WHO conference: Combating stigma crucial to mental health progress

The issue of stigma is one of the focuses of the action plan adopted by the conference. The plan refers to the danger of stigma jeopardising mental health policy development.

A panel discussion of policy leaders held during the conference also stressed that the problem of stigma is pervasive enough to undermine mental health work.

Part of the reason, as Marc Danzon the WHO’s Regional Director for Europe pointed out, is the taboo commonly attached to mental health and psychiatry. “Mental health is part of life: everybody can have mental difficulties and everybody can have mental illnesses. But people are often surprised by what happens to them.”

Danzon said that families of people who have mental problems are often unaware of how to deal with the situation. And the fact that it is anyway a taboo compounds the crisis. “Stigma very often starts with the family.”

Danzon said that a second arena where stigma flourishes is the workplace. “What is going on in workplaces that they cannot tolerate differences?” he asked. “The workplace atmosphere increases the difficulties for patients to get over the difficult time they experience.”

Stigma also disrupts the psychiatric sector, said Danzon, as patients postpone seeking treatment through primary healthcare and eventually have to seek specialist care.

Klaus-Theo Schröder, Secretary of State at the German Ministry of Health and Social Security, said that mental illness has always been associated with exclusion and that prejudices are even deep rooted within the medical profession.

“The challenge is to change people’s basic attitudes and allow mental health to proceed within our communities so that it no longer stigmatized.”

Rosie Winterton, Minister of State for Health in the UK said that top priority must be given to reducing the stigma of mental illness and to promoting social inclusion. She pointed out that high unemployment rates among people with mental ill health - 24% in the UK - reflects how stigma is a barrier to work.

“We [in the UK] have an action plan to end stigma and exclusion in mental health. Its main feature is that it involves all government departments and local authorities.”

Boris Kazakovtsev. Chief Psychiatrist at the Russian Ministry of Health spoke of the need in his country for psychiatry to build trust among the population. “We have to involve users in addition to medical personnel. We have to do much more to monitor patient’s rights – something NGOs can help with,” he said.

Gabor Gombos, Advocacy coordinator of the European Network of (ex-)Users and Survivors of Psychiatry, said that stigma, discrimination and exclusion are strongly interrelated.

He stressed that users of mental health services are the best placed to lead anti-stigma work, and reminded delegates of the slogan of the anti-disability movement: Nothing about Us without Us.

He also called into question the root causes of stigma.

“We need anti-stigma campaigns, but until psychiatry stops using inhuman and degrading treatment how can you expect that stigma will disappear? If we cannot end the use of caged beds or end the placing of women naked in cages - as is done in some mental institutions in Europe - we cannot tackle stigma.”