1. Public attitudes to mental health
Bearing in mind how advanced and open the society appears to be in the 21st
century that we are in, it is quite revelatory that there are still some things that
we humans find hard to accept and therefore are reluctant to change our minds
about.
Mental illness is still very much a ‘hush, hush’ subject as it was so many years
ago. Admittedly, there are positive changes to public opinion but not much for it
to be of great significance. Generally, people would prefer to ignore it and walk
away until of course it knocks on their doorsteps. Sadly, by then, people are not
equipped to deal with the situation and the cycle goes on and on …
People with mental illness experience prejudice and discrimination in almost
every area of their lives, the effects of which many have found more disabling
than the illness itself. Frank Bruno in his interview with the Sunday Mirror on 03
April 2011 revealed how shocked he was by the way some people treated him
following his breakdown. “After I came out of hospital people would cross the
road rather than walk past me in the street,” he says. “I felt like I was in panto
again. It made me realise there is still a huge stigma attached to mental health.
It is embarrassing for many people to deal with.” What is more interesting was
his own struggle to admit his illness when he fell ill.
Research has shown that much of public attitude to mental illness stems from
ignorance and fear backed by negative images portrayed by the media (Cinema,
TV and newspapers in particular) Most people have little knowledge about
mental illness and their opinions are often factually flawed. Consequently, people
with poor mental health are pre-judged, find it hard to get/sustain jobs and
sustain friendships and relationships (including close friends and family
members). They become socially excluded from mainstream society. There is a
stigma on poor mental health.
A survey of public attitudes in Britain, conducted by the Royal College of
Psychiatrists as part of its Changing Minds campaign against stigma, shows that
stigmatising opinions about poor mental health are more common among young
people than older people. It also discovered that various mental illnesses
attracted different types of prejudices. Stigmatising opinions were particularly
common towards people with schizophrenia and those with drug and alcohol
problems. In contrast, the public showed a degree of tolerance towards people
with eating and panic disorders. A large percentage of respondents showed
some knowledge about the prognosis of psychiatric illnesses. “Our study shows,”
said Professor Gelder, “that some people do know something about mental
illness, as they do differentiate between different disorders.” This has important
implications for reducing stigmatisation, he argued, as it means that “you have
to give people more than knowledge—there is also an emotion behind their
opinion.” There was no consensus, however, on the most effective way to
improve public attitudes.
2. A CIPD and KPMG consultants’ survey involving over 600 employers reported
that doctors are not doing enough to help people with mental illness. Only 3% of
participants rated doctor support as “very good”. It is worrying to think there is
a possibility that doctors really don’t know what else to prescribe to someone
with depression other than drugs and time off work. It was also reported that
52% of employers said they never hired anyone with a history of mental illness.
On a positive note, some of those that did hire said the experience had been
“positive”
Language used to describe mental ill health also contributes to discriminatory
attitudes. Research carried out by the Institute of Psychiatry and Rethink Mental
Illness (at the time Rethink) 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.
Reducing stigma
Research carried out by the Institute of Psychiatry with Rethink Mental Illness
has shown that the most effective way to reduce stigma is through direct
personal contact with someone who has a mental illness.
One research project showed that making education about mental health a
routine part of the schoolcurriculum made a difference to the attitudes of pupils.
Personal stories of people with mental health problems also made a big
difference to the views of police officers. People who took part in the research
testified that listening to personal stories helped them challenge their
preconceptions and to treat people with respect.
Other research recruited people diagnosed with mental ill health and family
members to offer training to trainee psychiatrists at the start of their careers in
a bid to change discriminatory attitudes among health professionals.
A project currently run by researchers at the Institute of Psychiatry seeks to find
out if a short training course, focusing on the facts about mental health and
presenting people’s personal experiences, can make a difference to the attitudes
and actions of student doctors, trainee teachers, teachers already based in the
classroom and other schoolstaff. This training is run by Rethink Mental Illness as
part of Time to Change, the across-England anti-stigma campaign.
Not in the least in the bid to reduce stigma are the recent trail of high profile,
celebrity admissions of mental illness. There is no doubt that personal stories of
people such as Alastair Campbell, Stephen Fry, Frank Bruno, Ruby Wax, Emma
Thompson, Helena Bonham Carter to mention a few and most recently Welsh
Actress Catherine Zeta-Jones have brought awareness to mental illness. The
danger, as Sue Baker (Director, Time to Change) said, “is that members of the
public start to believe depression or bipolar disorder is something only suffered
3. by famous or creative people. "It can almost seem that this is the price of
success, which is nonsense. Major life changes can have an impact on anybody's
mental health and wellbeing." Still, one cannot deny the impact of celebrity
‘endorsement’ of mental health issues.
There is a huge debate about the role of the media on shaping public attitudes to
mental illness. Many believe if nothing at all, the media can play a major role in
reducing stigma. Commenting on the media frenzy about Catherine Zeta-Jones’
revelation about her mental illness, Alastair Campbell challenged the Guardian
“to open up a few pages of G2 to fellow sufferers most of us have never heard of
… Then your readers will see that not all bipolar sufferers look like Stephen Fry
or Catherine Zeta-Jones ...”
A new Department of Health funded website, WordsMatter allows people to
praise or criticise mental health reporting, with the aim of improving media
coverage over time. It is no wonder Janet Street-Porter was vilified for a
newspaper article she wrote about depression as some kind of trendy new
illness. Alastair Campbell publicly hit back at her in a newspaper article in 2010.
Legislation has also been suggested as playing an important role in reducing
stigma on mental illness. The Equality Act 2010 makes it illegal to discriminate
directly or indirectly against people with mental health problems within public
services, access to premises, work, education, associations and transport.
The Royal College of Psychiatrists has produced a new guide to mental health
which was published in November 2007 and is aimed at informing the general
public about what mental illness is and is a big step towards tackling the stigma
that is still attached to mental illness.
Altering Attitudes
There is no doubt that a lot is being done to raise awareness of mental illness in
the public domain and positive changes in public attitude is happening albeit
slowly. Report from Attitudes to Mental Illness 2011 (Survey by Department of
Health) suggests more people now view poor mental health as an illness like any
other, but less favourable views on some issues still exist.
Paul Farmer, chief executive of charity MIND, which is a partner in the Time to
Change campaign aimed at changing public perceptions, said that though "some
significant progress has been made around tackling stigma and discrimination …
shifting people's perceptions of mental health is the task of a generation".
The survey report, published by the NHS Information Centre, revealed that of
1,741 adults interviewed in February and March 2011, 77% agreed that "mental
illness is an illness like any other", compared with 71% in 1994.
Some 70% would be comfortable talking to their family and friends about their
mental health, compared with 66% in 2009 (the first year this question was
4. asked); while 43% would be uncomfortable talking to their employer about their
mental health, compared with 50% in 2010 (the first year this question was
asked).
Despite these positive views, Marjorie Wallace, chief executive of charity Sane,
said "fear and prejudice" remained despite some improvements. "Thousands of
people have contacted us over the years and described in often agonising detail
how the stigma they face daily is as bad, if not worse, than the mental health
problems they suffer from”.
“Mental illness doesn’t discriminate it can affect any one of us at any time
regardless of our age gender or social background and yet the stigma attached
to mental illness still persists. Although a number of government initiatives,
awareness campaigns and organisations have been set up specifically to tackle
mental health stigma and change our attitudes towards mental health in general,
there is still a long way to go.
It is therefore up to each and every one of us as individuals to make sure we are
well informed and understand the issues involved because only when the public
are fully aware of the facts will mental health stigma become a thing of the
past”. Extract from Attitudes to Mental Illness – 2011 survey report.
One thing is clear more work is still needed in order to change negative public
attitude to mental health to positive. It is the responsibility of everyone to
support the various campaigns aimed at tackling stigma on mental health
problems and be more tolerant towards people with mental illness.