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Karen Steadman

Glimmers of hope on World Mental Health Day

Authors: Karen Steadman Karen Steadman

10 October 2013

It has been a struggle to find a positive in terms of mental health stigma in a week where The Sun newspaper (see my colleague Professor Stephen Bevan’s blog) disappointed and angered many of us by plastering a spurious association between mental health conditions and violence over their front page. However, the widespread condemnation of the headline - filling up my Twitter and Facebook feed, provided me with cause for hope – leaving me with the feeling that perhaps, actually, the messages have been getting through, and this type of stigma-based, incorrect view of mental health is reducing. Indeed, despite such damaging incidents, progress does seem to have been  made in terms of what people see as acceptable in regards to mental health commentary (not to mention standards of journalism!), and therefore in terms of battling the stigma often associated with mental health conditions.

The number of signatories to the petition which flew around the internet in response to The Sun’s article, is further testament to the positive shift in public views - at last look over 65,000 people had called on The Sun to apologise. Whether the apology will come remains to be seen, but even if it does I fear it will only be lip service to the issue – after all, the mental health training that The Sun journalists went on after an incident last year, appears, on this week’s evidence, to have made little difference!

There have been other glimmers of hope in recent times - particularly in terms of mental health stigma at work. Over 40% of the organisations surveyed as part of the CIPD/Simplyhealth Absence Management report (to be released on Monday 14 October) identified an increase in the reporting of mental health problems by employees – this is double the amount identified in 2009. This may imply that increasing numbers of employers are becoming aware of mental health conditions in the workplace, and have been able to create environments where employees feel able to disclose their condition. This reflects the findings of Aviva’s 2012 Health of the Workplace report, in which 28% of employees surveyed said they felt that stigma associated with mental health in the workplace had decreased since the previous year, with many attributing this to an improved understanding of mental health.

Mental health stigma is still deeply entrenched in individuals and in systems. Research released this week from Australia highlighted how stigma rooted within the health system can impact people’s employment outcomes. The study published in the Medical Journal of Australia, looked at sickness certification of employees (collected through a centralised sickness benefit compensation system), and highlighted the low numbers of employees with mental health conditions being certified as ‘fit for work’ by Australian GPs. In fact a staggering 94.1% of workers with mental health conditions were issued with ‘unfit-for-work’ certificates, considerably more than for those with physical health conditions. The authors concluded that “health professionals were likely to perceive the potential health outcomes of people with mental illness as poorer than they really were”. In this regard, the situation appears to be a little better in the UK, where the use of ‘fit notes’ promotes a more positive approach to return to work by highlighting what an individual can do as opposed to emphasising what they can’t. A recent evaluation of the fit note scheme found one in 10 of those with a mental health condition did not return to work – a significant amount, and not to be disregarded, but relatively speaking, quite positive!

The stigma within the health care system was reflected in another study from Australia this week, highlighting the contrast between the high rates of mental health conditions and stress among health care professionals, and the low likelihood they will seek help for their conditions. The Australian National Mental Health Survey of Doctors and Medical Students survey of some 14,000 doctors and medical students, found  that one in five medical students and one in 10 doctors had had suicidal thoughts in the past year. This was compared to one in 45 people in the general population. The research also emphasised the high and persistent levels of stigma identified among doctors about mental health. 40% felt that other medical professionals with a history of mental health conditions were perceived as less competent than their peers, with almost half believing they were less likely to be appointed than doctors without such a history. Such findings reflect those of previous studies in the UK, as well as real life stories.

There is clearly still a long way to go, but I do believe we are moving in the right direction in raising awareness of mental health conditions and reducing the stigma that most often comes from misconceptions and a lack of understanding. The Time to Change campaign, now entering its seventh year, has done amazing work in this area. One of its many recent achievements has been to support Lisa Rodrigues, CEO of Sussex Partnership Foundation Trust, to ‘come out’ about her experiences with depression.

Such public admissions of senior, highly respected people are extremely valuable in terms of demonstrating that mental health conditions do not have to be barriers to success, in employment or in other areas of life. This has been further demonstrated by the number of MPs now coming out and offering their support to the Time to Change campaign – a number of whom will be signing  the Time to Change Pledge in Parliament today. In honour of World Mental Health Day, I encourage you to join them and the 45,000 organisations and individuals who have already signed up, and make the pledge to end mental health stigma.