People with mental illness report that stigma and discrimination often disable them more than the illness itself. This research programme tackles that hidden burden head-on. Currently, most evidence on stigma comes from attitude surveys, not from studies of what actually works to reduce discrimination. The programme fills that gap by developing standardised tools—such as the Discrimination and Stigma Scale (DISC) and the Questionnaire on Anticipated Discrimination (QUAD)—to measure real-world experiences of stigma and the self-imposed social exclusion it triggers. It also creates a scale to assess clinicians’ attitudes and a new measure of the financial costs stigma imposes. Analytical studies will compare discrimination across different diagnoses and ethnic groups, including black mentally ill people, a group often overlooked. Intervention studies test practical solutions: whether disclosing a psychiatric history helps or hinders job seeking, and whether live or recorded training materials from service users reduce stigma among healthcare staff. If successful, the programme will provide concrete, evidence-based tools and training packs that health and social care services can use to improve access to care, physical health provision, and employment outcomes for people with mental illness.
View original technical description
5.1 Aims and objectivesTo strengthen the evidence base to improve outcomes for people with mental illness by reducing stigma and discrimination, through research on: (i) help-seeking and access to mental healthcare; (ii) provision of physical healthcare; (iii) outcomes related to occupation and work. Achieved by: (i) methodological development of standardised, outcome measures; (ii) analytical studies to assess discrimination; (iii) evaluative studies of training tools; and (iv) knowledge transfer activities to disseminate results.5.2 Background Stigma and discrimination have been described by many people with mental illness as more disabling than the primary condition. Research shows that stigma and discrimination faced by people with mental illness is frequent, often severe and contributes to poorer health outcomes, and is a significant factor in the reluctance of people with mental illness to seek treatment and care. In relation to health outcomes three specific elements are impaired: (i) help seeking and access to healthcare, (ii) the provision of physical and mental healthcare, and (iii) low rates of participation in employment which hinder recovery from mental illness. As the empirical base of research on stigma is mostly limited to attitude surveys, there is a lack of evidence of effective interventions. A further knowledge gap concerns disadvantaged groups, such as black mentally ill people, which will be addressed in this programme. We have led or collaborated with numerous related research projects on intervention, analytical and methodological studies. This programme will therefore build on and accelerate this work to lead to more effective interventions.5.3 Research plansWe propose an inter-related portfolio of elements within this programme: 4 methodological studies; 5 analytical studies, 3 intervention studies; and 4 knowledge transfer actions.Methodological studies: development of the Discrimination and Stigma Scale (DISC) to assess experiences of discrimination and create the Questionnaire on Anticipated Discrimination (QUAD) scale to assess such self-inflicted forms of social exclusion. We shall also further develop the scale of clinicians’ attitudes to people with mental illness (MICA) to assess views of medical and social care staff about providing mental and physical healthcare to people with mental illness, and create a new scale to measure the financial costs associated with stigma and discrimination.Analytical studies: to better understand the nature of stigma and discrimination include knowledge synthesis on population interventions to reduce stigma; comparison of discrimination in different diagnostic groups and ethnicity; developing a model of the financial costs associated with stigma and their measurement; and pilot study on diagnostic over-shadowing.Intervention studies: on diagnosis disclosure in job seeking and decisions of employers in relation to disclosure of psychiatric history will be conducted. We shall also compare live and recorded service user training materials to reduce stigma, as forms of active ‘social contact’. Knowledge transfer components: include publication of findings to specialist and non-specialist mental health audiences, production of a training pack aimed at health and social care; and dissemination of results at national and international conferences and on the mental healthcare and stigma websites.5.4 Research team The research team of this programme consists of expertise from health economics, psychiatry, social science, service users, and systematic reviews. We have a strong track record of research on stigma and discrimination.5.5 Research environmentThe South London & Maudsley NHS Trust and Institute of Psychiatry (including the Health Service Research Department) have a long-standing partnership in undertaking research to establish the best care for people with mental illness and have succeeded in attracting substantial external funding (£33.9m in 2005/06). 5.6 Anti
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know