The inaugural National Stigma Report Card has delivered alarming findings of stigma and discrimination experienced by people who live with severe and complex mental health issues, not least that relationships and mental healthcare services are among their top concerns and have led them to withdraw from seeking support.
The report card’s findings and calls for change are outlined in the article below by Dr Michelle Blanchard, Director of the Anne Deveson Research Centre and Deputy CEO of SANE Australia and Dr Christopher Groot, Research Lead of the National Stigma Report Card, from the Melbourne School of Psychological Sciences, University of Melbourne.
Michelle Blanchard and Christopher Groot write:
Australia is often heralded internationally for its forward-thinking approaches to reducing stigma towards people experiencing mental health issues. Indeed, Australia was one of the first countries to establish national efforts to reduce stigma and discrimination towards people affected by anxiety and depression.
However, for Australians who live with more severe and complex mental health issues, stigma and discrimination remain significant concerns.
The National Stigma Report Card is the flagship project of SANE Australia’s Anne Deveson Research Centre and is conducted in partnership with the Melbourne School of Psychological Sciences at the University of Melbourne, with the support of the Paul Ramsay Foundation.
The aim of the project is to gather Australian-first evidence on the experiences of stigma and discrimination for people living with complex mental health issues and to use this to drive positive change.
The first Report Card was published in October 2020 and draws on findings from the first Our Turn to Speak survey. A total of 1,912 participants aged between 18 and 86 living with complex mental health issues completed the survey between October 2019 and April 2020. Participants came from every Australian state and territory and completed the survey either online, in person, or by telephone.
The study was not intended to measure prevalence of stigma and discrimination, but to understand how and to what extent people living with complex mental health issues experience stigma and discrimination. The survey invited people to report experiences of stigma and discrimination across 14 life domains. Participants reported:
- experiences of past stigma and discrimination
- the extent to which they anticipated future stigma and discrimination
- whether they had withdrawn from opportunities for fear of stigma and discrimination
- positive treatment in connection with their experience of complex mental health issues.
They also shared whether they had also faced stigma or discrimination on the basis of other characteristics like: race, physical ability, body weight, sexuality or gender.
What did the survey find?
The findings from the Our Turn to Speak survey are presented in complete form in the full report and in abbreviated form in the summary report. Visitors to the National Stigma Report Card website can also explore the findings using the data explorer.
Relationships and mental healthcare services were among participants’ top concerns, with more than three-quarters of the sample reporting experiences of stigma and discrimination in these areas in the preceding 12 months.
Participants’ primary concern was stigma and discrimination in relationships. In total, 95.6 per cent indicated that they had experienced some level of stigma or discrimination in interpersonal relationships in the preceding 12 months.
Participants commonly spoke of anticipation of future experiences of stigma and discrimination, and withdrawal from opportunities to commence or maintain relationships.
Connection and social support play an important role in all our lives. These findings are of critical importance, especially given that we know that engagement in supportive relationships is a key factor in recovery and relapse-prevention for people living with complex mental health issues.
Withdrew from seeking support
Mental healthcare services have long been associated with the concept of asylum – a protective environment that is thought to support recovery. From this perspective, community or hospital-based mental health services are the very last place in which we should expect to see stigma and discrimination. However, the Our Turn to Speak findings present us with a contradicting and uncomfortable truth.
When asked, 81.6% of participants agreed that they had been treated unfairly when trying to get help for their mental health in previous 12 months. High levels of concern were reported regarding experiences with mental healthcare professionals, coercive treatment and being excluded from making decisions about care and treatment planning.
Many participants reported that they expected to be stigmatised or treated unfairly when seeking help.
A large number of participants indicated that they had withdrawn from seeking help for their mental health because of stigma. Of note, 81.5 per cent of responding participants indicated that they had stopped themselves from accessing emergency mental healthcare because of stigma. This is of particular concern given that people living with complex mental health issues are at elevated risk of dying by suicide when compared with the general population.
These findings echo those of the Royal Commission into the Victorian Mental Health System and suggest that many Australians who live with complex mental health face impactful stigma and discrimination when accessing mental healthcare services.
What needs to change?
Eliminating stigma and discrimination towards people living with complex mental health issues requires a coordinated effort from all tiers of government, multiple sectors, as well as the support of the Australian community.
We think that our leaders need to act to eliminate stigma and discrimination in Australia about complex mental health issues by:
- Developing and resourcing a comprehensive 10-year national program of work to reduce stigma and discrimination associated with complex mental health issues.
- Providing coordinated inter-jurisdictional governance and oversight by the National Mental Health Commission for implementation of this program of work, with the National Mental Health Commission responsible for coordinating implementation.
- Ensuring people with lived experience of complex mental health issues play a central role in training, service planning and ongoing oversight for health and social services.
Our detailed and targeted suggestions to support positive change are provided in the National Stigma Report Card recommendations for action.
Dr Michelle Blanchard is Director, Anne Deveson Research Centre, Deputy CEO, SANE Australia and Honorary Senior Fellow, Melbourne School of Psychological Sciences, University of Melbourne
Dr Christopher Groot is Research Lead – National Stigma Report Card, Director, Mental Illness Stigma Lab, Brain and Mental Health Hub, Melbourne School of Psychological Sciences, University of Melbourne.