Mental health policy and practice across Europe: an overview

Tackling social exclusion 53
Box 3.2
Strategies for greater inclusion
• Evidence shows contact between people with mental health problems
and other citizens has the most positive effects on attitudes and
behaviour.
• Contact should involve equal status.
• Inclusion in employment and education in itself changes attitudes and
behaviour.
• Educational messages that contradict stereotypes of violence and
incompetence, and emphasize contribution, are also effective.
• Messages focused on the cause of mental health problems – for instance
‘an illness like any other’ – are at best unproven and may add to
discrimination.
participate. It is encouraging that a recent American survey of professionals
and managers with mental health problems (from across industries and
sectors) found that the vast majority (87 per cent) had disclosed at work; and
most (61 per cent) had no regrets. One of the factors significantly associated
with disclosure was awareness of the Americans with Disabilities Act. Antidiscrimination
law can encourage confidence, and at best deliver greater safety
to disclose (Ellison et al. 2003). Increasing the proportion of European disabled
people who know their rights is crucial. Eurobarometer (2003) found that only
just over a third of Europeans would know their rights if they experienced
discrimination.
Policy directions
A report from the European Foundation for the Improvement of Living and
Working Conditions (2003: 26, 56), commenting on European labour markets
and income, concluded that ‘different studies find that people with mental
illness are those with most problems in comparison with other types of illness
and disability . . . Information campaigns have tried to de-stigmatise mental
illness, but there is still a strong stigma attached to it’.
Stigma is clearly a key factor in unequal life chances generally and should be
accorded much greater attention in mainstream work to reduce exclusion
(Link and Phelan 2001). The exclusion of people with psychiatric impairments
is unfortunately often mirrored in a second exclusion – from the arena of
policy-making on inclusion of disabled people:
Based on seven years of work, I find that two distinct groups of persons with
disabilities, those with intellectual and those with psychiatric disabilities,
are systematically more marginalized and isolated than other groups of disabled
people . . . Modern disability policy creates a motion from exclusion
towards inclusion. It is high time that the most vulnerable groups amongst