Neil Quinn

People Look at You Differently: Students' Experience of Mental Health Support within Higher Education.

ABSTRACT Against the backdrop of a massive expansion in higher education, the number of students in higher education (HE) experiencing mental health problems is increasing, which poses a significant challenge to HE institutions in terms of how they best respond to students with mental health needs. This paper considers the implications of such developments by assessing the experience of students with mental health problems within one HE institution. The factors influencing students’ ability to seek help is explored alongside their experience of accessing and using student support services. The study found that there was a general reluctance amongst students to disclose their mental health problems or to seek help, largely due to the stigma that exists. However, students who did seek help from University support and counselling services valued this and students benefited when there was a formal link between NHS and university support services. The implications of the study findings for HE institutions are then considered.

Community conversation: addressing mental health stigma with ethnic minority communities.

IntroductionStigma associated with mental health problems is a significant public health issue. Patterns of stigma and discrimination vary between and within communities and are related to conceptualisations of, and beliefs about, mental health. Population approaches to addressing stigma rarely consider diverse cultural understandings of mental health.Methods257 members of the major black and minority ethnic communities in Scotland participated in 26 mental health awareness workshops that were designed and delivered by community organisations. Questionnaires measuring knowledge, attitudes and behavioural intent were completed before and after the intervention.ResultsCommunity led approaches that acknowledge cultural constructs of mental health were received positively by community groups. The study found significant reported stigma in relation to public protection, marriage, shame and contribution, but also high levels of recovery optimism. The workshops resulted in significant positive change in relation to knowledge, attitudes and behavioural intent amongst participants, with most aspects of stigma showing significant improvement, with the exception of dangerousness.DiscussionThe paper argues community approaches to tackling stigma are more valuable than top-down public education and could form the basis of national initiatives. Refinements to the evaluation framework are considered.

Beliefs and Community Responses to Mental Illness in Ghana: The Experiences of Family Carers

Background: There is often a lack of agreement on how to understand mental illness in low-income countries and support those experiencing it. This article explores the debate on beliefs and the implications for how society responds. Material: Semi-structured interviews were undertaken with 80 family carers across four sites in Ghana to explore the themes of beliefs, attitudes, carer burden and support. Discussion and conclusions: There appears to be greater reliance on culturally specific explanations of mental illness in rural areas, combined with more acceptance and support, particularly in one rural area with strong traditional belief systems. This suggests the need to develop integrated mental health services, which reflect these differing beliefs.

The impact of a national mental health arts and film festival on stigma and recovery.

Quinn N, Shulman A, Knifton L, Byrne P. The impact of a national mental health arts and film festival on stigma and recovery.

Media, Mental Health and Discrimination: A Frame of Reference for Understanding Reporting Trends

Mental health-related stigma and discrimination are a significant public health issue. Media reports can both reflect and influence public attitudes. However, media reports can be subtle and contradictory and many previous studies do not adequately capture trends in the range and balance of reporting of different mental health problems. This paper develops a frame of reference that identifies a wider range of themes that can be used to capture a more representative picture of reporting than pre-imposing content analysis categories. This frame of reference was applied to assess trends in schizophrenia reports in the broadsheet media in Scotland, between 2001 and 2005, to coincide with See Me, a national anti-stigma media campaign. A number of key findings emerged, including a wider than expected range of both positive and negative images. This study suggests that a national media campaign can succeed in breaking the perceived link between schizophrenia and dangerousness. However, campaigns should give more emphasis to the range of subtle, negative reporting. They should promote, in conjunction with media volunteers, a wider range of positive stories about recovery, talent and social contribution.

Nature and impact of European anti-stigma depression programmes

Stigma associated with depression is a major public health issue in the EU, with over 20 million people experiencing depression and its associated personal distress each year. While most programmes against stigma related to mental health problems are of a general nature, the knowledge about programmes tackling stigma against people with depression is limited. This study therefore aims to assess the nature and impact of depression-specific programmes in EU countries. Using a web-based tool, 26 programmes were identified across the 18 EU countries taking part in the study. Most were universal and targeted the whole population, while many also targeted specific population groups or settings, such as young people or health professionals. The most common programme aim was improving literacy, although reducing stigmatizing attitudes and discriminatory behaviour and promoting help-seeking were also common. Most programmes originated from professional bodies, or as grassroots initiatives from service user groups/NGOs, rather than as part of national and local policy. The approaches used were primarily different forms of education/information, with some, but very limited, use of positive personal contact. Overall, the quality and extent of impact of the programmes was limited, with few leading to peer-reviewed publications. Specific programmes were identified with evidence of positive impact, and we drew on these examples to develop a framework to be used for future programmes against stigma and discrimination associated with depression. These findings are provided in full in the Anti-Stigma Partnership European Network Toolkit available at www.antistigma.eu.

Participatory action research with asylum seekers and refugees experiencing stigma and discrimination: the experience from Scotland

Using evidence from a participatory action research process with over 100 asylum seekers and refugees in Scotland, this study explores participants’ views on mental health problems, stigma and discrimination. The study found that migration can have adverse effects on mental health and well-being, due to racism and the asylum process, and this is worsened by stigma and discrimination. This stigma is influenced by both social and cultural causal factors, including fear, past trauma, isolation, racism and the stress of the asylum process coupled with negative cultural beliefs about mental health problems. The paper considers the international relevance of this approach and the value of a model grounded in principles of community development and grassroots action.

Promoting recovery and addressing stigma: mental health awareness through community development in a low-income area

One in four Scots will experience mental ill-health at some point in their lives, with increased prevalence in low-income communities. The associated stigma increases the negative impact on an individuals life. This paper outlines the development of a local anti-stigma programme that can be replicated in other areas, and presents key findings from the evaluation. This innovative model, which promotes recovery and addresses stigma, draws on a broad coalition of community support, and enables service users to lead its design and delivery. The paper argues that local initiatives, when complemented by a national programme, can achieve a positive additional impact on attitudes and behaviours; that multiple and flexible approaches are needed for different target groups; that the personal narrative about recovery has a particularly strong impact on participants; and that it may be desirable to tackle stigma in the context of addressing positive mental health. Refinements to the model are discussed.

Beliefs, stigma and discrimination associated with mental health problems in Uganda: Implications for theory and practice

Background: There are major gaps in knowledge about beliefs, stigma and discrimination in Uganda, including the relationship between different cultural beliefs and stigmatising responses, how stigma and beliefs result in discrimination and the impact of social factors such as gender, poverty and ethnic conflict. Aim: This exploratory study aims to understand beliefs, stigma and discrimination associated with mental health in Uganda in more depth from the perspectives of different stakeholders. Methods: Focus groups and interviews were undertaken with mental health activists, policymakers, practitioners, non-governmental and human rights organisations, journalists and academics. Results: Stigma was reported by individuals, families, communities and institutions, including health services. The study also found stigmatising beliefs linked to traditional, religious and medical explanatory frameworks, high levels of ‘associated stigma’, common mental health problems rarely medicalised and discrimination linked to poverty, gender and conflict. Conclusions: The findings suggest the need to address stigma in their cultural and social context, alongside other human rights initiatives.

Workplace interventions can reduce stigma

Stigma and discrimination towards people with mental health problems is a global issue, imposing a considerable public health burden in terms of social isolation, limited life chances, delayed help‐seeking behaviour and stress. While numerous initiatives have been undertaken to address these issues, an evidence base for what works is still emerging. This paper explores the impact of 15 population‐level awareness workshops delivered over a five‐month period to 137 participants. These were employees drawn from workplaces identified as being important in the day‐to‐day lives of people with mental health problems. Evaluation approaches maximised specificity, sensitivity and anonymity and they assessed participant knowledge, attitude and behaviour. The workshops significantly improved participant knowledge. Attitude change was more complex with an overall significant improvement in attitudes, particularly in relation to unpredictability and recovery, but not dangerousness, which had more positive baseline attitudes. Social distance, a proxy for behavioural intent, had significant improvements in relation to ‘moderate’ social contact only. Qualitative feedback indicated that complex, unanticipated and positive messages had been absorbed by participants and influenced beliefs and behavioural intent. Service user narratives focusing on recovery were identified as the most valuable component of the intervention.