The mainstream venue

For many people with a diagnosis of severe and enduring mental ill-health, there is a strong chance of never being employed again.

There are a variety of reasons for this.  Stigma is often put forward as the main block to obtaining work.  Stigma by employers.  Stigma by societal attitudes.  But there is more to it than stigma.

For a significant group of people with mental health conditions, living a life  outside of employment is part of the diagnosis.  Not only diagnosed with clinical illnesses they are also prescribed 'a career in mental health' (Dr. Pat Deegan).

Stigma is only a small part of the rationale behind this exclusion.  Certainly, stigma in employment is still prevalent.  But there are many steps to employment that people may wish to take before they feel ready for work after illness or hospitalisation.  These steps take in any area of aspiration, goals, hopes and dreams that an individual may feel are appropriate. All of these areas once identified should be in mainstream venues.  No-one is going to reach their hopes and goals from a day centre or a clinical setting.

Do mainstream outlets stigmatize against people with mental health conditions?  No, by and large.  Leave out employment where stigma is alive and well.  But elsewhere - in mainstream venues of all kinds stigma is not the issue.

Should people with long-term mental health conditions disclose this to mainstream venues they wish to access?  Only if they personally wish to do so.  It's the individual's choice and no-one should disclose on their behalf.

Someone might feel that disclosure to a mainstream venue might be beneficial or helpful to their progress in that venue.  There may be a key worker or support worker in place.  But the motive behind accessing a mainstream venue is not for 'support' per se.

The motive for a person with a long-term mental health condition to access mainstream is the same as anyone else.  We go to adult education centres to do courses of our choice.  We go to rehearsal studios to play music with our mates.  We go to art galleries to enjoy art.  We go to gyms to do exercise and get fit.  We go to libraries to check out books, use computers and get information.

The person with a mental health condition who accesses these venues is a consumer along with everyone else.  As such he or she is included within the rights of access, protection and insurance that all venues must provide as part of their service.

Is anti-stigma the new stigma?

The 'Time to Change' campaign challenges stigma and discrimination against people with mental health conditions. Time to Change is helping groups and individuals organise activities which actively cooperate in challenging discriminatory attitudes and behaviours.

Challenging discrimination is achieved primarily through engaging in mainstream as a contributor, a consumer or a provider. Many people with mental health conditions access mainstream activities, making their own choices as to whether to disclose or not. The greatest impact in challenging mainstream can be achieved by prioritising individual goals and aspirations. Support is also available to access mainstream from mental health organisations and bridge builders or through personalisation and direct payments.

'Time to Change' seems to insist that all people with mental health conditions wish to disclose as part of their eligibility for mainstream life. In a recent campaign video the broadcaster and service user Stephen Fry asserts that stigma and the attitudes of society in general are the main roadblocks that hinder the self-development of people with mental health conditions.

But many individuals with mental health diagnoses are accessing mainstream life without stigma, whether they choose to disclose or not. Disclosure is really up to the individual and far from discouraging service users to use mainstream, many organisations are open to all and are accessed by people with mental health conditions every day of the week. These are not simply voluntary organisations or groups limited to the health or charity sectors. These are consumer providers of all kinds - art galleries, libraries, recording studios, performance venues, gyms, sports centres, retail outlets and many more. To assert these these organisations are discriminating simply isn't fair on these groups, nor is it a realistic assessment.

Where people with mental health conditions may lose out is in having the initial confidence to set on the journey back to mainstream. This is particularly true of those who have been in secondary care and who may have become habituated to the life that Pat Deegan calls 'a career in mental health'. Dr. Deegan is referring to the lack of hope, aspiration and goals that can set in with hospitalisation or a long-term condition.

People who play football who happen to have mental health conditions are footballers. They aren't required to be 'positive mental health footballers'. People who play guitar who happen to have mental health conditions are guitarists, not mental health guitarists. People who are arts tutors who have a mental health condition are arts tutors. By continuing to tag mental health on mainstream activities and aspirations there is a danger of recycling stigma and not allowing people to move into valued social roles.

Could anti-stigma be the new stigma?