A Call to Action: The Intersection of Race and Mental Health Symposium

This blog is a reflection and to provide highlights of, “A Call-to-Action Symposium: The Intersection of Race and Mental Health” which took place on April 19, 2022, at Marquette University in Milwaukee, Wisconsin and virtually. The symposium  was the culmination of four virtual quarterly coalition meetings offered by WISE in 2021 on the topic. Those in attendance at the four coalition meetings expressed a strong desire for the conversation to move from learning about to acting on what was learned. This symposium provided the outlet for critical thinking, thought provoking discussion and action planning around race and mental health. The panel topics and speakers were:

  • Strengthening resources – Mr. Reggie Jackson and Ms. Brenda Wesley
  • Diversity in the mental health workforce – Dr. Maria Amarante
  • Disparity of reimbursement rates – Ms. Thomasina Jenkins
  • Training of police officers and first responders – Captain Sheronda Grant and Ms. Brenda Wesley
  • Ecosystem Mapping  -Dr. Rob Smith

Mr. Brooks Griffin, Emcee, was energetic throughout the day by introducing each of the distinguished panelist and sharing his heartfelt and powerful recovery journey. Mr. Griffin was an awesome moderator as well as keeping everyone focused and on task.  I participated virtually and felt the positive energy from each of the panelists, participants who commented and asked questions for the panelists, the action-planning breakout sessions for each of the topics, and the phenomenal group sharing with “Explaining my plan of action”. The My Plan of Action worksheet was a unique way for participants to write down their plan and meet up afterwards in the community, and maybe share a picture of themselves working together. To encourage post-event collaboration, participants were offered a gift card for one of three local coffee shops.

My reflections and lasting thoughts from the panelists:

Mr. Jackson reiterated that we must highlight the “Superheroes in Milwaukee and stop being so humble about the positivity in Milwaukee. We need to know about organizations and resources that can actually help and care”. Ms. Wesley started with a critical question, “How do we open our community to the secrets of mental health and mental illness?” She responded by saying, “We talk about it, we start a conversation, tell the stories of strength, resiliency, and happiness and tell the stories of rejection, sadness, and stigma.” Dr. Amarante reflected on her journey from Patterson, New Jersey and now living in Wisconsin. She stated that, “She is humbled to be at the table, to see that her words actually matter, and to be in the season of her life where she can sit before an audience that actually cares about what she has to say.”  

Ms. Jenkins provided us with a detailed PowerPoint about The Mental Health Parity and Addiction Act of 2008 (Federal). She discussed how some behavioral health facilities will accept a certain insurance company, but it is out of network meaning that more “out of pocket money” will be needed from individuals seeking treatment. Ms. Jenkins stated, “This is a problem because individuals seeking treatment do not have the “out of pocket” hundreds or thousands of dollars for the services needed from the facility or hospital.” Captain Grant discussed how the training for the Crisis Intervention Team (CIT) was a “Breath of Fresh Air” which helped her as a police officer in Milwaukee to engage effectively with individuals who are suffering from mental health challenges. Ms. Wesley provided us with some brief history about the induction of (CIT) team trainings, how the team training was phenomenal and her role as a certified facilitator for this evidence-based training. She discussed how the philosophy of (CIT) should have been maintained for officers who are trained voluntarily to engage effectively with individuals who are in a crisis.

Dr. Smith provided us with a vivid example of ecosystem mapping and the EVE approach to three interconnected systems-change processes to assist stakeholder communities. The EVE approach starts with the Ecosystem Mapping, Value Driven Dialogue, and Emergent Action. The hope is to use this mapping to map the many resources available for mental health and wellness in the Milwaukee community.

Break-Out Sessions

We were able to participate in the four breakout sessions via in person or virtually. I participated in the session about training of police officers and first responders. Our breakout session was led by Sue Dicks; we were challenged to discuss the following questions:

  1. We have heard examples of solutions that are in place in this area of need. What other positive things are happening?
  2. Where is there opportunity to support what is already happening? Are there glaring gaps?
  3. How would you get involved either as an individual, team, or organizational level?
  4. What next steps do you need to take to get involved? Who might you partner with to take these next steps?

There were about eight of us in our group and we had a great discussion about this topic. One participant discussed how to get the positives out and a weekly meeting that is going on at his church. I was able to discuss how mental health providers are housed at the police department in the city where I live in Illinois. The mental health provider is trained to assist the police officers to go on crisis calls to intervene and use their crisis training to engage with the individual who is experiencing the crisis.  

Break-out Group Sharing

The breakout group sharing was monumental because each group provided us with specific action plans as individuals or their piece of plan of action. One example of a plan of action with the community that materialized was a virtual workshop entitled, “Equity in Reimbursement for Mental Health Providers” led by Ms. Thomasina Jenkins on May 25, 2022.  I attended the virtual workshop, and I was elated about the content and the specific action steps for the participants to do in the community to help move Equity in Reimbursement for Mental Health Providers forward.

The symposium was mind-blowing, and I was energized from the beginning to the end as a virtual participant and if I was in person, I can only imagine that high power energy, passion, healing, growth and leadership radiated throughout the symposium. I was honored and humbled to be part of the dynamic event as well as the unique layout of the symposium. It set a high standard of how powerful an event can function online as well as in person.

If you want to view:

A Call to Action: The Intersection of Race and Mental Health Symposium

We want to hear from you! Send comments you want to share with us to wise@eliminatestigma.org

Our next WISE online Coalition Meeting entitled, Addressing Stigma at the Intersection of Substance Use Disorders and Mental Health: Recovery Realities and Provider Challenges of Fatigue and Stigma on Tuesday, August 16, 9:30-11:30 am.

About the Author

Dr. Ricardo Anderson is a Certified Recovery Support Specialist (CRSS), a co-facilitator of a recovery group for all types of addictions, serves on the Executive Board for WISE as well as the Leadership Board for Peer Professionals. He is an advocate to help eliminate the stigma of mental health among individuals, the community and people of color.

Substance Abuse and Generational Trauma

As we begin to recover from the pandemic, we are not ready to exhale and breathe a sigh of relief that this pain and suffering from this worldwide event is over. When we examine the far-reaching implications to our collective mental health, one can’t help but to think about our personal traumas and how we deal and process the corresponding feelings. We might also consider the option of self-medicating and wonder if our parents, grandparents, or siblings had similar thoughts.

For many of us we might not even know the impact of the trauma on us personally until we think about our last family gathering. In my experience, funerals and weddings allowed me to interact with my extended family. It was the opportunities to see where I came from and enjoy the wisdom of my aunts, uncles, and other cousins. It didn’t take long for a few of my relatives to indulge in their drug of choice, alcohol. There were whispers about these relatives including the fact that they were “moody.” When I was younger, I took their actions and those comments in stride and didn’t give them further thought. As I got older, I thought about the trials and tribulations that my mother and her brothers and sisters went through growing up in Little Rock, Arkansas. Each of them left their hometown as soon as they were of age. As a nosey nephew, I would pry my aunts and uncles about growing up in the south and I would be met with silence. It didn’t take much on my part to recognize that my aunts and uncles had been traumatized and their response to their children and me over the years would bear that out. I relied on my mother’s filter to explain the toll that southern racism had on their spirit and how they decided to cope with this stress via their drug of choice, alcohol.

I remember my cousins following their parents before reaching the age of consent and none of the adults dissuading the underage children from indulging in alcohol. As the years passed, my cousin’s children followed in the footsteps of their parents. What struck me was the fact that no one noticed the patterns or asked why its ok for everyone to drink like this at family gatherings. And I know first-hand there was a lot of drinking when there was no family gathering. This was combined with comments about certain family members that were “off” or “special.” It was clear that trauma was ever present, but my family spent time pretending it didn’t happen or wishing it away. No one seemed to acknowledge the obvious, including me. In short, I witnessed the impact of generational trauma and substance abuse most of my life.

Phoenix House Newsletter shared that “generational trauma is defined as trauma that isn’t just experienced by one person but extends from one generation to another.” My family has been impacted by generational trauma, and our lack of authentic and transparent communication has created the opportunity for this trauma to not be addressed, not to mention the impact of the substance abuse disorders.

Nellie Galindo in her article The Connection Between Substance Abuse Use and Trauma provided the following statistics about substance use disorders and trauma:
One-fourth to three fourths of individuals who have survived abusive or violet traumatic experiences report problematic alcohol use.

Women who are exposed to traumatic events show an especially increased risk for alcohol use disorder.
Five percent of individuals with PTSD also met criteria for a substance use disorder diagnosis.
As it relates to my family, I suspect that my uncle who were labeled as “special” and drank excessively fit into this category. He passed his unshared trauma to his children and they passed it to their children. My aunt who drank in excess, suffering from an unspoken trauma and considered to be slower than her other brothers and sisters, drank herself into a stupor. Her children (my contemporaries) following their mother’s path decided to drink like their mother when they came of age and now their children have followed their parents. And my family like many other families don’t speak of the substance use and they definitely won’t speak of the mental health issues because our family isn’t mentally ill. And we don’t talk about mental health issues. There was, and still is, a stigma about talking about mental health issues that is still part of our family tradition.

Florien Menlewater and her colleagues in their paper Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment Based Perspective identified five latent mechanisms of transmitting intergenerational trauma (1) early interpersonal childhood experiences in mothers; (2) trauma as a precursor of substance use; (3) substance use as a (self-fooling) enabler of parental functioning; (4) continued substance use impacting parental functioning; and (5) dysfunctional parental functioning and its relation impact upon off spring.

For my family, these mechanisms make perfect sense. The trauma, not addressing the trauma and then self-medicating with alcohol is how my family coped with stress. This is not the path of healing.

A recovery mindset and a focus on building resiliency is crucial for this population.


  • Brown, P & Wolfe, J (1994) Substance abuse and post-traumatic stress disorder comorbidity. Drug and Alcohol Dependence Vol.35 (1) 51-59
  • Galindo, N (2020) The connection between substance use and trauma. Relias.com
  • Menle, F & De Pauw, S and Vanderplasschen. (2019) Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective. Frontiers in Psychiatry. Vol 10:728
  • Phoenix House Florida. (n.d.) Breaking Generational Trauma and Addiction. Phoenixfl.org

Thank you for reading this article and we welcome your comments and reflections.

About the Author

Dr. Warren Braden is a native of Chicago, Illinois. Dr. Braden is currently in private practice as a Marriage and Family Therapist-In Training in the State of Wisconsin. He is also an online instructor at the University of Phoenix and Concordia University-Wisconsin. Dr. Braden’s focus is on connecting health care providers to community-based health agencies with the goal of improving the overall health and wellness of the population, as well as, enhancing the training and skills of the health care, social work and public health practitioners in the field, through evidence-based practices.

The Brain Behind Behavior

I was asked to consider writing this blog post just a few months into my new career here at Rogers and I had to ask myself; Why me?  Is it because of my Disability?  Is it because of any particular skill, knowledge, or my experience and I realize this is the stigma?  What is a stigma? Two simple dictionary definitions I found are

  1. A mark of disgrace associated with a particular quality circumstance,  or a person. or 
  2. A visible sign of an illness or a disease.

Taking a closer look at these definitions I came to two conclusions or realizations.  The first definition is clearly an internal perception, my disgrace relating to a particular quality or characteristic that I see about me and am uncomfortable with.  Second, an external perception the visible sign or symptom of the disease.  One is clearly what I see or feel and the second is what others see or feel.  One of the two, therefore, I have control over and the other I clearly do not.  As a result, it seems there are two specific logical responses.

First, what I can assert some control over is engaging in positive strategies to manage my illness.  Among those are: medication management, coping skills and strategies along with the life and daily choices that support my recovery and prolonged mental health.

Second is the items I cannot control.  What do others think, do or say when encountering symptoms of mental illness.  If I have no control over a particular aspect of the illness, then I have no rational need to be affected by that or attend to it or it’s associated feelings and thoughts;  Rational behavioral therapy?  Let’s consider these particular responses from a purely brain or neurologic perspective.  If I have no control, I do not need to attend to the issue and if I have to attend there are specific ways in which I can and/or will attend to them. 

Attention control can be understood from a neurologic perspective and then has purely neurologic  or sensory based solutions.  Dr. Michael Thaut professor and researcher in neuroscience and Neurologic Music Therapy, at the University of Toronto and Dr. Gerald C. Mcintosh, chief Neurologist in the Powder Valley hospital system in and around Colorado State University in Ft. Collins writes in “Rhythm Music and the Brain” and countless research studies; there are three specific types of attention to be mastered.  Initially, sustained attention is the ability to focus on one thing over time.  Second divided attention is the ability to focus on one thing while other things are occurring in the environment.  Third is the skill of alternating attention, that is the ability to rapidly alternate between multiple tasks and not lose your place, or your cool.  Each is a learned and rehearsed skill that can be positively or negatively impacted by the nature of the environment wherein it is learned; including at eight weeks of gestation. Yes in the womb when the auditory cortex is developed.  This introduces the need for a discussion of how lifestyle and environmental choices not only impact us, but begins the brain training of the baby in our or another womb.  We can begin to shape and improve a perception of circumstances in this way and in these moments thus reshape the future of our field and more importantly for those who will not need our services simply because they were not wired for the anxiety responses we now treat.  Think for a moment about patients or anyone with disrupted neurologic patterns and attention control needs.  The inability to sustain, divide or alternate attention will not only manifest in attention problems, but consider the associated anxiety and depression and the effect it has on life, learning and relationships.

First consider a biomedical application of rhythm perception.  When consistent patterns of perception, rhythm, are present it regulates impulse patterns in the amygdala that sends the neural impulse to the kidneys and stops the production of Cortisol, the stuff that causes stress. 

John Hopkins research into the brain reveals being stuck in sustained attention or vigilance can cause or look like repetitive behavior.  This can also keep us focused on the negative emotions and behaviors associated with that brain loop.     

Another consideration from this neurologic perspective is then how we train our brain, or that of our patients through consistent sensory, sensorimotor and patterns of behavior.  In a recent discussion with Dr. Clifford Sanders, the Brain Reprogramming Doctor, and in his research, we learn the following.  through our intentional choices and in clinical approaches it is not only possible, but very effective to re-wire brain processes through specific standardized auditory and motor techniques.

Additionally, if we or others struggle with alternating and/or divided attention, think of the stress and anxiety related to keeping your schedule, appointments and all the other daily distractions etc. 

So what?  Our perceptions, experiences and associations form our perspectives and that of those around us.  Fostering and nurturing healthy relationships, environments and habits  will not only improve our mental health, but will build the bridges necessary to remove  the barriers and stigma that cripple our communities and societies     

Considering stigma associated with mental health and understanding some of these basic principles of the brain function in them; let us renew our passion not only in what we know, but what we are learning about the brain, perception and then our preconceptions about why we are doing what we are doing and does what we are doing positively impact ourselves, our mental health and more importantly those we treat in our organization.

Have questions about this perspective and the related research I reference?  Let’s blog about it!  Looking forward to meeting you in the blogosphere.

About the Author

John D. Hartman is a neurologic Music Therapy Fellow in Milwaukee Wisconsin.  He is sought out as a speaker, trainer and clinician relating to adults and children with complex neurologic disabilities. He has a personal connection to his field having lost his own vision at age nine due to brain cancer.  This gives him a unique insight and perspective on disabilities services and solutions to produce prosperous and exciting outcomes for all. John believes that only by tearing apart the system and putting it back together with fundamental principles; we can realize dramatic results and life changing miracles. His engaging and entertaining clinical work,  speaking and writing style are sure to inspire and motivate readers and leave them with tools to make a difference.  To learn more about his work and experience visit him at www.accelerate-ability-llc.com.

A Matter of Color

White all Right, Black Get Back

While dark skin denotes acceptance and a sense of belonging on the African continent, light skin raises questions of authenticity and a conflicted sense of identity. A division of individuals based on the difference of appearance began with slavery and colonialism and has led to discrimination and violence. It can have other forms, such as colorism, a concept intertwined with racism but distinct.

This article will explore why certain skin tones are exposed to forms of prejudice and look into the colonial legacies that still manifest within our society through media platforms and globalization processes.

Colorism discriminates against people according to their skin tone or shade. According to Hunter, colorism lies within the dual system of discrimination; but its outcome will differ dramatically by skin tone.

Colorism is not exclusive to the African American community. It negatively affects Africans throughout the diaspora through feelings of a lack of authenticity among those with lighter skin and feelings of inferiority among those with darker skin. It causes a divide between those who identify within the black African ethnic group.

The World Health Organization reported that 77% of Nigerian women use skin bleaching products regularly. Togo follows them with 59%, South Africa with 35%, and Mali at 25%.

The Dark Girls, a documentary released in September 2011, outlines the characteristics of colorism, Bill Duke and Channsin Berry direct it. Both directors were encouraged to produce the film after their personal experiences with discrimination due to their skin shades. Dark Girls explores the issue of colorism, a social form of bias, within Black culture against individuals, particularly women, of darker skin tones. Although racism is an equally important matter, colorism is a different phenomenon that needs to be addressed.

The documentary describes racial profiling as the beginning of the division between the ‘house negroes and the slave negroes’. Those who could successfully pass the ‘brown paper bag test,’ a test that looked at whether you are lighter or darker than a paper bag. Therefore, allowing for the internalization of the idea that those with darker skin were the lowest of human beings. Those with lighter skin were considered superior among descendants of African ethnicity.

Divide and conquer The House Slave vs. The Field Slave

From 1619 to 1865, slaves were treated like animals and considered property. Slaves were commodities, unworthy of the rights that white people benefitted from. Slave owners raped their women slaves, which produced lighter skin tones for their offspring. 

Individuals with mixed black and white ancestry (Mulattos) had some privileges over those with darker skin color.  Many slave owners preferred lighter skin slaves. They assigned them positions where they could remain inside rather than work outside.

An article written in Forbes magazine reported that ‘147 million people worry about their identities. Colorism is also evident within Africa, which many scholars have also identified as a colonial legacy, as European settlers socially implemented it in the 19th century through concepts of racial profiling.

Rwanda is an example of Europeans using differences in African Ethnicity as an instrument for applying western social constructs of hierarchy (Pareisse 2014). Colonial administrators attempted to form order and decentralize the tribes by giving specific power and privileges to the Tutsis because they were ‘whiter’ than the Hutus (San 2010). Europeans measured the noses, skin color, temples, and faces of the African ethnic groups, to determine who was superior or closer to the Europeans.

The colonial administrators gave more power to the Tutsis. They were more ‘white than the Hutus.’ This allowed a complex of social superiority to evolve amongst the different groups. The slave owners performed a similar case in the U.S.

A recent study by the University of Cape Town suggests that in South Africa, one in three women bleaches her skin. The women say they use skin-lighteners because they want “white skin.”  Skin bleaching is widespread from Africa through Asia and the Middle East to North and South America – promoting light skin as the standard of female beauty.

Skin whitening cream has become a big industry in the global beauty industry. Sales grew to $43 billion in 2008 (Dark Girls 2011, Norwood 2015). Africans accounted for significant portions of sales in Africa and African Americans in the United States (Dark Girls 2011).

Bleaching agents destroy or stop melanin production, the pigment responsible for skin color. Without Melanin, the skin becomes vulnerable to UV light and leads to cancer. Many of these skin bleaching products have hydroquinone, a substance that thins the skin to the extent that it easily rips and becomes hard to repair.

In pre-colonial Congo, dark skin was preferred to such an extent that parents put babies in the sun to become darker. However, today, 30-40% of women in the Congo use skin whitening cream.

Darker-skinned people worldwide continuously attempt to change their appearance to conform to socially constructed pre-existing stereotypes. Because of the white supremacy that exists, which subconsciously infers that to live successfully, one must conform to the social appearances of mainstream society.

In the documentary, “lighter skin women said they felt they had to prove they were Black when in front of members of the community who were of darker skin tones/” (Dark Girls 2011).

Major media publications like Time Magazine and the Los Angeles Times published articles that used headlines such as ‘Is Obama Black Enough?’ (Coates 2007). Questions surrounded the ethnic legitimacy of President Barack Obama not being black enough.

The Effects of the Media and Globalization

“The documentary accurately encapsulates the damaging effects media plays in shaping colorism and allowing for its perpetuation through the choice of actors, presenters, and musicians broadcasted globally. White women are the primary women in black music videos.” (Dark Girls 2011).

The media continues to broadcast lighter skin tones by choosing those of lighter skin (Gabriel 2007). “Once those of darker skin makes it to the media outlets, their image is often photoshopped, altering darker-skinned individuals’ skin color to lighter skin tones.”

Gabriel explores how dark skin women are depicted as welfare mothers, and dark-skinned men are gangsters or criminals. In contrast, Black individuals of lighter skin are shown to be the ‘leading woman’ or ‘heroines’ (Gabriel 2007). Media platforms allow this continuance of social domination by exporting images around the world of western beauty standards that subconsciously encourage women and men to alter their appearance.

“While the U.S. simultaneously exports imagery of the ‘good life’ with ‘white western beauty,’ it allows ‘African Americans to internalize white-dominated American society’s ideals and seek participation in the American Dream by becoming whiter.” 

In Conclusion, media outlets and globalization maintain structural racism by consistently displaying white beauty with success and negative images of Black people synonymous with crime, poverty, and unhappiness. “It not only causes discrimination between those of the same ethnicity, and has multiple other subconscious implications that transcend cultural boundaries and allows prejudice to form a preference for lighter skin people within our global society” (Dark Girls 2011).

Colonialists and white imperialists have contributed to this conception of prejudice through early forms of racial Caste systems of categorization and role assignment, which have been able to infiltrate various cultures through the media and globalization processes (Dark Girls 2011, Norwood 2015).

About the Author

Heddy Keith M. Ed, CI, CPS is a retired master teacher, Hypnosis instructor, author, and speaker. She is the author of 3 books: Through it All: A Memoir of Love and Loss The story of her journey through grief and loss and healing from trauma. Through It All Trauma Recovery Journal and African American Scientists and Inventors an Accelerated Learning Curriculum, which teaches about the accomplishments of African American Scientists and inventors who contributed to our country and the world. Heddy is the founder and CEO of the Center for Leadership of Afrikan Women’s Wellness (CLAWW), whose mission is to increase awareness and develop a network of services and circles of individualized support for Black/African American women affected by trauma in Milwaukee County.

The Effects of Racism and Trauma on Black and Brown Students’ Mental Health

This blog is an outlet for individuals to discuss and to provide possible solutions for mental health issues in our community. The topic of Black and Brown students’ race- based traumatic events continues to erode the consciousness and mental health of our students. As a former school administrator in a school district of predominately Black and Brown students and mostly white educators. I found it challenging to bridge the gap among the staff and our students to address the effects and impact of trauma, racial issues, and to bring understanding and cohesiveness within our school. 

What Are Trauma and Child Traumatic Stress?

Traumatic events involve (1) experiencing a serious injury to oneself or witnessing a serious injury to or the death of someone else; (2) facing imminent threats of serious injury or death to oneself or others; or (3) experiencing a violation of personal physical integrity. Child traumatic stress occurs when children’s exposure to traumatic events overwhelms their ability to cope with what they have experienced. Traumatic events can have a wide-ranging impact on children’s functioning and can cause increased anxiety, depression, symptoms of posttraumatic stress disorder, difficulty managing relationships, and, most important for educators, difficulty with school and learning.

What is Historical Trauma and Race-Related Trauma?

Historical trauma is a form of trauma that impacts entire communities. It refers to cumulative emotional and psychological wounding, as a result of group traumatic experiences, transmitted across generations within a community (SAMHSA, 2016; Yehuda et al., 2016). This type of trauma is often associated with racial and ethnic population groups in the US who have suffered major intergenerational losses and assaults on their culture and well-being. The legacies from enslavement of African Americans, displacement and murder of American Indians, and Jews who endured the Holocaust have been transferred to current descendants of these groups and others.

Race-related trauma is defined as exposure to traumatic events due to an individual’s race (Bryant-Davis & Ocampo, 2005). Specifically, race-related trauma is a byproduct of racism when racism disrupts the psychological, emotional and physical well-being of children, adolescents, and adults.

Some of the Causes of Racial Trauma

The longstanding systemic history of racism within this country also contributes to this cumulative traumatic effect. The various types of stressors that people of color experience can be categorized as:

Intergenerational stressors:
The traumatic effects of racism, whether it be specific events or systemic structures, are often passed down through generations. This is the result of the United States’ history of colonialism and slavery. The experiences and stories that are shared often pass along the emotional pain associated with them either consciously or unconsciously. An example of this is how many Black and Brown parents have conversations with their children where they explain how to interact with police as a person of color. 

Vicarious stressors:
This includes the impacts of living in a systemically racist society and indirectly experiencing acts of racism. Even when individuals are not directly impacted by events, they can experience the same psychological and physiological effects on the nervous system. For example, one of the most common means by which people of color can be triggered is by witnessing hate crimes, racial microaggressions, or other direct racist encounters that are    recorded and made constantly available by social media.

Direct stressors:
These are the direct impacts of being in a systemically racist society or directly experiencing an individual attack as a result of race. Examples of this include hate crimes, being racially profiled or heavily policed, housing discrimination, unfair treatment in schools. Furthermore, communities of color have had previous negative experiences with “helping systems,” such as law enforcement, social and child protective services, mental and physical health care providers, and school systems, and that these encounters can result in significant distrust and be distressing for some students (Vaught & Castagno, 2008; Sotero, 2006) or a culmination of microaggressions.

Black and Brown students’ educational trauma

Racism proceeds to disrupt a young person’s sense of belonging, their relationship with others, and their access to resources.  Using the public school system as a backdrop, the race-related trauma framework aims to identify how schools exercise power and control against black and brown children and adolescents through alienation, discriminatory policies and practices, and psychological violence. Teachers and school administrators often perceive Black and Brown children as being older, more aggressive and more culpable, even when they exhibit the same developmentally-appropriate behaviors as their white peers — a phenomenon known as “adultification.” These beliefs and other biases against and beliefs about Black and Brown students and families, can lead to the disproportionate punishment, criminalization and harsh treatment of Black and Brown students, pushing them out of their classrooms into the school-to-prison pipeline and erecting unnecessary barriers to their success. They are more likely to attend schools that are underfunded, low student expectations (academic)  by teachers,  and often do not have access to ethnic studies courses, and culturally-sustaining school climates.  Research shows this is true for both Black and Brown boys/ Black and Brown girls, who are more likely to be suspended, sent to alternative schools and have contact with school police than their peers. These factors can impact Black and Brown students’ connections to and ability to thrive in their schools.

Students of color thoughts and incidents.

“[Teachers are a] lot sterner with students of color. Well, mainly Black and Latinx students.”
– 11-year-old student

“Teacher cut a child’s hair in front of the classroom because she was frustrated”
– 7-year-old student

“Black kids, in school… always act to [teachers’] expectations. You can’t act normal.”
– 12-year-old student

“A Black girl was arrested in front of her class and taken into custody for not giving a drawing that disturbed a white parent.”
– 10-year-old student

“A student not able to walk across the stage at his graduation due to length/style of his hair.”
– 17-year-old student

How do we begin healing racial trauma in students?

Healing racial trauma in students can be sectioned into four equal phases:  See Diagram:

(1) Adopting stress reduction practices, (2) advocacy through youth-adult partnerships, (3) teach the historical foundations of racism for people of color (4) promote racial justice initiatives for reform.  

Adopting stress reduction practices, such as mindfulness, in schools to use with youth, teachers, and other school personnel can reduce tension and mitigate conflict. The work of the Holistic Life Foundation shows that mindfulness reduces stress-related behaviors by using meditative practices to improve attention, reduce stress, and increase self-regulation among adults and children. If we identify ways to adopt stress reduction practices in school, we can potentially reduce racial tensions.

Advocacy through youth-adult partnerships centers on improving community and civic engagement among youth. These partnerships can link youth to social support and provide opportunities for them to address racism and participate in decision-making in school. These types of activities can improve school engagement and build several skills for youth, such as social competence and self-efficacy (Zeldin, Christens, & Powers, 2013). 

The Historical Foundations of Racism can be taught as a pathway to show transparency about systemic racism and oppression for people color.  Students should be able use their higher- level thinking skills about institutionalized racial disadvantages and systemic racial inequality. This will open the lines of communication to engage in dialogue about how America’s history has influenced our society and institutions today.

Racial Justice is the systematic fair treatment of people of all races, resulting in equitable opportunities and outcomes for all. Racial justice initiatives address structural and systemic changes to ensure equal access to opportunities, eliminate disparities, and advance racial equity—thus ensuring that all people, regardless of their race, can prosper and reach their full potential. Racial justice and equity are not achieved by the mere absence of racial discrimination or the perceived absence of harmful racial bias, but rather through deliberate action to dismantle problematic and build positively transformational systems – action must be carried through with the conviction, policies, laws, commitment and dedication of advocates.

Schools are a place for us to nurture the minds of future generations, and we must continue to help students learn to read and write and think. But we must not ignore the impact that this type of trauma can have on students’ long-term well-being and educational attainment. We must also help our children learn how to process the immense emotional and mental hardships they have experienced.

We want to hear from you! Send comments you want to share with us to Blog-WISE Wisconsin.

Our next WISE online Coalition Meeting entitled, “Addressing Stigma at the Intersection of Addiction and Mental Health” will be on Thursday, February 15, 2022, from 9:30am-11:30am.

Here are some references and resources you could use to further your understanding about the effects of racism and trauma on Black and Brown students’ mental health.

Further readings

Brown, T. M. (2007). Lost and turned out: Academic, social, and emotional experiences of students excluded from school. Urban Education, 42 (5), 432 –455.

Bryant-Davis, T., & Ocampo, C. (2005). Racist incident-based trauma. The Counseling Psychologist, 33 (4), 479-500.

Ferguson, R. F. (2003). Teachers’ perceptions and expectations and the Black-White test score gap. Urban Education, 38, 460–507.

Henderson, D. (2017). Race-Related Trauma in the Public Education System. Psychology Today.

National Child Traumatic Stress Network, Justice Consortium, Schools Committee, and Culture Consortium. (2017). Addressing Race and Trauma in the Classroom: A Resource for Educators. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

Substance Abuse and Mental Health Services Administration (SAMHSA) (2016). Understanding historical trauma when responding to an event in Indian country. Retrieved from http://store.samhsa.gov/shin/content/SMA14- 4866/SMA14-4866.pdf

Zeldin, S., Christens, B. D., & Powers, J. L. (2013). The psychology and practice of youth-adult partnership: Bridging generations for youth development and community change. American Journal of Community Psychology, 51, 385–397. doi: 10.1007/s10464-012-9558-y

Video Links

Understanding Racial Trauma
Systemic Racism Explained

About the Author

Dr. Ricardo Anderson is a Certified Recovery Support Specialist (CRSS), a co-facilitator of a recovery group for all types of addictions, serves on the Executive Board for WISE as well as the Leadership Board for Peer Professionals. He is an advocate to help eliminate the stigma of mental health among individuals, the community and people of color.

Our Mental Health Matters Too!

I was honored to be one of the guest speakers at the August 2021 WISE Coalition meeting on The Intersection of Race and Mental Health: Trauma in Education and Treatment. This blog is a response to the survey results asking us to continue the conversation.  I have a strong desire to help move our conversation to action.  It is our hope for this blog and the one that will follow, that we help eliminate the stigma of mental health and provide a safe space for individuals to comment, provide resources, and to engage in transparency about solutions to assist Black and Brown individuals to have a voice about our experiences and perspectives.

Mental health issues are prevalent in Black and Brown Americans, however, the historical dehumanization, oppression, trauma, and violence against Black and Brown people continue to fuel the ongoing mental health crisis. Black and Brown communities are more inclined to say that mental illness is associated with shame, embarrassment, and a sign of “weakness.” Furthermore, the lack of cultural competency among providers that leads to their clients not being affirmed or understood and are often misdiagnosed which reinforces Black and Brown Americans distrust in seeking services. Black and Brown Americans mental health matters and we must find effective outlets to tell our truths and experiences for systematic change. Policies can be changed, and new ones written that allow us the same opportunities to obtain equitable mental health services as our counterparts without the backlash of disparities because of our race.

This table dispels some of the stigma about mental health in Black and Brown communities.

Black and Brown Community MythsThe Reality
Mental Health illness is a sign of “weakness”Real Strength is facing challenges as they arise
People are seen as “Crazy” who have mental health issues People with all diagnoses can learn how to take control of their mental health and live a satisfying life
Family Culture of “secrecy and privacy” about mental health issues is being “strong”Being “Strong” is the ability find strategies to discuss your mental health openly and to obtain sincere help

Life during this pandemic (COVID-19) already has a host of stressors from family crises, job-related issues, to health concerns. Now coupled with the added stressors of “the new normal,” many individuals lack the coping capacities and strategies to effectively deal with the overwhelming emotional burden these may cause. Some may be unsure if they should seek out a mental health professional, particularly Black and Brown individuals. Ask yourself if you have any disruptions in your activities of daily living (ADL’s) – sleeping, eating, enjoying once pleasurable activities, working, socializing, thought processes, etc.  This is just a start, you can continue this self-evaluation by seeking input from safe outlets such as trusted family, friends, telehealth, and online sites. You can discuss your mental health or barriers you experience to seeking mental health services.  Family and friends should also monitor the mental welfare of those around them.  Bring attention to a loved one who is “out of sorts,” or behaving differently than usual.  

Education surrounding mental illness and normalizing mental health problems may help individuals recognize that treatment for a mental health problem doesn’t have to be any more shameful than treatment for a physical health problem.

Breaking down the stigma involves a two-pronged approach, increasing the number of culturally competent providers and changing the narrative surrounding mental illness. Let’s keep the conversation going!

We want to hear from you! Send comments you want to share with us to Blog – WISE Wisconsin.

Here are some resources you could use to further your understanding: Culturally relevant apps and websites that people can turn to for advice, resources, and even online therapy for Black and Brown individuals to discuss our mental health.

Our next WISE online Coalition Meeting entitled, “Healing Generational Trauma: The Intersection of Race and Mental Health” will be on Thursday, November 18, 2021, from 9:30am-11:30am.

Online Resources
Blog – WISE Wisconsin
How to Find a Therapist Who Understands Your Culture
Black Emotional and Mental Health (BEAM)
Indigenous Story Studio
Therapy for Latinx
Asian Mental Health Collective

Community Mental Health Engagement with Racially Diverse Populations

About the Author

Dr. Ricardo Anderson is a Certified Recovery Support Specialist (CRSS), a co-facilitator of a recovery group for all types of addictions, serves on the Executive Board for WISE as well as the Leadership Board for Peer Professionals. He is an advocate to help eliminate the stigma of mental health among individuals, the community and people of color.

The Science Behind Mental Health

Mental health is full of misconceptions, the most common of which is that mental illness is rare when, in fact, about 1 in 2 people will experience a mental illness in their lifetime according to the Centers for Disease Control and Prevention, or the CDC. Another is that living with a mental illness in a healthy way is a matter of an individual’s ability or choice to do so. This view doesn’t treat mental illness as an actual illness that may require medical attention and, sometimes, treatment, so much as a state that can be changed with personal effort. It also fails to take into account the many factors that affect our mental health, including biochemistry, current challenges, effective community support, and trauma. In this post, we will discuss why this is incorrect, as well as the science behind mental illness in regards to biochemistry.

According to the National Center for Biotechnology Information, or NCBI, many researchers or scientists who study the brain believe that the development of most mental disorders is caused, at least in part, by an imbalance of chemicals within the brain, or neurochemicals. According to Very Well Mind, neurochemicals “are…chemical messengers that carry, boost, and balance signals between neurons, or nerve cells, and other cells in the body” and  “can affect a wide variety of both physical and psychological functions.” If an imbalance occurs, the brain cannot communicate with the body effectively, thereby inhibiting a healthy or safe response to various stimuli. Take a look below at several neurochemicals that can be unsafe if processed in incorrect amounts and may be associated with a variety of mental disorders.

·       Adrenaline/ Epinephrine – According to the Hormone Health Network, adrenaline is a hormone that helps regulate muscle contraction, heart rate, and blood pressure. It also triggers the body’s stress response, often called the fight or flight response. Too much of this hormone can lead to chronic stress, difficulty concentrating, dizziness, and fatigue, as well as anxiety and anxiety disorders.

·       Dopamine – According to Psychology Today, dopamine is a neurotransmitter that helps control the brain’s reward centers. It enables us to see rewards and take action to move toward them. It also helps regulate our emotional responses to various stimuli. According to Carolina Integrative Medicine, too little of this neurotransmitter may be related to addictive behaviors such as alcohol or drug use, cravings, compulsions, depression, and loss of motor control. Too much may be related to attention disorders, autism, mood swings, and psychosis, a symptom commonly associated with schizophrenia.

·       Norepinephrine – According to Everyday Health, norepinephrine is a hormone that helps mobilize the brain and body for action. It does so by affecting blood flow, increasing alertness, regulating heart rate, and speeding up reaction time. Too little of this hormone may be related to a lack of energy or focus, symptoms commonly associated with attention disorders and depression. Too much may be related to anxiety, hyperactivity, and stress.

·       Serotonin – According to WebMD, serotonin is a neurotransmitter that helps regulate mood and social behavior, appetite and digestion, sleep, memory, and sexual desire and function. Too little of this neurotransmitter may be related to fluctuating hormones, high stress, and insufficient nutrients. Too much may be related to anxiety and anxiety disorders, depression, and obsessive actions and thoughts, a symptom commonly associated with obsessive-compulsive disorder, or OCD.

There is, then, some relation here. However, despite the fact that the brain plays some part in our experience of mental health challenges, we also need to understand that this implication seriously affects how those with mental disorders are thought of or treated by others. According to IFL Science, “people who attribute mental health problems to brain disease or heredity tend to blame affected people less. However, they are also more pessimistic about recovery, more willing to socially exclude affected people, and more likely to see them as dangerous.” These beliefs are not only untrue but also unhelpful, as they don’t generate a compassionate culture that builds resilience, inclusion, and hope in our communities. IFL Science goes on to say that, though it is correct to say that mental disorders are technically biological disorders, that narrow definition leaves a lot to be desired. The point here is that those facing mental challenges, just like those who aren’t facing mental health challenges, are so much more than their brain’s chemistry. Like we all, they have the ability to change, grow, and improve over time. Like we all, they deserve to be treated with empathy, kindness, and respect.

That said, it’s still unfair to assume that one can simply “will” their mental illness away without having access to certain techniques and tools that engage and retrain the brain.  As those who aren’t facing mental health challenges increase their understanding, they can work with those facing challenges firsthand to create supportive and accepting environments for healing and recovery and advocate for access to resources and services for all in need.

Putting the “Men” in MENtal Health

What do actors Ryan Reynolds and Dwayne (The Rock) Johnson, NFL wide receiver Brandon Marshall, Cleveland Cavaliers’ Kevin Love, Princes William and Harry, musician Logic, Olympian Michael Phelps, and comedian Wayne Brady have in common?  They are champions of increasing awareness of mental health issues and decreasing mental health stigma specific to men. Each has used their prominent voice to share their mental health challenges and recovery. You may read about their individual efforts here. It inspires hope that as more male figures speak out about their experiences, other men will relate, feel less alone, and be more inclined to speak up and get support! Here, we share additional well-designed, innovative programs seeking to create healthy, enabling environments for men to acknowledge, discuss, and seek support for their emotions and mental health challenges.

NFL All-Pro wide receiver, Brandon Marshall, has been a leader in making mental health advocacy a part of his platform. In partnership with Bring Change 2 Mind, whose mission is “to end stigma and discrimination related to mental illness,” Marshall launched the #StrongerthanStigma PSA campaign. This campaign features a collection of video stores highlighting courageous men sharing their stories. Key themes among the videos include emphasizing that mental health challenges among men are common, discussing the many reasons men do not seek out help, sharing the benefits of speaking out, and underscoring the bravery and guts it takes to begin conversations about mental health challenges. Check out the videos here.

Another great male-focused resource library and intervention is specific to men living with depression. It is estimated that over 6 million men live with depression (https://rogersbh.org/about-us/newsroom/blog/why-telling-men-simply-talk-about-it-simply-isnt-enough). Heads Up Guys is a collaborative effort of researchers, clinicians, and people with lived experience who provide tips, tools, resources, and recovery stories to support men in their fight against depression. It is an action-oriented site, helping men to create action plans to improve sleep, manage stress, enhance their social lives, increase physical activity, eat mindfully, and mend their sexual and intimate relationships. Essentially, the site promotes men’s feeling of agency by providing practical strategies they can use to improve their wellbeing, connect with others, and support other men. Their resources attempt to tackle many of the myths related to depression and masculinity, which are summarized in the table:

To hear more about how masculinity norms impact men’s mental health and one man’s efforts to redefine what it means to be masculine and strong, you might listen to the following podcast episode, entitled “Manhood and Depression” which can be found here.

Heads Up Guys is only one of many projects funded by the Movember Foundation, the only charity focusing on men’s mental health and suicide prevention on a global scale. Their mission is to “help men lead longer, happier, healthier lives.” If you are familiar with the “mustache” movement – an annual event in November where men grow mustaches to raise awareness of men’s health issues – then you know of one Movember movement. The Movember movement specifically funds programs designed to reduce the number of preventable deaths, including deaths by suicide. Founded in Australia and New Zealand, the Movember Foundation has now been launched internationally; it has even received the distinction of being named one of the world’s top non-governmental organizations. To access information about all of their internationally funded projects related to mental health and suicide prevention, go here. While there are dozens of interventions, some of the most novel involve sports-based interventions, meeting men where they are at (such as in bars, bathrooms, and sporting events), programs for particularly hard to reach populations (newly retired, indigenous communities, gay men, men of color, veterans), online and app-based interventions, and father-son programs.

Middle-aged men are particularly vulnerable to mental health challenges, substance abuse and suicide. Indeed, over ¾ of national suicide deaths are males (https://rogersbh.org/about-us/newsroom/blog/why-telling-men-simply-talk-about-it-simply-isnt-enough), with middle-aged men being the highest risk group for suicide. In 2012, a 24/7 online service integrating the power of technology and humor was launched to reach this group of men,  provide a space where “men come to be men,  offer “therapy the way a man would do it,” and teach men about stress, anger, depression, addiction, and suicide. This online service has since partnered with numerous state local health departments (including in Wisconsin), grown internationally, and catalyzed thousands of men -who wouldn’t ordinarily do so- to access mental health services. Man therapy is essentially a resource for men who have never before addressed mental health challenges. It introduces the audience to a fictional doctor – Dr. Rich Mahogany- who is a caricature of masculinity stereotypes and uses a humorous approach to run a virtual office. Here, Dr. Mahogany shares video testimonials of men living with mental health challenges, offers an 18-point “head inspection” (e.g., mental health assessment), provides a mental health report card along with strategies for addressing common mental health challenges, and gives referrals and links to local therapists, support groups, and suicide crisis lines.

There is not a one-size fits all approach to addressing the mental health crises among men. These and numerous other programs are leading efforts to decrease the male suicide rate, tackle mental health through a male-dominated lens, provide services specific to men, help men stay mentally strong and resilient, and build communities where men are comfortable talking about their own mental health and wellness. We invite you to be a part of this conversation…

Beginning in August, WISE will consider a possible future initiative to explore the stigma men face when it comes to mental health and suicide. Please email WISE @WiseWisconsin.org if you would like to attend our planning meeting where we will bring together those interested in this topic, share current research and information about local programs, and brainstorm possible next steps. This meeting will take place in Oconomowoc from 9-11:30 on August 21. Location details will be provided upon registration.

The podcast highlighted in this blog was produced by Giving Voice to Depression.

Sarah and the WISE Team

Fighting Shame to Increase Vulnerability

Last September, we discussed the work of researcher, social worker, and storyteller Dr. Brené Brown. That post summarized concepts from Dr. Brown’s TED talk titled The Power of Vulnerability, which can be found here. In that TED talk, Dr. Brown also touches on the subject of shame — or the belief that we’re not enough — and states that it is what stops us from being vulnerable and, consequently, making authentic connections with others. After realizing that she hadn’t done the subject justice, Dr. Brown returned to give another TED talk titled “Listening to Shame” which can be found here. This post will briefly summarize the concepts from that TED talk as a follow-up to WISE’s previous post, Vulnerability: The Key to Authentic Connections which can be found here.

Shame is a feeling of personal deficiency or failure. Unlike guilt, which is a negative feeling of responsibility for an action done incorrectly or wrongly, shame doesn’t necessarily arise from our actions but stems instead from some actual or perceived shortcoming in our character. According to Dr. Brown, shame is an inner voice that tells us we’re not enough. Simply stated — Shame tells us that if we are feeling bad, we are bad.

It is for this reason that shame is highly correlated with mental health challenges. According to Psychology Today, many people feel shame for having a mental health challenge at all. They may feel unacceptable or unworthy and believe that in order to connect with others, they have to be somebody other than who they are. Shame also prevents them from acknowledging their challenges, making it even more difficult to respond to their own moods and patterns and seek help accordingly.

Shame is a feeling that all experience but that few are comfortable discussing. Because it may mean being seen as unfit or weak by others and treated or used accordingly, we — understandably — tend to avoid it. Dr. Brown encourages us to confront shame freely and intentionally instead. She says that secrecy, silence, and judgment are all that allow shame to continue and that the key to getting out from under these feelings and connecting with each other is to talk about it, thereby understanding how it affects us. When we listen to others’ shame, it is critical that we are compassionate and empathetic, as we ourselves have also experienced those feelings. Dr. Brown even goes so far as to say that the two most powerful words that we can hear when we’re facing various challenges are “Me too.”

This is demonstrated by the Me Too movement, an international movement against sexual assault and violence that was awarded Time’s Person of the Year award in 2017. The goal of the Me Too movement is to empower women through empathy and reveal the extent of the issue by showing how many people have experienced these events themselves. This was done primarily through the #MeToo hashtag that went viral in October 2017.

In summary, Dr. Brown gives us a long quote from Theodore Roosevelt that says, “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena… who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Despite the negative feelings that may be associated with our actual or perceived shortcomings, we should “dare greatly” and face our challenges despite our personal fears. She encourages us to reach out to others while doing so, as “vulnerability is the most accurate measurement of courage and the birthplace of change, creativity, and innovation.” While shutting down due to feelings of shame is understandable, it doesn’t lead to increased connectivity. It divides instead of strengthens and unites. If we want to be vulnerable and authentic, compassionate and courageous, we must shed feelings of shame by practicing empathy, not only for others but also for ourselves.

For more information on Dr. Brené Brown, check out her website, which can be found here.


Lucy and the WISE Team

#Bethe1To Connect

Anyone can help prevent suicide — you don’t have to be a mental health professional. There are countless examples of silent heroes who recognize emotional suffering in people, respond compassionately to someone in distress, and then take action to promote healing and offer hope.

Listen to just one inspiring example. When an empathetic stranger confronted someone planning to jump off of a bridge, the young man found the courage and determination to give life another chance.

Many of us worry we wouldn’t know what to do in that circumstance. To help promote more silent heroes, the National Suicide Prevention Lifeline created the #Bethe1To campaign. If you believe someone may be at risk of suicide, or you recognize warning signs of suicide, follow these clinically proven steps to #Bethe1To communicate with someone who may be suicidal.

Step 1: Ask. There is a myth that asking about suicide increases suicidal thoughts. On the contrary, asking about suicide in a direct, non-judgmental way reduces suicide ideation and gives people an opportunity to talk about their emotional suffering. As Dr. Barbara Moser, chair of Prevent Suicide Greater Milwaukee, describes in this podcast, asking people in a direct way if they are thinking about killing themselves often brings relief. She shares three tips for how to initiate the conversation.

·       First, preface the question. Before asking about suicidal thoughts or intent, mention your care and concern and what you have observed or heard that makes you think someone is suicidal. For instance, “I know you have a lot going on right now and have been feeling pretty hopeless and miserable. I’m concerned about you. Are you thinking about suicide; are you thinking about killing yourself?”

·       Second be specific. Rather than ask “Are you thinking of hurting yourself?” ask instead, “Are you thinking about suicide?” or “Are you thinking about killing yourself?” Though this can be a difficult question to ask, it gets to the heart of your concern, makes responses easier to interpret, and communicates that you are open to talking about suicide.

·       Third, take responses seriously. If responses are ambiguous, don’t let it go; circle back and ask again. If someone does share feelings of being suicidal, find out more about what is going on – both more about their emotional suffering (What’s going on?), as well as their reasons for living (What brings you joy? And what has kept you alive until today?”).

Step 2: Keep them safe. The second step first involves an assessment about a person’s safety and plans. As Dr. Moser describes, this is a time for blunt, direct questions that help you determine if a person has a plan and the means and intent to enact their plan. Questions to consider, include: “Do you think that you would act on those thoughts?” and “Have you thought about what you might do? Do you have a plan?” If they have a plan, you will also want to determine if they have access to their intended method. Keeping them safe then becomes about developing a safety strategy to decrease access to their chosen means.

Step 3: Be There. Just being there helps establish connection and feelings of belongingness, both of which are key protective factors that decrease suicidal ideation and action. Stay with the person, or if you are unable to, think of who else might be available to help. The suicide crisis is often acute, so being present with someone may help them ride out the time in which they are in the most immediate danger. To hear a story exemplifying the power of connection, listen to the story of Travis Pipes, who reached out to a stranger “at a desperate time when he wasn’t having connected conversations with others.” There is power in patient, non-judgmental listening. There is hope in connection.

Step 4: Connect with Resources and Supports. Build a circle of support. This may mean helping the person connect with local resources, treatment professionals, and/or crisis counselors. It may mean helping initiate conversations with loved ones. It is recommended that you add the suicide prevention hotline (1-800-273-8255) and/or text line (Text “HOPELINE” to 74174) to your phone to increase access to crisis supports, which provide 24/7 free and confidential support. Finally, if someone is acutely suicidal, this may mean calling 911 so police can have the person evaluated by a professional. Getting immediate, appropriate help trumps confidentiality.

Step 5: Follow up. Reach out. Show continued support whether in person, via phone, text, or a card. Small gestures to check in can increase the feeling of connectedness. Simply letting people know you are thinking of them can make a big difference.

Connection and compassionate action are fundamental to all of these steps that can provide hope and support to people experiencing emotional pain and crisis. To learn more about how you can recognize warning signs of suicide, help someone in a crisis, and become a silent hero, consider attending QPR (Question, Persuade, Refer) gatekeeper training, either locally or online.

Thank you,

Sarah and the Wise Team

For support and resources, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line. The podcast highlighted in this blog was produced by Giving Voice to Depression.

Preparing for Another Season of 13 Reasons Why

The recent release of13 Reasons Why season 2 is prompting an essential dialogue in our communities related to bullying, depression, sexual assault and harassment, self-harm, suicide, and substance use. Because many of13RW’s central characters are teens, much of this conversation is taking place in middle and high schools, where many administrators are concerned about the show’s possible consequences. School officials are urging adults to be prepared to process13RWwith the young people in their lives. For more information on the first season13RW and the importance of dialogue, click here.

According to Dr. Jerry Halverson, the chief medical officer of Rogers Behavioral Health, 13RW presents a great opportunity for real talk. “These conversations with teens are difficult to have but important. The show provides an entrée to discuss the types of issues affecting mental health and can be extremely relevant in a teen’s life. 13 Reasons Why creates the chance to talk about the challenges of peer pressure, trauma, relationships, and substance use,” shares. Dr. Halverson.

While watching 13RW, consider starting a conversation using the suggested questions below. These are taken from a discussion guide that Netflix created as a result of public outcry criticizing the subject matter without ways to support its viewers. Created with the help of organizations like The American Foundation for Suicide Prevention and the American Foundation of Suicidology, among others, this discussion guide contains information about the TV show, tips for watching/ rewatching season 1, definitions and explanations of the subject matter, and ideas to start a conversation with someone who may be facing mental health challenges. Find it here.

  • Do you think the characters in the show are behaving in ways that are similar to people you know? How so? How are they different?
  • What do you think about what happened in this episode?
  • Did parts of the story make you think about how people who are struggling do not show the full picture of what they are dealing with to others?
  • What did you learn about “so-and-so character’s” situation from this episode? For example, what did you learn about what happened to Jessica and sexual assault?
  • How does what you have seen change how you view some things that happen in real life?
  • Do you think the adults did anything wrong? What could they have done better?
  • What would you do if you knew a friend was considering suicide or had been sexually assaulted?
  • Who would you go to if you were experiencing any of the situations these teens went through?
  • Have you ever felt the way that Hannah, Clay or any of the other characters feel? Which ones?
  • Have you ever wanted to tell someone about a sexual assault or bullying but worried that it was tattling?
  • How do you know when to offer compassion/support/empathy and when to set clear boundaries?

While engaged in this and other discussions involving similar content, do your best to observe the “Seven Promises” for being a “Safe Person”, which can be found here. The Safe Person Decal was created in partnership with WISE, Wisconsin Initiative on Stigma Elimination, to provide more accessible, dependable spaces for those in need, so that people willing to offer support could better connect to those seeking it. Click here for more information or to download and order the Decal.

As you participate in conversations about 13RW, listen to and gauge how your friend or family member is feeling and respond accordingly. If you sense that they are dealing with emotional challenges but are in no danger of harming themselves or others, the most important thing to do is to show them that you’re there for them. Check in frequently, and make yourself available to get together or talk. If possible, connect them to additional support, such as a trusted coach, counselor, family member, friend, or teacher.

In an emergency, get immediate support by calling the National Suicide Prevention Lifeline at 1-800-273-8255 or texting the Crisis Text Line at 741741, and call 911 or take your family member or friend to the emergency room for assistance.

For additional ideas on how to talk to someone in need of help, click here to read one of WISE’s previous posts.

We urge adults to be aware of and prepared to process13RWwith the young people in their lives. This TV show will impact our communities and systems, but, armed with awareness and resources, we have the ability to influence what that impact will be.

Additional Resources:

In response to requests for additional resources following 13RW, Netflix also created many additional resources and tools including a website, found here, for those who may be facing mental health challenges. On the website, one can find a list of advocacy organizations that provide additional services and support as well as the13RWdiscussion guide mentioned above.

Since 13RW’s release, other organizations are also more prepared to handle these issues too. Additional resources include:

  • The 13 Reasons Why Toolkit created by the Suicide Awareness Voices of Education. This toolkit “provides practical guidance and reliable resources… related to the content of the series” in an effort to “develop tools to help encourage positive responses” to 13RW. Click here to find PDFs for clinicians, educators, media, parents, and youth which provide information on how to identify and help youth who may be affected by the show.
  • Common Q & A’s by The Suicide Prevention Resource Center, or SPRC. These questions, asked by community leaders, media, parents, and schools provide resources to help discuss 13RW and access suicide risk and prevention in youth. Find it here.
  • A Facebook Webinar by The American School Counselor Association, or ASCA. This provides preparation for13RW season 2. Find it here.
  • A 1-Pager for school staff and parents by the ASCA. This includes training to recognize the warning signs of suicide, as well as what to know about the issues raised in 13RW. Find it here.
  • A13RW Resource Collection by the ASCA. This includes the resources from above and a list of additional resources. Find it here.

Challenging Our Negative Self-Talk

In this post, we want to share an empowering strategy taught in WISE’s Honest, Open, Proud program. For more information about HOP, click here. It is called the 5 step strategy for challenging our hurtful self-talk. Hurtful self-talk is a form of internalized stigma or shame, which occurs when we come to believe the negative, limiting, critical things that we have heard elsewhere. To read more about self-stigma, click here. The beauty of this strategy is that it can be applied to negative self-talk that is related to virtually anything – not just our experiences of mental health challenges.

Step 1. The first step requires a degree of mindfulness, as we must first recognize our negative self-talk. We all have degrees of negative self-talk. Harmful self-talk is a limiting belief, an inner voice that is skewed toward the negative. Red flags for negative beliefs may include the words “always,” or “never.” One good way to identify our negative self-talk is to ask ourselves if we would say it to a best friend. For example, if we wouldn’t tell friends they will “always be crazy” because they have mental health challenges, it is a good indicator that it is a hurtful self-belief if we say it to ourselves! While it can be difficult to notice this inner critic, this is the first step towards challenging and conquering these unhelpful beliefs and doubts!

Step 2. The second step is to imagine instead that we have this belief about others. In this step, we create a universal statement and apply it to people in general. This step creates some distance between us and our belief. The key to this step is to take our belief out of an “I” statement and turn it into a “universal statement” by using the word “people.”  For example, if our hurtful self-belief is “I am weak because I need medication,” then we might say “People who need medication are weak.” In this step, the belief already starts to lose a little of its power, as many people are much more compassionate towards other people than they are towards themselves! Some people may already begin to think ‘that sounds untrue when I think about it that way.’ But, since many of our hurtful self-beliefs are very deeply rooted, this step alone is often not sufficient enough to counter our negative belief.

Step 3. Many of our hurtful self-beliefs are self-defeating, irrational, and untrue! This step asks us to engage in reality testing and to gather evidence to find out whether our thoughts are actually true. Ideally, we will identify people we trust and whose opinions we value so that we can seek out their opinions. If we are not comfortable asking people their opinions, we can collect evidence in two additional ways. First, we might seek out evidence in popular media, online, or look for examples from famous people we admire; for example, if we have a belief that people with mental health challenges are unable to recover, we might look for examples of people who have done so.  A second option: we might imagine someone we trust and what they might say regarding our self-belief. The key here is to identify someone (or multiple people) unlikely to validate our hurtful self-belief!

Step 4. And then we ask (or for those using alternate means, then we collect facts and ideas that challenge our belief). For this step, to avoid being too vulnerable, we can ask about our universal belief (step 2), rather than share our self-belief.  Framing questions using the universal question also helps ensure we are more likely to believe people’s answers; then we cannot convince ourselves that they are just being kind. For example, if we believe that we will never have a healthy, long-term relationship because of our challenges with addiction, we would ask our trusted person if they believe people with addictions are capable of having relationships. Ideally, we collect this information by talking to people we trust, as shame tends to break down when we hear people being compassionate about the very things that we have beaten ourselves up about.

Step 5. The final step is to create a realistic counter statement. The key word here is “realistic”! Our counter statement needs to be a statement that is believable so that it can be internalized into our self-concept. We don’t want it to set off our internal lie detectors! This step is sort of like creating a personal mantra, something that we can remind ourselves of whenever our negative self-talk starts to creep up on us.  This counter can also take advantage of the power of “possible” thinking. For example, if our negative self-belief is that “I must be unattractive because I am overweight,” then a neutral (and believable) counter may be “I’d like to lose 10 pounds” or “People my size have friends and lovers.”

Let’s catch ourselves the next time our inner critic speaks up and try this approach to challenge those beliefs. With enough practice, this strategy will help us grow our self-compassion!

To learn more about strategies and activities in the Honest, Open, Proud program, visit: https://eliminatestigma.org/blog/an-introduction-to-honest-open-proud/ or email WISE@WISEWisconsin.org.


Sarah and the Wise Team

How to Talk to Someone in Need of Help

One of the biggest concerns that many who wish to help others face is the difficulty of bringing up and discussing various challenges. Mentioning private or sensitive subject matter may make you—or your family member, friend, or peer—feel awkward, shameful, uncomfortable, or vulnerable. Too often, fear of experiencing these feelings stops us from communicating and, consequently, connecting with others, including those in need of help. For more information by Dr. Brené Brown on the subject of connection as it relates to shame and vulnerability, click here. That said, if a family member, friend, or peer is facing challenges that are affecting their behaviors or thoughts (which we will discuss below), it’s important to acknowledge them, as doing so will help them feel accepted, included, and understood.

One useful tool that WISE created in an effort to make bringing up and discussing the challenges of others easier is the Safe Person Decal which, if displayed, indicates your desire to be a safe person for others by observing the Safe Person Decal 7 Promises, which can be found here.

Here, however, we will be featuring another resource called Seize the Awkward. Their website, which can be found here, includes all of the information below, as well as videos sharing the personal stories of how talking to others, can make a difference.

How do I know if my family member or friend may be going through a hard time?

Family members or friends facing challenges may not want to be around others. If they do, they may seem anxious, distracted, hopeless, or negative. They may experience sudden shifts in behavior or mood, take unnecessary risks, harm themselves physically, or increase alcohol or drug use. It’s important to acknowledge and address these signs if seen, as it may indicate a need for help. Click here to watch a short video on how to know if you should reach out to a family member or friend.

How do I start the conversation?

If you know that a family member, friend, or peer is facing a challenge or if you notice any of the aforementioned signs, find a time to sit down with them in a private location. Start by asking open-ended questions like ‘Are you all good?’, ‘Is everything OK?’, or ‘I’ve noticed you’ve been down lately. What’s going on?’ Help them to talk by avoiding close-ended questions that end in “yes” or “no.”  Click here to watch a short video on how to start a conversation with your family member or friend about their mental health.

What do I do during the conversation?

While you’re having the conversation with your family member or friend, try to relax. Make yourself available to them, and tell them that you are someone they can rely on to listen and support. Tell them that this won’t change your opinion of them and that it’s OK to feel the way they do. Let them lead the conversation, and really listen to what they’re saying. Avoid offering advice or trying to fix their problems. Instead, ask if they’ve seen an expert and encourage them to do so if they haven’t. Click here to watch a short video on how to continue to talk with a family member or friend about their mental health after you’ve asked about how they are feeling.

What do I do next?

The most important thing to do is show your friend that you’re there for them. Be available to get together or talk, and keep checking in. Respect their trust in you by keeping your conversation private unless they or someone else is in danger. In an emergency, call 911 right away or take your family member or friend to the emergency room for assistance.  In a crisis, get immediate support by calling the National Suicide Prevention Lifeline at 1-800-273-8255. It’s free and completely confidential unless it’s essential to contact emergency services to keep yourself or others safe.

As individuals a part of various communities and groups, it’s important that we consider others, especially those who may otherwise be neglected or overlooked and attempt to assist them in what ways that we can. Simply making ourselves available is the easiest way to connect with others and, potentially, make a meaningful difference in their lives. The recommendations shared here align well with the Safe Person 7 Promises. Order decals indicating your interest in being a safe person for others here.


Lucy, and the WISE team

Mindfulness and Mental Health

At WISE, we talk a lot about the importance of self-care, or the providing of care by you and for you, and its importance in improving your compassion resilience, or CR, and maintaining your overall well-being. Click here to read WISE’s previous post about self-care.

One common form of self-care that is practiced cross-culturally is meditation, or the practice of focusing on a particular activity, object or thought to achieve inner calmness and clarity. There are many types of meditation that vary in skill and technique, including chakra, mantra, yoga, and Zen, among others. A more complete list can be found here. One type that has been highly popularized due to its confirmed health benefits is mindfulness. The practice of mindfulness can be seen in a brief, animated video which can be found here.

According to Mindful, “mindfulness is a natural quality that we all have… When we practice mindfulness, we’re practicing the art of creating space for ourselves — space to think, space to breathe, and space between ourselves and our reactions.” Mindfulness not only sharpens our attention, but also strengthens our feelings of compassion, empathy, and gratitude. This is part of why mindfulness is so helpful in improving and forming a foundation for CR. Just a reminder that CR is the ability to maintain our physical, emotional, and mental well-being while responding compassionately to people who are suffering. Read more about CR here.

Mindfulness not only improves our CR, but also our overall health. If practiced consistently, it can relieve stress, lower blood pressure, reduce chronic pain, and improve sleep. According to Mindful, it can also aid in treating various mental health conditions by promoting “stress reduction, attention and emotion regulation, reduced rumination” and the like. In fact, mindfulness has seen such positive results that it is often combined with a type of psychotherapy known as cognitive behavioral therapy, or CBT. Help Guide says that “this development makes…sense since both meditation and cognitive behavioral therapy share the common goal of helping people gain perspective” on harmful and hurtful thoughts.

There are hundreds of mindfulness techniques and ways to become more present in our daily lives. Mindfulness is something we can all develop and benefit from, especially with regular practice. If you’d like to try mindfulness on your own, here is one place to start. These recommendations can also be found on Mindful.

  • Sit down. Choose a position in which you are comfortable and relaxed and in a place that is calm and quiet.
  • Set a time limit. If you’re new to this practice, it’s helpful to choose a short time, such as 3 or 5 minutes. If you’d like, you can also download a free app, such as Headspace or Stop, Breathe, and Think, to serve as a guide for your practice.
    Feel and focus on your breath. Follow the sensation of your breath as it goes in and out of your body.
  • Notice when your mind has strayed to other subjects. When you do, don’t judge yourself for these thoughts or obsess over their content. Acknowledge their existence and then return your attention to your breath.

Another common mindfulness practice is called the body scan, which allows you to focus on one part of your body at a time, heightening your awareness of your body’s sensations. Click on the links below to watch videos created by Elisha Goldstein, a renowned mindfulness author, who will lead you through this exercise.

3 Minute Body Scan

5 Minute Body Scan

10 Minute Body Scan

In summary, mindfulness, and meditation in general, are pervasive techniques that continue to grow in popularity, especially as we look for additional ways to maintain healthy and well-rounded lifestyles that emphasize the importance of mental health alongside physical health.  Many who practice mindfulness find it an incredibly useful tool in improving CR, practicing self-care, and maintaining their overall well-being.  But there is no one way to practice mindfulness. Find what appeals to you and helps you stay focused on the present moment!


Lucy, and the WISE team

Suicide: The Ripple Effect as a Prime Example of Stigma Resistance

In previous posts, we discussed stigma change processes and the use of TLC4 as a planning model for framing stigma change efforts. In both of those posts, we explored the effectiveness of contact-based strategies for decreasing stigma and offering realistic hope to those facing similar challenges.

The success of contact-based strategies exemplifies that stories are powerful! People who advocate, broadcast their stories, and use their personal experiences as a foundation for helping others are exhibiting stigma resistance.  Stigma resistance is an individual’s capacity to counteract both internalized stigma and public stigma. Proactive stigma resistance strategies are intentional, agentic responses that improve self-concept by confronting stigma and/or challenging the negative attitudes and behavior of others. Given that empowerment and stigma resistance go hand in hand, it is no wonder that stigma resistance is strongly and consistently associated with recovery and well-being!

Stigma resistance operates at the personal, peer, and public levels. Let’s take a look at each of these levels using an example from a recent documentary film, Suicide: The Ripple Effect. This film documents the journey of Kevin Hines, who at 19 attempted to take his life by jumping from the Golden Gate Bridge, and how since then, he as catalyzed a movement to spread messages of hope, recovery, and wellness.

At the personal level, stigma resistance focuses on alleviating internalized stigma and maintaining recovery. In the film, Kevin shares with the audience how he works diligently to cope with his “brain pain” and stay as mentally healthy as possible; he also gives insight into his will to live. He provides an inspirational example of someone who has developed an identity apart from his mental illness (as a husband, survivor, a storyteller, a public speaker, an activist, and a documentary filmmaker) as he vividly describes and exhibits how his survival has given him a new sense of meaning and purpose.

At the peer level, stigma resistance manifests as using one’s experience to help others fight stigma. This type of stigma resistance is exemplified by peer support workers and specialists who model recovery and offer lived examples of the possibility for growth and living a fulfilling, satisfying life. In “The Ripple Effect,” the audience is privy to a bird’s eye view of the many ways in which Kevin’s story has impacted individuals living with mental health challenges (see the story of a local man impacted by Kevin Hines) and the families of those who have lost loved ones to suicide. It is in these interactions with the people touched by Kevin’s story, where it is most evident that sharing one’s personal challenges and recovery can bring hope, healing, and support to others; even those who have experienced the tragedy of suicide. It is also in these interactions with those close to Kevin where we see how loved ones can meaningfully support, encourage and motivate stigma resistance.

At the public level, the film is a powerful example of how stigma resistance can have a ripple effect that inspires others, touches countless lives, and creates positive change. Kevin’s advocacy combines education, sharing his lived experience, and challenging stigma related to mental health and suicide.

If you would like to learn more about Kevin’s story and witness stigma resistance in action, join us for one of the upcoming local showings (in and near Milwaukee) that will take place during Mental Health Awareness Month this May. WISE will be partnering with Prevent Suicide Greater Milwaukee, NAMI Waukesha, MHA, and Waukesha’s Department of Health and Human Services, to provide three showings. Proceeds will support local youth suicide prevention efforts. Thanks to Rogers Behavioral Health for their sponsorship.  Click here to watch the trailer, purchase tickets, and join the resistance!


Sarah, and the WISE team

The Benefit of Emotions in the Workplace


As a young adult whose professional experiences have been limited, it never occurred to me to think about the extent that my own emotions are present in the workplace and how they do or don’t affect my work. This goes to show just how much our emotions are permitted in these areas — a.k.a. little to none. That is, until I read an article in Time The Science of Emotions called “Go Ahead, Cry at Work.” This eye-opening article established that, in many cases, employees are often expected to leave their emotions at the door in favor of productivity and profit. Emotions, especially those seen as negative such as anger, confusion, fright, jealousy, or sadness, are often seen as a hindrance and are expected to be left at the door. This is, of course, not true in all fields depending on what your role is as well as how your business treats such topics.

Wham! The recognition of this truth hit me like a ton of bricks. What interested me is both how intolerant and how unrealistic this expectation is. While we may not be conscious of these assumptions, they certainly have the capacity to alter our actions and can create a negative environment that decreases morale and diminishes the potential value of our emotions. After all, experiencing a wide range of emotions is a fundamental part of being human. We know they have the capacity to affect us, often whether we’re conscious of it or not, so it stands to reason that it’s no different in a workplace setting. According to Fast Company, “if we’re happy, relaxed, and focused, we’re more willing to be flexible, collaborative, and look forward to new challenges,” but “when we’re feeling depressed, unappreciated, or stressed… the quality of our work and how we interact with others can suffer.” This recognition was part of our rationale to develop the compassion resilience toolkit. You can find more information about compassion resilience here.

Not only that but blocking or censoring our emotions isn’t healthy and can lead to personal and professional setbacks. If we can’t share our feelings with our peers, we can’t process them appropriately, which may lead to symptoms such as fatigue, feelings of inadequacy, loss of concentration, pessimism, and restlessness. Physical symptoms such as changes in appetite, chest pain, headaches, general aches and pain, high blood pressure, and weight gain or loss, among many others, can also occur.

Thankfully, there are a variety of efforts to enhance the well-being of employees. Benefits that promote physical health, such as health education classes, access and discounted rates to fitness facilities, and policies that promote healthy behaviors such as tobacco-free campuses, abound. However, benefits or practices that promote mental health are, as in many parts of our society, largely absent, thereby undervaluing their importance. Recently, the importance of mental wellness is on the rise, and many benefits, such as creating a mental health benefits package, establishing an employee assistance program, appointing a contact for managing mental health communications, or arranging for mental health education and resources onsite, have been established to provide businesses with a more positive and well-rounded benefits package and work environment. For more ideas from The Balance, click here. Or to see the CDC’s workplace health model recommendation, click here.

Rather than suppress emotions, businesses could attempt to acknowledge, accept, and utilize them, a trait which The Wharton School in Pennsylvania calls emotional intelligence, or EQ, “a skill through which employees (and employers) treat emotions as valuable data in navigating a situation.” According to The Wharton School, there are three different, but equally important types of emotions to be aware of, “all three (of which) can be contagious…and have an impact.”

  • Discrete – Short-lived emotions. Examples: Anger, disgust, joy, shame, surprise.
  • Moods – Longer-lasting feelings that aren’t necessarily tied to a particular cause. Examples: Negative, positive.
  • Dispositional – Personality traits that define a person’s overall approach to life. Examples: Cruel, flexible, greedy, optimistic, passionate.

Skilled employers and employees are adept at recognizing and respecting all of these types. According to Good Therapy, this is especially true for roles with large amounts of interpersonal communication and leaders who are responsible for “creating the type of work environment where each person feels…motivated to succeed.” In order to do so, leaders must “view their team members as individuals with unique abilities, backgrounds, and personalities, rather than as a uniform collective. Effective leaders seek to understand and connect emotionally with their staff…” which allows them to “build mutual trust and respect…”. Employees with high levels of emotional intelligence “may be better able to cooperate with others, manage work-related stress, solve conflicts within workplace relationships, and learn from previous interpersonal mistakes.” To read more from Good Therapy, click here.

It’s clear, then, that there is some benefit to making room for emotions in the workplace and letting people be, well, people. According to Fast Company, the following three tips can help employees and employers alike manage and take advantage of their workplace emotions. Click here to read more from Fast Company.

1.     Encourage a sense of belonging – Feeling connected to others fulfills a basic need for belonging. Relationships anchor people’s commitment to a business, its brand, and its overall purpose. Try to create areas or incorporate practices that encourage connection. Examples include creating welcoming entrances with visible hosting, providing ample and well-equipped spaces for all workers to work individually or in teams, and designing informal areas for socialization, both in person and virtually.

2.     Help people see their worth – It’s natural to want to understand how you impact and contribute to an overall business. When people feel a sense of purpose, it can contribute to building a resilient enterprise based on trust and collaboration. To help cultivate a sense of meaning in the workplace, businesses should create spaces that give people choices and empower them to work alone or together;, include spaces beyond the lobby that reinforce the purpose, history, and culture of the company, and use technology to display real-time information that can help employees feel connected and informed

3.     Encourage engagement by promoting mindfulness – When workers are truly engaged, they are fully immersed in a feeling of energized focus. They have full involvement in the task at hand and a true enjoyment of what they’re doing. However, multitasking and cognitive overload often prohibit people from finding this level of focus. Try to help people fully engage in their work by designing areas that allow workers to control their sensory stimulation, offering places that are calming (through materials, textures, colors, lighting, and views) and creating areas where people can connect with others without distractions.

For many businesses, creating a cultural shift to support emotions can be difficult. In the long run, however, providing employees and employers with a space to feel what they’re feeling without fear of being perceived as incapable or weak will increase workplace morale and, consequently, productivity.


Lucy, and the WISE team

An Introduction to Honest, Open, Proud


In February, we discussed the TLC4 Model, which explains how WISE reaches various populations and produces tangible change throughout Wisconsin. Click here to reread that article. In that post, we also said that the best way to reduce stigma is to share our own mental health challenges and story of recovery with others. However, WISE understands that stigma can also make it incredibly difficult to share our stories with people close to us, let alone, publically. This is completely understandable, as sharing our story requires us to be open and vulnerable to others and their opinions.

Honest, Open, Proud, or HOP, is another of WISE’s resources that aids in making strategic, safe decisions related to sharing our story of mental health challenges and recovery. HOP, is a multi-session group-program that is facilitated by trained leaders with lived experiences. HOP was developed by Dr. Patrick Corrigan, the director of the National Consortium of Stigma and Empowerment, or NCSE. HOP was developed through extensive community-based participatory research led by people with lived experience. The program was also tested by the NCSE and has been recognized as an evidence-based program registered with the National Registry of Evidence-Based Programs and Practices of the US Substance Abuse and Mental Health Administration.

In short, HOP seeks to replace harmful and hurtful self-stigma with beliefs of recovery, empowerment, and hope. The goal of HOP is not to convince people to share their stories, but rather to provide a venue among peers by which they might consider the various choices they face related to sharing their stories. HOP assists participants in considering the pros and cons of talking about their experiences, learning various ways to disclose, and writing and telling their story in a way that emphasizes strength, wisdom, and recovery. In an effort to make HOP accessible, all program and training materials are available here.

If you take a look at the program, you’ll see that HOP has several parts. The key concepts for each part of the HOP framework are as follows:

The Story We Tell Ourselves

  • When we recognize a possibility for improving our situation and make a first step towards exploring those options, we begin the path to recovery.
  • On that non-linear path, we gain wisdom about and for our life.
  • How others have defined the challenges and spoken about and treated others who have faced similar challenges will impact how that person understands their experiences and who they are in relation to it. False ideas leading to distorted beliefs and discriminatory behaviors is the definition of stigma.
  • We can identify and change hurtful self-attitudes impacted by such stigma.
  • The process of changing hurtful self-talk involves identifying it, considering how it would apply to others, and countering it with realistic and hopeful self-talk.

Pros and Cons of Sharing our Experiences

  • How we talk about our experiences with others will impact our self-perception and the perception others hold of us. It can also be an opening or a barrier to getting and giving support, and to be known for who we are.
  • We make decisions on a daily basis about if and how we talk about ourselves to others.
  • There are pros and cons to sharing our personal challenges and wisdom gained on the path of recovery. These vary from situation to situation and person to person.
  • Knowing our goal or reason for sharing this personal information in any given situation will guide our decision. Some goals include being understood, being accepted for who we are, receiving an accommodation, offering support to someone else, etc.

Points to Consider About Sharing our Experience

  • There are characteristics that we can look for in another person to help us decide if that person will likely help us to meet our goal once we have opened up to them. We can even test that person out before talking to them to see how they respond generally to people who face similar challenges we have faced.
  • When faced with a decision to share our experience, our options are to share, not to share, or to postpone the decision.

If the Decision is to Share our Experience

  • If someone does not respond in a way that we had hoped, our most powerful, gracious, and helpful response is to let them know what we were hoping to have happened (our reason) and that we had assessed them as someone who could respond in that manner.
  • Sharing our story is most often done in small segments over time. We share more or less of our story based on our goals. We are in control of how much and in what detail we talk about our experiences.
  • If part of our goal in sharing our experiences is to reduce stigma, it is important to share our strengths that we brought to our challenges and those we have discovered in recovery.
  • We are not alone. Others are making decisions about sharing their experiences. Peer support can be very helpful in our recovery journey.

HOP is a great tool that enables participants to consider the many decisions they face related to sharing their stories. Ultimately, it empowers participants with the realization that they have a lot of control over their story of mental health challenges and recovery. If you are interested in learning more about HOP or becoming a HOP facilitator, click here or email WISE@wisewisconsin.org.


Lucy, and the WISE team

Challenging Victim-Blaming

In July, we learned about “public stigma” – the stigma that people express towards others. Click here to read that article. In this post, we will examine one type of public stigma that can have a devastating psychological impact on people who are recovering from abuse.

Victim-blaming is the tendency to view victims as responsible for the violent acts perpetuated against them. Victim-blaming implies the fault for events such as domestic violence, sexual assault and harassment, and other acts of violence lies with the victim rather than the perpetrator. Common negative social reactions include anger, disbelief or skepticism, implicit or explicit blame, and even the refusal of assistance for victims seeking help. Victim blaming also takes many forms and can be quite subtle; for example when a woman who is pickpocketed is chided for her decision to carry a purse.  Any time someone questions what a victim could have done differently, he or she is participating in the culture of victim-blaming.

Simply talking about an abuse experience requires significant vulnerability and bravery! Victim-blaming severely hampers our ability to best support people who have entrusted us to their story. At its core, victim blaming reinforces what abusers have been saying, thus increasing the sense of shame and self-stigma that invariably comes from internalizing some of the emotional and mental injury perpetuated. Being blamed for traumatic experiences can lead to increases in mental health challenges such as depression, anxiety, and PTSD. The cultural tendency for victim blaming also decreases the likelihood that people will seek help and support due to fear of being further shamed or judged. It even prevents people from reporting crimes; This is true not only in cases of sexual assault but also in cases of domestic abuse or hate crimes.

The challenge to changing and dismantling victim-blaming attitudes lies in the fact that such responses are pervasive, often automatic, and emanate from people’s desire to feel safe themselves. Blaming victims allows us to feel that the world is just, that we have control over what happens to us, and that we can avoid traumatic experiences ourselves. While these attitudes grant us some sense of control over our lives, they also compromise our ability to empathize with others and perpetuate public stigma.

Survivors benefit from being around supportive people who understand the pitfalls of victim-blaming. Fortunately, there are a number of strategies we might use to offer unequivocal support and compassion to survivors who share their stories with us:

·      Acknowledge how incredibly difficult it is to share stories of trauma and abuse. Believe people who choose to share their stories with you. Realize that they are trusting you to treat them and their personal life experiences with respect;

·      The first step is awareness. Be aware of the mental trap of believing that the world is just. It is difficult to accept that sometimes, bad things happen to good people. Recognize the tendency to rationalize suffering, trauma, and misfortune in this way;

·      Survivors sharing their story with us may interpret “why” questions as a guised form of blame. Avoid accusatory questions. Pointing out how the victim could have acted or responded differently is not useful and can be invalidating. Offer compassion by listening to what they have to say without offering interpretations of the event;

·      Since many people attribute part of the blame to themselves, reassure survivors that “it is not your fault;”

·      Language surrounding acts of violence often focus on the victim rather than the perpetrator, which can have the effect of erasing the behavior of the perpetrator. When discussing acts of violence, use active voice to focus attention on the perpetrator (“X hit Mary”). Reframe questions to focus on the perpetrator’s actions (“What did X do next?”).

While these strategies allow us to communicate and offer support to individual survivors, these are also a number of ways we can attempt to challenge the culture of victim-blaming on a more systemic level:

·      Challenge victim-blaming statements when you hear them. People may not realize their attitude is one that makes it seem as if a victim is a fault. Kindly counter their statements and increase awareness in others by challenging statements that condone victim blaming;

·      Remember that the only one at fault for a crime is the perpetrator. When perpetrators or their enablers make excuses, hold them accountable and do not let them rationalize their actions by blaming the victim or minimizing their crime;

·      Jokes normalize victim-blaming by making light of trauma. Challenge jokes about traumatic events by calling it out immediately and explaining why it makes you uncomfortable;

·      Educate your community by collaborating with organizations (e.g., local women’s organizations, domestic violence organizations, rape crisis centers, and victim’s rights organizations) that can teach people the importance of supporting survivors.

For those reading this who may be in need of additional support for survivors of sexual abuse, domestic abuse, or hate crimes, please click here, here, or here to connect to resources.


Sarah, and the WISE team

The TLC4 Model

In December, we discussed several stigma change processes, including protest, education, and contact. Of these, contact with those with lived mental health experience is the most effective. Hearing about the mental health challenges and the recovery efforts of others is the best way to decrease stigma and offer realistic hope to those facing similar challenges. To read more about this, click here. Changing minds isn’t easy and certain approaches are more impactful than others in reversing harmful and hurtful beliefs. WISE uses the TLC4 model to aid us in reaching various populations and producing tangible change. TLC4 stands for the following:

  • Targeted – Where do people experience stigma in your community? Public stigma is often experienced in multiple settings. Stigma change efforts should be targeted to particular groups of people or settings where people have encountered stigma. Stigma change strategies can then be tailored to the particular group or setting being targeted. (e.g. health providers, school staff, faith groups, civic groups, etc.)
  • Local – Stigma reduction works best if designed to meet the unique characteristics of a local area. What works in Madison may not work best in Rhinelander. Tailoring discussions and providing specific tools to meet local needs serves these areas most effectively.
  • Credible – Contact with a peer, or someone who is similar to us in some way, establishes rapport and allows us to see each other’s perspectives more clearly. If we view each other as more alike than different, we can listen and converse while feeling understood and open to the ideas of others. (e.g. parent to parent, nurse to nurse, teen to teen)
  • Continuous – While one conversation with someone who is facing or has faced mental health challenges may make a difference to an individual, it’s not usually enough to make a lasting difference. Reversing stigma is a cultural shift and will take dedication over time by those who are committed to it. It’s also important to note that variety is needed in order to establish a wide and progressive base for change.
  • Change-focused – Determine what you want the targeted group to do differently as a result of your efforts. How will you know that you have made an impact?
  • Contact – If we’ve said it once, we’ll say it again. Contact with those with lived mental health experience is the single best way to reverse self and public stigma and increases inclusion and supportive behavior by and for all.

With that said, if you’re feeling inspired and want to do your part to reverse stigma, here is a list of what you can do right now to make a difference:

  • Seek out those with lived mental health experience. Listen to their story, and support their recovery and resilience. Not sure how to do that? The Seven Promises that go with the Safe Person Decal give a good outline of how to be an effective listener and to offer support. If you feel comfortable, vow to be a safe person for others by displaying the Safe Person Decal. Download or order the Safe Person Decal here.
  • Wear lime green, the color of mental health awareness. Be prepared to speak up about what it means and why you’re wearing it. In an effort to create curiosity and start conversations with others, WISE offers free, lime green bandanas, which can be ordered here.
  • If applicable, consider sharing the story of your own mental health challenges and recovery. If you’re unsure about whether or not you’re ready to disclose your personal experiences, tap into WISE’s resources and go through the HOP training or download the HOP workbook here. HOP, which stands for Honest, Open, Proud, is a program to assist in making strategic disclosure decisions. More information on HOP will be posted on WISE Words soon, so check back again, or, if you can’t wait to get started, read more about HOP here.
  • If you have permission, share the stories of others. Click here to watch short video stories created by one of WISE’s partners, Rogers InHealth. These are excellent resources to watch and share with others.
  • Bring the conversation to your various communities – work, civic, faith, and schools. WISE has several offerings, including the WISE Basics presentation and discussion, HOP training, and consulting with organizations as they design, implement, and evaluate TLC4, that can assist these communities in reducing stigma. To request a training or find out more, please email WISE@wisewisconsin.org.

Employing the tips provided and following the TLC4 Model will give you a better idea of how to end stigma effectively. In our next few posts, we’ll be discussing HOP in more detail. In the meantime, feel free to sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.


Lucy, and the WISE team

Logic’s 1-800-273-8255 Making News & Breaking Records

Becase of their unique, stylistic elements, rappers pride themselves on their narratives, which often address current issues and/or popular trends. However, topics related to mental health have been noticeably absent from the rap genre.

That is… until last April when the rapper, singer, and songwriter known as Logic released 1-800-273-8255, a song named after the National Suicide Prevention Lifeline (NSPL) which “thoughtfully and creatively…inspires listeners to seek help and find hope” according to a press release issued by the NSPL. Their website, which you can visit here, “…provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week..” 1-800 was released with the full cooperation of the National Suicide Prevention Lifeline.

In a recent press release, the National Suicide Prevention Lifeline shared that, on the date of 1-800-273-8255’s release, they received 4,573 calls — the second highest daily call volume in the NSPL’s history. Since, baseline Google searches for the NSPL have increased by 100% and have remained 25% higher than before 1-800 was released. That more people are calling the NSPL attests to the powerful impact that music and entertainers can have on promoting mental health.

On his personal Twitter account, Logic himself even declared that 1-800 is “the most important song I ever wrote.” Big words from a man with three albums, all of which are RIAA certified Gold, and two Grammy nominations, both for 1-800-273-8255, to his name. Logic not only credits his fans for this success, but also for convincing him to tackle such difficult subject matter. After fans commented on the power of his voice, Logic challenged himself to write songs with even more meaning and purpose by asking, “…what could I do if I actually tried to save somebody’s life?” And so 1-800 was born, a product of Logic’s own experiences, past and present, with mental health challenges.

According to CBS, Logic, whose birth name is Sir Robert Bryson Hall II, was raised in a biracial household by an African-American father and a Caucasian mother. The first was incarcerated, and both faced various mental health and substance abuse challenges. Amidst this difficult upbringing, Logic left home at 17 and dropped out of high school in order to “devote himself to music full-time…”

Today, Logic faces his own mental health challenges in a “form of anxiety called derealization disorder.” According to Logic, derealization disorder is “an intense form of anxiety where you feel like you’re…separated and there’s a filter between you and reality…because you’re hyper-analyzing the situations around you…” By Logic’s own admission, his derealization disorder was caused by his refusal to take breaks from his routine to maintain a well-balanced lifestyle. Once he decided to say “no” to certain opportunities and prioritize his own well-being, Logic’s condition greatly improved.

Logic continues to speak openly about his difficulties, both past and present. He realizes that his experiences are not uncommon and uses his talents to connect with others. He realizes that this is not only the best way to decrease the stigma surrounding mental illness, but also a way to encourage those with mental health challenges to seek help, if necessary. Of his motivation to write 1-800-273-8255, he says, “I just wanted them to know that they really weren’t alone. That’s why I write songs like that… I want people to be themselves no matter who they are…” To see Logic’s powerful performance, in which he urges others to join in his movement for mental health advocacy, click here.

In December, Khalid, who collaborated with Logic on 1-800 performed at The Rave/Eagle’s Club in downtown Milwaukee, Wisconsin. This event was hosted by KISS FM and sponsored by two of WISE’s partners, Rogers Behavioral Health, or RBH, and Mental Health for American, or MHA. RBH and MHA had a presence at the event and gave approximately 3,500 attendees glow-in-the-dark wristbands, which listed the Safe Person URL on them to promote the Safe Person Decal with the Seven Promises. To read more about the Safe Person Decal, click here. The Safe Person initiative is part of WISE’s work to eliminate the stigma surrounding mental illness and educate people on how to be supportive of those who may be struggling. To download or order Safe Person decals, click here.


Lucy, and the WISE team

Stigma Change Processes

Back in July, we discussed what stigma is and where it comes from. Click here to read that article again. While this information is useful, the most important thing to know about stigma is that, in a perfect world, it wouldn’t exist. In this post, we’re going to discuss how we can reverse and eliminate stigma. This information is what WISE uses to frame its goals and accomplish its mission to build resilience, inclusion, and hope in Wisconsin’s communities.

Research by CA Ross and EM Goldner indicates that, in any given situation, we can be stigmatizers, stigmatized, or de-stigmatizers. This means we’re either contributing to, receiving, or reversing stigmatizing behaviors. Obviously, we at WISE strive for the latter and encourage others to do the same! Below are common ways that others have attempted, or you can attempt, to reduce or eliminate stigma:

Protest – Protests usually garner a lot of attention thanks to media coverage, which can be positive or negative depending on the nature of the protest. The issue here is to be aware of the unintended consequences of well-intended actions. For instance, protests have the potential to have a rebound effect and actually increase negative stereotypes. For example, when the cast on Duck Dynasty made strong declarations against same-sex marriage, people protested the show, suggesting others no longer watch or purchase items related to the show. Rather than have the intended effect, highlighting the issue without any accompanying support for a change in attitude, actually emboldened those in agreement with the stigma. The result was that ratings and sales increased.

Education – Education is often tried as a way to reverse stereotypes. For instance, we can dispel the myth that people with mental illness are dangerous by teaching people that people with untreated mental illness are only slightly more dangerous, especially when using drugs or alcohol. In fact, compared to people without a mental illness, people with a mental illness are actually more likely to be victims of violence. The real question is: does having that additional knowledge actually decrease personal or public stigma? Unfortunately, the answer is often no. More often than not, our opinions stay the same or change in the short term but revert to our previously held stereotype in the long term. Knowledge is not enough to reverse stereotypes that elicit strong emotions such as of fear.

Contact – The preferred way to effectively end stigma is to have meaningful contact with those who are living in recovery with mental health challenges. This is what WISE is all about. Hearing that others have faced mental health challenges, found a path of recovery, and have a satisfying life even if dealing with ongoing challenges, is the best way to decrease stigma and offer realistic hope to aid our own recovery. Resilience is the capacity to succeed and thrive, despite experiencing trauma, mental illness, and/or addiction. Recovery is a process of change through which people work to improve their health and well-being, live a self-directed life, and strive to achieve their full potential. The difference between this approach and education is that exposure to people’s stories and lived experiences are much more emotional and the brain makes deeper connections when emotions are involved along with factual information, which is why talking to those with lived mental health experience is so effective.

In general, stigma change processes can be measured in terms of their effectiveness by the chart below.


Media-Based In-Person
Protest X X
Education XX XX

This information shows that if you’re really looking to end stigma, put yourself in a position to interact with those who live with mental health challenges and encourage others to do the same. To start right now you, can watch a video or two of people sharing their stories of recovery made by Rogers InHealth, a WISE partner, click here. To be a part of WISE’s ongoing efforts, you can also sign up for the WISE newsletter below for more information or attend a WISE meeting to get more involved.


Lucy, and the WISE team

You and Your Self-Care


In October’s post, we talked about what compassionate boundaries are and listed six tips for setting compassionate boundaries with others. Incorporating these into your routine will help you build compassion resilience, or CR, and will allow you to do your best work and establish healthy relationships. If you need a reminder, review them here.

If you’re still having a tough time mastering CR, don’t worry. As we said before, CR is a process that requires constant maintenance and happens over time. Keep working at it by incorporating some of the tips we’ve mentioned so far and those on self-care that we’ll discuss below.

Self-care, or the providing of care by you and for you, is an essential part of achieving great CR. Why, you ask? Self-care helps you maintain your physical, emotional, mental, and spiritual self. Self-care also offers you the rare chance to check-in and prioritize your own well-being by acknowledging the fundamental responsibility that you have to care for yourself. This is critical, especially to those who are also responsible for providing care to others.

One common criticism of self-care is that it’s selfish. While you can guess that WISE disagrees, hear us out. According to PsychCentral, self-care is not only about considering our own needs, but also about knowing what we need to take care of ourselves and, consequently, others. This is where compassion resilience ties in. Self-care means investing in yourself now so that you can invest in others later. Think of it this way…If you’re feeling satisfied, you’re more likely to help others feel the same.

If you’re not sold on self-care yet, you’re likely thinking about the logistics. You don’t have the time or are too busy for self-care. According to Reachout.com, there are several strategies we can use to make self-care an essential part of our everyday life. Continue reading for WISE’s abbreviated version, or find the full article here. https://au.reachout.com/articles/6-strategies-for-self-care

  • Make time for it. Purposefully set aside at least 10 minutes or more each day to practice self-care. Remember that self-care is flexible and that there are multiple ways to do so successfully. It doesn’t need to be a certain activity or at a certain time. (But, it is true that consistency of time can help with consistency of practice!)
  • Make your self-care a priority by monitoring your schedule and staying organized. Don’t double book, and don’t necessarily change your self-care plans if other plans pop up.
  • Be prepared. Create a list of self-care activities that you would like to do or want to try. If you’re struggling, look at the list below for potential options. Keep it handy, so that you can use it when you have the time.
  • Tune-in. Take moments before, during, and after self-care to tune in to how you’re feeling. Become aware of self-care’s many rewards. Notice how other parts of your life shift when you provide care by yourself and for yourself.
  • Learn to switch off. If possible, try to be present while practicing self-care by turning your cell-phone off. We know it’s hard to do, but this time should be devoted to you and your own well-being as much as possible.
  • Learn some quick fixes. Find self-care practices that you can do without excessive setup or supplies. These could include deep breathing or stretching exercises. You’ll be able to do activities like these anywhere, which will increase your chances of doing them at all.

According to PsychCentral, self-care isn’t something that you should force yourself to do. It’s something that refuels us, instead of taking away from us. In order to achieve total health, a balance needs to be developed between 6 separate but related parts of your being, which include emotional, spiritual, social, physical, intellectual, and creative care. Look below for some ideas on how to practice self-care in each of these 6 categories.

  • Emotional – Create a goal board, cuddle with your partner or pet, go to a support group meeting, listen to or sing a mood-boosting song, plan your next vacation, revisit a childhood hobby or interest, write in a journal
  • Spiritual – Attend a service, commune with nature, forgive someone who has wronged you, meditate, plant a tree and watch it grow, pray, unplug for a few hours, volunteer
  • Social – Call or text a family member or friend that you care about to catch up, host a get-together, get to know your co-workers or neighbors, join a local team, unfriend negative influences on Facebook
  • Physical – Cook yourself a healthy meal, drink water, exercise, go in for check-ups and receive regular care, stretch, take an afternoon nap, try acupuncture or get a massage
  • Intellectual – Complete a puzzle, find a new hobby, make a to-do list, read a book about a topic you’ve been interested in but have never taken the time to learn about, sign up for a class
  • Creative – Decorate or rearrange your room, color, tackle a DIY project, take and develop photos, write a poem or short story

The importance of self-care has recently seen a resurgence in healthcare and is now considered a primary means of preventative care.  That said, self-care is not the end all, be all and doesn’t mean that environmental issues should be ignored in favor of individualistic pursuits. It does, however, play an important role in maintaining your overall well-being, so do yourself a favor, and indulge in some much-needed self-care. For more information on CR, feel free to sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.


Lucy, and the WISE team

Facebook’s New Self-Harm/ Suicide Algorithm


Social media is immensely popular, particularly the powerhouse Facebook, which boasts 1.2 billion daily users and is now worth over 500 billion dollars according to Zephoria.com. No, you didn’t read that wrong— that’s billion with a b. Due to Facebook’s immense following, as well as the subsequent rise of similar platforms such as Twitter, Pinterest, and Snapchat, much research has been done examining social media’s many effects, particularly among adolescents who’ve grown up utilizing this powerful technology. Much of this research has focused on Facebook’s potentially harmful effects, such as cyberbullying, which many researchers have linked to rising suicide rates in recent years according to USA Today.

Cyberbullying is, and will remain, a huge concern for families as access to and means of communication continue to expand. According to the Cyberbullying Research Center, over 50% of adolescents have experienced some form cyberbullying and between 10% and 20% experience it regularly. Bear in mind that, as with many sensitive subjects, these occurrences are often underreported.

Cyberbullying can take many forms from posting hurtful and/or threatening messages to sharing personal or private information meant to put down or shame. Unsurprisingly, cyberbullying can lead some victims to have “low self-esteem and to consider suicide.” According to StopBullying.gov, this is possible given several concerns specific to digital communication that make cyberbullying even more harmful and hard to prevent than face-to-face occurrences of bullying. These include the following:

  • Persistence – The ability to instantly and continuously communicate means that it can be difficult to find relief from cyberbullying.
  • Permanence – The permanent and public nature of digital information means that an online reputation can develop and impact other areas of life for an extended period of time.
  • Hard to notice – The often imperceptible and unseen nature of cyberbullying means that it’s harder for adults to recognize and address.

Facebook, as the most popular social media platform, has been a hotbed for cyberbullying occurrences and is regularly criticized for its relatively lax and unregulated policies that seem to embrace, rather than address, the aforementioned concerns. However, a lesser-known fact is that Facebook is responding to this need and expanding its services by introducing a new tool designed to identify members who may be at risk of self-harm and/or suicide. According to BBC News, Facebook has developed “pattern-recognition algorithms” that identify need based on content posted, such as certain words or phrases used by both the individual and their family members or friends. Read their full article here. According to Scientific American, if Facebook recognizes an at-risk individual, it presents them with a number of options including contacting a helpline, getting tips on what to do in moments of crisis, or talking with a family member or friend.

There is some debate as to whether this will be an effective means of preventing self-harm and/or suicide. Because this trend is relatively new and ever-evolving, Scientific American says that science is still trying to make sense of what works best on these particular platforms. Read their full article here. While this feature may never make self-harm and/or suicide completely predictable,  everyone can agree that it’s definitely step in the right direction.

In the meantime, WISE encourages all adults to be aware of and present in their child’s online activities and to encourage healthy and safe online practices in order to prevent cyberbullying and other potential dangers. Look below for select tips and tricks from TeenSafe.com and Parents.com to see how you can encourage and ensure online safety.

  • Talk to your children openly and honestly about possible online issues. Let them know they can come to you for help if needed.
  • Encourage your child to friend only those people they know personally and are “real” friends with. Conversely, tell them not to associate or give information to anyone they don’t know.
  • Help your child set their privacy settings.
  • Friend your child online but interact sparingly. Avoid posting embarrassing photos and comments regarding your child. Instead, observe at a distance.
  • Keep electronics in common areas so that you can monitor your child’s online activity and usage.
  • If your child is being cyberbullied, have them wait to open Facebook until you can sit and read the messages or posts together. Be supportive and understanding. Find out the details, and ensure that you’ll work together to find a solution.
  • Talk to your school’s administrators, guidance counselors, or social workers so they can keep an eye out for bullying during the school day and intervene if necessary.
  • If there are threats of physical violence or the bullying continues to escalate, don’t hesitate to get law enforcement involved. Be sure to take screenshots and print off examples of the cyberbullying to act as proof.

For those reading this that may already be experiencing cyberbullying or having suicidal thoughts, please click here for a variety of valuable resources provided by StopBullying.gov that may help identify what you can do in a certain situation.


Lucy, and the WISE team

6 Tips for Setting Compassionate Boundaries

In September’s post, we discussed compassion resilience, or CR, and how to move from compassion fatigue toward wellness. We also discussed the 7 C’s of CR that we can apply in our work with others to ourselves. Review them here.

So far, we’ve talked a lot about what CR is and why it’s so important in maintaining your personal well-being and job satisfaction.  In this post, we will discuss 6 tips that will help you set compassionate boundaries. This may seem awkward or difficult to do, but establishing these boundaries will allow you to do your best work in the future and establish healthy relationships with the people you serve, co-workers, family, and friends.

What do we mean by setting compassionate boundaries? Typically people think of setting boundaries as being all about what to say “no” to in order to protect ourselves. We focus on words such as declining and refusing. We are trying to avoid feeling frustration, anger, hurt, resentment, or disrespected. While this is part of the concept, we believe that a more positive and proactive approach is actually more effective and compassionate. We start with the question, when you think of the person you want to be on the job, in your friendships, etc., what are the behaviors you want to demonstrate? Once you know that list of behaviors, you can identify the boundaries that you want to set in your relationships that will support you being the person you want to be. Here’s an example: On the job you want to be a person that your co-workers can turn to for assistance when needed. You also want to maintain a pleasant attitude. In order to be both pleasant and available to your co-workers (and get your tasks done!), you would appreciate some notice ahead of time to when your help might be needed. That is a boundary conversation that you can have with your co-workers. Later we will look at what you might say.  While it may be difficult in the short term to set boundaries at home or at work, not doing so may lead to many more problems in the long term.

What may indicate that we are not setting compassionate boundaries? Remember Gentry’s “zealot” stage of compassion fatigue, where people say “yes” to each and every opportunity but quickly can move to the “irritability” stage When we do not identify, set, and maintain compassionate boundaries, we may say yes when we really mean no. We may make other people’s problems our priorities, perhaps to the exclusion of our own needs. Not setting boundaries may also be evident when we accept abuse or unfair treatment. We may also become overly apologetic and not speak what we are truly feeling. In short, a lack of boundaries may be a catalyst for compassion fatigue.

In contrast, setting healthy boundaries is a way to stand up for our values and maintain both our self-respect and our respect for others. It is a way to prevent and limit our annoyance, frustration, and anger AND increase the likelihood of behaving in the ways that we desire. As Brené Brown says in her book, Daring Greatly, setting very clear boundaries about what we are willing to do, unwilling to do, willing to take on, and unwilling to take on, is an integral part of being compassionate. In the process of developing CR, we must, therefore, learn how and when to apply compassionate boundaries, as well as when to relax or let go of our boundaries.

Six Tips

  1. Know what you want to say “yes” to according to your own priorities and values. Take the time to judge whether a particular action or interaction may lead to us feeling caring and competent or hurt, overwhelmed, stressed, or angry. It may help to tune into your body and notice physical sensations. If you feel a boundary has been crossed, what physical sensations do you experience? Only once you are aware of your own feelings and needs can you take conscious action about how to communicate with the other person.
  2. If you can’t or don’t want to participate, remember that saying “no” is perfectly okay. Many people, especially women, have developed beliefs that we must be pleasing, agreeable, helpful and nice to earn love and appreciation. Taken to the extreme, this belief can make us “give to get” and feel uncomfortable saying no to requests for help. Click here for some additional tips on how to say “no” with compassion.
  3. If you feel that your boundaries are being crossed, respectfully tell that to whoever is crossing them. Tell them how you wish to be treated or state what you are or are not willing to do in words that describe what you value and desire for yourself and your relationships. Reinforce your point by pointing out past violations or near-violations. This will give them specific context and decrease the chances of it happening again. If you think someone will violate your request/wishes, also state the consequence, or what will happen if they do not respect your boundary. Follow through on the consequence if they violate your boundary again.  Be clear and firm, especially with people who don’t have very good boundaries themselves.
  4. Schedule proactive “meetings” to discuss your boundaries. Be firm but polite, and strive to have a natural discussion that involves natural give and take on both sides. This is a way that leads to compassion! This structure offers safety to both parties and allows everyone to leave feeling understood and respected.
  5. Give explanations that are specific and relevant to the other person. This will not only decrease confusion but also increase the likelihood of success. Try not to place blame on either side and focus on moving forward together to find shared solutions. Perhaps find a compromise you can both agree to.
  6. When setting a boundary, you must be willing to accept that you may not get what you want/need. Be willing to let go of the outcome. In sharing a boundary, you have shared what is true for you and honored your values and priorities. It is then up to the other person whether or not to abide by it.

So, let’s go back to how you might talk with co-workers about your desire to be helpful and the boundaries that requires. Using the tips from above, you might say:

“I would like to be someone you can count on to help you out when needed. I know that between my job tasks and time limitations, I will not always be able to say yes to your request. I ask that you consider giving me a “heads-up” a few days ahead of time when you can see that you might need some backup.  Because things often happen that you cannot plan for, please still feel free to ask even if you did not give me a “heads-up” and understand if I need to say no.”

This proactive boundary setting can support your ability to identify when the boundary is crossed and avoid you and others having an expectation that will always be able to step-up to help a co-worker.

Although establishing boundaries can be a challenging process, it is also empowering. If you’re still having a tough time mastering CR, don’t worry. CR is a process that requires constant maintenance and happens over time. Keep at it. Incorporating the above tips into your routine will help prevent and lessen compassion fatigue. We’ll be discussing self-care in November’s post as we continue our series on building CR. Be sure to check in then for more information. In the meantime, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.


Lucy, and the WISE team

Compassion Resilience: A Path to Wellness

In August’s post, we “pounced” on the subject of compassion fatigue and its harmful path by illustrating Eric Gentry’s research with the help of some cats. Need a reminder? Review it here.

Compassion fatigue can result in feelings of depression, anxiety, sadness, exhaustion, and irritation. Knowing what compassion fatigue looks like is key in understanding yourself and others and maintaining positive morale and productivity in the workplace. But,compassion fatigue is a normal response to the abnormal situations we might find in the workplace and hear about from those we serve. Rather than think of compassion fatigue as something to be avoided or fixed, it may be more helpful to figure out how to feed and grow our compassion resilience, or CR. CR is the ability to maintain our physical, emotional, and mental well-being while responding compassionately to people who are suffering. If you commit to growing your CR, there are various strategies you can use.  

  • Expose yourself to recovery and resilience. It is difficult to maintain a positive perspective on the hopefulness of our work if we are exposed to the complex challenges of the people we serve without also being exposed to the stories of eventual recovery and resilience of people who were in the same places at some point in their lives. To listen to brief stories of recovery and resilience, click here.
  • Establish compassionate boundaries. It’s hard to achieve a healthy balance if over-involved or under-involved in your personal and professional capacities.  A first step in setting compassionate boundaries is to identify the “Zone of Helpfulness”- the behaviors that you and your team agree are helpful to producing the environment in which to do your best work. From there, the boundaries that need to be set to support those helpful behaviors are more easily identified  An example is the helpful behavior of welcoming all visitors to your building. A boundary might be to avoid “shop talk” in the reception area when others are present so you can focus on being welcoming.
  • Connect with colleagues and others in the community. The most we can expect of ourselves is 100%. Times when we feel a need to go beyond our capacities are often due to not being connected to the people and resources to which we can then connect those we serve. WISE encourages organizational leaders to set aside time for staff to get to know key people and organizations that are “partners in compassionate care.”
  • Practice frequent self-care. Self-care will be discussed in detail in October’s post. Check in next month for more.

Our overall goal then is to establish an inclusive, supportive environment for yourself and your clients, patients, students, etc. We can do this by following  the 7 C’s of resilience, that we apply in our work with others to ourselves. These support the move from anger, apathy, and avoidance to resilience. Each description of what you offer others is followed by questions to help you apply the concept to yourself and your compassion resilience. As we learn in mindfulness practice, remember to notice but let go of negative emotions like anger or shame that come with this personal exploration.

  • Get to know people with non-judgmental curiosity. How does being curious about yourself in interactions with others impact your CR? What practices might enhance your self-awareness?
  • Form positive connections with the people you serve. What are two relationships that increase or support your CR? What is it about them that supports your CR?
  • Build trust through consistency. What do you already do to support your compassionate approach to others? What is most likely to get in the way of consistency in what is working ? How can you anticipate that? How do you get back on track?
  • Build competence to meet diverse expectations. As you become consistent with your current strengths, what are potential steps for you to take to further grow your compassion resilience/avoid compassion fatigue?
  • Support sense of control in others. What do you have control of that would further support your CR? Where do you want to expand your influence, and what stressors can’t you control that you would be best helped if you could  let go?
  • Engage in co-planning to arrive at self-directed decisions. Who can be your CR buddy this year to debrief and touch base with?
  • Show them the worth of their contribution, that “the world” is a better place with them in it. What are the strengths you bring to increasing CR in yourself, your workplace, and your family?

After this, slowly begin to integrate what you’ve learned or realized into your work. Be conscious of your efforts, and adjust as needed, remembering that this is a process. And don’t worry if you’re still feeling overwhelmed or uneasyWISE has more tips on setting compassionate boundaries, connecting with colleagues, and practicing self-care in the months ahead. In the meantime, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/. And be sure to check back next month to learn more about how to grow your compassion resilience.


Lucy, and the WISE team

Vulnerability: The Key to Authentic Connections

If you’re a social worker, you’ve likely heard of Dr. Brené Brown, a self-described “researcher and storyteller” who studies topics such as shame and vulnerability. Dr. Brown’s personal background is in social work, so these topics are obviously relevant to those in that field, but they’re also valuable and potentially life-changing to those who aren’t.

Firstly, if you want to hear from Brené Brown herself, her TED talk, titled The Power of Vulnerability, is definitely worth a look. Find it here. If you have more time or interest, Dr. Brown also has multiple bestselling books, including Daring Greatly, Rising Strong, and Braving the Wilderness, which offer more details and examples of how to engage with others and wholeheartedly give and receive love. This post will briefly summarize the concepts she has shared.

As Dr. Brown does, we’ll start with the importance of connection. If you think of what you value most, it’s likely some sort of personal relationship, like mother to daughter, coach to athlete, manager to employee, brother to sister, neighbor to neighbor, pet owner to pet, etc. Dr. Brown goes so far to say that connection is nothing short of “what gives purpose and meaning to our lives.” Not only that, but it’s also a biological necessity. Matthew Lieberman, a neurologist and psychologist, says that the brain is “the center of our social selves” and that “its primary purpose is social thinking.”

Through extensive qualitative research, Dr. Brown’s goal was to discover the primary cause of disconnection, which she deduced is shame, or the belief that “I’m not enough.” Shame is universal; feelings like failure and guilt are something we’re all familiar with and often all too self-conscious about. Moreover, Dr. Brown says that none of us are comfortable discussing our feelings of shame, because it may mean being seen as unable or weak by others and treated or used accordingly. In short, our unwillingness or inability to be authentically vulnerable is a root cause of our disconnection!

If we open up to others, we may feel there’s a chance of being attacked or harmed, physically or emotionally, and we’re hesitant to take the risk if our well-being isn’t guaranteed. Often, we even work to appear the opposite — competent and overconfident — to make up for our perceived flaws in front of others to lessen the  chance we’ll be judged. When we do feel vulnerable, Dr. Brown says we may cope in the following ways:

  • Numbing. We close ourselves off to negative emotions like anguish, discomfort, and regret. The issue, according to Dr. Brown, is that numbing can’t be done selectively. This means that if we choose not to feel negative emotions, we’re choosing not to feel positive emotions too. This is because emotions are understood relative to other emotions.
  • Making the uncertain certain. If forced to internalize, we seek a definite and tangible cause, such as an event or individual, that we can blame for causing our pain. We make the uncertain certain by giving it a name that we can understand, even if it’s unfair or untrue.
  • Perfecting. We try to organize or rationalize our emotions. We look for easy and foolproof solutions, even though our emotions are complex and many-sided.
  • Pretending. We don’t take responsibility for the role we might’ve played in causing our own pain. We diminish our own faults in order to deflect accountability for our actions, which may have affected others.

While these coping strategies are understandable responses to difficult situations, and likely familiar to us, coping in these ways doesn’t lead to increased connectivity. Instead, these strategies promote quick fixes that divide, not a long-term solutions that strengthen and unite. In fact, Dr. Brown discovered that the opposite is true—individuals that are authentic, compassionate, and courageous, all of which result from being vulnerable, are those with the strongest sense of connection. In short, vulnerability must occur for meaningful connection to happen.

The power of vulnerability is perfectly highlighted in WISE’s recent work with Pastor Greg Washington and his wife, Tiffany. As a child, Pastor Greg suffered trauma that led to severe depression and anxiety. As a faith leader, this was worsened by the pressure put on leaders to be certain and infallible examples for their followers. Before his marriage to Tiffany, Pastor Greg had been able to cover up or minimize his personal challenges. It wasn’t until after he was vulnerable that both he and Tiffany noticed how disabling and serious his mental illness was. After an incident which forced Pastor Greg to acknowledge and accept his own limitations, he sought professional help. Because of his experiences, he’s even closer to Tiffany, who he knows loves him fully, and continues to preach at the Parklawn Assembly of God in Milwaukee. For an in-depth account as told by Pastor Greg and Tiffany themselves, check back in with Rogers InHealth soon. It’s so new that we’re still working on it! In the meantime, find similar videos here.

The story above is just one example of how vulnerability can be beneficial. How can we cultivate vulnerability in ourselves and others? How do we, both individually and culturally, get to a place where we can open to vulnerability? Dr. Brown advises the following:

  • Let yourself be seen. Allowing others to see your whole self, while initially scary, can lead to closer, more meaningful relationships and the joy of self-acceptance.
  • Love with your whole heart. Though there’s no guarantee that you won’t suffer if unforeseen developments occur, giving any amount of love to others is a good thing if done with good intent.
  • Practice gratitude and joy. Make a conscious effort to recognize and pursue what makes you feel fulfilled.
  • Know that you are enough. It’s important to remember that you, just as you are, are worthy of connection. If you’re authentic and receptive, others will respect you just as you will respect them for being just who they are.


Lucy, and the WISE team

Opiates/Opioids and Heroin in the U.S. and Wisconsin

We all know about the usage of certain substances like tobacco and alcohol. Knowing the risks, you’ve probably even used them yourself, as both are legal and/or socially acceptable. However, illicit drug use is a different issue and often flies under the public’s radar. This is especially true with a substance that’s gaining popularity in the US, particularly in the Midwest, and has left authorities unprepared and overwhelmed – painkillers such as OxyContin and Vicodin. If you pay attention to current events or public health issues, you’ve likely heard about this, but what might be new to you is how addiction to painkillers is linked to heroin use. Heroin is actually a type of opiate and is cheaper, easier to obtain, and produces effects similar to painkillers, or opioids.

Since WISE is Wisconsin-based, we’re going to emphasize local data and facts, but it should be noted that opiate/opioid and heroin overdose (OD) deaths are increasing throughout the US. In fact, according to the CDC, there has been a three-fold increase in opiate/opioid OD deaths and a five-fold increase in heroin OD deaths since 2000. Also worth noting is that neither opiates/opioids nor heroin discriminates based on age, gender, race, or socioeconomic status. In other words, there has been an increase of use in almost every demographic according to WISN 1130.

Surprisingly, the Midwest currently leads the U.S. in OD deaths with an eleven-fold increase between 2000 and 2013. According to The Economist, this is because other regions, namely the Northeast and West, previously handled similar issues in the 1960’s and the 1980’s and are, therefore, better prepared now. The Midwest largely avoided an earlier epidemic due to its location far from the Atlantic and Pacific Oceans, which acted as easy and relatively unregulated import and export hubs; but adapting modes of transport and trafficking techniques have recently made smaller markets like Kansas City, St. Louis, and Omaha more accessible. While the Midwest may be overwhelmed by and unprepared for this opiate/opioid and heroin epidemic, law enforcement is working hard to employ safe and successful methods to curb this issue and treat those with substance abuse challenges.

Still, OD’s from heroin account for less than half of all deaths due to opiate/opioid use. According to the WISN 1130, there were approximately 44,000 total OD deaths in 2016, and 52% of them were from prescription painkillers. This includes those prescribed by medical professionals, those given by or stolen from family and friends, or those purchased from dealers.

Though it’s easy to place blame, medical professionals aren’t always at fault. It’s important to remember that, even when over-prescribing of opiates/opioids takes place, it’s most often out of compassion, not ill will. This is due to changing practices and techniques in medicine. Namely, that professionals have only recently begun using their patient’s pain as a guide to treatment. Though it’s surprising that pain wasn’t considered before, it also makes sense that the main vital signs – body temperature, pulse rate, respiration rate, and blood pressure – were addressed first.

It is true, however, that opiates/opioids are being prescribed more freely and, while beneficial in many instances and helpful if used correctly, have the potential to harm more than heal by causing dependency. “Just a few prescribed OxyContin can lead to dependence, which can lead to addiction…” says WISN 1130. Some people start out addicted to painkillers, then try heroin, which is more accessible and “five or ten times cheaper.”

So the question becomes – how do we respond? What can be done? Firstly, it’s important that we don’t let this growing issue continue unchecked. This is hard to do since it’s easy to ignore until it affects us directly. Even more so since there isn’t an easy solution due to the nature of addiction and the dependence that drives a person to seek out their drug of choice, much like a starving man or woman will seek sustenance. This means that arresting and jailing youth and adults who are addicted doesn’t necessarily lead to rehabilitation and can even exacerbate the issue. Additionally, eliminating the supply all together is nearly impossible. Without these options, what’s left to do?

Listed below are five approaches that, when combined, can lead to shifts in how we think about and approach prevention and intervention.

  • Provide prevention education that is specific, personal, and skill-based for professional (e.g. nurses, teachers, police officers), parents, and youth. Stopping before starting is often the best measure in limiting or eliminating future use.
  • Increase treatment options through public policy changes, which include expanding access to evidence-based treatments such as Medication-Assisted Treatment, which combines medication and counseling/behavioral therapies to treat substance use disorders. In order to do this, public opinion about substance abuse must change. We can balance the anxiety and fear that often immobilizes us with increased understanding of addiction and hope for recovery. To check out stories about recovery from substance use disorders, click here.
  • Reduce the stigma on individuals and families who have loved ones facing addiction so that they can reach out and get effective support. We can reduce stigma by talking about this topic in all settings of our life with compassion and curiosity.
  • Learn from places that have been effective in preventing and intervening in this epidemic.
  • If you or a loved one is battling addiction to opiates/opioids, heroin, or any other substance, offer them any resources and, most importantly, support in seeking sobriety. Assure them that no matter the situation, there’s always hope for improvement and recovery.


Lucy, and the WISE team

Compassion Fatigue’s Harmful Path

In our previous posts, If We Want To vs. If We Can and Self-Stigma: Internalizing Trauma, we considered the many, multilayered connections between trauma and compassion. Now, we’ll discuss compassion fatigue, or the gradual lessening of compassion over time, and how this can be a barrier to our experiences in and out the workplace.

What does compassion fatigue look like? Eric Gentry, PhD, researched this question and has described compassion fatigue’s harmful path. WISE added the visuals to make it purr-fect!

The first phase, known as zealot or idealist, is when someone is enthusiastic and excited to perform their job duties. Armed with a can-do attitude and a passion for their work, people here want to be involved and devote themselves to the cause, so much so that they may take on more than they can manage. Because this benefits their employer, as well as their clients or patients, they’re often rewarded for this extra effort.



The next phase, known as irritability, is when someone begins to feel cynical due to realizing that they work in imperfect systems which present barriers to doing the best for those they seek to help. They may feel that their job duties aren’t what they expected or that they’re not making a difference despite all of their hard work. They may begin to pull away from their colleagues and day-to-day responsibilities by daydreaming or cutting corners in order to avoid performing certain tasks that make them anxious or uncomfortable.




The next phase, known as withdrawal, is when someone begins experiencing extreme self-doubt and questions their own ability and effectiveness in their role, which leads to decreased job satisfaction and feelings of disappointment, frustration, and guilt. At this point, they likely feel detached from and exhausted by their job duties and are past the point of reaching out to others, including colleagues, family members, or friends, for help.




The last phase, known as zombie, is when someone fails to cope in a way that’s healthy and shuts down. Feelings of disdain, impatience, and rage now drive their behavior, and they are likely dominated by a pervasive sense that something isn’t right. They may question their own reasons for accepting a certain job or entering a certain profession and consider leaving all together.




At this point, there are two options – to leave the position or profession or to practice resiliency and move towards renewal. I think we can agree that the latter option is certainly preferable, because it means that highly qualified individuals remain where they’re sorely needed and have the information or resources needed to support renewal and resiliency. It’s a win-win. Our goal then is to prevent compassion fatigue by ongoing actions that maintain compassion satisfaction, which we’ll explore in-depth in September’s post.



In the meantime, here are three things you can do to further explore this topic now.

  1. Gauge how you’re doing right now. It seems basic, but often, we’re too busy to recognize our own wellbeing. Take a moment to practice self-awareness and acknowledge how your body and mind are doing. What does this look like? Take note of any symptoms you notice, taking your entire self into account. What led to this happening? Take note of any actions or events, bad or good, which made you feel like this. Notice and work to let go of any anger or shame that comes with this exploration.
  2. WISE has found the Professional Quality of Life (PROQOL) scale to be a helpful tool in assessing compassion fatigue. It is an easy, single page questionnaire, which measures compassion satisfaction, burnout, and secondary traumatic stress. Find it here.
  3. Check out this video called From Compassion Fatigue to Resilience for more information about this subject, and be sure to check back next month for our latest post, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/


Lucy, and the WISE team

What is Stigma?

The first step in understanding WISE’s mission is to ask two very important questions – what is stigma, and where does it come from? It’s really simple – stigma is a false idea that can lead to misinformed beliefs that may result in harmful actions towards undeserving people. The illustration above goes deeper into the definition of “public” stigma, the stigma that people hold towards others.

In a previous post, Self-Stigma: Internalizing Trauma we took a look at how external experiences are internalized, which can lead to self-shaming. Illustrated below, you’ll see the cycle is the same, but the focus has shifted from these experiences to public stigma, where those with mental health challenges experience exclusion and lack effective supports. Notice that the end result can be the same – a person gives up, and their sense of self-worth is diminished.

Unsurprisingly, public stigma’s primary driver is the media, which sets a biased precedent for what is newsworthy, based on what is or isn’t presented, and how we should feel about it. Often, these stories paint an incorrect portrait, or purposefully target the cases of substandard treatment – unethical research, negative drug side effects, or poor quality care, while ignoring stories of improvement or recovery. Beyond the news, we also see negative portrayals of people with mental health challenges being promoted in advertising, movies, and newspapers. It doesn’t take long to name a horror film or TV show that spreads or supports false stereotypes.

The media may also exert “benevolent stigma,” which depicts those with mental illness as lovable, but incapable. This may seem well meaning, but, in fact, it belittles and mocks their challenges by insinuating that their impact affects the person’s other capabilities. Another common type, called co-occurring, results when people experience stigma from more than one angle, that is if a person faces mental illness and identifies as apart of another stigmatized population group.

All of these false representations lead to an array of social issues that affect the human population worldwide. The impact is most seen on social inclusion, or the act of making all groups feel valued and important within a society. This is so critical because it encourages the beauty of diversity and promotes unity. Those facing social injustice may deal with lost employment, subpar housing, poor healthcare, diminished education opportunities, or alienation from their community.

These are big issues, and, contrary to popular belief, they’re not going away, at least not as quickly as we’d expect or like. The belief that the stigma surrounding mental illness is improving is true but does not acknowledge a complete picture. In fact, the percentage of Americans who view people with mental illness as dangerous doubled from 20% to 40% between 1956 and 1996.* This was over 20 years ago, so it may seem easy to disregard, but even more surprising is that this figure has remained steady at 40% from 1996 to 2006.**

This is not to shame and blame but to ask necessary questions about how false notions continue to be reinforced when, really, people facing mental health and addiction challenges are diverse and multi-dimensional, like everyone. We are all simply human in search of a happy and meaningful life. The question then becomes how to reverse the damage done and work toward WISE’s goal to end stigma and to build resilience, inclusion, and hope within our communities, countries, and the world.

We’ll explore this soon, so keep checking in, sign up for the WISE newsletter below for more information, or attend a WISE meeting to get more involved. All are welcome, and we’d love to meet you!


Lucy, and the WISE team

* BG Link, JC Phelan, M Bresnahan, A Stueve, BA Pescosolido American Journal of Public Health 89 (9), 1328-1333

** BH Link, JC Phelan – The Lancet, 2006

“13 Reasons Why” & The Importance of Dialogue

Suicide is a tough, but necessary subject to address and one that is often avoided by media due to its sensitive subject matter. This avoidance isn’t surprising as suicide can be upsetting to discuss, but it also speaks to how we manage these topics culturally – often, by omitting them. It’s rare then when an outlet chooses to tackle this subject head-on as is the case in Netflix’s 13 Reasons Why.

Even if you haven’t seen 13 Reasons Why, it’s likely you’ve heard about it. Clay and his friend, Hannah, who died by suicide after suffering bullying and sexual assault at the hands of her classmates, narrate the story through tapes Hannah recorded before her death that identify her peers and their role in her choice to end her life.

Because it visually portrays these acts, especially in such graphic fashion, 13 Reasons Why has been the subject of controversy since its release on March 31, 2017. Some praise it for addressing difficult but necessary topics and offering us a rare chance to discuss them openly. Others criticize it “for glorifying or romanticizing the act”* and posing severe risks to teens, who may be prone to “suicide contagion,” or the increase of suicides due to the exposure to suicide or suicidal behaviors.**

While we’ll leave you to decide your own stance on 13 Reasons Why, there’s no doubt that it’s forced adults and teens alike to start an essential dialogue on the subject. It’s also no surprise, given 13 Reasons Why’s setting, that much of this dialogue has taken place in middle and high schools, where many administrators have sent out letters warning of the show’s possible effects, urging parents and guardians to be aware of and prepared to process 13 Reasons Why with their child.***

However, there have also been many positive responses to 13 Reasons Why that are worth featuring. One of our favorite here at WISE is when a group of students at Oxford High School in Michigan created “13 Reasons Why Not” in the hopes of “reminding students that they are not alone.” Students, who were called to “share their…stories and list the positive people in their life,”* discussed a variety of topics, from bullying due to size or sexual orientation to mental health challenges, including depression. For 13 days, students shared their personal experiences over the intercom and chose to “focus on positive encounters that helped them get through tough times.” According to Todd Donckley, the principal, “the community has reacted…positively” and “the shift in the atmosphere…has been noticeably more welcoming.”***

According to the American Foundation for Suicide Prevention, suicide is the 10th leading cause of death in the United States. Even more shocking is that suicide is the 3rd leading cause of death between 10 and 24 and the 2nd leading cause of death between 25 and 34. For more information, click here. These statistics not only exemplify how prevalent suicide is but also how important it is to be aware of and discuss. Even if 13 Reasons Why is under fire for failing to demonstrate positive connections or encourage hopefulness, everyone can agree that these statistics are way too high. This is especially true because suicide is difficult, but possible to prevent with close attention and acknowledgement. If you or someone you know is contemplating suicide, please call 1-800-273-8255 right away to receive confidential and free support. To hear stories of hope and resilience from others who are facing mental health challenges, please visit here.


Lucy, and the WISE team


** http://www.cnn.com/2017/04/25/health/13-reasons-why-teen-suicide-debate-explainer/index.html

*** http://www.cbsnews.com/news/13-reasons-why-not-oxford-high-school/

Self-Stigma: Internalizing Trauma

In the first post, If We Want To vs. If We Can, we examined two ways of viewing human behavior in relation to success. One is based on motivation – “people do well if they want to” and one is based on having the necessary abilities and resources – “people do well if they can.” Now, we’ll consider the perspectives of those who’ve experienced trauma within that context, and why this can complicate relationships.

For our purposes, let’s imagine a person who believes, for whatever reason, that if they truly wanted to do well, they would. Their success is reliant on motivation, which means that their own sense of self-worth is linked to the outcome. If they are successful, this belief is validated, and the cycle continues. If they are unsuccessful, as we all can be, they take it hard. They don’t realize that failing at a particular task doesn’t make them a failure. In these cases, and especially for those who are or have experienced trauma, the cycle illustrated here can occur.

The belief that “If I really wanted to do something, I would be able to” can result in a lowered sense of efficacy and self-esteem. They may feel that their ability to produce a certain result is diminished, which can lead to the opinion, “I am not able” or they may lose confidence in their own self-worth, which can lead to the opinion, “I am not good.” Naturally, these feelings can lead to additional avoidance, anger, and apathy, at which point they’re likely to give up on the task, and worse yet, on themselves.

This is a cycle in which one incorrect belief feeds into the next and can only be interrupted by rational thought such as, “There’s an ability or resource I’m missing to make this happen” or “I can learn something from this attempt that will allow me to access what I need to do better next time.” The problem is that this requires previous experience to act as proof that, despite a failed attempt, we can eventually succeed. But trauma’s effects can distort or interrupt this rationale. This is particularly true for children, whose brains are still developing.

Illustrated here, the three parts of the brain most important in understanding how trauma is internalized are the prefrontal lobes, the limbic system, and the brain stem.

·      The prefrontal lobes are responsible for receiving information from our senses, which is used to form rational thoughts, or those established by experience. It asks and answers, “What can I learn from this?”

·      The limbic system is responsible for registering and responding to our emotions. It also assists in the formation new memories about our experiences. It asks and answers, “Am I loved?”

·      The brain stem is responsible for monitoring our internal functions, like heart rate and breath, and our survival instinct. It asks and answers, “Am I safe?”

Adults, whose brains are developed in relatively safe environments or have found ways to be resilient to the challenges they have faced, are able to make complex, well-informed decisions. However, children, whose brains are undeveloped, aren’t. To ensure their survival, infant brain’s stress response is stuck on “on,” and it’s only through experiences throughout childhood that it will learn to adapt to new conditions on a case-by-case basis. Because young children aren’t able to weigh costs and benefits, their rational thought processes take a backseat to their natural instincts. This is especially true for children who’ve experienced trauma, where the negative effects of trauma leaves the brain much less able to decipher what is safe and what is not.

This is of critical concern for many reasons, one of which is the long-term effects of trauma. If left untreated, a child who experiences trauma will likely have behavioral, cognitive, and/or emotional setbacks which can extend into adolescence and adulthood. Their symptoms may manifest into a basic mistrust of adults, a belief that the world is an unsafe place, a belief that bad things will happen and it’s their fault, the assumption that others will not like them, fear and pessimism about the future, and a sense of hopelessness and lack of control. Any of these may impair the ability to make well-informed decisions, which can, in turn, lead to poverty, dysfunction, and/or systems engagements. If they have children, they can then become impaired caregivers, and might lack the abilities and supports to raise their children free from the impact of trauma.

Often, the effects of trauma show up in behavior too. Children may be sensitive to noise, avoid touch, have heightened reflexes, demand lots of attention, be perfectionistic, be aggressive, be confused about what is dangerous, or resist separations from familiar people or places, just to name a few.

It’s incredibly important to remember that this cycle can be interrupted at any point, which is where you fulfill your role as a caregiver. Yours is rewarding and valuable work, but it isn’t easy. You are faced with the hardship and pain of others, so it’s understandable that you might struggle after encountering children with complex challenges. As mentioned previously in If We Want To vs. If We Can, this is called compassion fatigue, and we’ll examine what compassion fatigue is, how it works, and some solutions to help build compassion resilience in our next post. Be sure to check back next month for our latest post, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website by clicking here.


Lucy, and the WISE team

The Safe Person Decal

Even though we always aim to offer support, it’s often the case that we aren’t sure exactly what to say when presented with the challenges of others. We want to console and relieve but may feel like we don’t have the information or resources to do so. Or that there isn’t an easy way to connect the providers and receivers of that support.

So in an effort to provide more accessible, dependable spaces for those in need, the Safe Person Decal was created, in partnership with WISE, so that all individuals or groups willing to offer support could better access those seeking it. By publicly displaying the Safe Person Decal, the user actively narrows the gap between the giving and receiving of support through the 7 promises, which are listed below. These guidelines help to ensure that the interaction will be positive for both sides. A short video of local teens portraying the 7 promises can also be found here.

1. Acknowledge that reaching out for support is a strength.

Welcome the person by recognizing the strength it takes to speak up. They may feel nervous or unsure, so reassure them that this is a positive step. Express your own gratitude for their trust in you as someone who can offer support.

2. Listen and react non-judgmentally.

Listen without bias by recognizing that the person’s feelings are legitimate, even if you’re struggling to understand their perspective. Give their vulnerability your full attention and care in culturally appropriate ways.

3. Respond in a calm and reassuring manner.

You may have an emotional reaction to what you’re hearing. Remind yourself that your feelings can be addressed afterwards. Wait until the person is done speaking before you respond. When you do, offer realistic reassurance. Exhibit acceptance, empathy, and respect.

4. Reflect back the feelings, strengths, ideas I hear when listening.

Repeat or rephrase what you heard in order to check for understanding. Call attention to concrete examples of their resilience and strength. Listen for action they believe would be helpful and are ready to take.

5. Ask how I can be helpful and respond as I’m able.

Ask how you can help. If the person asks for your input, make suitable suggestions. Follow through if they accept your offer. If you aren’t able to help in a way they propose, let them know, and work together to find a compromise.

6. Do what I can to connect to other supports if asked.

Ask if the person would like to hear about other supports before you offer. If they accept, connect them to outside resources that may offer further assistance.

7. Maintain confidentiality and communicate if exceptions exist.

As a rule, maintain confidentiality. If you feel you’re the sole source of the person’s support, ask if there is someone you could engage in supporting them as a team. Inform them that, while you respect their rights, their safety is your top priority, and you will take action to ensure it if necessary. If your professional ethics require you to take such steps, inform them early in the conversation.

The Safe Person Decal is a great way to show your support for those facing mental health challenges. By committing to foster compassionate relationships in safe environments, you can help achieve WISE’s mission. To download decal art or order buttons or decals, please visit here. And don’t forget to check in next month for our latest post, sign up for the WISE newsletter below, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.


The WISE team

An Introduction to Essential Health Benefits

If you pay attention to current events (or even if you don’t), you likely know that Republican leaders in the House of Representatives, with the support of President Trump, are trying to repeal and replace the Affordable Care Act, which was put in place by then-President Obama in 2014.

If you’re confused by the ACA and its aspects, you’re not alone. It’s complicated and dense, but in essence, its goal is to improve the affordability and quality of healthcare. This is to counteract actions taken in the 1990’s when Congress created a tax credit to help low-income families afford healthcare. While this did lower costs, it also allowed health insurers to sell cheap products by limiting services, which left many in need without options.*

Striving for a better choice, Democratic leaders, with the support of then-President Obama, produced the ACA, which guarantees that all health insurers include certain services, or essential health benefits, that act as a standard in order to ensure quality. These are divided into 10 categories, some of which are controversial, for reasons we’ll explore later.

  • Ambulatory patient services or Outpatient care
  • Emergency services
  • Hospitalization or Inpatient care
  • Maternity and newborn care
  • Mental health services and addiction treatment
  • Prescription drugs
  • Rehabilitative and devices
  • Laboratory services
  • Preventative and wellness services
  • Pediatric services**

Consumer costs are divided into 4 “metal tiers” – bronze, silver, gold and platinum. Each designates a certain percentage of healthcare coverage, as well as general rules about monthly and out-of-pocket costs. For example, bronze plans cover about 60% of costs, leaving the consumer to pay the remaining 40% in the form of copays and deductibles. Platinum plans cover about 90%, leaving the consumer to pay about 10%. A more detailed breakdown can be found here.

To Democratic leaders, this was a win/win because it satisfied the need for options without excluding necessary services that many consumers needed. Plus, the ACA lowered overall costs by “providing insurance for millions and making preventative care free.” This is amidst a host of other, more technical benefits, which can be found here.

However, the Affordable Care Act also comes with its own issues. The most common criticism is that it has actually increased costs and grants fewer choices to consumers who want a more limited plan. Some argue that the ACA is too all-inclusive, because it forces people to pay, in part, for benefits they don’t need. For example, a man, who can’t physically bear children, might feel it’s unfair to pay for maternity and newborn care, as the ACA requires, since he’ll never actually use such benefits.****

Republican leaders hope that removing certain benefits, particularly those that don’t apply to the entire population, such as maternity and newborn care, mental health services and addiction treatment, and prescription drugs, will improve access to the market. Hence, more choices will be offered to consumers, and costs will be cut.***

But, since Republican leaders haven’t yet garnered enough support to make this happen, it’s difficult to anticipate exactly what changes will be made to the ACA and, consequently, what the big-picture outcomes will be. Further specifics will be announced as the House of Representatives continues to hash out this issue.

For now, it’s important that the average American stay aware and up-to-date on these events, which will not only affect modern healthcare, but also each and every one of us. Hopefully, this helped you untangle the knots of this subject and begin to weigh the advantages and disadvantages for yourself as you consider the proposed changes. If you feel strongly inclined one way or the other, we encourage you to reach out to your State Representatives and Senators and voice your opinions. After all, they’re there to represent you!

Be sure to check back next month for our latest post, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.  


Lucy, and the WISE team

* (https://www.nytimes.com/2017/03/23/upshot/late-gop-proposal-could-mean-plans-that-cover-aromatherapy-but-not-chemotherapy.html?_r=0)

** (http://obamacarefacts.com/essential-health-benefits/)


If We Want To vs. If We Can


If you work in any field where your primary role is to aid or act as a caregiver to those who’ve experienced mental health challenges, you may have, at some point or another, felt feelings of apathy, exhaustion, loneliness, and/ or negativity. What you’re experiencing is called compassion fatigue, or the gradual lessening of compassion over time, and it’s very common, experienced by between 40% and 85% of professionals in these fields.*

Later, we’ll examine compassion fatigue in more detail, but for now, we’ll focus on compassion-based resilience, or the ability to maintain your well being while working to effectively support people who deal with complex life challenges. The first step is to examine our beliefs about human behavior as they relate to growth. This will establish a connection between compassion and trauma that is critical to understanding how we receive and respond to suffering.

So the question we want to ask is, is growth a matter of motivation, or is it a matter of having the necessary abilities and supports? In other words, do people do well if they want to, or do people do well if they can?

According to Ross Greene, an esteemed psychologist who created Collaborative & Proactive Solutions, or CPS, a model to find solutions to behavioral challenges, the belief that “people do well if they want to” is common but, generally, incorrect. It implies that people, whether patient, child, or student, are uncaring of their success and unmotivated to achieve it. And it requires the motivator, whether caregiver, parent, or teacher, to force growth, thereby limiting their role to enforcer. In these cases, the issue is often left unresolved, because the core concern hasn’t been addressed or managed correctly.

According to Ross Greene, this directly counters the belief that “people do well if they can”, which is not only correct, but far more helpful. Instead of blaming people, it addresses whatever third-party obstacle is blocking their success. At that point, people are seen as lacking the skills required and coping in what ways they know how. And it requires the supporter to collaborate and problem solve, thereby changing their role to enabler. Success then comes from working together to figure out the best solution, which can be used to solve any similar problems thereafter.

So what do we need to do to make less “do well if they want to” people and more “do well if they can” people? Firstly, we need insight, which comes from the planning and practice of collaborative problem solving, using the “do well if they can” attitudes and techniques. We also need to give the “do well if they want to” people time to let go of their unhelpful behaviors and adapt a new approach. It’s important not to place blame, and to remember that the “do well if they want to” people’s behavior is well meaning. We need to gradually expose the people we are trying to support to triggers while giving them the support for maintenance they need, which includes time to refresh. Lastly and, perhaps, most importantly, we need to give them realistic and relevant hope.

Take some time to reflect on if you’re a “do well if they want to” or “do well if they can” person and what you can do, in either case, to progress your work and yourself. Ask yourself what your professional role is in the two different mindsets. Think of an experience from your own career when you believed a person “could if they wanted to” and your belief about that person changed. Don’t forget to check in next month for our latest post, sign up for the WISE newsletter below, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/.


Lucy, and the WISE team

*Mathieu, F. (2012). The Compassion Fatigue Workbook. (Routledge, NY).


The Who, What, When, Where and Why of WISE

Who are we?

WISE is an acronym that stands for Wisconsin Initiative for Stigma Elimination, a statewide collaboration of organizations and individuals. The work of WISE is supported by Patrick Corrigan, Ph.D., Illinois Institute of Technology, who is the lead investigator for the National Consortium for Stigma and Empowerment.

What do we do?

WISE’s goals are to:

  • increase inclusion, hope, and support for those struggling with mental health challenges
  • promote evidence-based practices, current research, and outcome evaluation
  • offer insights, resources, and support for stigma reduction

When and where do we meet?

We meet on the third Tuesday every other month from 9 a.m. to 11 a.m. Our meetings are held in Oconomowoc in order to be accessible to people from all over Wisconsin. If interested in attending, please subscribe to the WISE newsletter, which features up-to-date details and information, or contact us at https://eliminatestigma.org/.

Why is WISE’s work important?

WISE’s work is so important because the latest statistics from the CDC, or the Centers for Disease Control and Prevention, show that 1 in 2, or close to 50% of people will experience a mental illness in their lifetime. This means that the “they” we use when giving statistics is actually “us.” This isn’t a cause outside of our circle of care or relevance, because it affects us, or our co-workers, family members, and friends.

So what’s next?

For more information, sign up for the WISE newsletter, attend a WISE meeting to get more involved, or visit our website at https://eliminatestigma.org/. And don’t forget to check in for next month’s blog, which will further explore WISE’s work.


Lucy, and the WISE team