The below is the original draft of an article by Mark Brown which appeared in a different form at BBC Ouch under the title ‘Viewpoint: Talking about mental health is just the first step’
More people in the UK than ever before are talking about mental health and mental illness. On February 5th this year, people will be encouraged to spend five minutes talking about mental health as part of the second annual Time to Talk day, an initiative of the national anti-mental health stigma campaign Time to Change.
Launched in 2007, Time to Change is a partnership between Mind and Rethink Mental Illness, two of Great Britain’s largest mental health charities. Its website states that it is a “groundbreaking anti stigma campaign across England to challenge attitudes and change behaviour around mental health problems”. Time to Change is based on the idea that more people speaking about mental health difficulties will remove judgemental attitudes toward those people who experience them.
Stigma is the interaction between people or characteristics that society feels unacceptable and the people this labels. Experiencing a mental health difficulty can be isolating and frightening. We can find ourselves unwilling or unable to talk to others about the things we experience because we are fearful of the consequences. People experiencing mental health difficulties like schizophrenia, bipolar disorder, eating disorders and depression have often experienced prejudice, discrimination and have often been excluded from areas of life and community in which they might otherwise expect to take a full part. Part of stigma is the internalised feeling of shame for being what you are, and receiving positive responses rather than negative ones can help to dispel this feeling. From an individual perspective, it can be liberating and validating to be able to ‘come out’ and speak about difficult experiences or sensations.
To date, Time to Change has received £38million in funds to change our minds about people with mental health difficulties: £18m in its initial phase, £16m from the Department of Health and £4m from Comic Relief in 2011; with more funds promised to carry the programme beyond the end of its current funding March 2015. According to Mind, the most recent National Attitudes to Mental Illness survey, carried out in 2013, found that “since the beginning of the current programme of Time to Change (2011) an estimated two million people – or 4.8% of the population – have improved attitudes towards people with a mental illness.”
Whether the rise in positive attitudes translates into an improvement in the lives of those with mental illnesses is something critics of the programme question. Time to Change was launched at the beginning of worldwide financial crisis and has run alongside austerity reforms to social security protections such as the removal of Incapacity Benefit, the introduction of the Work Capability Assessment and cuts to social care and NHS funding which some source allege disproportionately affected the lives of many people with mental health difficulties. Critics of Time to Change claim its approach is too shallow and does not examine ways in which prejudice and discrimination can be structural as well as personal. Some liken Time to Change to similar campaigns in the broader Disability world which have focused on slogans such as ‘See the person, not the disability’ which focus on being ‘nicer’ to individuals rather than changing structures, laws and circumstances that disadvantage Disabled people collectively.
Some argue that Time to Change actually makes it more difficult for people who do have stigmatised experiences such as voice hearing; or who have periods of illness or symptoms that disrupt their lives; by pushing these less palatable experiences to the margins in an effort to sanitise the image of mental health difficulty for public consumption. A subsection of campaigners and activists feel that the focus on the telling of personal stories of mental health difficulty to fight stigma has individualised understandings of mental illness, moving the debate further away from what concrete, collective social changes need to be made to support people with their mental health. These people would claim that shame is not their problem but systematic prejudice and discrimination.
Over the lifetime of Time to Change discussion about mental health has risen in prominence in the public sphere, as have media portrayals and news coverage. The Liberal Democrats, as partners in the current Coalition government have given prominence to mental health within their campaign for this year’s general election and have promised new funds and standards for NHS mental health care.
As with all mass campaigns; a message clear enough to penetrate the background chatter of everyday life is in danger of losing some of its nuance and context.
The focus of Time to Change is not solely on encouraging people to have their first conversation about mental health, but this has been its most prominent call to action. The conversations that Time to Change encourages, from five minute chats to grand media saturated political performances are an attempt to build the platform for a wider change. There is a danger that the people talking about personal experiences and others accepting them is seen as the goal. For each year that it and programmes like it continue, the number of people who have already had their first conversation about mental health will grow.
Today, on Time to Talk day, some already comfortable speaking about mental health and mental illness will asking: if we’ve started people thinking and talking about mental health and how they behave towards people with mental health difficulties, how will we move people on to thinking about the way that society as a whole treats those same people?
Mark Brown is development director of Social Spider CIC. He is @markoneinfour on twitter