Mental health service users' responses to anticipated discrimination and the Time to Change program in England.

Gaia Sampogna,Vincenzo Giallonardo,Emily J Robinson,Lucia Gehlen,Graham Thornicroft,Claire Henderson

doi:10.1192/j.eurpsy.2020.114

Abstract

Responses to anticipateddiscrimination are common among mental health service users and can have adetrimental impact on their recovery. Since 2009, the Time to Change (TTC)anti-stigma program in England has aimed to improve service users' empowerment,reducing public stigma and discrimination. In this paper, we aim to evaluatewhether service users' awareness of TTC is associated with fewer responses toanticipated discrimination. We used data collected for the evaluation of TTC from samples of mental health service users interviewed by telephone in annual surveys 2009-2014. Five thousand and nine hundredand twenty-three participants completed the survey, mainly suffering from mooddisorders (depression, 28.4%, n=1,681) and schizophrenia related disorders(15.4%, n=915).In 23.2% of cases,participants were aware of any aspects of the TTC program, while participationin TTC was reported by 2.6%. Being aware of the TTC program was notsignificantly associated with responses to anticipated discrimination, exceptfor those participating in the TTC campaign in 2013. Stopping oneself fromapplying for work was significantly associated with experienced discriminationin both finding (p<0.001) and keeping (p<0.001) a job.Concealing mental health problems was associated with a general experience ofbeing shunned (p<0.001). Awareness of a nationalanti-stigma program may not be sufficient to encourage people to seek work/educationor to be open about their illness in situations in which they currentlyanticipate discrimination. There is the need to identify new multi-levelstrategies for challenging anticipated discrimination, even focusing ondifferent target groups.

Highlights

Stigma is a complex phenomenon resulting by three social-cognitive structures: stereotypes, prejudices, and discrimination [1]
Stigma and discrimination can be an additional burden to people with experience of mental health problems, to the point that many feel like it adversely affects their lives more than the actual symptoms [2,3]
Awareness or participation in Time to Change (TTC) might reduce anticipated discrimination if it leads to an expectation that others will be aware of TTC and as a result behave in the positive ways promoted by the campaign, instead of in a discriminatory fashion

Summary

Introduction

Stigma is a complex phenomenon resulting by three social-cognitive structures: stereotypes, prejudices, and discrimination [1]. Experiencing stigma or discrimination, both structural and interpersonal, is very common among people with mental health problems [4,5,6], as is the anticipation of negative responses to one’s mental illness [5,7]. We aim to evaluatewhether service users’ awareness of TTC is associated with fewer responses toanticipated discrimination. Being aware of the TTC program was notsignificantly associated with responses to anticipated discrimination, exceptfor those participating in the TTC campaign in 2013. Awareness of a nationalanti-stigma program may not be sufficient to encourage people to seek work/educationor to be open about their illness in situations in which they currentlyanticipate discrimination. There is the need to identify new multi-levelstrategies for challenging anticipated discrimination, even focusing ondifferent target groups

Objectives

Methods

Results

Conclusion