More than lip service: securing lasting change in the fight against stigma and discrimination
| Date | 01 September 2004 |
| Pages | 5-7 |
| DOI | https://doi.org/10.1108/17465729200400014 |
| Published date | 01 September 2004 |
| Author | Elizabeth Gale |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 3 •september 2004 © Pavilion Publishing (Brighton) Ltd
More than lip service: securing lasting change
in the fight against stigma and discrimination
Elizabeth Gale
Chief executive
mentality
Guest
editorial
Millions of people in the UK experience mental health
problems at some time in their life. Many are excluded
from areas of life that others take for granted, and the
damaging effects of this exclusion often persist long
after the symptoms of mental distress have been
resolved. For example, people experience problems in
relation to finding or staying in work, accessing quality
health and social care services and adequate housing,
enjoying family support and participating in local
community life (Social Exclusion Unit, 2004).
People with mental health problems consistently
identify stigma and discrimination as the major issues
affecting their quality of life. Stigma can damage their
mental health, leading in some cases to intensified
symptoms and increased relapse (Link et al, 1997).
As the prevalence of mental illness appears to be
rising (WHO, 2001), the levels of stigma and
discrimination appear to be following suit, with several
surveys showing that attitudes are becoming more
harsh and judgmental towards those who have
experienced mental illness (Department of Health,
2003). In the recent Social Exclusion Unit (SEU)
consultation about mental health, over 80% of
respondents with mental health problems said that
tackling stigma and discrimination is a priority, more
than half identified stigma as a barrier to employment
and more than half mentioned negative attitudes
towards mental health in the community.
Stigma and discrimination in many cases lead to a
wish for social distance from, and the exclusion of,
people with mental health problems. In a recent survey
by Mind 84% of people with mental health problem
felt isolated, compared with only a third of the general
public (Mind, 2004). Here again people with mental
health problems identified perceived stigma and
discrimination as a key factors in their exclusion.
National campaigns to tackle stigma and
discrimination have had mixed success. Despite the
investment of a great deal of time and energy in a range
of programmes in England, there has been no
significant improvement in public attitudes to mental
health. Since 1993 there has been a decline in the
percentage of people who agree with the statement that
‘We need to adopt a far more tolerant attitude toward
people with mental illness in our society,’ from 92% to
83% in 2003 (Department of Health, 2003). Fewer
than four in ten employers say they would recruit
someone with a mental health problem, and many
people fear disclosing their condition, even to family
and friends, for fear of prejudice (Manning & White,
1995). The media continue to play a significant part in
the perpetuation of myths about mental health
problems. One study found that two thirds of all
references to mental health in the media included an
association with violence, and in the tabloids 40% of
such references used derogatory terms such as ‘nutter’
or ‘loony’ (Ward, 1997). Lip service has been paid to
the importance of tackling stigma and discrimination
but programmes in England have not been evidence-
based, nor well evaluated, well funded or sustainable,
and therefore their impact is debatable.
For more than a decade campaigns have challenged
stereotypes that tend to demonise or alienate people
with mental health problems. While there has been
notable progress in tackling other forms of
discrimination such as homophobia and racism, the
prejudice and stigma related to mental health problems
endures as the last great taboo.
So what is working?
International evidence indicates that sustained work to
challenge discrimination is the best way to achieve
behavioural change. A recent review of effective
approaches has identified the key principles that
underpin best practice in mental health anti-
discrimination programmes (Gale et al, 2004). First
and foremost, mental health service users should lead
the work, challenging stigma and dispelling stereotypes
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