more powerful than the labels attached to people with other disabilities. This stigma may lead to social exclusion. Another obstacle that may result from stigma is "self-stigma," whereby people with a mental illness adopt and internalize the social stigma and experience loss of self-esteem and self efficacy. "People with a mental illness with elevated self-stigma report low self-esteem and low self-image, and as a result they refrain from taking an active role in various areas of life, such as employment, housing and social life," Prof. Roe explains.

In an attempt to address this problem, Prof. Philip Yanos of City University of New York Prof. David Roe and Prof. Paul Lysaker of Indiana University School of Medicine, with the help of a research grant from the National Institute of Mental Health, developed what they term "Narrative Enhancement Cognitive Behavioral Therapy (NECT)," which is aimed at giving people with a mental illness the necessary tools to cope with the "invisible " barrier to social inclusion -- self-stigma.

The research team ran a twenty-meeting pilot course of the new intervention at three separate locations: New York, Indiana and Israel. Following the pilot run, Prof. Roe headed a study in Israel, in which 21 people with a mental illness (with at least 40% mental handicap) completed the intervention. This study examined the effects of the intervention compared to a control group of 22 mentally ill people of similar disabilities who did not participate in the intervention. It showed that those who participated in the intervention exhibited a reduced self-stigma and, in parallel, an increase in quality of life and self-esteem.

"The intervention method that we developed helps persons with mental illness cope with one of the central obstacles that they face -- self-stigma. We hope to be able to train more professionals in this intervention and root the method in rehabilitation centers and community health centers, so as to assist in recuperation processes and in community inclusion over a larger and more significant population of people with a mental illness," Prof. Roe concludes.