What do surveys of public attitudes to mental health problems really mean (and do we mean what we say)?
| DOI | https://doi.org/10.1108/17465729200400027 |
| Published date | 01 December 2004 |
| Date | 01 December 2004 |
| Pages | 40-48 |
| Author | Michael Smith |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 4 •december 2004 © Pavilion Publishing (Brighton) Ltd
What do surveys of public attitudes to mental
health problems really mean (and do we mean
what we say)?
Michael Smith
Consultant psychiatrist
NHS Argyll & Clyde
Senior research fellow
Division of Community-Based Sciences,
University of Glasgow
Review
‘An approach to change must ultimately address the
fundamental causes of stigma – it must challenge the deeply
held attitudes and beliefs that lead to labelling,
stereotyping, setting apart, devaluing and discriminating…
In the absence of fundamental changes, interventions
targeted at only one mechanism at a time will ultimately
fail, because their effectiveness will be undermined by
contextual factors that areleft untouched by such a
narrowly conceived intervention.’
(Link, 2001)
Readers of this journal will not need reminding that
the public’s understanding of, and attitudes towards,
mental health problems is important. Mental health
problems are so common that most of the population
has either been affected by such difficulties
themselves or knows of someone who has. Direct and
indirect costs of mental health problems amounted to
an estimated £77.4 billion for England alone in 2003
(SainsburyCentrefor Mental Health, 2003).
Atany one time, about one in six adults in the
UK experiences mental health problems: most
commonly depression, anxiety and panic disorders,
with about one in 200 adults experiencing a
psychotic disorder and one in 25 a personality
disorder (Singleton et al,2001; Melzer et al, 1996).
Around half of people with common mental health
problems arelimited bytheir condition, and one fifth
are disabled by it (Melzer et al,2004). There seems to
havebeen an increase in the incidence of emotional
problems among children (Melzer et al,2000), with
rates of depression and anxiety among teenagers
increasing by 70% in the past 25 years. These
changes seem to result from real changes in behaviour
and experience, rather than diagnostic artefact
(Collishaw et al, 2004).
Recent years have seen a growing interest among
clinicians, researchers and policy makers in assessing
public understanding and attitudes to mental health
issues. This interest arises in part from evidence that
people with poor ‘mental health literacy’ are likely to
have an impaired ability to manage their own mental
health (Jorm, 2000; Stewart Brown, 2002), and the
viewthat an ill-informed and fearful population is
likely to perpetuate the pervasive discrimination and
stigma experienced by people with mental health
problems (Social Exclusion Unit, 2004).
Inaddition, such surveys potentially:
•enable researchers to track changes in public
attitudes to mental disorder over time
•enable policy makers to assess public
understanding of mental disorder,and to improve
efforts to promote public mental health
•enable commissioners to monitor the effectiveness
of public education campaigns.
40
ABSTRACT
Campaigns to improve public attitudes to people with mental health problems have yet to show significant impact, according to national
surveys. But how reliable are these surveys? Michael Smith reviews recent research in the UK and in Scotland and argues that their findings
are complicated by methodological bias and doubts about the public’s ability to acknowledge prejudice honestly.
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