Objective To summarize the ongoing activities of the Opening Minds (OM) Anti-Stigma Initiative of the Mental Health Commission of Canada regarding the 4 groups targeted (youth, health care providers, media, and workplaces), highlight some of the key methodological challenges, and review lessons learned. Method The approach used by OM is rooted in community development philosophy, with clearly defined target groups, contact-based education as the central organizing element across interventions, and a strong evaluative component so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. Results Results have been generally positive. Contact-based education has the capacity to reduce prejudicial attitudes and improve social acceptance of people with a mental illness across various target groups and sectors. Variations in program outcomes have contributed to our understanding of active ingredients. Conclusions Contact-based education has become a cornerstone of the OM approach to stigma reduction. A story of hope and recovery told by someone who has experienced a mental illness is powerful and engaging, and a critical ingredient in the fight against stigma. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming. The next challenge will be to scale these up so that they may have a national impact.

Objective: To summarize the background and rationale of the approach taken by the Mental Health Commission of Canada's Opening Minds (OM) Anti-Stigma Initiative. Method:The approach taken by OM incorporates a grassroots, community development philosophy, has clearly defined target groups, uses contact-based education as the central organizing element across interventions, and has a strong evaluative component, so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope.Results: OM has acted as a catalyst to develop partnerships between community groups who are undertaking anti-stigma work and an interdisciplinary team of academic researchers in 5 universities who are evaluating the results of these programs. Conclusions:Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming.

Objective Our paper presents findings from the first population survey of stigma in Canada using a new measure of stigma. Empirical objectives are to provide a descriptive profile of Canadian's expectations that people will devalue and discriminate against someone with depression, and to explore the relation between experiences of being stigmatized in the year prior to the survey among people having been treated for a mental illness with a selected number of sociodemographic and mental health—related variables. Method Data were collected by Statistics Canada using a rapid response format on a representative sample of Canadians ( n = 10 389) during May and June of 2010. Public expectations of stigma and personal experiences of stigma in the subgroup receiving treatment for a mental illness were measured. Results Over one-half of the sample endorsed 1 or more of the devaluation discrimination items, indicating that they believed Canadians would stigmatize someone with depression. The item most frequently endorsed concerned employers not considering an application from someone who has had depression. Over one-third of people who had received treatment in the year prior to the survey reported discrimination in 1 or more life domains. Experiences of discrimination were strongly associated with perceptions that Canadians would devalue someone with depression, younger age (12 to 15 years), and self-reported poor general mental health. Conclusions The Mental Health Experiences Module reflects an important partnership between 2 national organizations that will help Canada fulfill its monitoring obligations under the United Nations Convention on the Rights of Persons with Disabilities and provide a legacy to researchers and policy-makers who are interested in monitoring changes in stigma over time.

This study evaluated eighteen Canadian anti-stigma programs targeting high-school students. The purpose was to identify critical domains and develop a program model of contact-based interventions. Three steps were implemented. The first step involved collecting program information through twenty in-depth interviews with stakeholders and field observations of seven programs. The second step involved constructing critical ingredients into domains for conceptual clarity and component modeling. The third step involved validating the program model by stakeholders review and initial fidelity testing with program outcomes. A program model with an overarching theme "engaging contact reduces stigma" and three underlying constructs (speakers, message, and interaction) were developed. Within each construct three specific domains were identified to explain the concepts. Connection, engagement, and empowerment are critical domains of anti-stigma programs for the youth population. Findings from this study have built on the scientific knowledge about the change theory underpinning youth contact-based intervention.

The purpose of this study was to evaluate a contact-based educational symposium designed to reduce mental healthrelated stigma in journalism students. Repeated surveys conducted before (n = 89) and again after the intervention (n = 53) were used to assess change. The estimated average response rate for each survey was 90%. The instrument, adapted from prior research, contained items pertaining to stereotypical content, attitudes toward social distance and feelings of social responsibility (Cronbach's alpha =.74).There was a statistically significant reduction in stigma (reflecting a 5% reduction in the aggregated scale score). A large, item-specific change was noted pertaining to attributions of dangerousness and unpredictability (reflecting a 26% improvement). The majority of students reported that the symposium had changed their views of people with a mental illness. Half of these students considered that they would change the way they would report stories involving someone with a mental illness. A potential unexpected negative side effect was that 14% fewer students reported post-test a willingness to go to a doctor if they experienced a mental illness.Though it is difficult to draw firm conclusions from an uncontrolled study, it would appear that this relatively brief, contact-based intervention changed journalism students' views of people with a mental illness. More controlled investigation is needed to rule out alternative explanations that could account for this change.

Background. Much research is done on the stigma of mental illness, but little research has been done to characterize these phenomena from the perspective of people with mood disorders. Objective. To characterize the extent to which individuals with bipolar disorder and depression are stigmatized, determine factors related to higher levels of stigmatization, and assess the reliability of the Inventory of Stigmatizing Experiences in a population of people with a mood disorder. Methods. Two hundred and fourteen individuals with depression and bipolar disorder were recruited from a tertiary care psychiatric hospital and surveyed using the Inventory of Stigmatizing Experiences. Results. Participants reported high levels of stigma experiences and this did not differ by diagnosis (P = 0.578). However, people with bipolar disorder reported greater psychosocial impact of stigma on themselves and their family members compared to people with depression (P = 0.019). The two subscales produced internally consistent results with both populations. Conclusion. Stigma negatively affects those with both depression and bipolar disorder but appears to have a greater psychosocial impact on those with bipolar disorder.

Contact-based education is a promising practice for reducing stigma in high school students, although the field would benefit from fidelity criteria to reduce variation across interventions. Males and females react differently to antistigma programming; particularly those with self-reported mental illnesses and a small proportion may become more intolerant.

Governments in ontario have promised family physicians (fps) that participation in primary care reform would be financially as well as professionally rewarding. We compared work satisfaction, incomes and work patterns of fps practising in different models to determine whether the predicted benefits to physicians really materialized. study participants included 332 fps in ontario practising in five models of care. The study combined self-reported survey data with administrative data healThcare policy Vol.5 No.2, 2009 [e163]Financial and Work Satisfaction: Impacts of Participation in Primary Care Reform on Physicians in Ontario from ices and income data from the canada revenue agency. fps working in non-fee-for-service (ffs) models had higher levels of work satisfaction than those in ffs models. incomes were similar across groups prior to the advent of primary care reform. incomes of family health network fps rose by about 30%, while family health group fps saw increases of about 10% and those in ffs experienced minimal changes or decreases. self-reported change in income was not reliable, with only 47% of physicians correctly identifying whether their income remained stable, increased or decreased. The availability of a variety of ffs-and non-ffs-based payment options, each designed to accommodate physicians with different types or styles of practice, may be a useful tool for governments as they grapple with issues of physician recruitment and retention. RésuméEn Ontario, les gouvernements ont promis aux médecins de famille que leur participation à la réforme des soins de santé primaires comporterait des avantages à la fois financiers et professionnels. Nous avons comparé la satisfaction au travail, le revenu et les régimes de travail de médecins de famille oeuvrant dans divers modèles de pratique, afin de déterminer si les avantages prévus se sont effectivement matérialisés. Cette étude comptait sur la participation de 332 médecins de famille en Ontario oeuvrant selon cinq modèles de prestation de soins. Nous avons tenu compte de données de sondage déclarées volontairement par les médecins ainsi que de données administratives provenant de l'Institut de recherche en services de santé (IRSS) et de l' Agence du revenu du Canada. Les médecins de famille qui travaillent selon des modèles autres que la rémunération à l' acte (RAA) ont indiqué de meilleurs taux de satisfaction au travail que ceux qui fonctionnent selon la RAA. Avant l'instauration de la réforme des soins de santé primaires, les revenus entre les groupes étaient similaires. Le revenu des médecins qui travaillent dans les réseaux de santé familiale a augmenté de 30 pour cent et celui des médecins qui travaillent dans les groupes de santé familiale a augmenté de 10 pour cent, tandis que les médecins qui travaillent selon la RAA ont vu peu de changement ou une diminution de leur revenu. Les fluctuations de revenu déclarées volontairement ne sont pas fiables, car seulement 47 pour cent des médecins ont indiqué avec préci-sion si leur revenu s' étai...