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Between 2008 and 2019, we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign.
Aims
Using data from the Attitudes to Mental Illness survey (2008/2009 to 2023), we investigated the extent to which positive changes in stigma were sustained by 2023, 2 years after the programme's end in 2021.
Method
We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes toward workplace discrimination, using data from the British Social Attitudes Survey for comparison.
Results
CAMI scores improved between 2008 and 2023 (s.d. 0.24, 95% CI 0.16–0.31), but decreased since 2019 (P = 0.015). After improvements between 2009 and 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases in stigma-related knowledge (MAKS scores declined 7.8%; P < 0.001) and willingness to interact (RIBS scores declined by 10.2%; P < 0.001) since 2019. Conversely, comparison with British Social Attitudes Survey data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved.
Conclusions
The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the COVID-19 pandemic and economic stress.
This chapter provides a discussion of the reported findings. The research questions are revisited and caveats to the research are discussed. I provide suggestions for how research into the language of mental illness may be developed in future studies. I also discuss the practical implications of the research reported in the book.
Chapter 8 explores the ways in which the press talk about people having mental illness using a mixed-methods approach. In the chapter, the frequency and semantic and pragmatic content of the verbs ‘suffer’ and ‘ experience’ in the context of prescribed forms for talking about having mental illness are investigated. I show that ‘suffer’ and ‘experience’ occur in different semantic contexts in the MI 1984–2014 Corpus as well as general language corpora, which may contribute to ‘suffer’ being a more problematic term for describing mental health than ‘experience’. Moreover, I show that ‘suffer’ is proportionally less likely to be used in first-person narratives because ‘suffering’ is attributed to people with mental illness by others, for example, medical professionals, in reported speech. I bring together my findings in a set of lexicogrammatical heuristics based on the semantic content of ‘suffer’ and ‘experience’ in context (e.g. whether the word encodes animacy or is temporally bounded).
Chapter 7 explores the labels associated with mental illness in more detail, specifically through naming analysis. I discuss prescribed forms for referring to people with mental illness (such as person-first language) and explore the frequency of such prescribed forms in the corpus. In addition, salient naming strategies in the corpus, particularly the labels ‘patient’, ‘sufferer’ and ‘victim’ are investigated. Using corpus evidence, I show that these labels are patterned to specific illness types. Furthermore, I argue that the tendency in the corpus to refer to people as quantities and statistics depersonalises people with mental illness. I argue that the ‘rhetoric of quantification’ (Fowler, 1991: 166) provides a way for the press to sensationalise news events related to mental illness which in turn constitutes the representation of mental illness as a ‘moral panic’ (Cohen, 1973).
Our aim was to investigate patterns of change in public knowledge, attitudes, desire for social distance and reporting having contact with people with mental health problems in England during the Time to Change (TTC) programme to reduce stigma and discrimination 2009–2017.
Methods
Using data from an annual face-to-face survey of a nationally representative quota sample of adults, we evaluated longitudinal trends of the outcome measures with regression analyses and made assumptions on the basis of a simple random sample. We tested interactions between year and demographic subgroups.
Results
There were improvements in all outcomes in 2017 compared with baseline measures (2008 or 2009). Reported in s.d. units [95% confidence interval (CI)], the improvement for knowledge was 0.17 (0.10–0.23); for attitudes 0.25 (0.18–0.31); and for social distance 0.29 (0.23–0.35). A higher likelihood of reporting contact was also associated with most recent survey year (odds ratio 1.47, 95% CI 1.27–1.71). Statistically significant interactions between year and region of England suggest greatest improvements in attitudes and intended behaviour in London, where both outcomes were significantly worse in the early years of the survey. However, for attitudes, this interaction was only significant among women. Other significant interactions suggest that attitudes improved most in the target age group (25–44).
Conclusions
The results provide support for the effectiveness of TTC across demographic groups. However, other societal changes may influence the results, such as the increasing prevalence of common mental disorder in young women.
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