Minnesota initiative is a model for mental illness dialogue

President Obama challenged two of his top cabinet members this year to launch a "national conversation" to reduce the regrettable but still very real sense of shame and embarrassment that often accompanies a mental illness diagnosis or — even worse — prevents people from seeking treatment.

The key advisers given that important assignment — U.S. Secretary of Health and Human Services Kathleen Sebelius and U.S. Department of Education Secretary Arne Duncan — should look to a groundbreaking new Minnesota campaign called "Make It OK" as a national model for kick-starting this potentially lifesaving dialogue. About one in four Americans experience a mental illness or substance abuse disorder each year.

Minnesota, so often ahead of the health care curve, is again a public health pacesetter thanks to the Make It OK campaign, which boldly but pragmatically moves beyond previous efforts to reduce the stigma of mental illness.

Instead of simply raising awareness about the need to have a conversation about this, the Make It OK initiative provides concrete steps on how to hold one and, above all, say something helpful, not hurtful.

"Thanks for sharing," "I'm sorry to hear that," and "That must be tough" are phrases that are both encouraging and lead to further conversation. Responses to be avoided include "Everyone feels like that sometimes," which may seem sympathetic but instead downplays how serious these conditions can be.

"This is really about … how do we create empathy and respect for somebody who is going through this, how do we make people more comfortable? What we're talking about is different than raising awareness. It's the next step, " said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness (NAMI).

HealthPartners CEO Mary Brainerd also notes that the Make It OK campaign stands out because its development was guided by extensive input from those who have mental illnesses and their families. The thoughtfully worded responses recommended by the campaign are rooted in real-world experiences, she said.

Clever advertisements that urge Minnesotans to "stop the silence" have begun appearing on the air and in print and will continue across the state throughout the year.

The work of Minneapolis marketing and communications agency Preston Kelly, the ads deftly depict the awkward pauses in conversation that still often ensue when people say they are struggling with a mental illness. Instead of the expected exchange of words, a blank conversation bubble, like those used in comic cartoons, rises leadenly into the air as people uncomfortably look anywhere but at each other.

It's a lighthearted but provocative take on the age-old problem of mental illness stigma. The ads and the resource-rich MakeItOK.org website should get people thinking hard about why mental health disorders are still treated differently than so-called traditional diseases.

Another facet of the Make It OK effort — training and education sessions that will be offered later this year to Minnesota employers and community groups — will also provide how-to advice on easing conversations about mental illness.

Brainerd said this week that she is heartened by the early interest from around the state from other organizations that are interested in becoming part of the initiative. She said she hopes Make It OK becomes something that "everybody owns."

Ramstad, who has long identified himself as a recovering alcoholic, said it's "tragic" that fear or embarrassment still acts as a barrier for people getting the medical help they need. Overcoming the stigma associated with these disorders is "half the battle," he said, in beating these serious but often underestimated medical conditions.

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