We have launched a pilot project in partnership with the 2gether NHS Foundation Trust and the Northumberland, Tyne and Wear NHS Foundation Trust (NTW), and people with experience of mental health problems, to look at what can be done to tackle stigma and discrimination reported within mental health services.
Working with the Trusts, we will focus on bringing together professionals and people who have used mental health services to facilitate an open dialogue about changes that could make a big difference to both people’s experience of mental health services and the experiences of staff. The sessions will highlight positive examples of where mental health staff have challenged stigma and discrimination with the aim of empowering others to do the same.
Evaluation at the beginning and end of the pilot will measure improvements in staff attitudes and behaviour.
The pilot builds on previous work of both Trusts and adopts some of the principles of a dialogue model used in our 300 Voices pilot in Birmingham. We commissioned a scoping study and roundtable in 2014, which brought together 45 experts from different parts of the mental health sector, and wider health and social care sectors, to consider what role staff could have in tackling stigma and discrimination. Through this work we aimed to understand the complex nature of the discrimination reported by people using mental health services.
Qualitative analysis by the Institute of Psychiatry, Psychology & Neuroscience and the McPin Foundation was also undertaken. Researchers looked at information given by 50 respondents to an earlier annual survey, which asks people who have used secondary mental health services in England about the areas of life where they face discrimination. Analysis showed that people defined discrimination when using mental health services in different ways. Some were examples of staff attitudes and behaviour, some related to access issues and some were about the design of services (i.e. the lack of a recovery focus).
These pilot projects are being informed by the previous scoping study, and each Trust Chief Executive is providing senior leadership on the issue. At the same time as rolling out the dialogue workshops, there will also be additional communications activity linked to a new campaign that is currently being researched and developed in partnership with NHS England.
Sue Baker, Director of Time to Change, said: “Data since 2008 on attitudes and discrimination have shown us that there have been significant improvements in public attitudes and people using mental health services have reported reduced levels of discrimination from their family, friends, neighbours, dating and social life.
“What has remained almost static was the level of discrimination reported in mental health services and other parts of the NHS. We’ve been researching this area, and are now launching two pilots very much in equal partnership with two Trusts and people who have used their services. We know it is important to create a non-judgemental space for open dialogue, where positive examples of staff tackling stigma can be shared as well as an acknowledgement of the many pressures staff face. We also want to see if staff feel more able to talk about their own mental health. Our aim is to bring benefit to people using services as well as staff, and tackle stigma collaboratively with strong leadership to support change. We are delighted to be working with staff at NTW and 2gether on these pilots.”
Shaun Clee, Chief Executive of 2gether NHS Foundation Trust, which provides services in Gloucestershire and Herefordshire, said: “At 2gether we have been committed to tackling mental health stigma for some time. The Time to Change initiative offers us further opportunity to reach our aspiration of providing the best service experience for people who use mental health services. As such, we have pledged to lead a series of forums this year, working with our teams to consider the ways we currently impact – either positively or negatively - upon the stigma felt by people who use mental health services.
“The sessions will be attended by staff at all levels of our organisation, and from a wide range of teams and services in Gloucestershire and Herefordshire. We will deliver the work alongside people with lived experience of our service, who will be invited to openly share their own experiences of interacting with 2gether staff. Part of the work will be to consider ways in which practice can be enhanced to reduce mental health stigma. To do this, all participants will be invited to share their personal pledge to tackle mental stigma through and in their health care professional practice.”
John Lawlor, Chief Executive of NTW, said: “At NTW we are embracing the opportunity to work with Time to Change to tackle the difficult issue of stigma. Our service users tell us that they experience discrimination, and it’s difficult to hear them say that they encounter stigma in mental health services too. We want to work with local people to understand what it is about mental health services that needs to change, to open up some challenging conversations and evaluate what makes a difference. Our peer support workers are crucial to this and we hugely value their expertise.”
Lisa Rodrigues CBE, voluntary chair of the project working group, said: “Stigma towards those who need mental health support manifests itself in many ways. In particular, the CQC recently highlighted lack of empathy towards those who self-harm or are otherwise in crisis, and low expectations from clinicians about prospects for people who experience serious mental illness.
“But I have high hopes. There is absolute acceptance amongst those involved in this project, and many other mental health professionals, that things need to change. And that instead of simply asking people who work in mental health to be more compassionate, that the change needs to start at the most senior level.”
 300 Voices pilot works with Young African and Caribbean men, the local mental health trust and police service to improve experiences when accessing mental health care.