title: Viewpoint survey of mental health service users' experiences of discrimination in England 2008-2012.
abstract: OBJECTIVE
  Research suggests levels of discrimination among mental health service users in England are high, but fell over the course of the first phase of the Time to Change programme to reduce stigma and discrimination (2008-2011). The aim of this study was to determine changes in discrimination levels, both overall and by the area of life in which discrimination is experienced, since Time to Change began and over the first year of its second phase (2011-2012).
  
  
  METHODS
  Separate samples of mental health service users were interviewed annually from 2008 to 2012 using the Discrimination and Stigma Scale. In 2011 and 2012, social capital was also measured using the Resource Generator-UK.
  
  
  RESULTS
  Sample percentages of participants reporting the experience of discrimination in one or more life areas for years 2008-2012 were 91.4, 86.5, 86.2, 87.9 and 91.0 %, respectively. A multivariable logistic regression model was performed to test for significant differences by study year, weighted to match the study population and adjusted for employment status and diagnosis as potential confounding factors. The odds of reporting discrimination in one or more life areas were significantly lower as compared to 2008 for all subsequent years except for 2012 (0.76, 95 % CI 0.49-1.19). However, a weighted multiple regression model provided evidence of decreased mean overall discrimination in 2012 as compared to 2008 (mean decrease -7.57, 95 % CI -11.1 to -4.0, p < 0.001). The weighted mean number of social resources was 13.5 in 2012 as compared to 14.0 in 2011 (mean difference -0.60, 95 % CI -1.25 to 0.06).
  
  
  CONCLUSIONS
  While the overall level of discrimination across the life areas studied has fallen over 2008-2012, there is no evidence that more people using mental health services experience no discrimination. We suggest that the pattern suggesting a recent rise in discrimination following an earlier reduction may be linked to economic austerity. Further, the welfare benefits system has become an increasing source of discriminatory experience.
authors.affiliation: Health Service and Population Research Department, David Goldberg Centre P029, King's College London, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK, Claire.1.henderson@kcl.ac.uk.
authors.forename: R C
authors.initials: RC
authors.lastname: Henderson
authors.forename: E
authors.initials: E
authors.lastname: Corker
authors.forename: S
authors.initials: S
authors.lastname: Hamilton
authors.forename: P
authors.initials: P
authors.lastname: Williams
authors.forename: V
authors.initials: V
authors.lastname: Pinfold
authors.forename: D
authors.initials: D
authors.lastname: Rose
authors.forename: M
authors.initials: M
authors.lastname: Webber
authors.forename: S
authors.initials: S
authors.lastname: Evans-Lacko
authors.forename: G
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D000328:Adult; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011287:Prejudice; D066270:Social Capital; D057545:Social Stigma; D011795:Surveys and Questionnaires