In 1990 I started working with people with mental health problems and became aware for the first time of the level of stigma they faced. It was a time when attitudes around the world were changing - Nelson Mandela was freed and Germany was unifying after the fall of the Berlin Wall – ideas of inclusion were replacing those of fear and segregation. So could stigmatising attitudes around mental health also change?
Fast forward nearly a quarter of a century and an MSP is reporting the local opposition to a new care facility for people with mental health problems and asking Alex Salmond in First Minister’s Question Time what the government is doing to tackle the stigma around mental health.
So does stigma against those with mental health problems still exist?
The Scottish Social Attitudes (SSA) 2013 survey showed that stigmatising attitudes towards people with mental health problems do exist in Scotland and haven’t changed significantly in the past decade. However, the news is not all negative. Most people (82%) think that people with mental health problems should have the same rights as everyone else and would be willing to make friends with someone with depression (75%). Yet there still seems to be a sense of fear around mental health with over a quarter (28%) of people in Scotland feeling that people should be better protected from those with mental health problems and 1 in 5 believing that people with mental health problems are often dangerous.
Should we be surprised by this lack of change?
Some attitudes do change in a relatively short space of time - take, for example attitudes to gay men and lesbians marrying. In 2000 only 2 in 5 thought gay men and lesbians should have the right to marry; only ten years later this had increased to 3 in 5 and in December we will see the first gay and lesbian weddings in Scotland.
But this stands out as the exception rather than the rule. Generally, negative, discriminatory attitudes towards specific groups in society take a long time to erode in spite of attempts by governments, policy makers, charities and voluntary organisations to challenge such views.
Certainly there has been political will in Scotland to reduce the stigma around mental health. It has been a key aim of the government’s mental health strategy for over ten years and they funded the ground-breaking ‘see me’ social media campaign which launched in 2002. Alongside this sits the work of many charitable organisations who are trying to tackle stigma daily at the grassroots level.
So this research has shown us where prejudice lies but perhaps we also need to understand more about how these attitudes develop. What is the role of the media? Does the reporting of mental health issues reinforce negative stereotypes? When high profile celebrities, such as Stephen Fry and Ruby Wax, open up about their mental health problems, does this increase people’s knowledge and make them less fearful? We know that younger people already hold less negative attitudes than older people, so what role does education have in reducing stigma over time?
One thing that is clear is that reducing stigma around mental health is important because it has real consequences - over a third of people with mental health problems have experienced some form of discrimination. So we need to use the knowledge we have about which negative attitudes and stereotypes persist, and further explore where these attitudes come from, to help find new and innovative ways to tackle stigma. Perhaps, then, the next twenty-five years will look very different to the last twenty-five.
Full report on Attitudes to Mental Health in Scotland (separate exec. summary available here)
Full report on Attitudes to discrimination and positive action