Efforts have been made since the 1950s to reduce the
prejudice towards people with mental illness (Cumming
& Cumming, 1957; Nunally, 1961). Despite these
attempts, stigma (Hall et al., 1993; Brockington et al.,
1993), discrimination (Sayce, 1998), and misconceptions
about mental illness continue to be pervasive (O’Grady,
1996; Borinstein, 1992; Weiner et al., 1988; Corrigan et
al., 2000; 2002; 2004; Link et al., 1999; Thompson et al.,
2002). Citizen-driven not-in-my-backyard (NIMBY)
campaigns obstruct the placement of residential facilities
(Boydall et al., 1989; Repper et al., 1997). The percep-
tion of stigma by people with psychosis is associated with
enduring negative effects on their self-esteem, well-
being, mental status, work status, and income (Link et al.,
1997; Link, 1987). Public and professional opinions
about mental illness adversely affect its detection and
outcome (Hall et al., 1994; Jorm, 2000; Link et al., 1999;
Stuart & Arboleda-Florez, 2001; Magliano et al., 2004).
Both the 1999 US Surgeon General’s Report (NIMH,
1999) and the 2001 WHO World Health Report (World
Health Organization, 2001) cite stigma as one of the
greatest obstacles to the treatment of mental illness.
In the past decade we have seen an increase in the will
to combat stigma. We have also seen the application of a
new tool, social marketing, to this task. This editorial
describes how two sites in the World Psychiatric
Association (WPA) Programme to Reduce Stigma and
Discrimination Because of Schizophrenia – Calgary,
Alberta, and Boulder, Colorado – harnessed this tool to
Social-marketing campaigns have been used success-
fully around the world in AIDS prevention, smoking ces-
sation, and many other causes (Rogers, 1995).
Effectiveness is increased by audience segmentation –
that is, partitioning a mass audience into sub-audiences
that are relatively homogeneous and devising appropri-
ately targeted promotional strategies and messages
(Rogers, 1996). In developing such campaigns, it is use-
ful to conduct a needs assessment that gathers informa-
tion about the groups’ cultural beliefs and the media
through which they could best learn about the topic. The
needs assessment may incorporate focus groups, tele-
phone surveys, or information from opinion leaders.
Epidemiologia e Psichiatria Sociale, 17, 1, 2008
Implementing local projects to reduce the stigma
of mental illness*
Abstract. This editorial describes strategies used and the lessons learned in implementing two local anti-stigma projects. The
WPA Programme to Reduce Stigma and Discrimination Because of Schizophrenia established projects to fight stigma in 20 coun-
tries, using social-marketing techniques to enhance their effectiveness. First steps at each site were to establish an action commit-
tee and conduct a survey of perceived stigma. Based on survey results, the action committees selected a few homogeneous and
accessible target groups, such as employers, and criminal justice personnel. Messages and media were selected, tested, and refined.
Guidelines are provided for setting up a consumer (service-user) speakers’ bureau and for establishing a media-watch organization,
which can lobby news and entertainment media to exclude negative portrayals of people with mental illness. Improvements in
knowledge about mental illness were effected in high school students and criminal justice personnel. Positive changes in attitude
towards people with mental illness were achieved with high school students, but were more difficult to achieve with police officers.
Local antistigma projects can be effective in reducing stigma and relatively inexpensive. The involvement of consumers is impor-
tant in working with police officers. Project organizers should be on the lookout for useful changes that can become permanent.
Address for correspondence: Dr. R. Warner, Colorado Recovery,
2818 13thStreet, Boulder, Colorado 80304 (USA).
Fax: 303-540 5144
Declaration of Interest: Dr. Warner was part of the organizing
committee of the World Psychiatric Association Programme to Reduce
Stigma and Discrimination Because of Schizophrenia, which was sup-
ported by Eli Lilly pharmaceutical company.
* This editorial is an abbreviated version of a previously published
article: Warner, R. (2005). Local projects of the World Psychiatric
Association Programme to Reduce Stigma and Discrimination.
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Epidemiologia e Psichiatria Sociale, 17, 1, 2008
Implementing local projects to reduce the stigma of mental illness