One of the most pervasive barriers to achieving good mental health for all is the ongoing stigma and discrimination directed at experience, or perceived experience of mental ill health or suicide.

SDC generaly defines stigma and discrimination in relation to mental ill health in the following way:

stigma is understood as ‘any attribute, trait or disorder that marks an individual as being unacceptably different from the “normal” people with whom he or she routinely interacts, and that elicits some form of community sanction’ (Gilman; Goffman; both as cited in Thornicroft, 2006) (Goffman, 1963;  Scrambler, 1998 in Thornicroft, 2006); in this case, the 'trait' is the experience (or presumed experience) of mental illness or mental health problems.
 
Discrimination implies any distinction, exclusion, restriction or preference based on this trait (or presumed trait) ‘which has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise by all persons, on an equal footing, of all rights and freedoms’ (UN Human Rights Committee, General comment 18(37)).

The direct consequences of stigma and discrimination to individuals and communities can encourage isolation and social exclusion, discouraging people from seeking help for them or their family, and inhibiting recovery and everyday life activities, such as employment, education or interpersonal realtionships.

Progressive or re-inforced experiences of stigma or discrimination can contribute to the erosion of a person’s self esteem, to the extent that the fear or expectation can be as damaging as direct experience of stigmatising or discriminatory behaviour. This ‘self-stigma’ is a powerful barrier in many people’s recovery from mental ill health. Where a person has experienced mental ill health over an extended period, they may have lost skills, social networks and confidence. Re-building these is key to recovery of good mental health, and stigma is a barrier to achieving this.

Stigma and discrimination can have negative consequences for population mental health, and can affect initiatives to increase baseline positive mental health and prevent mental ill health.  The use of mental health related terms in a derogatory or perjorative sense in the media can for example, deter people from seeking help or advice at a time when early intervention can prevent substantial ill health. Similarly, efforts to increase the discussion of feelings and emotions in setting such as schools, workplaces or the family can be inhibited by attitudes that might discourage disclosure for fear of negative consequences.

SDC is committed to addressing stigma and discrimination in mental health, as a key component of our activities to address inequalities in relation to mental ill health, and as part of our mental health improvement work.

examples of SDC projects

Evaluation of 'see me…' the Scottish campaign against the stigma and discrimination associated with mental ill-health

In association with partners from the Institute of Psychiatry, King's College London and the voluntary organisation Rethink, SDC is currently undertaking a Scottish Executive funded evaluation of the 'see me...' anti-stigma campaign. This 15 month-evaluation aims to assess the impact of the campaign since it was launched in 2002, as well as to develop recommendations for on-going anti-stigma and discrimination work. The final report of the evaluation will be submitted to the Scottish Executive in November 2007.

WHO anti-stigma toolkit

With a similar coalition to the 'see me....' evaluation, SDC are delivering an anti-stigma toolkit for the WHO Collaborating Centre on stigma, which is hosted by Health Scotland.