title: Challenging stigma and discrimination in communities: a focus group study identifying UK mental health service users' main campaign priorities.
abstract: BACKGROUND
  Stigma and discrimination experienced by people with mental health problems have been identified as major obstacles to treatment and recovery. Less is known about how to effectively tackle stigma-discrimination, although there are numerous international, national and local programmes attempting to improve public mental health literacy and anti-discrimination evidenced based practice.
  
  
  OBJECTIVE
  To explore mental health service users' views on how campaigns to address stigma and discrimination should prioritise their actions.
  
  
  METHODS
  Qualitative study using focus group discussions, involving 33 persons aged between 25 and 75.
  
  
  RESULTS
  A triad of diminished credibility, dis-empowerment with particular reference to communication problems and avoidance by their social network defined experiences of stigma. Reactions to stigma can be placed in four categories: avoid stigma, resign yourself to it, challenge it, or distance yourself from others with a mental health problem. A range of solutions was discussed with most favouring changes within the health services that are currently supporting them over traditional educational programmes with the public.
  
  
  CONCLUSIONS
  For mental health service users stigma must be tackled on many different levels reflecting the varied and complex impact that negative social reactions have on an individual's life. When asked to prioritise one area, most service users in our sample highlighted reforms within the health service for tackling stigma and discrimination.
authors.affiliation: Health Services Research Department, Institute of Psychiatry, London, UK. vanessa.pinfold@rethink.org
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pinfold
authors.forename: Peter
authors.initials: P
authors.lastname: Byrne
authors.forename: Hilary
authors.initials: H
authors.lastname: Toulmin
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D006293:Health Promotion; D006801:Humans; D008402:Mass Media; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011287:Prejudice; D013240:Stereotyping; D006113:United Kingdom / Q000453:epidemiology