Data Analysis

FOCUS GROUP ANALYSIS OF THEMES

Themes: Education

We found a common theme amongst the dialogue discussing education involving differences in age and generational perspectives. The first mention of age involved the conception of homosexuality from a generational standpoint. Years ago, homosexuality was considered a mental illness, however that is no longer the general consensus. Generational perspectives was also mentioned when discussing views of "therapy". At one point in time, seeking therapy was majorly stigmatized, however many kids today are involved in occupational and speech therapy in school which is becoming normalized.

Additionally, there is a crossover concerning age difference and forms of educating the general public about mental illness. Opinions concerning ways in which to educate varied. An overall consensus suggested mental health education start as early as grade school health class. However, there is a disconnect when it comes to the older generations who are outside of the school system. It is assumed that there will be a dialogue between young students and parents in terms of defining and clarifying mental illness, which we interpret as a generational crossover. Thus the incentive to self-educate will be a derivative of the education that children are currently receiving in health class concerning mental illness.

Concept of Mental Illness

Along with education, concept of mental illness also had a common dialogue. Along with the common themes within this, the topic of alcohol as medication, not so much as a deviant behavior. Another topic addressed was the difference between mental illness as neurological or genetic issue versus it being environmental influences. Poignantly, what is considered a mental illness to begin with? Is anxiety and depression, with its common diagnosis, taken seriously in society or as common as getting as a headache? Similarly, what is the difference between simple life events qualified as sadness, and a clinical diagnosis of depression. Finally, the group addressed that as a bystander, when is the right time to say to a friend: "an intervention is needed?"

Treatment threads:

Degree/Modality of Tx:

1. Tx as radical/elimination of symptoms/changes the person (ie psychiatric medication)

2. Tx as responsive to symptoms/progressively working twd change over time/preserves the person's prior nature (ie talk therapy)

Other dimensions of Tx:

3. Having a choice for type of Tx - implication for human rights issue

4. Tx type not relevant to efficacy 

5. Timeliness of Tx matters for efficacy ie. autism

6. Certain illnesses treatable vs. others not ie. autism v. anxiety

7. Combination of Tx modalities more effective (Therapeutic/Medical- ie.pills)

8. Overall optimism in diff types of Tx regardless of causality/type illness

9. Perception of Tx efficacy impacted by contact with MI

10. Tx efficacy linked to normalization ie. mainstreaming children with MI

11. Conflation of neurological disorder with idea of mental illness - ie. autism - not necessarily illness but disorder like narcolepsy - how this impacts ideas of Tx

12. Perception of seriousness of MI impacts perception of need for Tx

13. Symptoms of MI (ie addiction) exhibited as self-medication for underlying MI (ie depression)

Causal threads:

1. Genetic causal

2. Environmental

3. Combination of the two

4. Environmental (external) coping mechanism appears as MI, but actually masking internal (genetic?) MI that is present

Stereotypes

One of the recurring themes we found was that people placed a negative stereotype upon mental illness. The negative stereotype is associated with fear of talking about mental illness. We also found a recurring theme of empathy and understanding. There is a relationship between the amount of empathy someone will have for someone with mental illness depending on the extent of how much contact there is between the two. Also, found was that there is more empathy toward people with mental illnesses when the person with the mental illness is closely related to the individual. We found that a recurring theme was relationships in the sense that people are more skeptical of choosing a partner with a mental illness. The severe the mental illness, the more social distance is created. Lastly, we discovered that one of the themes would be related to education and media which has increased awareness of mental illness with views becoming more and more acceptant.

Social Distance

One of the first recurring themes we found relating to social distance was a combination of intervention and acceptance. We felt that people, especially children, are becoming more acceptant of seeing their peers with a mental illness in everyday settings. Another theme was related to stereotypes and hiding. People hide their illness because of the perceived negative stereotype that is commonly associated with mental illness. This causes many people to have a fear of even discussing mental illness, let alone disclosing personal information. A major theme among social distance was the formation of relationships which ties together with stereotypes. The severity of the mental illness will determine the types of relationships people will form together, specifically if a person has a perceived “severe” mental illness others will distance themselves and not consider them for romantic relationships.

Barriers

We found four different types of barriers mentioned: financial, cultural, immigration status, and that service providers are not Latino. Financial barriers included a lack of health insurance that prevents access to services. Cultural barriers refer to the concept of “dirty laundry” in the Latino culture, and that self-medication is more acceptable than talking about problems. Immigration status related back to health care because undocumented immigrants cannot get insurance or seek treatment. Latinos also feel that they can’t relate to providers who aren’t Latino, and the participant felt that a Latino service provider is very rare to find.

Stigma

We found that people mentioned denial of having a mental illness, and this was closely connected to the participants’ generalization and normalization of mental illness. Age was also a factor with older people; they felt less wary of seeking help. The passing of time was also mentioned as a way of growing out of the mental illness instead of seeking help. Participants discussed contact of mental illness; one thought that it passes from person to person. Contact was also discussed through the perspective that the closer the person with mental illness is to the individual, the less social distance the individual feels towards them.

DIAGNOSIS

 Themes: Schizophrenia as most scary/taboo, Depression as most common/acceptable, Autism as untreatable but not scary, Anxiety as maybe treatable

Autism was the first diagnosis to be mentioned by a focus group participant. This speaker stated that he or she did not believe that autism is very treatable, although there are early interventions that can be implemented to make the effects of autism less severe. This speaker was very adamant about the fact that one cannot “come back” from having autism. It was unusual for this to be the first diagnosis brought up during the discussion because autism may not widely be considered to be a mental illness. It is a possibility that this participant had prior exposure to an individual with autism.

 

Other diagnoses came up during the discussion over time. After a discussion about autism, schizophrenia was introduced to the conversation. The conversation was rather narrow at first but as the discussion progressed and other participants warmed up, others chimed in about depression, bipolar and anxiety. Comments about the diagnosis of depression were more light-hearted and included a mention about how most everybody is depressed and that depression as a diagnosis isn’t necessarily scary for someone to hear. Schizophrenia was acknowledged to be scarier than other diagnoses. The general sentiment of the group was that depression is more acceptable, easier to deal with, less of a negative warning signal than is schizophrenia. Anxiety was discussed briefly and it was felt that it can be serious but may be treatable – there seemed to be uncertainty about this. A focus group member mentioned that the reason the general public is less comfortable with schizophrenia is because there is not a great deal of awareness about it—there is a general stereotype/stigma about a person who is schizophrenic, but if it were made more mainstream, it would not be so scary and it would be less taboo.

  

MEDIA

 

Themes: Television as an avenue for education, Public Service Announcements/Commercials, Celebrity (eg: athele) spokespersons, Films addressing mental illness as a positive step, Recent news stories/media portrayal of mental ill criminals

 

The discussion related to media immediately introduced the recent Newtown, CT shooting. A speaker addressed the way in which the shooter has been portrayed as a monster in the media, rather than addressing the fact that he suffered from a disorder – Asperger’s disorder. There was also a decent amount of discussion about schizophrenia being taboo and the possibility of using television as an outlet for education to solve this problem. There was a discussion about how TV means a greater access to information since not everybody attends school/college, but most everyone has access to television. There was a discussion about the possibility of using public service announcements as well as references to PSA’s from the 1970’s about littering. Government funded commercial spots were suggested.

Using celebrity role models such as athletes speaking out about mental illness was also suggested (in the context of a speaker referencing the possibility of a basketball player speaking out about homophobia). Somebody responded to that by suggesting an episode of Sesame Street that addressed mental illness. This sparked a conversation about a movie that is currently in theaters—Silver Lining Playbook, which deals explicitly with mental illness (specifically bipolar disorder). The area of the plot discussed by the group was that the character viewed him/her self as an erratic person before receiving the diagnosis (bipolar disorder) but after receiving the diagnosis was able to make changes and address the problem.