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Over the years there have been many campaigns to tackle stigma and discrimination in mental health but none has led to significant changes in attitudes.

This week, health minister Rosie Winterton will launch the latest campaign, a five-year strategic plan, led by the National Institute for Mental Health in England (NIMHE) and funded with £1.1m.

But will it succeed where others - including the three-year Department of Health Mind Out for Mental Health campaign which ended in March - have not?

Figures in a report by the Social Exclusion Unit, published last week, reveal that urgent and overdue action is needed.

Of the 900 people and organisations consulted for the report, 80 per cent identified stigma as a priority area to be tackled, 55 per cent said it was a barrier to employment and more than half said there were negative attitudes towards mental health in the community.

Stigma and discrimination can have a greater impact on people's lives than the mental health problems themselves, says the report.

Jed Boardman, consultant psychiatrist and chair of the Royal College of Psychiatrists' general and community faculty, says the campaign should be sustainable: "You can't have a campaign that lasts for two years and expect it to have an impact."

Long-term and significant investment is also crucial and the allocation of just £1.1m to a campaign with such broad and complex aims gives little cause for celebration. However, to its credit, the government's approach, which seeks to make changes locally and nationally, appears more sophisticated than in the past. Specific groups, including the media, young people, the public, and the private and public sectors, will all be targeted.

The campaign's work will include an analysis of complaints about stigmatising or inaccurate portrayals and reporting in the broadcast media by communications regulator Ofcom. But when it comes to reporting mental health issues the worst offenders are tabloid newspapers. So it seems odd that more efforts have not been made to monitor their coverage.

Eight months ago The Sun devoted its front page to a story about former heavyweight boxing champion Frank Bruno being sectioned headlined "Bonkers Bruno locked up". The public outcry was so swift and so vocal that the headline in later editions was changed to "Sad Bruno in mental home". The next day the newspaper launched a fund for the former boxer.

The Sun's editor, Rebekah Wade, spent a day at charity Sane earlier this year to learn more about mental health issues in order to promote responsible reporting. How big an impact the Bruno fiasco had on the newspaper's coverage is difficult to judge but it is clear that behaviour is hard to change and individual incidents can only do so much.

Heart-warming as the public response to The Sun's story was, it would be dangerous to overstate its significance. A national sporting icon, the public sympathy that Bruno's situation provoked was exceptional. As a spokesperson for the Sainsbury Centre for Mental Health says: "If the story had been about Mike Tyson would the public have reacted in the same way? I don't think so."

For the estimated 630,000 ordinary people who suffer severe mental illness, public sympathy is also rarely in evidence. Routine reporting - especially in the tabloid press - of people with mental health problems as "loonies" and "nutters" passes largely without comment.

Adrian Thomas, of mental health charity Mind and NIMHE anti-stigma board member, says: "The problem is that the Press Complaints Commission doesn't really have any teeth and its guidelines are too open to interpretation. Stuff in the tabloids is a million miles behind broadcast media."


Peter Beresford, chair of national user group Shaping Our Lives, adds: "I don't think the problem lies with the public. There needs to be a focused campaign on those groups such as the tabloid press who would have the public think badly of mental health issues."

Training on the issue will be delivered in journalism colleges and there will be a drive to encourage mental health service users to take up jobs in the media as part of the campaign.

Beresford says it is important that the campaign is shaped by service users "so the public identify with real people" rather than celebrities.

He says the idea for a speakers' bureau to recruit, support and train people with mental health problems to become spokespeople for the programme, is a good one. But, given support, he says existing service user groups could do the job rather than "inventing" something new.

Conspicuous by its absence from the programme are measures to tackle discrimination within the benefits system, a perennial problem often cited by mental health users.

Fear of losing benefits if a return to work is unsuccessful can prevent people who have experienced mental health problems attempting to find work.

Gil Hitchon, chief executive of mental health support charity Maca, says: "I am not convinced we will see the level of change needed in the benefits system. There's a lot of goodwill in this area but it is a difficult thing to sort out."

But he does believe that the campaign's focus on targeting specific groups, such as the media, young people and private sector, is to be applauded. More important than any of those groups is the public sector, though, which he says can "make or break" the campaign.

Worryingly, professionals working with people with mental health problems are criticised in the Social Exclusion Unit's report for having low expectations of what service users can achieve.

But for all the work to urge more responsibility in the media, there is an inherent contradiction in the government's plans. Proposals in the draft mental health bill to detain people with untreatable personality disorders who have committed no crime serve only to promote a myth that people with mental health problems are dangerous and to be feared.

This leaves the government in the position of undermining its own efforts to de-stigmatise mental health issues.


FIVE-YEAR PLAN

• Analysing Ofcom's complaints data on coverage by the broadcast media of mental health and raising awareness of how people can make complaints about stigmatising or inaccurate portrayals and reporting.
• Developing resources and best practice guidelines for reaching young people, the public sector, private sector and the media, with support from across government and voluntary sector organisations.
• Setting up a speakers' bureau to recruit, train and support people with mental health problems to be spokespeople for the programme and become involved in training and development for target groups of people.