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.

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