Harnessing the power to tackle stigma in healthcare

Heidi Tweedie, Jane Miller and Dr Patty Lozano-Casal reflect on the need to end mental health stigma and discrimination in healthcare.

Heidi Tweedie, Social Movement & Enterprise Lead at Moray Wellbeing Hub

We all have a right to health; however, stigma and discrimination is still a significant issue in our healthcare services in Scotland today and, in particular, mental health is still not held at an equal resource or strategic focus as physical health. See Me, the national programme to end mental health stigma and discrimination, published in 2022 the Scottish mental illness stigma study which revealed healthcare to be an area where those with severe and complex and/or enduring mental illness experience significant stigma and discrimination.

In my role, as social movement lead at Moray Wellbeing Hub, I am aware that whilst this challenge is yet to be solved, there is certainly more awareness and intentionality around the issue. In parallel, progress is being made in drug and alcohol recovery through the likes of the MAT standards demanding equal rights of access to mental health services for individuals, as well as the national development of a charter of rights.[i] Across of a variety of services we are seeing colleagues in health and social care keen to embed meaningful collective voice from those accessing services.

From the individual perspective we require knowledge and resources to empower us to know our rights and push for the realisation of these at every level of healthcare. This is why in 2022, with support from national partners See Me, we embarked on the creation of an accessible resource that draws from Moray Wellbeing Hub’s learning of what helps harness the power of lived experience to tackle mental health stigma and discrimination in healthcare. This digital resource we launched as part of Self Management week 2024 this September in partnership with ALLIANCE Scotland.

The ambition of this resource is to enable you as a person who accesses healthcare services, or who supports someone to do this, to tackle mental health stigma and discrimination at any level you feel will be most impactful on your wellbeing.[ii] Feeling compelled to take action is the very first step toward individually creating change but many of us feel confused around how healthcare is organised or concerned action will exhaust our personal resources, potentially making the situation worse.  In three sections the resource sets out foundational information around mental health, stigma and rights to access services, as well as a six-step action planning approach and top tips to increase your wellbeing through CHIME (connection, Hope, Identity, Meaning and Empowerment). The ambition is that the information collated from trusted sources rooted in lived experience is presented in a format that can be dipped into for a specific need as well as used as a step-by-step process, perhaps with a supporter or through group-based training.

Hosting the resource on See Me’s website enables the resource to have greater accessibility, reach and relevance. This includes relevant multimedia examples where champions from Moray Wellbeing Hub have provided their experience as quotes, videos and audio recordings.

In creating this resource as an activist and passionate supporter of social movements, my hope is that those who access this feel seen and guided. It takes a lot to make that first step in creating change around stigma and discrimination, but once you make the decision to act this resource could help in your planning and all-important connection to others, be that advocacy services, a local peer support group, through Care Opinion or national collective voice such as See Me – it is that connection that strengthens and amplifies individual voices.

It is undeniable that our healthcare system in Scotland is complex and should meet the needs of everyone living in Scotland; there is much work that citizens both as users and providers of the services within this need to do to ensure it is fit for purpose now and for the future. I am hopeful that this resource contributes to constructive action that we as individuals can take along this journey whilst also improving our own mental health by doing so in a way that provides hope, connection meaning.

Jane Miller, Programme Manager at the ALLIANCE

I was delighted to join Moray Wellbeing Hub and See Me as part of the launch of a new resource to tackle stigma during Self Management Week 2024. Last year, my team at the ALLIANCE Health and Social Care Academy undertook research which looked at ‘Investigating knowledge and understanding of the right to health’. Through this research, we discovered that there is a lack of understanding about the right to health and the process for making a complaint when rights have been breached. Additionally, the research found that stigma and discrimination can further restrict people’s ability to claim their right to health. One of the recommendations highlighted the role that the third sector can play in working with the community as experts to support the design and dissemination of accessible resources on the right to health. This resource has been coproduced with people with lived and living experience. It empowers everyone to see themselves as leaders in their own healthcare journey and as changemakers in the wider system. The resource is underpinned by a trauma informed approach and recognises the impact that influencing can have on wellbeing. One of the steps looks at ‘Influencing’ and acknowledges the power that your own personal testimony and the testimonies of others can have on influencing change. The resource also aligns with our Five Ambitions for the Future of Health and Care which calls for a rights-based approach to healthcare where power is shared.[iii]  I believe that supporting everyone to understand and claim their rights is central to the development of a human rights culture. The journey to change can feel long but together we can take the first steps towards a society free from stigma and discrimination where people enjoy their rights.

Dr Patty Lozano-Casal, Programme Manager (Settings) at See Me

See Me provides a national platform for anti-stigma and discrimination champions like Moray Wellbeing Hub to promote their work and learning, so that others wanting to take action can adapt and adopt existing universal approaches, tools and resources to their local needs, and connect with others across Scotland on their own journey and learning. As the lead for See Me’s programmatic work to address the pervasive structural stigma and institutionalised discrimination that people with lived/living experience of mental health problems or illness face, I feel this resource provides information, advice and guidance that individuals and collectives can use to take action in a way that works for them, and, more importantly, when they feel well and safe to do so. It’s my hope and that of our programme that this guidance, together with other existing helpful resources out there, supports people with lived experience to harness the power of their voice and help them find ways to share their experiences and influence the systems, processes and cultures within healthcare so that others don’t have to have the same negative experiences and, instead, receive time, space and compassion no matter what, making their access and experience of care, support and/or treatment a more inclusive experience. To those individuals accessing the resource I’d like to remind them: it is because of people like you that we will end mental health stigma and discrimination in Scotland – join the See Us movement!

[i] https://www.alliance-scotland.org.uk/lived-experience/engagement/national-collaborative/charter-of-rights-for-people-affected-by-substance-use/

[ii] https://www.seemescotland.org/health-social-care/guidance-for-people-wanting-to-influence-healthcare-settings-they-use

[iii] https://www.alliance-scotland.org.uk/health-and-social-care-integration/health-and-social-care-academy/five-ambitions-for-the-future-of-health-and-care/

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