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It’s Time to Change – the NHS should be at the forefront of the battle against mental health stigma

September 22, 2014

time to change

The thing I learnt most strongly when I joined a mental health charity nearly 8 years ago was that stigma and negative attitudes towards mental illness added an enormous burden to people affected by mental health problems and their families. Indeed it wouldn’t be overstating the matter to see stigma as the single biggest obstacle to improving the outcomes for those individuals.

I have always stressed that there were three reasons for this. First of all, stigma impacts dramatically here and now on the life chances of people with mental health problems. It prevents them getting jobs, it encourages social isolation, as friends and even family offer rejection rather than support, it leads to people getting a second class response from public services as is evidenced by the appalling physical health inequalities experienced by people with schizophrenia and other severe mental illnesses. Second, stigma and the fear of mental illness, prevents people being open about mental health issues and from seeking help. At the same time, it closes down the channels of peer support which sustain us through many other types of adversity. Finally stigma cuts off the public debate about mental health which, as is clear from so many other issues, is the engine house of getting politicians and others to change the system or make investment in better services.

Things are changing and my proudest moments as a mental health campaigner was to have been associated, while at Rethink Mental Illness, with Time to Change which over the last 7 years has made a very significant contribution to combatting stigma and changing attitudes for the better.   Through social marketing and a range of local engagement activities Time to Change has helped to deliver a statistically significant shift in public attitudes and a reduction, in some areas of life, in the reported experience of discrimination.

Just as importantly Time to Change has not done this on its own but has successfully drawn on a wide range of organisations in communities and amongst employers to help spread the word and share the task. A clear mark of this has been the more than 200 organisations, in all sectors of society, who have signed up to the Time to Change pledge and made their own commitment to support the fight against mental health stigma. I am delighted that today my new organisation the Tavistock and Portman NHS Foundation Trust will be signing the pledge.

Signing the pledge is not a mark that we, or anyone else, has got everything right but it is a sign that we care and that we are prepared to commit focus, effort and resources to ensure that people who use our services and their families do not experience stigma and that we are prepared to welcome and support staff and students who have their own experience of mental health problems. Above all we are saying loud and clearly that this is something we are prepared to talk about and consider no differently from any physical illness or any other issue.

While I am delighted my own Board has so enthusiastically embraced this agenda and committed to signing the pledge and the resulting action plan, I am disappointed that so far so few NHS organisations have engaged with this agenda. There are honourable exceptions but in general it is fair to say that the NHS has been slow off the mark to take action to stamp out stigma and discrimination towards people with mental health problems who use it services. It has also been slow to recognise the impact which mental health problems have on its own workforce and to match the “best of class” good practice which employers in other sectors have followed in creating a mental health friendly workplace.

This is disappointing in its own right but it’s impact goes much further when surveys of the experience of people with mental health problems indicate that health and social care services can be one of the most significant sources of stigma and discrimination and one which has shown the least improvement in recent years.  Behind the statistics are some terrible stories or people who have been treated judgementally when they have presented with suicidal thoughts or following self-harm or whose physical health needs have been overlooked because they are seen, inappropriately, as a consequence of their mental health diagnosis.

There has been much talk in recent years about the idea of “parity of esteem” between mental and physical health. If the NHS is really serious about delivering on this, one very good place to start would be for all NHS organisations to take the issue of mental health stigma seriously and commit to signing the Time to Change pledge. This is not beyond us, even in times when resources are badly stretched.

The NHS is one of our most treasured national institutions but it is put to shame if it is not prepared to challenge negative attitudes towards mental illness. It is time to change.

Details of Time to Change and how to commit to the organisational pledge can be found at the following link:


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