Can new campaign to fight stigma win over public hearts and minds?

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.