"Stigma is based on the fact that a person is not judged as an individual, but based on the characteristics attributed to their group," explains Rüsch. "Typical opinions are, for example: 'Mentally ill people are incompetent, dangerous or to blame'." The term "second illness" has become established among experts to describe the burden of stigmatisation, as it is often more stressful for those affected than the illness itself. It can significantly reduce quality of life by leading to social isolation and, worsened health and even the avoidance of effective treatment. Many sufferers internalise the prejudice, which is called self-stigma: "Because I am mentally ill, I must be incompetent." The problem is enormous: "A worldwide study, in which Germany and Switzerland also took part, surveyed over 1,000 people with schizophrenia and around 800 people with depression. Around 80 per cent stated that they had experienced stigmatisation," says Rüsch. Edmund Bornheimer, member of the Trialogue Centre Council of the DZPG, adds: "Due to stigmatisation, disclosing the illness can still have negative consequences today. I have experienced this several times in a professional context."
Relatives are also affected by discrimination
Discrimination doesn't just affect those affected themselves: "Relatives also continue to experience painful stigmatisation in everyday life. In particular, relatives of people with severe mental illnesses have an increased risk of developing mental health problems themselves," says Heike Petereit-Zipfel from the Federal Association of Relatives of People with Mental Illness (BApK) and also a member of the Trialogue Centre Council.
Improving society's perception of mental illness
The DZPG has not only set itself the task of improving the mental health of the population but also of reducing the stigma of mental illness. The group programme "Standing by yourself with dignity" (IWS) at the Department of Psychiatry and Psychotherapy II of the University Medical Centre Ulm at Günzburg District Hospital (BKH) helps people with mental illness to make a considered decision about whether or not to disclose their illness. This is a key decision in dealing with stigma and self-stigma. IWS is run by trained peers, i.e. people who have experienced the illness themselves.
Personal contact does more than factual knowledge
What research already knows is that awareness campaigns that provide information about mental illness have proven to be less effective in reducing stigma. Rüsch points to more effective means: "These include programmes that promote direct social contact between people with and without mental illness and enable individual encounters." Such programmes could also be a lever in the fight against stigmatisation with employers, the police or in clinics.
One example of contact-oriented anti-stigma work is the "BASTA" programme in schools at the DZPG site in Munich-Augsburg. At the contact seminars, the participating classes meet two members of the initiative: one who talks about their life with a mental illness, accompanied by a counsellor who moderates and provides expert advice. A scientific evaluation is now to determine whether such a programme reduces prejudice among pupils. This should also enable the programme to be developed for other population groups in the future. "Contact-based anti-stigma work is demonstrably effective," explains Rüsch.
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