Discrimination and stigma

Prejudice and discrimination

People with mental health problems experience prejudice and discrimination in almost every aspect of their lives. Many have said the stigma of mental ill health is more disabling than the illness itself.

Research has shown that people with mental health problems are pre-judged, find it hard to get jobs and sustain friendships and relationships. Research has also shown that ignorance, fear, and stereotypes presented in the newspapers, on the TV and at the cinema, all contribute to negative attitudes towards mental ill health. Most people have little knowledge about mental illness and their opinions are often factually incorrect.

In a survey of about 500 people given a diagnosis of schizophrenia and carried out by the independent 'Inquiry into the "Schizophrenia" label' in 2012, more than 80 per cent said the diagnosis made life more difficult. 88 per cent said they thought the public associated 'schizophrenia' with violence.

Studies have illustrated that prejudice and discrimination against people with a diagnosis of mental illness are common all over the world.

For example, more than 700 people with a diagnosis of schizophrenia in 27 different countries were interviewed as part of INDIGO (International Study of Discrimination and Stigma Outcomes), a research study carried out by the Institute of Psychiatry (now Institute of Psychiatry, Psychology & Neuroscience), King's College London, in collaboration with the World Psychiatric Association’s (WPA) Global Programme Against Stigma and Discrimination because of Schizophrenia. 72 per cent of those interviewed said they felt the need to conceal their diagnosis. 64 per cent said the anticipation of discrimination stopped them applying for work, training or education programmes and 55 per cent said it stopped them looking for a close relationship.

In addition, people who have experienced psychosis may feel discriminated against because of mental health law, which allows compulsory treatment. Side effects of antipsychotic medication – such as involuntary movements – may also make them feel set apart and seen as ‘different’.

Language used to describe mental ill health can contribute to discriminatory attitudes. Research carried out by the Institute of Psychiatry (now Institute of Psychiatry, Psychology & Neuroscience) and the charity Rethink Mental Illness asked nearly 500 secondary school students to describe people with mental health problems. They came up with 250 different words and phrases – most of them were derogatory and used as insults in the playground.

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Reducing stigma

Over the past decade, research carried out by the Institute of Psychiatry, Psychology & Neuroscience, King's College London, (some of it in collaboration with Rethink Mental Illness) has shown that personal contact with people with mental health problems is the most effective way to reduce discrimination and prejudice, and that social marketing campaigns can make a real difference.

Researchers have reviewed policies and laws that perpetuate stigma and analysed anti-stigma interventions used around the world to find out which methods work best.

This research has helped inform the development of Time to Change, England's biggest ever programme designed to tackle stigma and discrimination (see anti-stigma campaigns below).

One research project showed that making education about mental health a routine part of the school curriculum made a difference to the attitudes of pupils. Testimonies of people with mental health problems also made a big difference to the views of police officers. People who took part in the research said that listening to personal stories helped them challenge their preconceptions and to treat people with respect.

Anti-discrimination training for professionals that focuses on the facts about mental ill health and presents people's personal experiences has been developed and continues to be evaluated by the researchers at the Institute of Psychiatry, Psychology & Neuroscience as part of Time to Change (see anti-stigma campaigns below). One study, for example, has been testing the success of this type of short training course for student doctors, trainee teachers, teachers already based in the classroom and other school staff.

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Anti-stigma campaigns

Time to Change is the biggest ever anti-stigma campaign in England. It started in 2007 and has been given funding to run until March 2015.

Time to Change is led by the mental health charities Mind and Rethink Mental Illness and researchers at the Institute of Psychiatry, Psychology & Neuroscience, King's College London, are evaluating the success of the campaign.

First launched with financial support from the Big Lottery Fund and Comic Relief, Time to Change was then backed by the government in 2011.

In February 2011 the government committed to ‘support and work actively with Time to Change and other partners on reducing stigma for people of all ages and backgrounds’ in its new mental health strategy, No health without mental health.

In October 2011, the government committed up to £16 million to Time to Change over the next four years. The campaign also received another £4 million from Comic Relief.

In February 2012, Time to Change Wales was launched with three years' worth of funding from the Big Lottery Fund, Comic Relief and the Welsh government. The Welsh campaign is led by charities Gofal, Hafal and Mind Cymru.

The Time to Change campaigns include events and activities as well as press, radio, TV and outdoor adverts featuring people with personal experience of mental health problems (some of them 'celebrities') talking about what it is like to live with a mental illness and how others have helped or hindered their recovery.

To find out more about the many different activities run under the Time to Change banner – and how to get involved – visit the Time to Change (England) website or the Time to Change Wales website.

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Are the anti-stigma campaigns working?

The team of researchers at the Institute of Psychiatry, Psychology & Neuroscience, King's College London who are evaluating the English campaign are carrying out regular surveys of people with mental health problems to find out if Time to Change is having an effect on their lives. The team is also monitoring and analysing the way mental illness is portrayed in the media.

In 2008, researchers interviewed 537 people with all sorts of mental health problems about the discrimination they had experienced. They have repeated this 'Viewpoint' survey annually ever since, aiming to interview about 1,000 people each year. In 2011, they interviewed 1,016 people.

There was overall a small reduction in the discrimination reported between 2008 and 2011: in 2008, 91 per cent reported one or more experiences of discrimination. In 2011, the equivalent figure was 88.2 per cent.

In 2011, 72.3 per cent of those interviewed said they felt they had to hide their mental health problem. This number had dropped from 75 per cent in 2008.

There has been no reduction in the amount of discrimination from mental health professionals that people experience.

Details of the evaluation results are posted on the Time to Change website Evaluation reports page. 

The results of the 2011 government survey Attitudes to mental illness showed that public attitudes are slowly becoming less discriminatory. The 2011 survey was carried out by the NHS Information Centre for Health and Social Care.

Anti-stigma campaigns like Time to Change have been proven to work in other countries. Like Minds, Like Mine, an ongoing country-wide anti-stigma campaign launched in New Zealand included a successful programme of adverts featuring celebrities speaking about their experiences of mental ill health. A series of national opinion polls over the past decade has show a gradual improvement in attitudes in New Zealand. The Scottish campaign, See Me, was launched in 2002 and is managed by an alliance of five mental health organisations. See Me has launched a national publicity programme and worked with the media to encourage responsible reporting.

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The repeal of discriminatory laws

At the end of February 2013, the Mental Health (Discrimination) Act became law. The Act repeals or amends three laws that have previously prevented people with experience of mental health problems from taking, or continuing to hold, public office.

It has repealed section 141 of the Mental Health Act 1983. This means an MP (or member of devolved assemblies and parliament) no longer automatically loses his or her seat if they are compulsorily admitted to and detained in hospital for more than six months. It also abolishes any 'rule of the common law' that disqualifies someone from membership of the House of Commons because of their mental illness.

It has amended the Juries Act 1974. This has abolished the blanket ban on people with mental health problems becoming jurors. People who are receiving treatment for a mental health problem and who are not in hospital can now undertake jury service.

It has amended the Companies (Model Articles) Regulations 2008. This means a company director can no longer be removed from office because of mental ill health.

The Mental Health (Discrimination) Act started life as a Private Member's Bill.

 

 


This page was updated 6 March 2013 (IoP name change incorporated 31 August 2014)
Links last updated: 31 July 2014
Next links check due: December 2014


Other useful websites

Time to Change
The website of Time to Change, England’s biggest ever anti-stigma campaign.


Time to Change Wales


See me
Scotland’s national campaign to end stigma and discrimination against people with mental health problems.


Like Minds Like Mine
New Zealand's public education programme aimed at reducing discrimination faced by people with experience of mental illness.


Resources

Shunned: Discrimination against people with mental illness
by Graham Thornicroft
published by Oxford University Press, Oxford, 2006. 
A book by Professor Graham Thornicroft who works at the Institute of Psychiatry. He quotes research and personal experiences of people to illustrate the extent of the problem of prejudice and social inequality and suggests ways to tackle discrimination at home, in personal relationships and at work.


Attitudes to mental illness 2011
Survey report, NHS Information Centre for Health and Social Care, June 2011.