News Release, 31 May 2006
A new report published today by the Mental Health Foundation claims that stand alone Government anti-stigma campaigns are failing people in the UK who are discriminated against because of their mental health problems. The charity says the mental health sector needs to put civil rights at the heart of the battle for equality, and press for more anti-discrimination measures.
The report, ‘Actions Speak Louder’, asserts that the sector has not always been clear about how discrimination can be tackled. While millions of pounds have been spent trying to tackle stigma and discrimination, it has been done without a clear model of how change can be achieved.
Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, says:
“I’m opposed to the concept of stigma because it is discrimination that affects the lives of people with mental health problems, not stigma. It is time to stop worrying about people’s attitudes and to start changing behaviour. Evidence shows that the only way to change people's opinions about mental illness is to put them in face-to-face contact with people who have mental health probl it uweems. But this can't happen when people who are labelled as mentally ill are kept out of work places and rejected for volunteering opportunities, where they would come into contact with people who are understandably prejudiced.”
Graham Thornicroft, author of ‘Actions Speak Louder’ and one of the world’s leading researchers in psychiatry, says:
“In all my years as a psychiatrist, I’ve listened to patients tell me that the discrimination is as bad as the mental illness they are experiencing. Discrimination blights the lives of many people with mental illness, making marriage, childcare, work and a normal social life very difficult.
“We need to use legal measures, such as the Disability Discrimination Act, to protect people with mental illness from unfair discrimination. The Act has been framed primarily in relation to physical disability, and does little to help people with mental health problems.”
In Actions Speak Louder, the Mental Health Foundation sets out an agenda for change for policy makers on how to tackle discrimination.
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KEY FINDINGS & STATISTICS
Public attitudes towards mental illness
- The level of general knowledge about mental illnesses is universally meagre. In a population survey in England, 55% believed that the statement ‘someone who cannot be held responsible for his or her own actions’ describes a person who is mentally ill.
- In the same survey, 63% thought that fewer than 10% of the population would experience a mental illness at some time in their lives.
- Older people are both less well informed about mental illness and less favourable towards people with mental illnesses.
- Women tend to offer more favourable views about people with mental illness in most Western surveys.
- Overall, mental health problems such as depression and anxiety-related disorders are perceived as ‘less alien and less extreme’, while schizophrenia and similar conditions have grown in their perceived threat. Something has occurred in our culture that has increased the connection between psychosis and violence in the public mind. Research shows that people link people with mental illness with a threat to public safety and people do not want people with mental health problems in their neighborhood.
- There is no known country, society or culture in which people with mental illness are considered to have the same value and to be as acceptable as people who do not have mental illness. Rejection and avoidance of people with mental illness appear to be universal phenomena.
Stigma at home, in relationships, at work,
Home
- Many people with mental illnesses experience strong support from their families. But many others find that when they are at their most vulnerable, they get the least support from their relatives. At the same time family members are themselves also the recipients of ‘stigma by association’, in which having a relative with mental illness can bring (or is expected to bring) shame upon the whole family.
- People with more severe mental health problems tend to have smaller social networks, with family members outnumbering friends. When it becomes obvious that someone is unwell, friends may often keep their distance. People with mental health problems are frequently careful about how much they reveal, in the hope that not disclosing information will prevent others from learning about the diagnosis.
Relationships
- Having a mental illness very often has a negative impact on a person’s ability to sustain intimate relationships such as marriage. A study of people with a diagnosis of schizophrenia in five different European countries found that two-thirds were effectively single, and only 17% were married.
- A large US study showed that married people with a diagnosis of severe depression had fewer positive interactions and more negative interactions with their partner, compared with people with other types of mental illness, and compared with people with no mental illness. The researchers concluded that poor quality intimate relationships are characteristic of people with severe depression.
- Studies show that people with smaller social network and intimate relationships, find it more difficult to manage social situations.
Parenting
- There is little evidence suggesting that women diagnosed with a mental illness cannot parent. Despite this, considerable evidence shows that a significant number of women with severe mental illness lose custody of their children far more frequently than the general population.
- A study of admissions to psychiatric mother and baby units in the UK found that the majority (70%) of women did not need social services support on discharge.
Work
- Many people with mental illness suffer unjustified restrictions in getting and keeping work and for some, discrimination in the work place is far greater than in any other domain. A recent review found that the proportion of the whole adult population in employment was about 75%, for people with physical health problems the figure was about 65%, while only 20% of people with severe mental health problems were employed.
- Employment rates for people with common mental illness, only reach about 50%. There is some evidence that the UK may be much worse than other EU countries. In a study of people with a diagnosis of schizophrenia in five European countries, the lowest employment rate was in England (5%), compared with 20% and 23% in Spain and Italy.
- The flexibility of the workplace also plays a large part in how far people with mental illness are included in the workforce. In England, one third of people with mental health problems say that they have been dismissed or forced to resign from their jobs, 40% say that they were denied a job because of their history of psychiatric treatment, and about 60% say that they have been put off applying for a job as they expect to be dealt with unfairly.
- Another survey showed that fewer than 40% of employers said that they would consider employing a person with a history of mental health problems, compared with 60% for people with a physical disability, and about 80% for long-term unemployed people and lone parents.
- People with mental disorders have the highest ‘want to work’ rate: In one survey, 52% of disabled people wanted to find a job, while 86% of people with ‘mental illness, phobias and panics’ stated they wanted to work.
The role of the media
- The media plays a very influential formative role in contributing to the pool of knowledge in the public domain about mental illnesses. But the evidence is overwhelming that the mass media portrays mental illnesses in ways that evoke negative emotional reactions of fear and anxiety.
- In general, film, television and newspapers create unease around mental health issues which supports reactions focused on reducing risk and containing threat. The factual information contained in most mass media coverage of mental health issues is grossly unbalanced, and the emotional tone that it adopts is one that directly supports the view that mentally ill people should be shunned.
- The popular media lead the way in shaping our cultural expectations of mental illness. Among the wide range of public views towards mentally ill people the core, repeated, themes in the majority of mass media coverage overwhelmingly reinforce only the most negative interpretations of what mental illnesses mean, and engender negative thinking about how to react to those affected.
- If the media’s role is considered in relation to the three key problems of stigma (ignorance, prejudice and discrimination) then at present it is fair to conclude that they do more to distribute inaccurate than accurate information, more to foster negative than positive emotional reactions, and that their combined effect increases rather than decreases discrimination against people with mental illness.
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Notes to editors
For further information and interview requests contact please contact the Press Office on 020 7803 1128 / 1130 or email the press office
Graham Thornicroft is Professor of Community Psychiatry at the Institute of Psychiatry, King's College London.
The Mental Health Foundation uses research and practical projects to help people survive, recover from and prevent mental health problems. We work to influence policy, including government at the highest levels. And we use our knowledge to raise awareness and to help tackle the stigma attached to mental illness. We reach millions of people every year through our media work, information booklets and online services.
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