{"id":222,"date":"2013-05-31T15:35:00","date_gmt":"2013-05-31T14:35:00","guid":{"rendered":"https:\/\/blogs.canterbury.ac.uk\/discursive\/2013\/05\/31\/when-the-ads-dont-work\/"},"modified":"2015-11-11T13:09:46","modified_gmt":"2015-11-11T13:09:46","slug":"when-the-ads-dont-work","status":"publish","type":"post","link":"https:\/\/blogs.canterbury.ac.uk\/discursive\/when-the-ads-dont-work\/","title":{"rendered":"When the Ads Don\u2019t Work"},"content":{"rendered":"

It\u2019s a sobering thought that, for many people who use mental health services, other people\u2019s reactions cause more distress than their original problems.\u00a0\u00a0 And attitudes may even be getting worse.\u00a0 A recent report from the Department of Health found that whereas in 1997, 92% of people questioned agreed that \u2018we need to adopt a more tolerant attitude towards people with mental illness\u2019, <\/i>in 2011 only 86% thought that we need to be more tolerant.\u00a0\u00a0 Worryingly, young people appeared to be the most prejudiced<\/a>.<\/p>\n

Relatively static attitudes to mental health stand in contrast to the changes there have been in attitudes about ethnicity and sexuality (we currently have a conservative Prime Minister advocating same-sex marriage).\u00a0 It\u2019s even more surprising given the effort that has gone into anti-stigma campaigns. \u00a0For example you may have seen the recent tube posters or TV ads from the government sponsored Time to Change<\/a><\/i> campaign.\u00a0\u00a0 So what\u2019s the problem?\u00a0 Perhaps part of the answer is what campaign ads actually say. Or what they don\u2019t.<\/p>\n

Traditionally, public education campaigns about mental health have aimed to reduce stigma.\u00a0 The assumption is that stigma is caused by people not recognising that mental health problems are \u2018illnesses like any other\u2019<\/a>. For Time to Change,<\/i> as our colleague John McGowan recently noted<\/a>, they are \u2018as real as a broken arm\u2019. A key assumption here is that unless distress is seen as part of an illness, people will blame sufferers for their own problems. Much better then to be genuinely sick.<\/p>\n

We\u2019re not sure about these underlying assumptions.\u00a0 Firstly, the very idea of stigma is problematic in that it individualises and medicalises what may be an issue of prejudice.\u00a0 We don\u2019t talk about the stigma of being a woman, or of being black; we talk, quite rightly, about sexism and racism.<\/p>\n

What about the idea that discriminatory attitudes are based on ignorance?\u00a0\u00a0 Many anti-stigma campaigns have aimed to increase so-called \u2018mental health literacy<\/a>\u2019\u2013 i.e. education about different mental illnesses.\u00a0Notable examples of this approach have included Every Family in the Land<\/i><\/a> and Defeat Depression<\/i><\/a>, both led by the Royal College of Psychiatrists. Considerable amounts of money have been invested into such campaigns. However, even their advocates<\/a> have been forced to admit that there has been little effect.\u00a0 If anything, things have got worse.\u00a0 We think that the reason for this lies in the third assumption. Reviewing the evidence, John Read and colleagues<\/a> found that viewing emotional distress as \u2018an illness like any other\u2019 actually increases prejudice and discrimination<\/a>.\u00a0For example, in one study<\/a> based on Stanley Milgram\u2019s famous electric shock obedience experiments, participants who were told that someone had a mental illness opted to give them more electric shocks than if the person\u2019s problems were described in more everyday language*.<\/p>\n

*The study\u2019s authors suggest that presenting problems as an \u2018illness\u2019 has the effect of making them seem mysterious and unpredictable, the people experiencing the problems as \u2018almost another species\u2019.<\/p>\n

So if the traditional approach isn\u2019t working, what\u2019s the alternative?\u00a0 In recent years two related approaches have gained ground.\u00a0 The first draws on an idea from the wider disability movement, namely the \u2018social model\u2019 of disability. This proposes that, rather than the problem for people with physical disabilities being the actual impairment, most difficulties lie in the way society organises itself. The classic example is putting stairs everywhere.\u00a0 While this model has its limits, these kinds of ideas were influential in the 1995 Disability Discrimination Act, and led to widespread changes, at least in our buildings.\u00a0 Within the mental health field commentators like Liz Sayce<\/a>have been influential in applying this model.\u00a0 Mad Pride<\/a>is a colourful example of an approach that says it\u2019s Society\u2019s role to change.\u00a0 This is not simply a romantic notion that we can wish distress away by challenging discrimination.\u00a0 While some people experiencing unusual and exceptional experiences want to be liberated, others may find the experiences distressing and seek some form of help.\u00a0 What both groups agree on is that discrimination is a major problem.<\/p>\n

The second approach is what you might call the psychosocial one.\u00a0 There is increasing evidence that even the most severe mental health problems are not the result simply of faulty genes or brain chemicals. They may also be a natural and normal response to the terrible things that can happen<\/a> to us.\u00a0 As our colleagues John Read and Nick Haslam have put it \u2018bad things happen and can drive your crazy\u2019<\/a>.\u00a0 To many people this is just common sense<\/a>.\u00a0Unlike the illness approach, it makes people\u2019s experiences seem more understandable, enabling people to empathise more.\u00a0<\/span><\/p>\n

So we have at least two alternatives to the \u2018illness like any other\u2019 approach:\u00a0 a focus on ending societal discrimination against people with mental health problems; and viewing distress as a response to negative life experiences.\u00a0 Although Time to Change<\/i> does not promote a medicalised approach we think it has missed an opportunity to challenge not only our attitudes but something much more fundamental: whether there are people who are \u2018normal\u2019 and people who are \u2018mentally ill\u2019 , or whether we\u2019re all in this together.<\/p>\n

For those unfamiliar with Milgram\u2019s experiment the \u2018shocks\u2019 were fake. Those asked to administer them were not made aware of this until after the experiment had concluded.<\/p>\n

About the Authors<\/h3>\n

Anne Cooke<\/a> is a Principal Lecturer at Salomons Centre for\u00a0Applied Psychology, Canterbury Christ Church University: anne.cooke@canterbury.ac.uk<\/a><\/p>\n

Dave Harper<\/a> is a Reader in Clinical Psychology, University of East London:\u00a0d.harper@uel.ac.uk<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s a sobering thought that, for many people who use mental health services, other people\u2019s reactions cause more distress than their original problems.\u00a0\u00a0 And attitudes may even be getting worse.\u00a0 […]<\/p>\n","protected":false},"author":3870,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[657],"tags":[26,554,82,78,198,30,186,194],"class_list":["post-222","post","type-post","status-publish","format-standard","hentry","category-comment","tag-anne-cooke-author","tag-dave-harper-author","tag-dsm","tag-medicalisation-of-everyday-life","tag-mental-health-campaigns","tag-psychiatric-diagnosis","tag-stigma","tag-time-to-change"],"acf":[],"aioseo_notices":[],"authorName":"Anne Cooke","featuredImage":false,"postExcerpt":"It\u2019s a sobering thought that, for many people who use mental health services, other people\u2019s reactions cause more distress than their original problems.\u00a0\u00a0 And attitudes may even be getting worse.\u00a0 […]","_links":{"self":[{"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/posts\/222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/users\/3870"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/comments?post=222"}],"version-history":[{"count":0,"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/posts\/222\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/media?parent=222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/categories?post=222"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/discursive\/wp-json\/wp\/v2\/tags?post=222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}