Mental health – Celebrities, challenging stigma and the ‘then what?’ moment

Mark Brown has been wondering about where the ‘battle against mental health stigma is now’ and where it might be going next

iA photograph of Stephen Fry, who I am not as funny as

A photo of someone I'm not as funny as

We talk about stigma a lot when talking about mental health difficulty, or at least some of us do.  A stigma is, strictly speaking, a physical mark of disgrace.  It’s something inflicted on a person’s body by a society that is understood by that society both as a punishment and a warning.  The thing is, mental health difficulty is something that happens in your head.

Erving Goffman described stigma as “The phenomenon whereby an individual with an attribute is deeply discredited by his/her society is rejected as a result of the attribute. Stigma is a process by which the reaction of others spoils normal identity.”

So what is it we’re stigmatising? What is it we’re spoiling? I think there’s two possible things we’re stigmatising: the behaviour of an individual and the way in which their condition affects their life. In having a mental health difficulty there is the direct consequence of what you experience and then, following from that, there is the effect this has on you, your life and the lives of those around you.

Anti stigma: Inspiration or corrective?

At present we’re at the beginning of a concerted effort to attempt to reduce stigmatising behaviour towards people with mental health difficulties.  National multi-year campaign Time to Change is both creating the impetus of this wave and riding it by funding grassroots anti-stigma activities, promoting positive media images and trying to drive up ‘social contact between people with mental health difficulties and people who do not.

Anti-stigma work in mental health, including Time to Change, has recently focused much on inspirational stories and role models or positive examples of people with mental health difficulties doing things.  The logic is that bad implications of mental health difficulty can be refuted by providing a positive image in opposition.  Early attempts at this kind of action tended to rather clumsy: ‘You think people with mental health difficulties are lazy? This man built the world’s largest shed!’

It’s often hard to tell whether an individual story is meant to be inspirational to people who already experience mental health difficulties or to mainly act as an answer to an existing stereotype about people with mental health difficulties.  Sometimes it feels that campaigns try to kill two birds with one stone, such as in the recruitment or publicity of celebrities who experience mental health difficulty.

It’s easy to fall back upon the inspirational story as the main way in which to tackle poor attitudes towards people with mental health difficulties.  The problem with the inspirational story, or indeed the celebrity story, is that it individualises mental health difficulty and, while seeming to appeal for greater acceptance, can inadvertently compound the idea that mental health difficulties are individual failings which may be overcome with a combination of vim, vigour and good humour.

The thing is, sometimes having a mental health difficulty is awful. Or embarrassing.  Or disruptive. Or can make you unemployable. Or turns your house into a mess. Or any of the other unpleasant things having an impairment to your mood, behaviour, thoughts, perceptions or motivations might cause if you don’t have some sort of aid to offset it.

Obscuring real needs

I’ve been wondering whether it’s possible that we are managing to obscure the real implications of having a mental health difficulty by focusing on ‘accepting the person’ while, as some would claim, erasing the circumstances under which they live?  And, as a result of that, are we failing to focus on what might reduce the impact a mental health difficulty has on the lives of people by being unable to see what adaptations and modifications might be made to situations?  In other other words, are we focusing too much on the idea that individuals are ‘judged’ by society and not enough on what it actually is that’s being judged?

The criticism of the foregrounding of celebrities in mental health acceptance campaigns is that the celebrities do not, in most ways, reflect what people are being asked to accept of other people with mental health difficulties.  Some people with mental health difficulties frame this defensively, seeing the celebrity with mental health difficulties as a failed inspirational figure who is targeted at them.  This might be termed ‘You’re not as funny as Stephen Fry’ syndrome.  This view goes as follows: the celebrity is being held up as an example of ways in which people with mental health difficulties can overcome their impairments and be successful.  The celebrity, though, has access to more advantages and material aids than an average person with mental health difficulties, therefore is a misleading guide to what ‘the public’ may expect from people with mental health difficulties in their lives.

If we step away from the personalising and relating to own circumstances in that argument, we are left with the core idea that what people are being asked to accept about mental health difficulties is that people have them, but aren’t being asked so much to consider what the implications of those difficulties and impairments actually are.

The reason why the use of celebrities with mental health difficulties by campaigns gets on people’s nerves is because people feel that their use involves asking the public to accept what they have already accepted.  They already know and like the celebrity, they are fairly aware of the various aspects of their story.  They accept that they have a degree of legitimacy as a person; they have, after all, succeeded enough to be famous.  This obscures the fact that for people with mental health difficulties to find a real advancement in our circumstances, we are not only asking for ‘the public’ to accept that people have mental health difficulties, but to also accept the effects having a mental health has upon people’s lives.

Accepting a person, ignoring a situation?

Mental health difficulty is a series of impairments.  These impairments have real implications for what any individual needs to live a viable and fulfilling life.  At present we are, to my mind, extremely bad at addressing that impairments cause needs which in turn cause outcomes when those needs are not addressed.

We know that having a mental health difficulty tends to make a series of social outcomes more likely for us.  We also know that different mental health difficulties tend to make different messes of your life.

I like to think that we are merely at the ‘coming in from the cold’ stage of mental health awareness; the initial stage of raising the idea that people with mental health difficulties are discriminated against and stigmatised.  On that basis, I think we need to see current campaigns and understandings as a transitional stage on the way to a better settlements for people with mental health difficulties.

But where are they a transitional stage on the way to?

At the moment, the idea of challenging stigma and the idea of making things better for people with mental health difficulties are viewed as synonymous, but I’d be very worried if this linkage were to continue indefinitely.   The danger is that we split into two mental health worlds, one involved in attitude change work and one that tangles with and knows how mental health difficulties play out ‘on the ground’.

For me, what’s holding us all back is being unable to stake out the ground for an exploration of what impairments mental health conditions cause and what we can do to assist and mitigate against those impairments.  I think this is the natural next stage after our current period of foregrounding the anti-stigma struggle – the shift from saying ‘accept people with mental health difficulties exist’ to ‘accept that we need to make changes to the way things are so that people with mental health difficulties are no longer excluded’.

I draw no comfort from ‘accept that it’s an impairment having a mental health difficulty’.  I have one.  I know that.  I’m more excited by the question of ‘how do we reduce how much the impairments presented by mental health difficulties actually disable someone?’

Can we get from saying ‘be nicer to people with mental health difficulties’ to reducing the mess that having a mental health difficulty makes of your life?

Then what?


Mark Brown is the Editor of One in Four magazine.  He is @markoneinfour on twitter

4 Responses to Mental health – Celebrities, challenging stigma and the ‘then what?’ moment

  1. Its a shame that its taken you almost 5 years to figure out that mental health issues can be and often are a significant impairment in and of themselves and much more of an immediate and ongoing life problem and barrier than being stigmatised or discriminated against by the general public while nipping out to the local store.

    Also note the – deliberate ? – overlooking of the role the dubious 1 in 4 statistic has played in the invisibilisation of less ‘media friendly’ mental health conditions , behaviours and certain patient and user groups and the degreees of severity of impairment within mental health – the deliberate obscuring of the blindingly obvious if you will.

    And now with this Road to Damascus -like conversion you’re suddenly able to see that so many people really are struggling to cope with the direct mental/emotional and physical impact of their mental health issues and the objective circumstances and material conditions that’s placed and trapped them in – or vice versa, as life is a tad more complex than the Time to Change ads depict, as you know – however your representation of the current ‘directional’ problem that mental health activists and people with mh issues face ignores the fact that all those carefully selected media friendly narratives and simplistic, heroic and celebritised projections of mental health that you now ponder moving on from have actually hijacked and reinforced the old prejudice of mental health issues being superficial compared to ‘real’ physical illnesses and disabling conditions , a situation that has resulted in anyone now claiming to suffer from a significant mental impairment or disability in an ongoing way being ridiculed , including within the mental health system, and being officially regarded as too lazy or stupid to reinvent themselves and achieve near instant recovery through the workplace.

    This re-invented prejudice is the the outcome of the ideological unleashing of a new cruel and very convenient strain of economic determinism, people with significant mental health difficulties ( and people with disabilities generally ) are being driven into the marketplace with ‘price tags’ representing their cost to the nation draped around their necks as the new stigmatising marks of disgrace and signs of moral failure and letting the species down and the public are being encouraged to hiss and boo and demonise these people for failing to conform to the new social value and accounting system, adapt or die.

    There’s no moving on from that, we have to move back and away from this dire situation to create real viable alternatives otherwise we’re just going to be swept along and away by the sheer brute force of it all, and that’s not a hopeful or inspiring prospect at all, its simply one that will make more and more people feel terrified about becoming unwell , being or becoming disabled and growing old and more dependent on others in a society that is being increasingly encouraged to view these outcomes as negative economic costs imposed by underserving , unproductive , unwelcome and unwanted individuals .

  2. I believe that these paragraphs conflate the agenda of the Tory / Liberal Democrat coalition with the effects of media attention on mental-health conditions in and through such things as Time to Change : the former is not, as I see it, the result of the latter, but despite the latter.

    Presenting mental-health conditions in a way that normalizes, or tends to normalize, them might lead ‘the public’ to infer that ‘these people’ are no different, but there is no such thing as the public, and some might think that, others not, and others still might continue to think whatever they thought before. As to Atos assessments leading to people being deemed to be fit for work, that is happening with people with physical and / or mental disabilities that clearly meant that they are not fit for work, otherwise 40% of decisions would not reportedly be overturned on appeal.

    I have seen none of the recent Time to Change broadcasts, so I cannot say whether ‘carefully selected media friendly narratives and simplistic, heroic and celebritised projections of mental health’ is a fair description of it or other media work. Certainly, the short film Psycho and other material attempted to embrace more severe conditions and the prejudice that went with them : that prejudice was already there, and, for some, ‘nipping out to the local store’ was, because they and their business were known where they lived, more like running the gauntlet.

    That is the vision with which these paragraphs ends, but I know that it was already the reality for all too many – in addition to the battle within and for the mind, made worse by such degrading experiences. The viciously minded and uncaring government that we have may be doing all that it can to exploit those existing feelings and tensions, but I cannot see that their genesis or presence can rightly be laid at the door of Time to Change and like campaigns.

  3. @The Agent Apsley

    Seems to me your opening paragraph simply betrays your reluctance to accept that the Tory and Liberal Democrat Coalition agenda around disability and welfare reform you despise is just a continuation of New Labour Government policy ,including mental health policy that saw organisations like Mind and Rethink, who manage the Time to Change portfolio, become more reliant on public funding and Government policy
    for their survival and provider-side direction, and it was organisation’s like the Mental Health Foundation and Sainsbury Centre for Mental Health, now the Centre for Mental Health, remote MH Think Tank organisations which were much more closely linked to Government policy wonks and the MH system than any grassroots activism or evidenced patient/service user/survivor hierarchy of concerns , that echoed the crass economic reductionism championed in David , now Baron, Freud’s review of the benefits system for New Labour, leading to shrill national headlines and catchy ambiguous soundbites about how much people with mental health issues and other disabilities were costing the nation, and its rather sad that
    you can’t or won’t accept that this dehumanising process was a cross party enterprise and nasty kneejerk reaction to the global economic meltown
    and reflection of the tech trend towards the quantification of everything , because Freud certainly got that it was as he slipped away from New Labour to become the architect of Welfare Reform for the Tories without anyone noticing any difference.

    As for the public simply being an abstract construct, similar arguments can and have been made about society and the 1 in 4 stat , which , incidentally, the mental health organisations were using without even being able to explain where it came from , as the author of this blog well knows, but rather than get bogged down with the theoretical lets stick with the practical , I have no idea of the actual impact , well intentioned or
    otherwise, of the mainly Government funded and policy focused anti-stigma campaigns , as such impact is not so easily measured and there we have
    the core problem in a nutshell as applying a price tag and cost to everything and everyone makes for much easier measurement and the main mental health organisations ran with that approach, introducing more and more of the same crude economic costing into their public messages and utterances and it horribly backfired, as we know, and that , my friend, is how the nasty Government policy and high profile anti-stigma media campaigns you mistakenly accused me of conflating actually merged with and fed off each other to almost singlemindedly represent mental health problems as economic costs .

    Hyperbole didn’t help either and a national headline planted by the shadowy Mental Health Foundation that Britain was spiralling into madness didn’t normalise anything it simply cancelled out the possibility of reasonably promoting any real wider understanding of the lot of people living with mental health difficulties , the area the owner of this blog now feels has been somewhat neglected, and the relentless focus on celebrity has tended to prioritise media attention over the relevance and clarity of signal or message and very early on in the Time to Change campaign an astute ThirdSector Blog post specifically warned of the dangers of using celebrities to promote a greater understanding of mental health issues , including the danger , by repetitious association with celebrity, of representing people
    with mental health issues as so stable, able and well – and well off – as to not warrant much thought , concern or help at all.

    I can understand why people need to believe that Time to Change’s high profile mental health anti stigma campaigns in the media have been really successful, what I don’t understand is why and how people can cling to that belief when even the organisations behind the campaigning acknowledge
    that attitudes towards people with mental health problems and disabilities are hardening and have become more uncaring and cynical .

    I also get why people may think and really want to believe that there’s been a certain levelling of the playing field through attempts at positive and affirmative discrimination but not when mental health services are being pared back to the bone and modernised away and disabled claimants are being catapaulted en masse at non existent jobs and fictitious in work support schemes for purely economic reasons.

    As for ATOS’s role in all this, I dont need telling, I really don’t as the DWP took the decision to stop my benefits overnight last week because I had the audacity to turn up at the DWP Examination Centre and question why all the corespondence I had received ref my ATOS assessment scheduled there, including the DWP’s own WCA ALIC 06/12 explanatory Leaflet about same, referred to it as a ‘ medical assessment ‘ not a functional one . A
    reasonable enough question given my Paranoid Personality Disorder diagnosis (which we can be questioned as a discriminatory label without
    completely dismissing all of the traits and issues it captures ) and the fact that no medical records were available because MH services themselves stigmatise, discriminate against and repel people so diagnosed anyway , which meant that there was no way to safely convey or discuss difficulties around mental and physical function, their impact on each other, and poor social interaction in the workplace – or anywhere else for that matter – with a young nurse masquerading as ‘a disability expert ‘ , her term, who simply interpreted my need for clarity on exactly what was being assessed and how as an intimidatory challenge to her authority in spite of the fact that a DWP
    manager, who called me paranoid as an insult for seeking clarification in the first place , had insisted that I had to turn up on the day and ask about the nature of the assessment as all I was really being offered as far as he was concerned was ‘ an opportunity to be supported into employment.’

    Well I did ask and a week after attending the assessment I received a letter from ATOS stating that the ‘ medical assessment ‘ , the term actually used in the letter, had been cancelled and advising me that I was no longer required to attend it and this bizzare communication was promptly followed up by a letter from the DWP stating that my benefits would no longer be paid because I ‘had failed to attend the assessment and not provided a good enough reason for this’.

    And that’s a bespoke Employment Support process at least half the orgs behind Time to Change were involved in at Governmental level after they had put in bids to the DWP to run their own work schemes!

    So, just because you are paranoid doesnt mean you can’t see the writing on the wall way ahead of most other people , at least some of the time as quite often you can and do , and truth to tell, its been the mental health patients, service users, sufferers , survivors ( add your preferred term here …..) and their carers least acknowledged by the high profile mental health anti-stigma media campaigns who have most consistently and accurately warned of where all the lazy, incestuous Government policy and provider agenda led and celebritised gung ho stuff was leading, and that’s been no coincidence either as they have borne the brunt of it when the organisations have really screwed up and these people , often the harder to help, put their case to New Labour, NIMHE and the conflicted campaigning mental health provider orgs as well only to be lectured that it was all about ‘the many not the few ‘ , and quietly but authoritively informed that of course the campaigning misrepresented the reality of living with mental health issues and was essentially machiavelian in nature, as that’s just how things were , how the real world is and what was necessary to professionally shape and form public opinion and social policy through the media but not to worry as down the road a ways , once the main battle for the hearts and minds of the public was won they would double back and pick up the less stable, able and well, only the people at the top of those organisations had got so used to hanging out with politicians, policy wonks and celebrities, dining out on public funding and awarding each other prizes that they lost any real incentive to retrace their steps at all or worry about those unable to keep up or who had fallen by the wayside and been ploughed under. Those who were, anyway, just likely to remind people of ‘the unacceptable face of mental health’ rather than mirror the new happy shiny people one, and who were obviously too lazy, socially awkward or stupid to reinvent themselves and near instantly recover through the workplace as the campaigners suggested they would and the politicians clearly expected them to.

    So in addition to the mental health activist issue of ‘Where to next? that Mark Brown now ponders , what about the question of who actually decides on how best to promote a greater understanding of living with the impact of mental health problems, and not simply the media friendly issues, and what frameworks people want and need to help them better cope with and , where possible, overcome their mental health problems and related impairments , barriers and challenges?

    Is that question even on the table here? It certainly needs to be.

  4. The gift of writing can help.
    I am a first time author that has struggled with depression in the past and after a consultation with a therapist managed to turn my life around. Part of my book’s introduction details how difficult it was for me to try and find help but my doctor’s advice to write about my past saved me. I have recently self published a memoir and am seeking financial assistance to promote it with the wish to help others that are desperate for a way out. I hope to donate a portion of the profits to this cause. You can contact me at
    Thank you

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