Recovery From Schizophrenia: Psychiatry And Political Economy

296 DESEGREGATING SCHIZOPHRENIAcessation and a variety of other causes. 82 Carefully designed campaigns can havesubstantial effects on behavior. 83 Effectiveness is increased by “audiencesegmentation”—partitioning a mass audience into sub-audiences that are relativelyhomogeneous and devising promotional strategies and messages that are morerelevant and acceptable to those target groups. 84In developing such campaigns, it is important to conduct a needs assessmentthat gathers information about cultural beliefs, myths and misapprehensions, andthe media through which people would want to learn about the topic. The needsassessment method may incorporate focus groups, telephone surveys andinformation from opinion leaders. A pre-testing mechanism is then establishedthat allows the promotional strategy to be continuously refined. 85 Initially, specificobjectives, audiences, messages and media are selected, and an action plan isdrawn up. The messages and materials are pre-tested with the intended targetgroup and revised. The plan is implemented and, with continuous monitoring ofimpact, a new campaign plan is developed and constantly refined.Health promotion campaigns aim to heighten awareness and to provideinformation; the former is possible without the latter, but not the reverse.Awareness campaigns need to be supported by an infrastructure that can linkpeople to sources of information and support—for example, a telephone numberto call and trained people to respond to the caller. Ideally, the infrastructureshould be a central organization with a local network.A national anti-stigma campaignBuilding on these advances in communication technology, the Defeat DepressionCampaign was conducted in Britain between 1991 and 1996 with the goals ofreducing the stigma associated with depression, educating the public about thedisorder and its treatment, encouraging people to seek treatment early andimproving professional treatment expertise. Campaign media directed at thegeneral public included newspaper and magazine articles, television and radiointerviews, acknowledgement by celebrities of their own episodes of depression,press conferences, books, leaflets in multiple languages, audio cassettes and a selfhelpvideo. A program to educate general practitioners, which includedconferences, consensus statements, practice guidelines and training videotapes,was also launched. 86The results of the campaign were positive. Knowledge about and attitudestowards depression and its treatment were tested before, during and after thecampaign and showed progressive improvement of around five to ten per cent.At all stages of testing, counseling was regarded positively; antidepressants wereviewed with suspicion, as being addictive and ineffective, but attitudes towardsthem improved substantially during the campaign. By the end, members of thegeneral public regarded people suffering from depression as being more worthy ofunderstanding and support, and were more likely to acknowledge the experienceof depression in themselves and in close friends. They saw depression as more like