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Attitudes towards mental health improving despite recession

New research led by King's College London suggests that Time to Change, England’s mental health anti-stigma programme, is having a positive effect on public attitudes, and that stigma and discrimination in relation to mental health might be more prevalent without the campaign. 

The study, led by a team at the Institute of Psychiatry (IoP) at King’s and published in The Lancet Psychiatry journal, investigates 10 year trends in public attitudes in England before and during Time to Change, which ran its first public-facing national campaign in 2009. Time to Change is run by Mind and Rethink Mental Illness.

The longitudinal data from 2003 to 2013 shows a “step change” increase in positive attitudes in some key areas after the campaign launched. Although attitudes may have been at risk of deterioration during times of economic hardship, they continued to improve during the recession in England and the authors suggest this is likely to be due to the Time to Change campaign. 

Dr Sara Lacko-Evans, lead author of the study from the Health Service and Population Research (HSPR) Department at the IoP at King’s, said: “Attitudes towards mental health have been improving very slowly for the past decade. Our study shows that the Time to Change campaign has provided a significant boost to this upwards trend with attitudes improving more than we would have otherwise expected. Unlike other countries in Europe, where attitudes have worsened following the recession, it's extremely encouraging to see that attitudes in the UK are continually improving, no doubt in part due to the Time to Change campaign."

Changes in public attitude trends were assessed in three ways: 

  • The examination of long-term trends from 2003 until 2013 (six years before the start of the first Time to Change mass marketing campaign and four years into it)
  • An investigation assessing whether the time trend changed significantly after the launch of the campaign.
  • An examination of regional data to assess whether there is a “dose-effect” relationship between campaign awareness (of Time to Change activity) and mental-health-related knowledge, attitudes and intended behaviour. 

Around 1,700 respondents were surveyed each year (2003-2013) and attitudes were evaluated in two areas: ‘prejudice and exclusion’ and ‘tolerance and support for community care’. Under both headings people were asked to agree or disagree with statements such as ‘one of the main causes of mental illness is a lack of self-discipline and willpower’ (prejudice and exclusion) and ‘no-one has the right to exclude people with mental illness from their neighbourhood’ (tolerance and support for community care).

Findings suggest a significant improvement in attitudes related to prejudice and exclusion after the launch of Time to Change, but only slight non-significant changes relating to tolerance and support for community care. In both areas, being female and from a higher socio-economic group were characteristics associated with more positive attitudes.

Regional analysis showed that the regions of England in which there were greater levels of awareness of the campaign and exposure to local Time to Change activity, had greater improvements in attitudes and knowledge, but not intended behaviour over the period 2009-2013.

Sue Baker, Director of Time to Change, said: “This is really encouraging further evidence of positive changes in attitudes in England. It is always difficult to estimate where we might have been without the influence of Time to Change and all of our campaign supporters, but this data suggests that we would not have seen these levels of change if the campaign had not been active with social marketing and local events and activity.

“Of course there is a huge amount of work to do until we can confidently say that no one has to face stigma and discrimination because of a mental health problem in any community and in any walk of life.”

The research was funded by the UK Department of Health, Comic Relief, Big Lottery.

Paper reference: Evans-Lacko, S. et al. 'Effect of the Time to Change anti-stigma campaign on trends in mental-illness-related public stigma among the English population in 2003–13: an analysis of survey data' published in The Lancet doi: 10.1016/S2215-0366(14)70243-3

For further information, please contact Seil Collins, Press Officer, Institute of Psychiatry, King’s College London / (+44) 0207 848 5377