The document reviewed here is a Department of Health document ‘Attitudes to Mental Illness 2010’ and which is available here. I found the document slightly easier to read by starting at the back where the methodology is explained in detail. Random sampling took place and results were weighted according to the characteristics of the population in England in terms of age, sex and social grade (ethnicity data was included in the questionnaire). In the methodology section, the authors note that significant results imply that results are significant at the 5% level on the two-tailed t-test which presumably means that all of the sample data is normally distributed. I wasn’t clear on whether a correction for multiple comparisons was used. As there are a large number of comparisons being conducted between age groups, between genders and social grades as well as across surveys (i.e the previously conducted surveys) it would be expected that there would be false positives. So for instance with a Bonferroni correction, 10 comparisons would mean multiplying the resulting p values by 10 so that a p-value of 0.05 no longer remains significant at the 5% level. I wasn’t clear on this point. 1745 adults were selected using a random sampling method from areas across England (roughly 0.0035% of the English population). Results are displayed in graphs and also described in accompanying paragraphs. There is no interpretation of the data as far as I could see (e.g a discussion with reference to the literature).
Page 13 shows the sections of the survey. Scanning through the document there are 31 figures which I thought summarised the data effectively. There were a few points that I thought were interesting
In Figure 1 I didn’t notice any consistent trend in the data other than to say that the relationship between the lines remained fairly stable over time. The results here pertained to questions about social inclusion ranging from the nextdoor neighbour having a mental illness to a mental health institution being located within the neighbourhood. There was in fact a slight cross-over between the responses to the nextdoor neighbour and marriage questions over time seeming to indicate a possible trend to marriage becoming more acceptable to someone with a recognised mental illness.
Figure 2 was interesting because it showed significant age-group differences. Those over the age of 55 were more likely to judge those with a mental illness adversely i.e they shouldn’t hold public office. That is an interesting finding that would benefit from further follow-up with a qualitative study.
Figure 3 shows a significant difference between men and women in tolerance to people with a mental illness. Women were more likely to be tolerant in terms of their responses.
Figure 9 includes a graph of responses to inclusion in the community over time. Although there is an upward trend towards increasing acceptance in recent years the graph shows a lot of variability over time indicating many possibilites ranging from the question through to short-term factors that could influence responses.
Figure 16 was interesting as it most likely displays common perceptions of mental illness with schizophrenia being the most commonly identified mental illness with depression second. Perhaps here there could be clarification of what consitutes a mental illness. DSM-IV and ICD-10 contain a large number of diagnoses many of which may not feature prominently in the cultural ‘psyche’. It would be interesting to see the results of a survey in which familiarity with ICD-10/DSM-IV diagnoses is assessed in the general population as the public perception of mental illness may be biased towards a relatively small (although important) mental illnesses.
Figure 21 was encouraging in that 60% of the respondents samples believed that full recovery was possible for someone with a ‘mental health problems’ and there was confidence in the efficacy of medication and psychotherapy.
Figure 25 was interesting as it showed that only 4% of the sample reported having a mental illness themselves although many of the respondents recognised the figure of 1 in 4 people having a mental illness. This implies either under-reporting or a biased sample.
Figure 30 shows that 50% of the sample would be uncomfortable talking to their employers about a mental illness. This means that there is some way to go in this area.
Figure 31 suggests that there has been a decrease in stigma.
This is a broad survey which can be usefully compared to previous surveys in this series. There are a number of encouraging findings in particular those relating to public perception of the possibility of recovery, integration into the community and efficacy of medication and psychotherapy. Areas which I thought were interesting were the self-reporting of mental illness as well as age-related perceptions of mental illness. These could be investigated further using a qualitative design.
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