Time to Change

Findings from the evaluation of the first three years of Time to Change England’s biggest ever anti-stigma campaign, were published on 3 April in the British Journal of Psychiatry and commented upon by journalists at the Times and Guardian. This evaluation includes the Viewpoint Survey, run by King’s College London in partnership with the McPin Foundation. Our telephone survey asks around 1,000 users of specialist mental health services each year about their experiences of discrimination.
The Time to Change campaign set itself a target of reducing experiences of discrimination by 5%. The Viewpoint survey found that in 2008 around nine in every ten participants (91%) had experienced discrimination in at least one area of life. This number dropped by 3% in 2011; a definite improvement but not quite reaching the target which the campaign had set itself.
So, what can we learn from the Viewpoint survey? More importantly, what can Time to Change, and campaigns like it around the world learn from this evaluation to further improve people’s lives?
First and foremost, it reminds us that discrimination is complicated. It is a difficult thing to define, but ‘we know it when we see it’. More specifically, we know it when we are the victim of it. We may find it harder to recognise it when we do it ourselves. The most common groups of people who discriminate are probably those who would be most upset if they were told that that’s what they were doing – friends, family and mental health professionals whose job it is to work with people with a mental illness.
There is a theory, central to many anti-stigma campaigns, that the more contact people have with someone with a mental illness, the less likely they are to hold negative attitudes about mental illness. So why is it that these groups, the people closest to our participants, are the ones doing the discriminating? One explanation is that because they have most contact with the person there is simply more opportunity to do something discriminatory. But this doesn’t fully explain it. There are other groups who have regular contact but who discriminate less, for instance neighbours and professionals treating physical health problems.
We would suggest that to get to the bottom of this we have to do more to understand what discrimination is. Some forms might be straightforward to define (though not always easy to identify) – being denied a job or access to a service on the basis of a diagnosis, being labelled with judgements, either personally or as a group. But the published findings suggest that the most common discrimination experiences for people with a mental illness go beyond this. They are about being let down by the very people that they should be able to turn to for support.
Mary Nettle writes in her comment on the study, in order to understand better what these experiences are, we need to go beyond the numbers in this study and look at what people are telling us in more detail through qualitative work. This is something we hope to address in the near future. In the meantime, we hope that Time to Change is able to build on these modest but promising beginnings and continue to change lives for the better.