Discrimination and stigma

• Prejudice and discrimination
• Reducing stigma
• Anti-stigma campaigns

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.

People with mental illness also get a worse deal from some NHS services offering care for physical health problems, and from travel, insurance and financial services.

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 in collaboration with the World Psychiatric Association’s (WPA) Global Programme Against Stigma and Discrimination because of Schizophrenia.

47 per cent of those interviewed said they had found it hard to make or keep friends, 43 per cent said they had experienced discrimination from family members, 29 per cent in finding a job, 29 per cent in keeping a job and 27 per cent said had experienced discrimination in intimate or sexual relationships. 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. 72 per cent of those interviewed said they felt the need to conceal their diagnosis.

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

Language used to describe mental ill health also contributes to discriminatory attitudes. Research carried out by the Institute of Psychiatry 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 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 (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 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 that focuses on the facts about mental ill health and presents people's personal experiences has been developed and continues to be evaluated as part of Time to Change.

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Anti-stigma campaigns

Time to Change is the biggest ever anti-stigma campaign in England. It started in 2007 and is led by the mental health charities Mind and Rethink Mental Illness. The Institute of Psychiatry is evaluating the success of the campaign, which was first launched with financial support from the Big Lottery Fund and Comic Relief.

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, Care Services Ministers Paul Burstow committed up to £16 million to Time to Change over the next four years. The campaign also received another £4 million from Comic Relief. The £20 million funding will help Time to Change continue its work in England until March 2015.

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 

The team at the Institute of Psychiatry (IoP) that is evaluating the English campaign continues to carry out regular surveys of the public to see if attitudes are changing, and 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 July 2010, results from the IoP evaluation showed that discrimination reported by people with mental health problems had dropped by four pent compared to the previous year. 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.