Aims Time to Change, an anti-stigma programme in England, has worked to reduce stigma relating to mental illness in many facets of life. Newspaper reports are an important factor in shaping public attitudes towards mental illnesses, as well as working as a barometer reflecting public opinion. This study aims to assess the way that coverage of mental health topics and different mental illnesses has changed since 2008. Method Articles covering mental health in 18 different newspapers were retrieved using keyword searches on two randomly chosen days of each month in 2008, 2009, 2010, 2011, 2013, 2014, 2016 and 2019. A content analysis approach using a structured coding framework was used to extract information from the articles. Logistic regression models were used to estimate the change in odds of each hypothesised stigmatising or anti-stigmatising element occurring in 2019 compared to 2008 and 2016 with a Wald test to assess the overall significance of year as a predictor in the model. Further logistic regression models were used to assess the association between the diagnosis that an article was about and the odds that it was stigmatising, and whether this relationship is moderated by year of publication. Results A total of 6731 articles were analysed, and there was a significant increase in anti-stigmatising articles in 2019 compared to 2008 (OR 3.16 (2.60–3.84), p < 0.001) and 2016 (OR 1.40 (1.16–1.69), p < 0.001). Of the 5142 articles that specified a diagnosis, articles about schizophrenia were 6.37 times more likely to be stigmatising than articles about other diagnoses (OR 6.37 (3.05–13.29) p < 0.001), and there was evidence that the strength of this relationship significantly interacted with the year an article was published (p = 0.010). Articles about depression were significantly less likely to be stigmatising (OR 0.59 (0.69–0.85) p = 0.018) than those about other diagnoses, while there was no difference in coverage of eating disorders v. other diagnoses (OR 1.37 (0.67–2.80) p = 0.386); neither of these relationships showed an interaction with the year of publication. Conclusion Anti-stigma programmes should continue to work with newspapers to improve coverage of mental illness. However, interventions should consider providing specific guidance and promote awareness of rarer mental illnesses, such as schizophrenia, and evaluation should examine whether reductions in stigma extend to people with all mental illness diagnoses.
Background Media coverage on mental health problems has been found to vary by newspaper type, and stigma disproportionately affects people with mental illness by diagnosis. Objective This study investigated the relationships between types of UK national newspaper (tabloid vs. broadsheet), illness classification (SMI–severe mental illnesses vs. CMD–common mental disorders), and stigmatising coverage of mental disorders, and whether these relationships changed over the course of the Time to Change anti-stigma programmes in England and Wales. Methods Secondary analysis of data from a study of UK newspaper coverage of mental illness was performed. Relevant articles from nine UK national newspapers in 2008–11, 2013, 2016 and 2019 were retrieved. A structured coding framework was used for content analysis. The odds an article was stigmatising in a tabloid compared to a broadsheet, and about SMI compared to CMD, were calculated. Coverage of CMD and SMI by newspaper type was compared using the content elements categorised as stigmatising or anti-stigmatising. Results 2719 articles were included for analysis. Articles in tabloids had 1.32 times higher odds of being stigmatising than articles in broadsheet newspapers (OR 1.32, 95% CI 1.12–1.55). Odds of stigmatising coverage was 1.72 times higher for articles on SMI than CMD (OR 1.72, 95% CI 1.39–2.13). Different patterns in reporting were observed when results were stratified by years for all analyses. A few significant associations were observed for the portrays of stigmatising elements between tabloid and broadsheet newspapers regarding SMI or CMD. Conclusions Tailored interventions are needed for editors and journalists of different newspaper types, to include specific strategies for different diagnoses.
Background Domestic violence and abuse (DVA) and mental illness during pregnancy have long-lasting and potentially serious consequences, which may have been exacerbated during the COVID-19 pandemic. Aims To investigate how the UK COVID-19 lockdown policy influenced the identification of DVA and depressive symptoms during pregnancy in health services in South-East London in Spring 2020, using eLIXIR (Early-Life Data Cross-Linkage in Research) maternity and mental routine healthcare data. Method We used a regression discontinuity approach, with a quasi-experimental study design, to analyse the effect of the transition into and out of the COVID-19 lockdown on the rates of positive depression screens, DVA recorded in maternity and secondary mental health services, and contact with secondary mental health services during pregnancy. Results We analysed 26 447 pregnancies from 1 October 2018 to 29 August 2020. The rate of DVA recorded in maternity services was low throughout the period (<0.5%). Within secondary mental health services, rates of DVA dropped by 78% (adjusted odds ratio 0.219, P = 0.012) during lockdown, remaining low after lockdown. The rate of women screening positive for depression increased by 40% (adjusted odds ratio 1.40, P = 0.023), but returned to baseline after lockdown lifted. Conclusions Rates of DVA identification in secondary mental health services dropped during and after lockdown, whereas overall rates of DVA identified in maternity services were concerningly low. Healthcare services must adopt guidance to facilitate safe enquiry, particularly in remote consultations. Further research is vital to address the longer-term impact on women's mental health caused by the increase in depression during the lockdown.
Objectives To address the lack of individual-level socioeconomic information in electronic health care records, we linked the 2011 census of England and Wales to patient mental health records from a large secondary mental healthcare provider. This paper describes the linkage process and methods for mitigating bias due to non-matching. Setting South London and Maudsley NHS Foundation Trust (SLaM), a mental health care provider in southeast London. Design Clinical records from SLaM were supplied to the Office of National Statistics (ONS) for linkage to the Census through a deterministic matching algorithm. We examined clinical (ICD-10 diagnosis, history of hospitalisation, frequency of service contact) and sociodemographic (age, gender, ethnicity, deprivation) information recorded in CRIS, as predictors of linkage success with the 2011 Census. To assess and adjust for potential biases caused by non-matching, we evaluated inverse probability weighting for mortality associations. Participants Individuals of all ages in contact with SLaM up until December 2019 (N=459,374). Outcome measures: Likelihood of mental health records' linkage to census. Results 220,864 (50.4%) records from CRIS linked to the 2011 census. Young adults (Prevalence ratio (PR) 0.80, 95% CI 0.80-0.81), individuals living in more deprived areas (PR 0.78,0.78-0.79), and minority ethnic groups (e.g., Black African, PR 0.67, 0.66-0.68) were less likely to match to Census. After implementing inverse probability weighting, we observed little change in the strength of association between clinical/demographic characteristics and mortality (e.g., presence of any psychiatric disorder: unweighted PR 2.66, 95% CI 2.52, 2.80; weighted PR 2.70, 95% CI 2.56, 2.84) Conclusions Lower response rates to the 2011 census amongst people with psychiatric disorders may have contributed to lower match rates, a potential concern as the census informs service planning and allocation of resources. Due to its size and unique characteristics, the linked dataset will enable novel investigations into the relationship between socioeconomic factors and psychiatric disorders in the future.
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