Ronaldson Amy, Henderson Claire
Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
BJPsych Open. 2024 Nov 6;10(6):e199. doi: 10.1192/bjo.2024.801.
Between 2008 and 2019, we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign.
Using data from the Attitudes to Mental Illness survey (2008/2009 to 2023), we investigated the extent to which positive changes in stigma were sustained by 2023, 2 years after the programme's end in 2021.
We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes toward workplace discrimination, using data from the British Social Attitudes Survey for comparison.
CAMI scores improved between 2008 and 2023 (s.d. 0.24, 95% CI 0.16-0.31), but decreased since 2019 ( = 0.015). After improvements between 2009 and 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases in stigma-related knowledge (MAKS scores declined 7.8%; < 0.001) and willingness to interact (RIBS scores declined by 10.2%; < 0.001) since 2019. Conversely, comparison with British Social Attitudes Survey data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved.
The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the COVID-19 pandemic and economic stress.
2008年至2019年期间,我们报告了英格兰成年人群体在心理健康污名化和歧视方面的积极变化,这支持了“改变时刻”运动的有效性。
利用对精神疾病态度调查(2008/2009年至2023年)的数据,我们调查了到2023年,即该项目于2021年结束两年后,污名化方面的积极变化在多大程度上得以持续。
我们使用回归分析来评估结果趋势。测量指标包括与污名相关的知识(心理健康知识量表(MAKS))、态度(社区对精神疾病患者的态度量表(CAMI))以及社交距离意愿(报告和预期行为量表(RIBS))。我们还根据抑郁症和精神分裂症的案例研究,研究了与他人互动的意愿,并使用英国社会态度调查的数据来比较对职场歧视的态度。
2008年至2023年期间,CAMI得分有所提高(标准差0.24,95%置信区间0.16 - 0.31),但自2019年以来有所下降(P = 0.015)。在2009年至2019年有所改善之后,2023年的MAKS和RIBS得分与2009年得分没有差异,这表明自2019年以来,与污名相关的知识(MAKS得分下降了7.8%;P < 0.001)和互动意愿(RIBS得分下降了10.2%;P < 0.001)有所下降。相反,与英国社会态度调查数据的比较表明,2007年、2015年至2023年期间,与抑郁症和精神分裂症患者互动的意愿逐渐增加,对职场歧视的态度也有所改善。
持久的积极变化反映了对非歧视的支持以及在唤起熟悉感后与他人互动的意愿。除了“改变时刻”运动的结束,其他结果下降的原因包括新冠疫情和经济压力。