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Mental health discrimination is coming from the top, not the public

The government, together with Comic Relief, has announced £20m further funding for the Time To Change campaign against mental health stigma and discrimination, extending it until 2015. But the big question is, why is the government supporting an anti-discrimination campaign when its rhetoric in relation to welfare reform is saying something very different?

Eighty per cent of people in the Time To Change campaign’s own recent survey said they had experienced stigma and discrimination at some time; 60% say that the stigma people face is as bad as, or worse than, the symptoms, while nearly a third say that stigma has made them want to give up on life. The campaign’s view is that it has “achieved a lot in the last four years”. It says that its campaign is “based on robust evidence from other international campaigns to show what works to change public attitudes and behaviours; and it has been shown to be a cost-effective way of delivering behaviour change on a mass scale”.

There is no reason to question this. But a larger point looms. Is a public education campaign really what is needed, when the principle shapers of negative public opinion actually seem to be the government and the tabloid media?

Speaking as a long-term user of mental health services myself (who has been fortunate to escape some of the extremes of stigma and discrimination), the point that seems important to make is that it may be less a matter of educating the public, than of the government educating itself and the tabloid media. A major lead in stigmatising this group of disabled people seems to have been coming from government and its stereotyping of mental health service users in its campaigns to get people off benefits. Mental health service users are particularly targeted and recent research highlights the negative role of the media and government policy in this.

As one mental health service user, anxious to maintain her anonymity, said to me recently: Institutionalised discrimination runs through the highest levels of government and their departments. People cannot access legal aid or Citizens Advice Bureaux through cutbacks for welfare representation at tribunals. That money could fund charity/human rights lawyers to contest what’s happening to people in higher courts, or an entire advocacy service – but now, instead, it will fund this campaign.

The welfare reform programme of the coalition government has focused particularly on getting disabled people off welfare benefits, particularly the old incapacity benefit and the new employment and support allowance (ESA). In this policy, it is following the last government, which promised to get one million people off incapacity benefit. Sadly, we know that this arbitrary and unevidenced policy hits disabled people very hard. We also know that the group of disabled people it seems to hit the hardest are mental health service users – because they don’t necessarily use wheelchairs, have white sticks or clear signs of impairment. This at least sometimes means that the Benefits Agency and the Department for Work and Pensions have to acknowledge that people are not in a position to get and maintain a job in the often inflexible, discriminatory and poor-quality labour market that is out there.

This shift towards trying to force people into jobs – jobs that increasingly don’t exist and remove them from benefits – has been associated with the most harsh, cruel and inaccurate scapegoating and stigmatising of mental health service users on benefits. We know that the processes of so-called medical assessment are fiercely discriminatory. We know that many mental health service users are feeling increasingly anxious and desperate because of this, with emerging reports of suicide when people are facing the loss of benefits but no prospect of employment. Challenging mental health stigma and discrimination is one policy that needs to come from the top down, rather than the bottom up, and this is a key message for the Time To Change campaign if it is truly to punch its weight.