Lewis Macleod from includem shares his thoughts on the ALLIANCE Annual Conference session Reducing stigma, emphasising humanity.
*Please be aware this piece will touch on emotive topics such as addiction, suicidal ideation and mental health problems.
Tackling stigma is a central focus of public discussion around mental health. Large-scale awareness campaigns are encouraging people to talk more openly with family, friends, and health professionals alike. Open, empathetic discussion is undoubtedly vital in de-stigmatising mental health issues – but when people talk openly, do they then get the support and care they need? What are the barriers to access? And what are the solutions?
The Friday morning panel discussion at Equally Valued: Equally Connected, the ALLIANCE Annual Conference, considered these challenges with depth and nuance, featuring powerful contributions from Tommy Kelly and Martin Paterson, who shared their experiences of recovery from an eating disorder and gambling addiction respectively. See Me’s Wendy Halliday considered how far along the road Scotland really is on its journey to eliminating mental health stigma, and Shirley Windsor from Public Health Scotland reflected on the role of stigma in relation to suicide.
Wendy observed that while there has been a significant and positive shift in how mental health is framed in the media, this does not translate to an equivalent ‘sea change’ in how mental health is treated and supported. Some who do speak out say they don’t feel heard, that confidentiality isn’t respected, and that they can’t access the personalised services they need to heal.
Indeed, this reflects the experiences of young people and families we support at includem. Young people have told us they face various barriers to accessing care and support – from long waiting times for Child and Adolescent Mental Health Services (CAMHS) to an overly ‘clinical’ approach which does not meet their individual needs.
Shirley notes that those who have attempted suicide don’t always get the compassionate care they need from their GP or at A&E, asserting we must consider what professionals need so that they see patients as a ‘whole person’ – beyond just the issue that they are presenting with. For both Tommy and Martin, reaching out to their GP did not lead to appropriate care in the first instance, with Martin highlighting the need for more pathways to access gambling addiction support.
Considering the significant stigma still attached to men with eating disorders, Tommy reflects on how the secrecy, shame, and guilt that stigma both creates and exacerbates, serves to further fuel the illness itself. Through the lens of gambling addiction, Martin highlights the role of multi-million-pound corporations in perpetuating stigma, with industry giants eschewing responsibility by pushing a narrative of individual blame. Feelings of shame and guilt are also very common for those bereaved by suicide – with many left questioning whether they could have done something to prevent it, or if they had perhaps even contributed.
As the panelists made clear, there is no one single solution to ending stigma – particularly the ‘vicious cycle’ of self-stigma that prevents people accessing support in the first place. But ensuring that services are underpinned by a right-based, compassionate approach and are available and responsive when people do open up is vital.
But in order for services to be available and responsive, we must close the gap between policy ambition and practice reality. To achieve this, there must be increased investment in the workforce, including in education, training, and capacity building.
There was much to reflect upon after this thought-provoking panel discussion on stigma, but at the heart was this core message: awareness must lead to action, and talking openly must lead to treatment for anyone that needs it, when they need it.
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