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“It can happen to anyone” A world free of stigma and discrimination Dr. Katie Pybus University of York. What is stigma?. How does it affect people with mental illness?. The rise of anti-stigma campaigns. Transition from hospital based care to the community A focus on recovery not cure
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“It can happen to anyone” A world free of stigma and discrimination Dr. Katie Pybus University of York
What is stigma? How does it affect people with mental illness?
The rise of anti-stigma campaigns Transition from hospital based care to the community A focus on recovery not cure Housing, education, employment, social integration An end to stigma and discrimination
See Me Time to Change Rethink Mental Illness Heads Together ...and many more
We talk more about mental health but…. Mental illness remains strongly associated with socioeconomic disadvantage1 Consequences of recession (labour market and attitudes)2,3 Over-representation in benefit sanctions and food bank use4,5
Social Security Claimants with mental health conditions are more likely to be perceived as fraudulent by the public6 Claimants with mental illnesses feel disadvantaged by their health condition during eligibility assessment processes7
“I feel like my benefits have been cut because they don’t believe it’s a good enough reason, what I believe is that I’ve got to be in a wheelchair in their eyes” “If your bed was on fire, you’d soon move” “It’s still back to that, I haven’t got a broken arm or leg...so because they can’t actually see it, it’s not stamped on my head, you know, I’m the one that’s wrong.” “I failed..you know, well of course, I can get up in the morning, I can feed myself”
Odds ratios for claims disallowed following an eligibility assessment during reassessment from DLA to PIP for psychiatric conditions compared to non-psychiatric conditions.8 ‘Musculoskeletal conditions’ includes Arthritis, Back Pain, Diseases of Muscles, Bones and Joints, Spondylosis, ‘Neurological conditions’ includes Epilepsy and Multiple Sclerosis CI, confidence intervals, *<0.05, **<0.01, ***<0.001
The socioeconomic context of stigma Data from 27 European countries Key factors: income inequality, the disability poverty and social exclusion gap and individual financial difficulties The economic context can create more or less inclusive environments for people with mental health conditions
“Stigmatization is entirely contingent on access to social, economicand political power that allows the identification of differentness, the construction of stereotypes, the separation of labelled persons into distinct categories, and the full execution of disapproval, rejection, exclusion and discrimination.” Link and Phelan (2001)9
Layers of stigma Everyday interactions Life chances Societal structures and systems
Achieving parity of esteem Need to change the debate . . . stigma is also about disadvantage How do we design systems to best support people with mental health conditions? How do we ensure our policies don’t promote stigma? Funding commitments, equality impact assessments
Thank you and any questions? katie.pybus@york.ac.uk @kjpybus
References 1.Marmot, M. G. (2010). Fair Society, Healthy Lives [electronic resource]: The Marmot Review. 2.Evans-Lacko, S., Knapp, M., McCrone, P., Thornicroft, G. and Mojtabai, R. (2013). The Mental Health Consequences of the Recession: Economic Hardship and Employment of People with Mental Health Problems in 27 European Countries. PLoS One, 8(7), e69792. 3.Bianchi, E. C., Hall, E. V. and Lee, S. (2018). Re-examining the Link Between Economic Downturns and Racial Antipathy: Evidence That Prejudice Against Blacks Rises During Recessions. Psychological Science, 29(10), 1584-1597. 4.Loopstra, R. and Lalor, D. (2017). Financial insecurity, food insecurity, and disability: the profile of people receiving emergency food assistance from The Trussell Trust Foodbank Network in Britain. https://www.trusselltrust.org/wpcontent/uploads/sites/2/2017/07/OU_Report_final_01_08_online2.pdf 5.Joint Public Issues Team (2015). Rethink Sanctions. [online]. Available at: http://www.jointpublicissues.org.uk/resources/rethinksanctions/. Accessed 25/04/17 6.Briant, E., Watson, N. and Philo, G. (2013). Reporting Disability in the Age of Austerity: The Changing Face of Media Representation of Disability and Disabled People in the United Kingdom and the Creation of New Folk Devils;. Disability&Society, 28(6), 874-889. 7.Shefer, G., Henderson, C., Frost-Gaskin, M. and Pacitti, R. (2016). Only Making Things Worse: A Qualitative Study of the Impact of Wrongly Removing Disability Benefits from People with Mental Illness. Community Mental Health Journal, 52(7), 834-841. 8.Pybus, K., Pickett, K.E., Prady, S.L., Lloyd, C. and Wilkinson, R. (2019). Discrediting experiences: Outcomes of eligibility assessments for claimants with psychiatric compared to non-psychiatric conditions transferring to Personal Independence Payment in England. British Journal of Psychiatry Open. 5(2). 9.Link, B. and Phelan, J. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385.