Challenging mental health-related stigma through social contact.

Stigma is one of the greatest challenges facing people with mental illness today. In addition to the distress and feelings of rejection it causes, stigma can lead to housing and employment discrimination and can cause people to avoid seeking help for their illness due to shame and fear. Social contact—direct, personal contact between members of the general public and members of a stigmatized group—is one of the most promising strategies for reducing stigma and discrimination. 1 Since the 1960s, research has investigated the use of social contact between members of the general public and people with mental illness to reduce stigma associated with mental illness. Recent research has incorporated more sophisticated rando-mized trials 2 and meta-analysis methods 1 to investigate specific components and mechanisms of social contact. The current literature, however, lacks natur-alistic studies which apply the social contact theory at the population level. In this viewpoint, we discuss Time to Change 3 as an example of a way to facilitate research and application of the social contact theory in naturalistic settings at the population level and the necessary features which should be incorporated in order to optimize results. We argue that the development of novel and innovative ways of incorporating social contact in the field of public mental health will make a significant impact towards decreasing stigma and discrimination against those with mental illness. In January 2009, two mental health charities, MIND and Rethink, launched the largest ever programme in England to combat mental health stigma and discrimination, 3 with the Institute of Psychiatry as the evaluation partner. A key aim of the Time to Change programme is to reduce stigma by facilitating social contact between members of the general public and people with mental illness on a large scale. This is particularly significant as it addresses two limitations of previous social contact research. First, it has been noted that one of the problems of using social contact as a means to combat stigma is that, unlike education, it is difficult to reproduce on a large scale and there have thus been relatively few large-scale social contact interventions. 2 A second limitation is that social contact research in the past has mostly been conducted in experimental rather than naturalistic settings, making it difficult to evaluate whether or not the results can be translated into the real world. 4,5 Although Time to Change aims to incorporate social contact across the …