Quotes from Youth in the Urban Settings for the Randomized Control Trial Research 

 

“Life and school are way too busy for us to be able to listen and share. [This program] created an open space for this.”

“I don’t get much from talking to adults. I’m more interested in being with other students.”

“[This program] helped all of us feel more comfortable with mental illness.”

“Finally someone was looking at us as being normal, not just as kids with problems.”

“I know all kinds of kids have mental disorders like mine, but I didn’t really think about it until I heard their stories.”

“Since [this program], I’m now starting to do more school activities.”

“I feel like I’m learning more at school because I finally got my story out.”

“Taught me that while I shouldn’t always care about what others think about me I should always care about what I think of me.”

“Thinking about my story before I told it helped me see my thinking patterns and how they might be helping or hurting me.”

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“[This program] helped me reframe my story in

a way that helps me move forward.”

“I didn’t feel ashamed about sharing what I’ve been through. It was a good experience for sharing what I’ve accomplished in getting through my problems.” 

Internalized Shame/Self Stigma

Reversing Self and Public Stigma

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I am not goodSelf Esteem

I am unableEfficacy

Why try? Avoidance, anger, apathy

Public Stigma

Up to Me – High School in Seven,   45-Minute Sessions  Lesson 1.  pages 6-9 

Up to Me Introduction 

Helpful and Hurtful Self-Talk 

Lesson 2.  pages 10-21 

Challenging Hurtful Self-Talk 

Considering the Pros and Cons of Disclosure 

Lesson 3.  pages 22-34 

Choices and Settings for Disclosure 

Disclosure Decision Practice Game 

Lesson 4.  pages 35-43

To Whom Might You Disclose? Are They Safe To Tell? 

How Might Others React To Your Disclosure? 

Lesson 5.  pages 44-49 

How To Tell Your Story  

Lesson 6.  pages 49-51 

Story Practice 

Lesson 7.  pages 52-57

Up to Me through SOLIDARITY and Peer Support  

Putting It All Together 

 

Appendix A:  Definitions pages 58-59 

 

Appendix B: Protections Against Unwanted Disclosure pages 60-61 

 

Booster Session pages 62-75 

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Up to Me Framework

Up to Me seeks to replace self-stigma that some who have faced trauma, mental illness, suicide attempts and/or other challenges with beliefs of recovery, empowerment, and hope. It does so by: helping people consider the tone of their internal narrative, explore the costs and benefits of disclosing their personal narrative, learn strategies for disclosing relatively safely, and craft a message that best represents personal goals. The Up to Me program is being disseminated throughout the globe with a variety of populations. The various age and population focused versions include a manual for facilitators and a workbook for participants. Beyond the curriculum, Up to Me provides a framework for people to use whether making choices of their own or supporting others to make such disclosure decisions. The key concepts of this framework are:

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 of 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 experience and who they are in relation to it. False ideas leading to distorted beliefs and discriminatory behaviors are 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.

Benefits and Costs of Disclosure • How we talk about our experiences to others will impact our self-perception and the perception others hold of us. It can also be an opening or a barrier to getting support, giving support to others, and to being known for who we are; including our strengths. • 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.

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• Knowing our goal or reason for disclosing this personal information in any given situation will guide the decision of whether or not to disclose. Some goals include being understood, being accepted for who we are, receiving an accommodation that allows us to meet expectations in school or work and relationships, offering support to someone else, etc.

Points to Consider When Deciding About Disclosure• 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 disclosed to them. We can even test that person out before disclosing to them to see how they respond generally to people who face similar challenges we have faced.• When faced with a disclosure decision our options are to disclose, not to disclose and to postpone our decision. • If we choose to move from isolation or secrecy, we may decide to select one person or a small group of people or we may choose to speak out to all who will listen. When we speak out to broad audiences, we most often do so for advocacy purposes. If the Decision Is to Disclose • If someone does not respond in the way that we had hoped, our most powerful, gracious and helpful response is to let them know what we were hoping to have happen as a result of our disclosure (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 the goal of the disclosure. We are in control of how much and in what detail we talk about our experiences. • If part of our goal in disclosing is to reduce the stigma, it is important to disclose our strengths that we brought to our challenges and those we have discovered in recovery. • We are not alone. Others are making these daily decisions about disclosing their

experiences. Peer support can be very helpful and comforting.

To download Up to Me resources go to wisewisconsin.org/UptoMeTo arrange a facilitator training, email WISE@wisewisconsin.org or Sarah.Reed@Rogershospital.org.

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A Comparison of the Adult and High School Versions  

Adult Honest, Open, Proud

High School Up to Me

3 two-hour sessions plus booster  5 one-hour sessions plus booster 

Uses language of “mental illness” throughout Challenging Personal Hurtful Self-Talk is lesson one 

Challenging Personally Hurtful Stigma section is in appendix (use it during lesson one) 

Uses “mental health challenges” throughout 

Asks participant to look at if they identify themselves with mental illness (lesson one) 

Condenses some concepts so has a few less worksheets 

 The manual italicizes everything that the participants do not have in their workbook  

  Facilitator is a mandated reporter 

 Includes three interactive “games/role-plays.” The facilitator needs to print cards to be used for two of them. 

  Includes social media discussion 

 Incorporates grounding experiences to end the sessions 

 Two brief video clips can be used to support learning about pros and cons and choices of disclosure. 

Up to Me – Switching Lesson One to Follow Lesson Three

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 New Lesson 1.  pages 4-5 and 14-27 (old lesson two) 

Up to Me Introduction Considering the Pros and Cons of Disclosure  Choices and Settings for Disclosure  

New Lesson 2.  Pages 28-43 (old lesson three) Disclosure Decision Practice Game  To Whom Might You Disclose? Are They Safe To Tell? How Might Others Respond To Your Disclosure?  

New Lesson 3.  pages 6-13 and page 54 (old lesson one) Helpful and Hurtful Self-Talk Challenging Hurtful Self-Talk Prep for Lesson Four 

 Lesson 4.  pages 44-51 

How To Tell Your Story  Story Practice 

Lesson 5.  pages 52-57Safe Person Decal and Seven PromisesSOLIDARITY and Peer SupportPutting It All Together 

 Appendix A:  Definitions pages 58-59  Appendix B: Protections Against Unwanted Disclosure pages 60-61 

Booster Session pages 62-75 

Labels and Language

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Words matter. Language is powerful. Part of how people tell their story is evident in the terms they use to describe themselves. In creating the workbook, we have attempted to: 

Understand that labels and hurtful references about people facing mental health challenges are common and may have been used to cast judgement;  Be inclusive of people facing various mental health challenges;   Be respectful that different terms help different people;  Appreciate that part of recovery may be a change in the labels people use to describe their experiences 

Throughout the workbook, we use the term “mental health challenges” to refer to the experiences of people who have/have had mental health concerns. Mental health challenges may refer to anyone seeking to maintain their mental health, irrespective of whether they have received a mental health diagnosis. The stories located throughout the workbook use various terms, including diagnostic terms. These terms were not changed in an attempt to honor the choice that each individual has in how they refer to themselves. It is recommended that facilitators model language of resilience in discussing their personal stories and describing people who face mental health challenges. Below are a few examples. This list is not exhaustive, but provides examples of the diverse ways that individuals may identify:  

Person with lived experience  Trauma survivor or psychiatric

survivor  Mental health consumer  Person diagnosed with a mental

disorder  Person with mental health issues  Person with mental health history  Person with psychosocial disability  Person with mental and emotional challenges  Person in recovery  

Person with ______________(fill in with mental health diagnosis) 

Person diagnosed with _________ (fill in with mental health diagnosis) 

Person living with _______(fill in with mental health diagnosis) 

Person experiencing alcohol/drug/addiction problem 

I have a name, not a label! Insert your name here [e.g., Jane Smith] 

Person. Human being! Period! 

In facilitating this program, keep in mind the following: 1.) The terms people use to think about themselves and describe their experiences may change over time. In lesson One- Setting the Scene, as you describe the program creators’ use of “Mental Health Challenges,” ask participants to think of the words they are comfortable using when describing themselves (do not ask them to share these). In Lesson Four you will revisit terminology and participants may want to practice using different terms in their story;  2.) Terms people use in telling their stories may change as a result of their reasons for disclosure;  3.) Program participants may choose to use terms and/or labels comfortable to them. Emphasizing this point is a good way to introduce the importance of CHOICE throughout the program!  

Best and Worst Facilitator Practices

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Some of the BEST things a facilitator can do:

1. Carefully assess the needs of the members / audience2. Be fully present3. Probe sensitively into people’s feelings4. Create an open and trusting atmosphere5. View yourself as a guide6. Make audience the center of your attention7. Speak in simple / direct language (no acronyms)8. Show your energy and enthusiasm9. Treat all audience members equally10. Work on evenly distributed eye contact11. Stay flexible and ready to adjust if needed12. Listen intently to fully understand what is being said13. Every once in a while summarize key points14. End on a positive and hopeful note15. Be aware of the body language in the room16. Respectfully redirect when needed–use name cards to direct discussions17. Carefully use an aspect of your story to illustrate a point18. Draw on the audiences experience / expertise

Some of the WORST things a facilitator can do:

1. Never check on audience concerns2. Fail to listen and respond to what’s being said3. Try to be the center of attention4. Fail to be in touch / honor audience feelings or reactions5. Get defensive and try to cover up mistakes6. Allow discussion to get badly sidetracked7. Be insensitive to cultural issues represented in the room8. Use inappropriate humor or crass language9. Simply read to the audience10. Use your story to intimidate or punish an audience11. Ignore body language especially when someone is emotional 12. Assume you know everything and the audience does not

*Adapted from ‘Tune Up Workshop’ 2010 Recovery Innovations, Inc.

Up to Me

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Segments of Lessons for Young Adult Facilitator to Lead  Assist the young adult co-facilitator to take a lead in activities that have less likelihood of challenge or push back from the youth participants. Select more direct and concrete activities such as: giving directions / ice breakers / role plays to model   Some areas of the lessons that may work well for a young adult facilitator are: 

  Lesson #1:  

o The first icebreaker o Self-Talk Puzzle

Lesson #2: Part 2 – Levels of disclosure 

o Go over the 5 points to remember about disclosure o Social media discussion

Lesson #3:  

o Game  instructions and go around to small groups o Model possible responses before youth do activity

Lesson #4: Lead discussion on their response to Grenesha’s story 

Lesson #5:  o Lead discussion on use of the logo   o Lead discussion on place to find peer support 

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A Few Comments About Trauma   What might trauma look like in a group setting? 

Sensitive to noise   Avoid touch  Heightened startle reflex   Demand lots of attention  Perfectionism  Aggression/Defiance  Confused  - What is dangerous?  Who can help?  Resist separation from familiar adults and/or peers  Reactive and impulsive 

 The world perspective of many who come from a place of trauma: 

Basic mistrust of adults/ inability to depend on others  Belief that the world is an unsafe place/ bad things will happen and they are usually my fault  Assumption that others will not like them  Fear and pessimism about future  Feelings of hopelessness and lack of control 

 Increasing resiliency factors 

Connection- empathy  Competency  Control   Consistency 

 Connection keys 

Self-awareness > non-judgmental curiosity > connection  Create safety    Assess at transition times  Sensory intervention - arousal   

People who are resilient see themselves as safe, capable and worth positive regard. 

  

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Responding to Student Disclosure of Emotional Pain, Trauma or

Mental IllnessCover Letter for AdministratorsPrior to distribution of this resource, we recommend that you have the following conversation with support staff to evaluate the effectiveness of your school’s referral pathways.

1. What are the referral pathways at this school? Where are they displayed? How are staff (administration, teachers and all other staff) educated about what to do?

2. What are the strengths and challenges of this process and how could it be improved (i.e. what needs to be kept, adjusted or let go)? How are all staff encouraged to provide feedback about its effectiveness?

3. How consistently is the process implemented across the school? How do you know?

Background InformationDisclosure happens in a context of relationships of trust. In a recent study entitled, ‘Should youth disclose their mental illness?’, middle and high school-aged youth in Wisconsin were asked how they determine if a teacher is accessible and someone with whom they can safely talk. Responses highlighted the importance of someone who is trustworthy, welcoming and supportive and teachers who know their students. Other enablers to youth disclosure included a teacher who would keep the information private, someone connected to their family and who had strong student bonds.

Teachers who disclose their own experiences were also seen as more genuine to students as this suggested that teachers were once young with similar problems. Teachers’ modelling of vulnerability was also connected to the broader message that sharing was okay and students were not alone.

Buchholz, B., Aylward, S., McKenzie, S., & Corrigan, P. (2014). Should youth disclose their mental illness? Perspectives from students, parents and teachers: Manuscript submitted to the Community Mental Health Journal.

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Responding to Student Disclosure of Emotional Pain, Trauma or

Mental IllnessCover Letter for AdministratorsPrior to distribution of this resource, we recommend that you have the following conversation with support staff to evaluate the effectiveness of your school’s referral pathways.

1. What are the referral pathways at this school? Where are they displayed? How are staff (administration, teachers and all other staff) educated about what to do?

2. What are the strengths and challenges of this process and how could it be improved (i.e. what needs to be kept, adjusted or let go)? How are all staff encouraged to provide feedback about its effectiveness?

3. How consistently is the process implemented across the school? How do you know?

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Up to Me - Facilitator Checklist

Looked at the room where sessions will be held to plan seating arrangement

Flip chart paper and markers for each session

Checked to see if water and any other snacks will be available, restrooms, emergency exits

Checked to see if youth need permission slips to participate – agency should use their standard permission forms

Spoke to school/agency about mandated reporting procedures and roles that are not mandated reporters

Verify that the host agency has procedures in place should any medical or safety concern arise. Know the contact for you to call for assistance during the session times.

Assessed if session four could be extended, if extra time is needed

Reviewed roles with co-facilitator in advance

Printed youth workbooks

Printed scenario cards on cardstock paper (laminated if possible)

Printed certificates for youth to handout after session 5

Planned a date for the booster/check-in session 1 month after the initial 5 sessions

Completed Basic Information Sheet for Facilitators after the final session and emailed to WISE contact

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Mandated Reporting  

When you facilitate Up to Me, you are a mandated reporter. Let the school or agency in which you are conducting the sessions know that you are a mandated reporter and ask about their mandated reporting status and policies. Also ask what roles in the organization are not mandated reporters. Reports of alleged child abuse or neglect should be made to the county where the child or the child’s family resides. Contact the county department of social/human services. Reports can also be made to local law enforcement offices.  It is important to immediately let the youth know that you are a mandated reporter in order to build and maintain their trust. If youth seek someone to talk to who is not a mandated reporter, be prepared to share examples of roles or actual names that the agency gives you. Suggest that youth ask the person before disclosing anything that they do not want reported.  Below is a sample statement to youth to be made in the first session during the setting of ground rules and again at the beginning of Session 4:  Before we get started, I want to let you all know that I am a mandated reporter. Some of you may know what this means, and it might be new for others, so I’ll just spend a minute or two to review it for everyone. As a mandated reporter, I am responsible for helping to keep young people safe. Because I care about all of you, if I hear anything that would lead me to believe that you or any children who are not here today might be at risk of being hurt by themselves or by someone else, I would report that to people in the community who could help to keep us all safe and healthy. Does anyone have any questions about this? If so, feel free to stop me at any time during this group, or find me during one of the breaks, and I’d be happy to clear up any questions you have.  Websites that facilitators may find helpful to better understand mandated reporting include:  http://www.dcf.wisconsin.gov/children/CPS/progserv/manrpts.HTM  http://sspw.dpi.wi.gov/sspw_can  

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Up to Meto erase the stigma of mental health challenges

Youth Version

Self-stories are shaped early in the process of facing mental health challenges. When a child is experiencing early stages of illness and trauma, families, schools and community can unintentionally have a negative influence on these stories.

Empowerment is a desired state for anyone who has a challenge to face. Negative self-stories are barriers to empowerment. A sense of empowerment can be gained through being assisted to acknowledge one’s resilience in the face of challenge. Empowerment is further increased as one shares aspects of their story from a perspective of resilience whether to seek connection and support or to offer support to others. It is important to assist youth as they make daily decisions of whether or not to share their story.

Up to Me – High School is a small group program for youth (8 th grade-young adult) who have faced mental health challenges. It is based on the international, evidence-based adult program of the same name. Disclosure decisions are ones that youth face now and will certainly face in their near future. This program seeks to proactively empower them to make the best decision for themselves. It does not advocate that youth should tell their story. It offers support in making such decisions. Up to Me is led by a trained facilitator and, typically, co-led by a young adult peer. The lessons are often completed in five one-hour increments, however, there is guidance available on how to divide the material appropriately when one hour-long blocks are not available and sessions are shorter.

Youth explore the story they have been telling themselves about their challenges and resilience. They practice skills to reverse hurtful self-talk and then take a deep look at the goals, costs and benefits of talking to others in the various settings of their lives (friendships, workplaces, school, etc.). For situations where the youth decide to talk about their challenges and strengths, the program prepares them to respond to unanticipated reactions. They practice writing their story from a strengths based perspective and, if they desire, sharing that with the group. The fifth session focuses on options for positive peer and adult support. One month after the initial five sessions, the group re-convenes for a booster/check-in session.

WISE, Wisconsin Initiative for Stigma Elimination, is the home for Up to Me – High School in Wisconsin. To find a program facilitator in your area or to be trained as a facilitator, contact wise@wisewisconsin.org.

Up to Me

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to Erase the Stigma of Mental Health Challengesfor Adults and High School Aged Youth

Self-stories are shaped early in the process of facing mental health challenges. When a person is experiencing early stages of illness and trauma, families and community can unintentionally have a negative influence on these stories. A sense of empowerment can be gained through being assisted to acknowledge one’s resilience in the face of challenge. Empowerment is further increased as one makes strategic decisions about if and how to disclose their experience from a perspective of resilience. It is important to assist youth and adults as they make daily decisions of whether or not to share their story.

Participants explore the story they have been telling themselves about their challenges and resilience. They practice skills to reverse hurtful self-talk and then take a deep look at the costs and benefits of talking to others in the various settings of their lives (friendships, workplaces, school, etc.). For situations where the person decides to talk about their challenges and strengths, the program prepares them to respond to unanticipated reactions. They practice writing their story from a strengths based perspective and, if they desire, sharing that with the group. The last session focuses on options for positive peer and adult support. One month after the initial sessions, the group re-convenes for a booster/check-in session.

WISE, Wisconsin Initiative for Stigma Elimination, is the home for Up to Me – High School and trains facilitators in all version of Up to Me. To find a program facilitator in your area or to be trained as a facilitator, contact wise@wisewisconsin.org.

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Up to Me – High School is a five-session program for high school youth who have faced mental health challenges. It is based on the international, evidence-based adult program of the same name developed by Patrick Corrigan, PhD. This program seeks to proactively empower people to make the best decisions about disclosure for themselves. Honest, Open, Proud is led by a trained facilitator and, typically, co-led by a peer.

Ever wonder what to say to your friend about what you’ve experienced?

Wonder how to tell Grandma about the challenges you have faced?

Sick of keeping a big secret but not sure if others can be trusted?

Think you have some wisdom to share with others but aren’t sure where to start?

Up to Me may be for you!

The goal is for you to think about the upsides and downsides of talking about your experiences with mental health challenges in the daily settings of your life (friendships, workplaces, school, etc.). Together, you learn ways to talk about yourself that have worked for other teens. This program empowers you to make the best decision for yourself and, if you decide to talk to others, to be ready for any unexpected responses. We meet together for five times, one hour each.

The five meetings will be:

Dates:

Location:

To sign up for a spot in the group of 12, talk to:

WISE, Wisconsin Initiative for Stigma Elimination, is the home for Up to Me – High School in Wisconsin. Visit WISEwisconsin.org for further information.

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Basic Information Sheet for Facilitators 

As part of our Up to Me tracking process, we need you to provide some information about your experience facilitating an Up to Me session. Please fill out the information listed below, and after the form is completed, please return it via email to WISE@wisewisconsin.org. If you have any questions or concerns, feel free to contact the WISE staff at that email as well.  

Contact Information Name: ________________________________________________________________________________________________ Phone Number: ____________________Email Address: ________________________________________________ 

Training Details ADULT YOUTH Date of final Session: ____________ Location: ________________________________________________________ County: ___________________________ Number of People Starting Up to Me: _____________ Number of People Completing Up to Me: _________

From what groups/organizations did you recruit the participants? __________________________________________________________________________________________________________________________________________________________________________________________________________________What went well? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What provided challenges? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please provide any additional comments here:  ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 

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