Reproduced with kind permission of Oxford Mental Health Forum
Ever since I have worked in the field of mental health I have realised that changing public attitudes towards mental illness is crucial to improving the prospects of current and future generations of people with mental health problems.
Stigma and discrimination are a regular reality in the lives of people with mental health problems and those of their families. When we started Time to Change four years ago we undertook a major survey of the experience of service users and carers. At that time 90% of service users and 60% of carers reported personal experience of stigma and discrimination. This included rejection by family, friends and neighbours, discrimination from employers or potential employers, negative attitudes from public bodies, including sadly the very health and social services which are meant to be there to help. A number of respondents highlighted that the sense of rejection and exclusion created by the stigma towards mental illness was sometimes as bad as the symptoms themselves, terrible though they were.
The impact of stigma goes further. Negative attitudes and a reluctance to talk about issues relating to mental health are major obstacles for people to seek help when problems first arise. Furthermore stigma silences a wider public debate about mental health which in turn lessens the impact which the issue has on public debate and priorities.
Things have been changing. The evaluation of the first phase of Time to Change suggests small but significant changes in attitudes and reported experience. Overall attitudes have improved (against a backdrop of having been static or worsening over much of the last 15 years) and there has been a reported drop in the proportion of service users experiencing discrimination in their daily lives. Some aspects in particular discrimination in individuals’ social lives show particularly marked improvement. Finally our tracking of media coverage of mental illness also shows things getting better highlighted by a noticeable increase in positive portrayals of people with mental health problems.
The statistics are borne out by wider developments. It has been particularly striking to see changes, for instance, in the world of sport where a series of high profile sportspeople such as Marcus Trescothick, Johnny Wilkinson and Tasha Danvers talking openly about their own experience of mental health problems. Last month’s debate in Parliament where four MPs shared their personal experiences was similarly groundbreaking. They are indicative of a wider comfort in talking about mental health problems and a greater acceptance that mental health problems should not exclude someone from fulfilling their ambitions. They are also high profile examples of the underlying dynamic of changing attitudes. If we know someone personally with mental health problems our attitudes will be more positive than if we rely on stereotypes from the media.
So can we reach a tipping point where we shift the paradigm in society towards a positive and accepting view of mental illness in society? I believe we can but there are some significant challenges.
The commitment of the Government to this issue is welcome, not only through their decision to support Phase 2 of Time to Change but also in the backing they have given for the private members’ legislation which Gavin Barwell MP will bring to Parliament in September to end the arbitrary discrimination against people with mental health problems in respect of serving as a juror or acting as a company Director. Such commitment will also need to be reflected in efforts to raise the priority given to mental health across Government policy and a readiness to take action to ensure mental health is not disproportionately affected by cuts.
The workplace will remain a critical area of focus and will provide the single biggest indicator of the level of success we are having in countering stigma. Again there is some evidence of positive change with a number of prominent employers such as BT taking proactive action to support people with mental health problems in their workforce and others beginning to follow suit. The 2010 Equalities Act was a step forward in shifting the focus of disclosure away from pre-interview health questionnaires to the moment when someone was actually offered a post.
Despite this there is a long way to go for many employers and it is clear that there are still many people who are facing discrimination at work or when seeking work on account of mental health problems. The economic climate and the competition for work does not help nor do mistaken Welfare Reform policies such as the Work Capability Assessment which do nothing to help people with mental health problems to secure work and cause an immense amount of stress for many people who any sensible view would suggest are not well enough to work.
As in any movement to change societal attitudes young people will be a crucial audience but this is particular so with mental health where so many problems start in youth. I am delighted that Rethink Mental Illness is leading the new Children and Young People’s programme within Time to Change which will attempt to broaden out the messages on stigma and attitudes to reach younger people and those who work with them. In the longer the goal of seeing mental health and wellbeing as a core aspect of the school curriculum and of wider youth work must be a key objective.
So I think there are grounds for optimism that attitudes can change and the history of other issues such as race and sexual orientation show the kind of path which mental health might follow. It will be crucial that as a sector we focus on this agenda in a joined up way and don’t undermine change by failing to make common cause around this agenda.
The prize is a big one because if we can encourage a culture of openness and make mental health a topic of wider conversation then we have a much greater chance of getting the resources and attention we need to improve the lives of people affected by mental illness.
Paul Jenkins is Chief Executive of mental health charity, Rethink Mental Illness.