Stigmatization Related to Mental Disorders – Bulgaria (AMSB)

Name of the activity: Stigmatization Related to Mental Disorders

Country/NMO: Bulgaria (AMSB)

Program: Mental Health

Contact information: [email protected]

Type of the activity: Campaign

General description:

Stigmatization of people with mental disorders decreases their own and their acquaintances’ life quality in various degrees at certain aspects such as social contacts, family relationships, self-esteem, economic well-being etc. and creates a human rights gap between those with and without mental illness. Despite the fact that early interventions are crucial for effective treatment of mental disorders, individuals experiencing problems with mental health abstain from seeking help because of the fear of being stigmatized by our society. The concept of stigmatization was not mentioned in the previous national action plan and is mentioned in the current national programme for mental health very slightly and vaguely. We would like the increase the actions for public awareness. We plan to interact with medical students, society, patients admitted to the psychiatrics clinics, and government of Republic of Bulgaria via this campaign. We will inform medical students with facts about mental health and stigmatization and they will inform and survey patients and people without mental disorders about their experiences with stigmatization. We will analyse and publish the data from surveys. We will present the project to the governmental delegation of Republic of Bulgaria to the 71st World Health Assembly (WHA) and advocate for better policies and actions for stigmatization related to mental disorders and youth involvement in the process.

Focus area:

Mental Health advocacy and public awareness

Problem statement:

Stigmatization of people with mental disorders and the stigma on the concept of mental disorders in our society are the problems that we would like to address with our activity ‘’Stigmatization Related to Mental Disorders’’. In our society, as well as many others, stigma decreases the quality of lives of people with mental disorders and their acquaintance in various degrees at certain aspects of life such as social contacts, family relationships, self-esteem, economic well-being etc. and creates a human rights gap between those with and without mental illness. Despite the fact that early interventions are crucial for effective treatment of mental disorders, individuals experiencing problems with mental health abstain from seeking help because of the fear of being stigmatized by our society. The concept of stigmatization was not mentioned at the previous national action plan and is mentioned in the current national programme for mental health very slightly and vaguely. Ministry of Health of Republic of Bulgaria acknowledges the burden of mental disorders as stated in the Objectives For Health 2020 with the sentence ‘’Mental disorders are second in terms of contribution to disease proliferation (measured through the indicator “years of life being sick or disabled) in the European region (19%) and represent the most important disability factor.’’. We welcome the long term task stated as engaging politicians in the country with mental health problems and to convince society in the need for change. And we emphasize the need for more ambitious goals and actions including erasing the stigma related to mental disorders! We, medical students, being a vulnerable group as well as public health leaders, must fight against stigmatization and advocate to eliminate it!

Target groups and beneficiaries:

We will address and interact with the following target groups directly:
1. Medical students
2. Society
3. People with mental disorders in the psychiatric clinics
4. Governmental delegation of Republic of Bulgaria to the 71st World Health Assembly (WHA)
The primary long run beneficiary of our campaign is people with mental disorders living in Bulgaria and secondarily whole public in Bulgaria experiencing a better mental well-being with the decrease in stigmatization related to mental disorders.

Objectives and indicators of success:

1. Medical students are informed about general facts for mental health and stigmatization related to mental disorders.
Indicator of success: Medical students conducting the surveys are able to explain about mental health and stigmatization to people who are filling in the surveys.
2. Society is informed about general facts for mental health and stigmatization related to mental disorders.
Indicator of success: People filling in the surveys understand the general concept and are able to interpret and give meaningful input to the questions of survey.
3. Obtaining information about experiences of people with mental disorders about stigmatization to be used to improve the quality of services and public attitude towards them.
Indicator of success 1: Patients at the psychiatric clinics are given proper information about the use of survey, helped for any questions came up while filling in the survey and gave meaningful input to be interpreted.
Indicator of success 2: Meaningful amount of surveys, for example at least 40 per a clinic which has around 800-2000 admitted patients per year, which will be assigned by their professor, are collected.
4. Comparison of society opinion and people with mental disorders about stigmatization.
Indicator of success: Same amounts of surveys for patient and healthy individuals are collected by each local committee according to what their professors assigned.
5. Presentation of our project to the governmental delegation of the Republic of Bulgaria to the WHA to pressure on the decision makers to adapt policies accordingly.
Indicator of success: We could contact them at the WHA, presented our work and made calls.

Methodology:

How will you achieve your objectives? What are the concrete actions that make up your Activity? Maximum 700 characters.
• Make a call for participants and choose at least 4 people for each local committee until 15th April .
• Create a facebook group to arrange online meetings and share information.
• Create a google doc for tasks overview for the participants to fill in
• Create google docs explaining introductions for surveying patients, surveying healthy individuals, entering data of healthy individuals, entering data of patients.
• Create google docs for suggestions to improve the quality of lives of people with mental disorders and suggestions for presentation & topics to mention.
• Create a project proposal for having permission of Professor of Psychiatry and Committee of Ethics.
• Create a doodle form and set one or two online meetings according to the participants availability until 17th April.
• Upload instructions, surveys, data sheets to the google drive until 19th April.
• In the online meeting
welcome participants to the project
provide general facts about mental health and stigmatization
give information about methodology and tasks
clarify any further questions
invite them for further studies if they would like to work for publication
select a chief responsible for each local committee to work more effectively and create a facebook local committee group chats for communication
• Participants choose their tasks until 26th April and fills in the tasks overview document.
Methodology for implementation:
1.Meeting with your Professor of Psychiatry until 03.05.2018
• Introducing the project
• Obtaining permission
• Learning approximately how much patients can be surveyed in the meantime until 14th May
2.Obtaining permission of the ethics committee of your university until 03.05.2018
3.Surveying patients until 13.05.2018
• Please be available for your patient’s questions
They might not understand some questions and if you do not explain what essentially the question asks they may give unmeaningful and irrelevant answers – especially patients with schizophrenia
4.Surveying healthy individuals until 13.05.2018
• Same amount as surveyed patients
• NOT the relatives of patients to prevent bias
• Preferably in the same age level of your patients – most probably will be adults at least survey adults if you cannot find same age range
5. Entering data until 13.05.2018
Excel form is created and the instruction surveys are present
6. Statistical analysis until 16.05.2018
7. Suggestions to improve quality of life of people with mental disorders until 18.05.2018
8.Suggestions giving your input for presentation until 18.05.2018
9.Preparing one pagers until 20.05.2018
10. Presenting the project to peers at the Pre-WHA for future collaboration and to the governmental delegation of Republic of Bulgaria for better mental health policies and actions including stigmatization until 26.05.2018

Plans for evaluation:

We will evaluate our campaign according to the following criteria:
• Enough students (at least 20) wanted to take part in the campaign.
• Students acknowledged the importance of stigmatization around mental health issues and showed interest to take action.
• Professors approved application of surveys in the clinics and helped for ethics committee approval.
• Society were informed about stigmatization related to mental disorders and they made a self reflection, saw their position in the spectrum and how their attitude affects people with mental disorders. They showed interest to improve the present situation.
• Approximately 150 surveys are collected from patients in total.
• Approximately 150 surveys are collected from healthy individuals in total.
• Data is analysed and correlation between demographic data of patients and healthy individuals and their experiences with stigmatization are established to be used in further publication.
• One page briefs are made to present the governmental delegation of Republic of Bulgaria at the 71st WHA.
• Governmental delegation showed interest to improve the situation related to stigmatization for people with mental disorders and involve youth work in the process.