Experience of the Time to Change programme in England as predictor of mental health service users' stigma coping strategies

Abstract

Aims. In the field of stigma research, an area of interest is the coping strategies that mental health service users can use in response to discriminatory experiences. As a part of the evaluation of the Time to Change (TTC) anti-stigma programme, the Viewpoint telephone survey was run annually in order to assess service users' reported levels of discrimination and selected coping strategies. The study aim is to test the extent to which experience of TTC programme is a positive predictor of selected coping strategies.Methods. Telephone interview surveys carried out by peer interviewers were conducted annually. 'Educating others' and 'challenging' coping strategies were assessed alongside anticipated and experienced discrimination.Results. During 2011-2014, 3903 mental health service users were interviewed. Participants more often adopted the 'educating others' strategy (2.31 ± 0.01) than the 'challenging' strategy (2.15 ± 0.02) ( p < 0.001). On the other hand, those who participated in campaign activities endorsed 'challenging' more frequently than people who were not aware of TTC (2.78 ± 1.23 v. 2.09 ± 1.08, p < 0.001). According to the multi-variate linear regression model, we found that being actively involved in TTC activities (OR = 0.74, CI: 0.29-1.19; p < 0.05), having a diagnosis of a depressive disorder (OR = 0.20, CI: 0.04-0.36; p < 0.05) or personality disorder (OR = 0.23, CI: 0.04-0.43; p < 0.05) were good predictors of endorsing a 'challenging' strategy even after adjusted for confounding variables. Conclusions.A positive relationship between participating in the TTC programme and using the 'challenging' strategy was found. There is still a need to disentangle the complex association between these two coping strategies and the role of anti-stigma campaigns, promoting further local activities led by service users and carers' as well as all others stakeholders' associations.

Mental health service users’ responses to anticipated discrimination and the Time to Change program in England

“…In particular, Abiri et al [32] reported that people with greater insight of the mental health stigma could find it more difficult to limit their impact. It could be that anti-stigma programmes are useful tool for improving positive coping strategies such as challenging and educating others [27], whereas the reduction of the levels of self-stigma might require more specialized psychosocial interventions [32][33][34][35][36][37][38].…”

“…The overall consequence of discrimination is the reduction in achieving personal recovery, through the achievement of personal life goals, such as having a satisfying job or a supportive relationship [16][17][18][19][20][21]. As part of the programme evaluation, a series of telephone interviews, called the Viewpoint Survey, was conducted annually between 2008 and 2014, with the primary objective of measuring discrimination experienced by service users [6,24,27]. Consistent with the improvements in stigma related knowledge, attitudes and intended behaviour observed among the general public since 2009, these surveys showed an overall fall in the 4 experience of discrimination between 2008-14 and that fewer respondents stopped themselves from starting a relationship in 2014 compared to 2013 [6], however there was no clear pattern of change in terms of this or other responses to anticipated discrimination [28].…”

“…Mental health service users aware of TTC reported higher levels of confident behaviours, such as challenging and educating others [27], raising the question of whether awareness of TTC, for example having seen social marketing campaign material, or participation in TTC activities may affect responses to anticipated discrimination. If those aware of TTC are more willing to educate or challenge others, they may also be less likely to avoid doing things that are likely to involve disclosure of their mental health problem to others, and less likely to conceal their mental health problem in general; if so this is also likely to apply to those who have taken part in activities run by TTC.…”

“…As part of the program evaluation, a series of telephone interviews, called the Viewpoint Survey, was conducted annually between 2008 and 2014, with the primary objective of measuring discrimination experienced by service users [6,24,27]. Consistent with the improvements in stigma-related knowledge, attitudes and intended behavior observed among the general public since 2009, these surveys showed an overall fall in the experience of discrimination between 2008 and 2014 and that fewer respondents stopped themselves from starting a relationship in 2014 compared to 2013 [6].…”

Estrategias para la reducción del estigma hacia la salud mental en el contexto escolar:estudio preliminar y pilotaje del programa Lo Hablamos

“…La reducción del estigma se ha configurado como un objetivo relevante dentro de las políticas sanitarias de salud mental y se han planteado intervenciones específicas para actuar sobre el mismo. De manera general encontramos tres tipos de programas: por un lado, los que están diseñados como estrategias globales con varios contextos de actuación y mayor alcance poblacional como por ejemplo "Beyonblue" en Australia; (Corrigan, Powell y Al-Khouja, 2015) ,"Time to Change" en Reino Unido (González-Sanguino, Potts, Milenova, y Henderson, 2019;Sampogna et al, 2017) o "Opening Minds" en Canadá (Stuart et al, 2014;Szeto, Dobson, Luong, Krupa y Kirsh, 2019); por otro, los destinados a grupos específicos (adolescentes, estudiantes universitarios, profesionales de la salud, empleadores etc.) (Deb et al, 2019;Harris et al, 2019;Heim et al, 2019;Sugumar, Fleming y Ogden, 2019) y finalmente los programas individualizados para disminuir el autoestigma (Setti et al, 2019;Yanos, Lucksted, Drapalski, Roe y Lysaker, 2015).…”